Facilitators and barriers for tuberculosis preventive treatment among patients with latent tuberculosis infection: a qualitative study.

BACKGROUND: Various factors influence tuberculosis preventive treatment (TPT) decisions thus it is important to understand the health beliefs and concerns of patients before starting TPT to ensure treatment compliance. This study aims to explore facilitators and barriers for TPT among patients diagnosed with Latent Tuberculosis infection (LTBI) attending six primary healthcare clinics in Selangor, Malaysia. METHOD: In-depth interviews were conducted face-to-face or via telephone among patients with a clinical diagnosis of LTBI using a semi-structured topic guide developed based on the common-sense model of self-regulation and literature review. Audio recordings of interviews were transcribed verbatim and analysed thematically. RESULTS: We conducted 26 In-depth interviews; Good knowledge of active tuberculosis (TB) and its associated complications, including the perceived seriousness and transmissibility of active TB, facilitates treatment. LTBI is viewed as a concern when immune status is compromised, thus fostering TPT. However, optimal health is a barrier for TPT. Owing to the lack of knowledge, patients rely on healthcare practitioners (HCPs) to determine their treatment paths. HCPs possessing comprehensive knowledge play a role in facilitating TPT whereas barriers to TPT encompass misinterpretation of tuberculin skin test (TST), inadequate explanation of TST, and apprehensions about potential medication side effects. CONCLUSIONS: Knowledge of LTBI can influence TPT uptake and patients often entrust their HCPs for treatment decisions. Improving knowledge of LTBI both among patients and HCPs can lead to more effective doctor-patient consultation and consequently boost the acceptance of TPT. Quality assurance should be enhanced to ensure the effective usage of TST as a screening tool.

Lifestyle and preventive behaviors among adults during the early phase of the COVID-19 movement control order (MCO) in Malaysia.

BACKGROUND: Enforcement of the movement control order (MCO) in Malaysia caused by COVID-19 impacted people's health, social, behaviors, and economic consequences. Thus, this study aims to identify adults' lifestyle and preventive behaviors during the MCO's early phase. MATERIALS AND METHODS: This study was conducted in April 2020 using a convenience sampling technique. A total of 9987 adults aged 18 years and above from all over Malaysia participated in the study. The questionnaire was distributed through online platforms, such as Facebook, Telegram, WhatsApp, and the official website. Descriptive statistics and Chi-square test were used to describe the categorical data and the independent T-test and one-way ANOVA tests were performed to compare continuous variables between two or more groups. The level of statistical significance was set at P < .05. RESULTS: Selangor showed the highest participation (28.4%) and most of the respondents were females (68.2%), married (67.8%), and aged between 36 and 45 years old (34.1%). This study found that 10.3% were smokers, and 46.7% of the smokers intended to quit smoking. Most respondents took their three main meals daily (72.4%), but not even half completed daily food groups (45.1%). The frequent activities were internet surfing (18.8%) and house chores (18.2%). Almost 98% of the respondents agreed to implement preventive behaviors. This study also revealed that attitudes toward preventive behaviors significantly differed across genders, age groups, categories of marital status, and monthly income categories (P < .05). Furthermore, regarding readiness for behavior change after MCO end, only gender shows a significance difference (P < .05). CONCLUSION: This study shed light on understanding public behavior during the early phase of the pandemic that may significantly impact public health in designing relevant regulations and policies to reduce the spread of COVID-19 infections and preparing strategies for future outbreaks or pandemics. As COVID-19 evolves, continuous efforts to promote positive behavioral changes in lifestyle and preventive behavior are needed to ensure the public practices a healthy lifestyle and complies with pandemic preventive measures.

Development of Assessment Tool to Measure Children's Knowledge on Dengue Prevention Activities in Malaysia.

Dengue is one of the public health concerns in developing and developed countries. Since the main control measure for dengue is health prevention and control activities, especially among children, it is essential to assess children's knowledge on dengue prevention activities in preventing the disease. This study aimed to develop an assessment tool (CAB-IHBR-Dengue-C-01) attempting to measure children's knowledge of dengue prevention activities in Malaysia. Twelve (12) pictorials with descriptions were developed to capture children's understanding of the correct method of dengue prevention activities. Cronbach' alpha test was used to assess the internal consistency of the items, and the test and retest reliability method was used to measure the consistency of the questionnaire. For test-retest reliability analysis, tests were conducted twice, with an interval of two (2) weeks from the first test. In total, 58 respondents comprising of Malay, Chinese, and Indian aged between 7 and 12 years old were included in this study. The results showed the intraclass correlation coefficient (ICC) score was 0.640; with moderate reliability; meanwhile, Cronbach's alpha score was 0.606. In conclusion, CAB-IHBR-Dengue-C-01 (Cognitive Affective Behaviour-Institute for Health Behavioural Research-Dengue-Children-Version 01) is reliable to be used.

Regeneration of mandibular ameloblastoma defect with the help of autologous dental pulp stem cells and buccal pad of fat stromal vascular fraction.

