Asia Pacific Journal of Health Sciences and Research
Aims and Scope: APJHSR, the official biannual publication of SEGi University, aims to inform readers about research, clinical advancements, and relevant health sciences topics. It publishes Original Articles, Reviews, Systematic Reviews, Case Reports, and Letters to the Editor in dentistry, medicine, pharmacy, and optometry. Manuscripts must be original, devoid of fabrication, plagiarism, or fraud, and not previously published or under consideration elsewhere.
Dual Dental Anomalies: Fusion and Talon's Cusp Coexisting in the Mandibular Anterior Region
The fusion of two teeth and the presence of a talon cusp are prevalent developmental anomalies frequently encountered by clinicians. Typically, these anomalies are observed as isolated occurrences and rarely in conjunction with other dental irregularities. Talon cusp predominantly manifests in the maxillary anterior teeth within the permanent dentition, while fusion is more frequently observed in the mandibular teeth during the primary dentition phase. The simultaneous presence of a talon cusp and fusion in the mandibular permanent teeth is exceedingly rare and scarcely documented in the literature. This article delineates an unusual case of the fusion of permanent mandibular central and lateral incisors, accompanied by a talon cusp on the lingual aspect, in an elderly patient, resulting in periodontitis.
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Assessment of knowledge and awareness of parafunctional oral habits and their effects on dentofacial structures among parents visiting SEGi Oral Health Centre with children aged 5-13 years
Background: Oral habits play a significant role in the etiology of malformation in dento-facial structures. Despite the high prevalence of oral habits in children, few studies have been conducted to assess parental knowledge on the effects of parafunctional oral habits on a child’s dentofacial structures. Aim: This study aimed to assess knowledge and awareness of Malaysian parents with children of age ranging from 5-13 years regarding the parafunctional oral habits and their effects on the dentofacial structures. Methods: A cross-sectional study was conducted in SEGi Oral Health Centre, Selangor, Malaysia from June 2021 to January 2022. About 166 randomly selected parents of children within the age group of 5-13 years, who have visited SEGi Oral Health Centre were included in the study. A self-administered questionnaire was used to obtain the required information which contained questions pertaining to knowledge and awareness about parafunctional habits. Data was analyzed using SPSS Version 22. Descriptive statistics and Chi-square tests were performed. P-value less than 0.05 was considered significant.Results: It was found that the general awareness of parafunctional oral habits among most of the parents was moderate (49%). About 58% believed that the oral habits were a part of child’s development and 87% believed that oral habits are preventable. Less than half of the parents were aware of the oral effects of parafunctional habits on teeth like spacing, crowding etc. It was found that there was no statistically significant difference between age, education level, income, and occupation of parents on their awareness level (p-value was more than 0.05).Conclusion:The evidence from the current study indicates that parents visiting SEGi Oral Health Centre had good knowledge of thumb sucking habits but had poor knowledge of tongue thrusting habits. To prevent malocclusion of a child’s dentition and its effects, more emphasis should be put on educating parents on the detrimental effects of parafunctional oral habits in children.
Evaluation of Mandibular Third Molar of Patients Visiting SEGi University Oral Health Centre from Year 2017 to 2021 by Orthopantomography
Introduction: Studies have shown that third molars are frequently associated with various problems such as impaction and agenesis in 70% of modern humans. Third molar removal is indicated if the third molars are impacted or are causing pain that interrupt a patient's daily life activities. Prior to third molar removal, assessment of the radiograph is necessary to study the status of the third molar and the difficulty level for extraction. Aim: To evaluate the prevalence and pattern of impacted mandibular third molars based on orthopantomography (OPG) of patients and to assess the difficulty of surgical removal. Methodology: This study was undertaken on records of patients at Segi oral Health center. After obtaining permission to access records, 200 Orthopantomographs of patients indicated for third molar removal were studied. Winter's classification, Pell and Gregory Classification (PG classification) were used. Difficulty assessment was done for all the impacted mandibular third molars using Pederson Difficulty Index. Data was analysed using SPSS. Results: Most prevalent angulation in relation to the long axis of the mandibular second molar (Winter’s classification) was mesioangular impaction (180 third molars) followed by vertical (96 third molars), horizontal (82 third molars) and, distoangular (42 third molars). As for the Pederson’s Difficulty Index, it was found that the most mandibular 3rd molar extractions were of moderate difficulty (213), followed by that of minimal difficulty (135) and very difficult extractions (35). While vertical and mesioangular impactions were higher in females as compared to males, distoangular and horizontal were higher in males. Overall, the most prevalent was mesioangular. This was significant with p=0.027. Conclusion: Based on this study, a mesioangular impaction is the most common type of impaction. However, results cannot be generalized as the study has been done only on Asians. More studies are required on diverse population to confirm the results.
