Inter-hospital trends of post-resuscitation interventions and outcomes of out-of-hospital cardiac arrest in Singapore

INTRODUCTION@#Hospital-based resuscitation interventions, such as therapeutic temperature management (TTM), emergency percutaneous coronary intervention (PCI) and extracorporeal membrane oxygenation (ECMO) can improve outcomes in out-of-hospital cardiac arrest (OHCA). We investigated post-resuscitation interventions and hospital characteristics on OHCA outcomes across public hospitals in Singapore over a 9-year period.@*METHODS@#This was a prospective cohort study of all OHCA cases that presented to 6 hospitals in Singapore from 2010 to 2018. Data were extracted from the Pan-Asian Resuscitation Outcomes Study Clinical Research Network (PAROS CRN) registry. We excluded patients younger than 18 years or were dead on arrival at the emergency department. The outcomes were 30-day survival post-arrest, survival to admission, and neurological outcome.@*RESULTS@#The study analysed 17,735 cases. There was an increasing rate of provision of TTM, emergency PCI and ECMO (P<0.001) in hospitals, and a positive trend of survival outcomes (P<0.001). Relative to hospital F, hospitals B and C had lower provision rates of TTM (≤5.2%). ECMO rate was consistently <1% in all hospitals except hospital F. Hospitals A, B, C, E had <6.5% rates of provision of emergency PCI. Relative to hospital F, OHCA cases from hospitals A, B and C had lower odds of 30-day survival (adjusted odds ratio [aOR]<1; P<0.05 for hospitals A-C) and lower odds of good neurological outcomes (aOR<1; P<0.05 for hospitals A-C). OHCA cases from academic hospitals had higher odds ratio (OR) of 30-day survival (OR 1.3, 95% CI 1.1-1.5) than cases from hospitals without an academic status.@*CONCLUSION@#Post-resuscitation interventions for OHCA increased across all hospitals in Singapore from 2010 to 2018, correlating with survival rates. The academic status of hospitals was associated with improved survival.

Methods of Instruction on Knowledge Retention Among Orthodontic Patients: A Randomized Controlled Trial

@#Introduction: Delivering oral hygiene instruction is one of the integral parts of orthodontic treatment. However, there is scarce information regarding the impact of audiovisual method on knowledge retention among orthodontic patients. This study aimed to assess knowledge retention of the patient after instruction delivered in audiovisual (AV) method and compare it to the standard written and verbal (WV) method. Methods: This prospective clinical trial was conducted on 60 patients aged 13 to 40 years. They were randomized into the audiovisual group (n=30) and written & verbal group (n=30). Patients’ knowledge retention was measured using a self-administered questionnaire in Google form, immediately after instruction given as short-term retention and long-term retention for three timepoint, i.e., 1-month, 3-month, and 6-month. Results: There was a significant improvement in knowledge for both AV and WV methods at immediate and 1-month assessment and the knowledge retained until 6-month follow up. The AV method demonstrated a significantly higher increase in knowledge retention at immediate and 1-month than the WV method. Conclusion: The AV method was significantly more effective in improving patient's knowledge retention compared to the written & verbal methods. Repetition of instruction also influence the retention of knowledge.

A Descriptive Summary Of Unlicensed Dental Practice

@#Despite the fines and action taken by authorities against illegal dental practise, it could not be eliminated and remain a threat to the public’s oral health. The aim of this study was to gather holistic evidence on unlicensed dental practice by collating news coverage, scientific research publications, and information on social media activities of illegal dental practitioners. Information on news coverage was collated via Google, Yahoo and Bing while information on research publications was obtained through three databases, Scopus, Pubmed and Google Scholar. Public data from Facebook and Instagram were extracted to gain information on illegal dental services actively provided. Out of 195 news reported regarding unlicensed dental practitioner, only 110 news reported on legal actions received with 81 news reports were on financial punishments, and the rest was on jail terms or probation. For scientific publications, only 13 related publications were found, and the majority were case reports. Despite having a law that stated an unlicensed dentist would be punished, there were more than 170 Facebook, and Instagram users with thousands of followers found actively offering illegal dental services to the public. In conclusion, not much attention was paid by the scientific community on illegal dental practice despite it being a significant public health issue and covered quite thoroughly in the news, and services are still actively offered through social media. This descriptive report helps give a holistic perspective on the illegal dental service providers issue, especially in Malaysia.