Ameloblastoma is benign odontogenic tumor, which is locally aggressive in behavior. Till date, the treatment of choice is resection and reconstruction using a variety of modalities. Inadequate resection may lead to many complications such as bone deformity and dysfunction. This report is about a 14-year-old male with ameloblastoma treated with autologous dental pulp stem cells (DPSCs) and stromal vascular fraction (SVF) and evidence of bone regeneration. Marsupialization was performed; tooth was extracted and sent for DPSC cultivation. On the day of surgery, SVF was processed from buccal pad of fat, and platelet-rich fibrin (PRF) was prepared from patient's peripheral blood. During the procedure, labial plate resection and curating of tumor lining were done. After which, a mesh packed with SyboGraft T-plug, prepared SVF, DPSCs, and PRF were placed over lingual cortex and pressure dressing was done. After the 1(st) month of surgery the postoperative course was uneventful, the wound shrinkage led to exposure of mesh in the intraoral region. Removal of exposed mesh was done. The correction surgery with removal of part of mesh and primary closure was achieved with SyboGraft plug, SVF and PRF. Enhanced bone formation was seen in post-operative OPG and CT Scan after 10(th) month. In this article, we propose an innovative approach to manage these cases by using a combination of autologous DPSC and buccal pad of fat SVF to regenerate a mandibular defect left by the resection of an ameloblastoma with 1.5 year follow-up. We were able to demonstrate bone regeneration using this technique with no recurrence of tumor.

Mandibular Reconstruction in Ameloblastoma Using Allogeneic Cord Stem Cells and Alloplastic Graft Material - Case Report.

Ameloblastoma is a histologically benign odontogenic tumour and has a tendency of locally aggressive behaviour. This is second most prevalent odontogenic tumour and most common in the molar-ramus-angle region and surgical resection is only treatment option. In this article, we propose an innovative approach to deal with these cases by using alloplastic graft with cord stem cells. Over 2.5 years follow-up, we could demonstrate bone regeneration using this technique with no recurrence. To the best of our knowledge, this is the first report of successful regeneration of part of ramus and body of mandible using allogeneic cord stem cells in cases of Ameloblastoma.

Treatment of osteoradionecrosis of mandible with bone marrow concentrate and with dental pulp stem cells.

Osteoradionecrosis (ORN) is a noninfectious, necrotic condition of the bone occurring as a complication of radiotherapy. Most cases occur following trauma or surgical manipulation of the irradiated site. Mandible is the most common bone to be affected following head and neck irradiation. The aim was to develop a successful therapeutic approach for ORN. A spectrum of treatment modalities is practiced for ORN with variable success rate that includes simple irrigation of the affected bone to the partial or complete resection of the jaw bone. In this paper, we present two cases which had successful therapeutic approach for ORN of mandible with autologous bone marrow concentrate stem cells and allogeneic dental pulp stem cells (DPSC) with platelet rich plasma (PRP) following failure of conventional methods. Autologous bone marrow aspirate concentrate (BMAC) was injected around the socket and into the periosteum for one case, and DPSC were mixed with tricalcium phosphate and inserted at the site of the defect in one case. The patient treated with BMAC remained asymptomatic and complete bone remodeling was noticed after 1 year. The extraoral sinus was excised, and healing was uneventful without recurrence in the patient treated with allogeneic DPSC and PRP. Periodic panoramic radiographs revealed an appreciable bone formation from the 2(nd) month onward. We have successfully treated two cases of ORN with BMAC and DPSC, respectively.

Effect of copper on growth and enzyme activities of marine diatom, Odontella mobiliensis.

The 72-h IC(50), 7-d no observable effect concentration (NOEC), low observable effect concentration (LOEC), Chronic values were derived for copper on the growth of marine diatom, Odontella mobiliensis. The effect of copper was also studied on cell morphology, size, nitrate reductase and antioxidant enzymes (Catalase, Superoxide dismutase and peroxidase). The 72-h IC(50) of 298.4 ± 28.3, NOEC of 15.6, LOEC of 29.6 and chronic value of 21.5 µg Cu L(-1) were found in the present study. The chlorophyll a was significantly decreased with increasing concentrations of copper. The length of the cell (apical axis) was extended from 30.14 ± 5.98 µm at control to 71.4 ± 6.29 µm at 574 µg Cu L(-1), the spines were absent at 574 µg L(-1) and the cell structure was entirely damaged at 926 µg Cu L(-1). The antioxidant enzymes viz. Catalase, Peroxidase activities and Melondialdehyde were increased whereas the Nitrate reductase and activity was reduced at 21.5 µg Cu L(-1) during 7 days exposure.

Immunosuppression in broiler chicks fed aflatoxin and inoculated with fowl adenovirus serotype-4 (FAV-4) associated with hydropericardium syndrome.

A total of 240 unvaccinated day-old broiler chicks, which had been found to be negative for antibodies against FAV-4, were divided into four groups of 60 chicks each. Group A was fed aflatoxin at 1 ppm from 7 days to 7 weeks of age. Group V was infected intra-abdominally at 14 days of age with 0.2 ml of FAV-4, having a titre of 10(5.5) TCID50 per 0.2 ml. The combined group AV was given the aflatoxin and infected with FAV-4. The fourth group C served as the control. More pronounced clinical signs, a higher mortality rate (56.7%), and reductions in body weight gain and in the organ to body weight ratios of the bursa and spleen were recorded in group AV. A significant (p < 0.01) reduction in the HI antibody titre following vaccination against Newcastle disease, and of skin thickness in the delayed hypersensitivity test following sensitization with DNCB, indicated an additive immunosuppressive effect from aflatoxin and FAV-4 on the humoral and cell-mediated immune responses in group AV compared to groups A and V. Microscopically, marked depletion and degeneration of lymphocytes in the thymus, bursa, spleen and caecal tonsils were observed in group AV up to 5 weeks PI.