Parental knowledge, attitude and behaviour of varicella and its vaccination in Klang Valley, Malaysia
Background: Varicella is a childhood disease with potentially severe complications and has seen a significant reduction in its impact in countries such as the United States, Taiwan, and Hong Kong due to successful vaccination programs. However, vaccination efforts worldwide face challenges stemming from parental misconceptions and limited knowledge about the disease. Notably, Malaysia currently does not include varicella vaccination in its routine immunization schedule, making it a critical area for study. This research aims to explore parental knowledge, attitudes, and behaviours related to varicella vaccination, as well as their correlation with demographic factors and health beliefs. The overarching goal is to address the existing knowledge gap and improve its awareness in Malaysia, where varicella’s prevalence remains understudied. Materials and Methods: This study gathered data from 400 voluntary participants, collecting information on demographic backgrounds, knowledge levels, behaviours, and attitudes concerning varicella and its vaccination. Results: There was an overall 69% of positive vaccination behaviour. Health belief statements showed a statistically significant difference between the recommended vaccination and not recommended vaccination groups (p <0.05); and between three groups of knowledge level and their perception towards varicella and its vaccination (p <0.01). A higher knowledge level is associated with positive behaviour towards varicella vaccination. Low parental education, low household income, widow and higher number of children were predictors of antagonistic behaviour towards varicella vaccination (all p <0.05). Conclusion: This study underscores the need to include varicella vaccination in the Malaysia National Immunization Programme, particularly focusing on promoting varicella vaccination in schools. Such an initiative can help combat varicella and address the identified predictors of reluctance towards vaccination.
Measuring Scleral Lens Vault with Accuracy – A Case Report
Keratoconus is a non-inflammatory ocular pathology affecting the cornea's shape due to thinning and protrusion. This condition can be unilateral or bilateral with asymmetric presentation between both eyes. Refractive correction with spectacles is helpful in the initial stages; however, contact lenses play a significant role in the advance stages. Various options for contact lenses are available, and practitioners can use those depending upon the severity of the condition, shape of the cone, and other factors. Scleral lenses have gained popularity in recent years because they vault over the cornea and the limbus with no touch and land on the sclera. Caution is warranted on the amount of vault created between the scleral lens and the cornea; hence accurate measurement can be a valuable tool for practitioners’ confidence in prescribing these lenses. This case presentation summarizes the use of Anterior Segment Optical Coherence Tomography (AS-OCT) to accurately measure the vault and finalize the lens fitting.
Dynamic Visual Acuity Between Frisbee Players and Non-Frisbee Players
Background: Dynamic visual acuity (DVA) is the ability to resolve a moving stimulus. Dynamic visual acuity is in general superior in athletes than non-athletes, which contribute to better visual abilities and translate to better performance. In this study, it is hypothesized that Frisbee players have better dynamic visual acuity due to greater perception of active images through perceptual learning from the constant tracking of Frisbee discs at a vertical and horizontal trajectory. Materials and Methods: To measure dynamic visual acuity, participants were asked to indicate the orientation of a broken ring like a Landolt C while it traverses across a screen in the two trajectories with a computerized software (DinVA 3.0 software8). Result: Frisbee players (n=17) showed no significant difference in mean DVA at both the meridians (V:0.377m/s+0.05; H:0.394m/s+0.05) compared to non-Frisbee players (n=33) (V:0.396m/s+0.09; H:0.405+0.08). Similarly, within group analysis showed non-Frisbee players had no significant difference (p=0.327) between vertical and horizontal DVA. However, there was a statistical significance (p=0.017) between the vertical and horizontal mean DVA in Frisbee players. Conclusion: This concluded that there was no significant difference between the two groups but may suggest that Frisbee training does improve dynamic visual acuity but in the horizontal meridian due to a constant and improved tracking ability to predict horizontal stimulus.