Sociodemography, Oral Health Status and Behaviours Related to Oral Health Literacy

Abstract Objective: To assess the relationships of socio-demography, self-reported oral health status, and behaviour with oral health literacy (OHL) among adults. Material and Methods: A cross-sectional study was conducted during a mega carnival in Kuala Lumpur. Socio-demographic, oral health status, and oral health behaviour data were obtained using a questionnaire, and OHL was determined by a validated Malay version of the 14 items Health Literacy in Dentistry Scale (HeLD-14). A total of 165 data of participating adults were tested using Pearson's correlation, Independent t-test and One-way ANOVA with a significance level set at p<0.05 Results: The mean age of participants was 30.4 years (S.D. 9.7 years). Malay HeLD-14 scores were higher among those who were from better socio-economic class (household income within the top 20% of the population) (p<0.005) those with good self-reported oral health status (good oral health status, no active caries) (p<0.005) and those with good oral health behaviours (brushed daily, flossed daily, does not vape) (p<0.05) Conclusion: Household income, self-reported oral health status, and behaviours were significantly associated with oral health literacy. Therefore, oral health literacy assessment is vital to help tailor appropriate oral health education and care.

Relationship between Food Habits and Tooth Erosion Occurrence in Malaysian University Students

Background: Tooth erosion is a growing dental problem; however, the role of diet in the aetiology of tooth erosion is unclear. A cross-sectional study was conducted to determine the association between tooth erosion occurrence and the consumption of acidic foods and drinks among undergraduate university students. Methods: A total of 150 undergraduate students (33 males and 117 females) aged 19 to 24 years at Universiti Kebangsaan Malaysia participated in this study. The Basic Erosive Wear Examination was used to assess the occurrence of tooth erosion. Information regarding dental hygiene practices, usual dietary habits, and consumption of acidic foods and drinks was obtained through a structured questionnaire. Results: In all, 68% of subjects had tooth erosion. Subjects who reported having received information about healthy eating were less likely to have tooth erosion (χ2 [1, N = 150] = 7.328, P = 0.007). The frequencies of milk (OR = 0.29, 95% CI = 0.13–0.67) and tea/coffee (adjusted OR = 0.42, 95% CI = 0.19–0.95) consumption were negatively associated with tooth erosion. Dental hygiene practice, the frequency and amount of acidic food and drink intake, and body mass index classification were not significantly associated with the risk of tooth erosion (P > 0.05). Conclusion: A high prevalence of tooth erosion was observed among this group of students. Preventive measures, such as dietary advice and increased consumption of milk at a younger age, may reduce the occurrence of tooth erosion among this age group.

The Role of Treating Nicotine Addiction prior To Treatment Of Periodontal Disease

Introduction and Objective: Tobacco use is a significant risk factor for oral diseases. Periodontal disease has been known to be associated with tobacco use for over twenty years. Despite that, dentists and particularly periodontist does not include tobacco use cessation as part of their initial treatment in treating periodontal disease or placing implants in patients who use tobacco. The increase in prevalence and severity of periodontitis among smokers cannot be explained by differences in the amount of plaque between smokers and nonsmokers. A possible explanation is that smoking may alter the quality of the flora. Dental professionals also have a crucial role to play in tobacco cessation counseling, particularly for patients with chronic periodontitis. More patients will be affected by periodontitis than will ever be affected by oral cancer. Methods and Results: Reviews of literatures were done on a clearly formulated question on the need of smoking cessation intervention to increase positive outcome of treatment on periodontal disease. Conclusion: Various epidemiological studies strongly suggest that tobacco use cessation is beneficial to patients following periodontal treatments for a better outcome.