Implant Dentistry- Transitioning into a New Niche
Implant dentistry has grown leaps and bounds over decades and currently it is at an unprecedented peak. Especially this decade has witnessed huge leaps forward in techniques, technologies, materials, concepts and philosophies of implant treatment. In less than just a few decades, dental implants have moved from the fringes of dentistry to the mainstream. Indeed, dental implants are now utilized in situations not foreseen even a decade ago. We need to reflect on the many significant developments in dental implants technology which offer better and a more satisfying treatment option to our patients. This article reviews the merits of current technologies as well as throws light onto the future of the implant speciality.
Hydrogel-based Drug Delivery for Tissue Engineering
Tissue engineering is a multidisciplinary field that aims to restore, maintain, and improve tissue performance by producing functional tissue constructs. The three major domains of tissue engineering are isolated cells or stem cells, biomaterial scaffolds and biomolecules. Hydrogels are commonly studied as scaffold materials for tissue regeneration due to its unique characteristics, i.e., excellent water absorbing and swelling capacity, tunable mechanical properties, porous structure, biocompatibility, biodegradability, flexibility similar to natural tissues and responsive to various stimuli (e.g., changes in pH, humidity, light and temperature). In the past decades, additive manufacturing (bioprinting) has emerged as a powerful technology in tissue and organ regeneration where it incorporates hydrogels as functional scaffolds. Various hydrogel-based delivery systems have also been developed in search of ideal scaffold for tissue engineering. In view of the potential of hydrogels in the field of tissue engineering, herein presents a review focusing on application of hydrogels for drug delivery in tissue engineering as well as additive manufacturing.
Microbial Growth Inhibitory Activities of Skin and Seed Extracts of Pisum sativum
Introduction: The improper use of antibiotics to treat various bacterial infections occurring in humans had caused the rise of antibiotic-resistant bacterial strains. These lead to an urgent need in developing novel antimicrobial compounds. Objective: The extracts of the skin and seeds of Pisum sativum were screened for antimicrobial activity against two different species of Gram-positive bacteria (Staphylococcus aureus and Bacillus subtilis) and one species of Gram-negative bacteria (Escherichia coli). Materials and methods: Methanolic crude extracts were prepared at different concentrations. Their antimicrobial activities were screened by disc diffusion assays and minimum inhibitory concentration (MIC) determination assays. Results: Antimicrobial inhibitory effects were observed in B. subtilis. However, further investigation is needed to identify the reasons of S. aureus and E. coli being resistant towards both types of phytochemical extracts. Conclusions: Our findings support the hypothesis that the skin and seeds of P. sativum possess antimicrobial properties. Subsequent studies should be driven towards the identification of key phytocompounds, which can be potentially developed into new plant-based antimicrobial agents.
A Preliminary Institutional Study on Short Term Effects of Dietary Intake and Physical Status in Edentulous Patients after Prosthodontic Rehabilitation.
Background: Edentulism in the elderly population has been related to changes in food intake and nutritional deficiency as it has a measurable impact on mastication. Providing denture helps in enhancing the chewing ability and dietary intake of the elderly population, thus improving their physical status. Aim: The objectives for this study were to identify the preliminary changes in physical status of edentulous patients, to identify the changes in calorie intake, and to examine the association between calorie intake with physical status of edentulous individuals before and after prosthodontic rehabilitation. Methodology: This cross-sectional study involved 39 patients. The parameters used to conduct the study for evaluating and comparing the dietary intake with physical status were clinical extra oral and intra oral examination of the patients, anthropometric records and 24-hour dietary recall method. Results: In 51.3% of the patients, there was increase in calorie intake after prosthodontic rehabilitation. Meanwhile, 28.8% had decrease in calorie intake and 20.5% showed no difference in their calorie intake. For the association between calorie intake with physical status, 33.3% showed an increase in calorie intake and normal BMI. While 25.6% showed a decrease in calorie intake with normal BMI after rehabilitation, 15.4% had no changes in their calorie intake with normal BMI. Conclusion: Majority of edentulous patients before and after prosthodontic rehabilitation displayed low calorie intake than the recommended value. There was an increase in calorie intake after rehabilitation while there was no significant difference between calorie intake and physical status of patients before and after prosthodontic rehabilitation.
Knowledge, Attitude, and Practices of Dental Undergraduate Students on Infection Control In Dental Clinic During COVID-19 Pandemic - A Cross Sectional Study.
Objectives: COVID-19 infection transmits through droplets in air. Dental setting can act as potential site for cross-contamination, and hence, calls for strict infection control protocols during dental treatment. Hence, this study was undertaken to assess the knowledge, attitude and practices of dental undergraduate students on infection control during COVID-19 pandemic, so that suitable measures can be undertaken to educate them. Methods: A cross-sectional survey was undertaken among 135 clinical year students of Faculty of Dentistry, SEGi University, Malaysia. A questionnaire containing 37 close ended questions pertaining to infection control during the COVID-19 pandemic, was developed and validated at the faculty. The survey was electronically disseminated through google forms. Data was analysed using SPSS version 22. Descriptive statistics and chi-square test were used. p<0.05 was considered statistically significant. Results: The response rate was 97%. All of our students exhibited adequate knowledge pertaining to COVID-19 infection. About 95% of the students showed positive attitude towards patient triage, use of personal protective equipment, social distancing in clinic, use of high vacuum suction for aerosols. However, about 50% felt stressed to treat patients during this pandemic and only 15% were willing to treat patients. Regarding practices,80% followed correct order of donning, however only 25% did the doffing in correct manner. Conclusion: Though our students exhibited good knowledge, there is a need to educate and reinforce right attitude and correct practices pertaining to infection control, for a safe and effective clinical practice in times of such pandemic. The faculty has developed strategies for the same.
Microbial Growth Inhibitory Activities of Extracts from the Peels, Juice Vesicles, and Seeds of Citrus paradisi
Introduction: Citrus paradisi is abundant in insoluble pectin fibre, rich in vitamin C and phytochemicals. With the increasing resistance of common clinically-important pathogens (especially bacteria) to antibiotics today, it brings the focus to antimicrobial properties of plant extracts containing bioactive phytochemical compounds which can potentially kill or inhibit the growth of microorganisms. Objective: This study aims to measure the antimicrobial effects of methanolic extracts of C. paradisi peels, juice vesicles, and seeds. Materials and methods: These samples were procured fresh and processed prior to antimicrobial assays, including disk-diffusion assays and minimum inhibitory concentration tests. In addition, independent t-tests and 1-way ANOVA were integrated to study the significance of microbial growth inhibition. Results: B. subtilis was found possessing the highest sensitivity towards all extracts, especially to juice vesicles and seed extracts. Other microorganisms (eg. Staphylococcus aureus and Escherichia coli) exhibited a moderate level of tolerance or sensitivity towards different extracts. Conclusion: To our knowledge, this is the first study reporting the antimicrobial effects of C. paradisi juice vesicles. We have also highlighted the needs in identifying and investigating the phytochemical(s) which are effective in inhibiting microbial growth.
Sore throat or sore tooth? A case of chronic pharyngitis and recurrent mouth ulcers
Sore throat and mouth ulcers are two common conditions seen at the outpatient clinic of family physicians or otolaryngologists. In this case, a 37-year-old female patient had a sore throat and recurrent mouth ulcers that persisted for two months. Despite two courses of oral antibiotics and various investigations, her problem did not resolve. It was later discovered that the patient had a re-root canal treatment and a metal crown fitted prior to the onset of her symptoms. The patient had an uneventful recovery following the removal of the metal crown. Had the dental history been carefully explored, the patient would not have suffered a prolonged course of the condition. This case also demonstrates the importance of careful use of antibiotics in the medical practice, and metal materials in the dental practice.
COVID-19, the coronavirus disease 2019, an infection of the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), needs no introduction. As of 1st March 2022, over 5.9 million individuals have lost their lives to the disease, globally1. Although the world population is hurtling to get vaccinated against this dreadful disease, the scientific community is still grappling with the conundrum of finding cures for the persistent, long-term symptoms (over four weeks after infection) in recovered individuals, commonly referred to as the long COVID-192. Factors such as cellular damage due to either the disease or treatment or both, persistent viral shedding, body’s response to the immune inflammatory process, and the enhanced tendency for blood clotting induced by the infection, have all been hypothesized as contributing factors to the symptom sequelae.
Challenges and strategies adopted in dental education during COVID-19 pandemic: An institutionalized experience
The unprecedented outbreak of COVID-19 in 2020 has significantly affected the curriculum delivery and clinical dental practice in dental schools. Many dental schools across the globe were temporarily closed to prevent the spread of the virus. On 18th March 2020, Malaysia for the first time declared a total lockdown resulting in switching to an online learning platform with live lectures,live interactive sessions, online group discussions, pre-recorded theoretical lectures, case presentations, and electronic learning tutorials. In addition, all elective dental treatment was deferred, and only emergency dental procedures were carried out with strict standard operating procedures (SOPs). The dental curriculum across the dental schools are similar with regard to their contents, however, each dental school has had its own modification of the educational process with regard to Teaching and learning methodology. The common statergy adopted by all dental school was the cease of practical and clinical sessions, and the introduction of online teaching-learning activities. At Faculty of Dentistry SEGi University, we addressed some of the challenges that encompass various dimensions of teaching-learning and safety of students,and concurrently bringing in an innovative student-centric approach to education and their well-being. This paper aims to provide insight into the various challenges encountered during this pandemic, strategies adopted to overcome them at our institution, and a brief insight into future opportunities in teaching and learning in dental education.
Impact of COVID-19 on mental and emotional health of dental undergraduate students: a cross-sectional study
Introduction: COVID-19 pandemic has disrupted all walks of life. The psychological impact of COVID-19 has been shown to be immense in terms of moderate to severe depressive and anxious symptoms in general public. Such data is important on dental undergraduates to help them cope with stress and promote overall wellbeing. Aim: To assess dental undergraduate students’ perception on impact of COVID-19 on their physical, mental and emotional health. Materials and Methods: A cross-sectional survey was undertaken among 227 students of Faculty of Dentistry, SEGi University, Malaysia. A questionnaire containing 25 close ended questions was developed and validated at the faculty. The survey was electronically disseminated through google forms. Data was analysed using SPSS version 22. Descriptive statistics and chi-square test were used. p<0.05 was considered as statistically significant. Results: The response rate was 85.4%. About 80% of students were concerned that their physical health might me impaired. About 40% reported disturbed sleep, 60% were anxious that they might contact corona virus while treating patients or attending face to face class. More than half of them felt financial instability and 70% students’ emotional health was affected. About 30% felt angry, lost control and stressed due to pandemic changes. About 43% missed their social life and 20% felt lonely and depressed during the pandemic lockdown. Conclusion: Covid-19 has had an impact on mental and emotional health of our dental undergraduates. The faculty has already initiated suitable measures to provide them with necessary moral and psychological support.
Atypical Orthodontic induced external apical root resorption: A Case report
Orthodontic induced external apical root resorption is one of the idiopathic phenomenon’s as an effect, force generated through mechanotherapy as one of the cause and the biological tissues with their diversified variations as witness. It is also sub classified into iatrogenic as a result of indeterminate application of orthodontic forces with subconscious appreciation of the existing conditions. Numerous factors were identified to be related to this irreversible pathologic condition, but none were proven scientifically. Genetics and salivary markers proved the reliability with time. Different assessment methods were also identified to clinically diagnose it both subjectively and objectively. Mostly it is identified through routine radiographic stage records or certain prediction radiographs for root resorption probability assessment. This case report discusses one such encounter which was experienced after stage 2 mechanics involving quite a few teeth. Considering the biotype of the individual and tooth morphology the treatment was terminated and recovery measures were briefed to uplift the self-esteem of the individual.
Assessment of IOTN application among dental undergraduates-A pilot study
Background: Various oral health problems can be affected with the presence of malocclusion such as compromising on dentofacial esthetics, speech, mandibular function, and psychological wellbeing of the individual. The degree of severity of malocclusion needs to be evaluated beforehand to plan orthodontic treatment accurately. This study was done to assess the application of dental health component and aesthetic component of IOTN among dental undergraduates. Materials and Methods: The sample consisted of 40 BDS students (24 females and 16 males) belonging to 2012-13 batch in their final year with a mean age of 24±2 years for grading the study models and photographs from the orthodontic department patient record library. The cast and photographs were examined for the dental health component (DHC) and esthetic component (EC) at faculty of dentistry, SEGi university. Results: The mean measurements of overjet, crossbite, displacement and overbite were 3.85mm, 4.09mm, 6.63mm and 4.34mm respectively of the students as against 3.50mm, 4.50mm, 7.00mm and 4.00mm of the control. The mean measurements were almost like the control value in overbite, crossbite and displacement. However, there was some variation with the measurement of overjet. 75% of students were able to get similar results as the control in the dental health component of IOTN while only 25% managed to get similar results with the control with the aesthetic component. Conclusion: Therefore, this suggests more emphasis is required in training before the skill demonstration of recording dental health component parameters and aesthetic component appreciation which can bias the overall grading and referral.
Index of orthodontic treatment need (IOTN)
Screening of Antiangiogenic Potential of Fresh Moringa oleifera Leaves Extract Using Chick Chorioallantoic Membrane Assay
Background: Angiogenesis is the formation of new blood vessels that supports the progression of cancer. Angiogenesis inhibition will inhibit metastasis and growth of tumour cells. Moringa oleifera leaves extracts have been reported to possess therapeutic effects like anticancer, antimicrobial, anti-inflammatory and hypotensive effects. Chick chorioallantoic membrane is an extraembryonic membrane which consists of high density of capillary networks. This enables it to be used in this research to screen the antiangiogenic potential of fresh Moringa oleifera leaves extracts. Materials and Methods: Preliminary phytochemical screenings were carried out on extracts. Fresh fertile chicken eggs were divided into different treatment groups. Sample treatment was given to the eggs on day six of incubation. Pre- and post- treatment images of the chorioallantoic membrane were taken using stereomicroscope. Percentage of blood vessels increased/ reduced after treatment were determined at the end of 24 and 48 hours of treatment. Results: Preliminary phytochemical screening of methanolic extract of Moringa oleifera leaves showed the presence of alkaloid, flavonoid, tannins, and steroid. The screening also revealed that aqueous Moringa oleifera leaves extracts contained alkaloid, flavonoid, saponins, tannins and steroid. Statistical analysis revealed that the antiangiogenic effect was increased with increased methanolic leaves extracts concentration (p<0.05). The analysis also found that the antiangiogenic effect was not significantly increased with the increased in aqueous leaves extracts concentration (p>0.05). Conclusion: Methanolic and aqueous extracts of Moringa oleifera contain various phytochemicals that inhibits angiogenesis.
An overview on the Infection Control Protocols for Dental clinics in the Pandemic Era
According to the surveys carried out Dental hygienists, Dental assistants and Dentists are at the highest risk of developing Covid 19. This is attributed to the fact that Dentistry is a branch pertaining to directly dealing with the mouth which is one of the highest reservoirs of microorganisms. Almost all the clinical procedures carried out in Dentistry are aerosols generating which puts both the dental personnel and the patients being treated at risk. The dental aerosols due to its small size and composition have the ability to linger in the air for a prolonged time which elevates the health risk. This article will provide an overview of prevalent guidelines and current practices, recommend correct use of PPE in the dental setting, and discuss various technologies which aid in air management thereby ensuring the safety of the entire dental team and patients during the covid-19 outbreak.
A case report of a bony swelling in the mandible of a young female patient
Ameloblastoma is a benign odontogenic tumour having the tendency to occur in the posterior mandible. It is speculated to be of epithelial in origin. Although it is slow growing in nature but it can slowly infiltrate into the surrounding tissues thereby causing the extensive damage to the jaw bones. Ameloblastoma is considered to be the lesion primarily occurring in elderly male patients. This article presents a case of multicystic ameloblastoma occurring in a young girl highlighting the typical radiographic features of this extensive lesion. Surgical en bloc resection was done for the patient over the right side of the mandible and reconstruction was done using the iliac graft.
Compound odontoma associated with impacted maxillary central incisor: A case report
Odontomas are the most common benign odontogenic tumors. The exact etiology is still unknown, however, local trauma, infection, inheritance, and genetic mutation play a role in the pathogenesis of this condition. The majority of these lesions are asymptomatic and are often detected during routine radiographic examination. Infrequently, few odontomas cause expansion of the cortical plates and facial asymmetry. Morphologically they are classified as complex, when present as irregular masses containing different types of dental tissues, or as compound if they have anatomic similarity to the teeth. Here, we report a case of a compound odontoma associated with impacted maxillary central incisor and retained deciduous central incisor in a 19- year-old patient.
The process for tooth eruption has been a matter of debate. Numerous theories of tooth eruption have been proposed. The understanding of recent advancements regarding the tooth eruption is needed as several types of cells and molecular factors that are believed to be responsible for the tooth eruption. This article reviews previously proposed eruption theories and the recent advances in the eruption mechanism.
Formulation and Evaluation of Topical Acyclovir Gel Using Different Polymers
Background: Acyclovir is usually given as protracted therapy and at greater dosing frequency for complete remittance of the disease due to its low oral bioavailability, but this is associated with side effects. Topical preparations of acyclovir are the alternative route of administration to treat local dermatological diseases caused by herpes simplex virus. Objective: To prepare and evaluate the topical gel formulations of acyclovir by using different polymers. Materials and Methods: Acyclovir gels were formulated by using three types of polymers, namely carboxymethylcellulose sodium (CMC Na), hydroxypropyl methylcellulose (HPMC) and carbopol-940 as gelling agents at different concentrations. They were evaluated for several physicochemical characteristics including physical appearance, grittiness, viscosity, spreadability, pH, drug content uniformity and in vitro drug release studies. The in vitro drug release of acyclovir from the selected gel formulations was evaluated as per the procedure described in United States Pharmacopoeia (USP), by using the standard 40mesh stainless steel dissolution basket (USP Apparatus 1) containing cellulose acetate membrane with phosphate buffer pH 6.8 as the dissolution medium. Results: Among all prepared gel formulations, formulation F8 containing 3% w/w of carboxymethylcellulose sodium was selected as optimal gelling agent in acyclovir gel formulation due to its desired physicochemical characteristics and it showed the highest acyclovir in vitro release rate of 96.21 ± 0.92% over 5 hours. Conclusion: The release of acyclovir from the gel formulations was significantly affected by the type and concentration of polymer (p-value < 0.05).
Inter -relationships between life satisfaction, self-esteem and perceived stress and their influence on academic achievements among medical and dental students at a Malaysian private university
Background: Life satisfaction, perceived stress and self-esteem have been found to be related to academic achievements of medical and dental students. However, the inter-relation of these three factors among medical and dental students has not been established. Materials & Methods: This was a cross-sectional study carried out on 239 pre-clinical medical and dental students at a Malaysian private University using the Satisfaction with Life Scale (SWLS), Rosenberg Self-Esteem Scale (RSES) and the Perceived Stress Scale (PSS). Data was analysed using the Statistical Package for Social Sciences (SSPSS) version 22. The SWLS, RSES and PSS scores are expressed as mean ± standard deviation. Comparison of means was carried out using the independent t test. Correlation of variables was carried out using Pearson’s Correlation. A p value ≤ 0.05 is considered statistically significant and a p value of ≤ 0.001 is considered highly significant. Results: Overall, medical and dental students showed an average level of life satisfaction (M=23.46, SD=5.52), moderate level of stress (M=20.49, SD=5.85) and normal self-esteem (M=17.61, SD=4.7). Among the three factors, only perceived stress had a significant effect on their academic achievements (p<0.05). All three factors also showed a significant correlation with one another (p<0.05). Conclusions: Findings from this study suggest that stress management is important to medical and dental students as this helps with their academic performance and has an influence on their self-esteem, as well as life satisfaction.
Factors affecting self-efficacy and the effects of self-efficacy on academic achievements among medical and health sciences students at a Malaysian private university
Self-efficacy refers to ones’ beliefs in his or her own ability to perform and complete novel tasks or to cope with adversity in challenging situations. It is an important aspect of the self-concept and has been linked to the one’s academic achievement, life satisfaction and self-esteem. The present study aimed to investigate the interdisciplinary differences in general self-efficacy (GSE) among medical and health sciences students at SEGi University, Malaysia. The effects of demographic factors on GSE, as well as the effects of GSE on the students’ academic achievements were also explored. Materials & Methods: This was a cross-sectional study involved 86 medical, 81 dental and 64 optometry Year 1 and Year 2 students at a Malaysian private university. The General Self Efficacy Scale (GSES) was used to assess the GSE of the participants. Analysis of data was carried out using the Statistical Package for the Social Sciences (SPSS) software version 22. Analysis of Variance (ANOVA) and t-test were used for comparisons of means. Relationship between two continuous variables was determined using Pearson’s correlation. A p value of <0.05 was considered statistically significant. Results: Findings showed significant interdisciplinary differences in mean GSE scores among medical, dental and optometry students. Various demographic factors were observed to play a role in the GSE of the students. However, the GSE of high achievers and non-high achievers did not differ significantly. Conclusions: Age, gender, nationality, family income and the type of course and accommodation of students were factors affecting the GSE, but GSE had no significant influence of the academic achievements of students.
I am a general dentist: Why is screening of obstructive sleep apnea in chronic kidney disease patients my concern?
Obstructive sleep apnea (OSA) is characterized by upper airway collapse while sleeping at night. There is an increasing body of evidence that links OSA with chronic kidney disease (CKD).1,2 Though this combination is seen commonly in this patient group, documented current global evidence ends with a note stating under-diagnosis of OSA.1Family physicians (FP) are the frontliners to identify the disease and serving their best. In such circumstances, why is screening of OSA in CKD patients’, a general dentist’s (GD) concern? Readers could raise the question that dental considerations for sleep apnea would be sufficient to elucidate this scenario? Given yes would mislead the title and not to get confused with the sleep apnea considerations in dental offices. The core discussion is about why a GD should screen OSA and most importantly why is it compulsory in CKD patients, rather than the diagnostic methods?
Formulation and Evaluation of Acyclovir Oral Disintegrating Tablets
Orally disintegrating tablets (ODTs) have recently gained attention as the substitute of conventional dosage form. Superdisintegrants, the main component in the ODTs, render fast disintegrating properties and facilitate the dissolution of active drug. Aims: In the present study, the main aims were to prepare acyclovir ODTs using superdisintegrants (sodium starch glycolate and croscarmellose sodium) by direct compression method and investigate the outcome of using various concentrations of superdisintegrant in single and combination formulations. Materials and Methods: Superdisintegrants incorporated in the formulations were croscarmellose sodium and sodium starch glycolate in single (F1, F2, F3 and F4) and binary combination (F5 and F6) and acyclovir tablets were directly compressed. Critical quality attributes investigated were uniformity of weight, thickness, hardness, friability, wetting time and water absorption ratio, in vitro disintegration time and in vitro dissolution study. One-way statistical ANOVA test and post hoc test were conducted by using Statistical Package for the Social Science (SPSS) software version 21. Results: The maximum acyclovir release rate was achieved in formulations F5 (90.09 ± 0.43%) followed by F2 (70.29 ± 0.07%) and F1 (61.33 ± 1.15%). Among the 7 formulations investigated, 1% w/w SSG and 5% w/w CCS in formulation F5 demonstrated shortest disintegration time (7.33 ± 0.246 seconds) and greatest dissolution rate (90.09 ± 0.43%). Such combination ratio provided synergism between mechanisms of action of two superdisintegrants (swelling and wicking) thus resulted in excellent wetting properties and water absorption ratio (p < 0.05). Conclusion: From the present study, combination of superdisintegrants in ratio 1:5 did result in better disintegration and dissolution rate compared to ratio 1:1 and other single superdisintegrant formulations in terms of critical quality attributes investigated.
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Caregiver Burden: Prevalence and Effect on Productivity among Adult Informal Caregivers of the Elderly in Klang Valley, Malaysia
Background: Caregiver burden refers to the physical, financial and psychosocial hardships of caring for a loved one. Informal caregivers, typically adult children who look after their elderly parents, shoulder an unspoken degree of stress from this filial responsibility. They report having to make major life changes and personal sacrifices. High degree of caregiver burden among working adults potentially affects their productivity at work. This study aimed to identify the prevalence of caregiver burden among adult family caregivers of elderly in Klang Valley, Malaysia and to determine the effect on work productivity. Methods: This cross-sectional study was performed on 281 adult family caregivers using a self-administered questionnaire. A short version of Zarit Burden Interview (ZBI-12) was employed to measure caregiver burden. Work Productivity and Activity Impairment as adapted for caregiving (WPAI: CG) was used to measure work productivity as well as regular activities. Results: Adult caregivers in Klang Valley reported experiencing moderate level of burden (ZBI-12 score =15.30) in providing care to their elderly. Employed caregivers reported an overall work productivity loss of 57.2% due to caregiver burden. The study subjects experienced 35.2% loss of regular activity productivity and it significantly correlated with the degree of caregiving burden (r = 0.499, p < 0.05). Factors affecting caregiving burden include ethnicity of caregivers (p<0.05) and care recipients (p < 0.05), education level of caregivers (p = 0.003), overall health status of caregivers (p = 0.006) and care recipients (p = 0.047), family relationship of caregivers with the elderly (p = 0.002) and living arrangement of the elderly (p = 0.005). Conclusion: Informal adult caregivers of the elderly in Klang Valley experienced moderate level of caregiver burden and it significantly affected their work productivity.
Prosthodontic Management of a case with massive Torus Palatinus using Molloplast-B
The management of patients with largetorus palatinus in denture fabrication can be quite challenging for a dental practitioner. A large palatal tori usually affect the close adaptation of the denture base to the mucosa thereby leading to loss of retention and stability of maxillary denture. It is, therefore, very important in the ways of management of patients with biglarge Torus palatinus. The purpose of this article is to provide an overview of the modified approaches during acrylic removable partial denture fabrication for a patient with large Torus palatinus.