Preschool Children Feeding Patterns And Early Childhood Oral Health Impact In Tanah Merah, Kelantan, Malaysia

@#Introduction: Poor feeding patterns increase risk of Early Childhood Caries (ECC), which can cause negative impacts on oral health-related quality of life (OHQoL) of preschool children and parents. This study aims to assess feeding patterns of preschool children and OHQoL of the children and their parents in Tanah Merah. Methods: A cross-sectional study was conducted involving 134 preschool children aged 5-6 years old from eight private preschools, chosen by multi-staged stratified cluster sampling. Parents answered adopted self-administered questionnaire on feeding patterns and oral health-related impacts. Mann-Whitney U test and Kruskal-Wallis test were used to compare the median between groups of feeding patterns. Results: A total of 122 parents responded. Majority of the children had history of bottle-feeding (97.5%) and being given solid food during infancy (61.2%). Many children were still using bottle to drink (38.5%). Majority were still given formula milk at least three times daily (51.1%) and were feed with bottle to put to sleep (97.9%). The Child Impact Section (CIS), Family Impact Section (FIS) and Overall ECOHIS mean scores were 2.39 (SD=3.41), 0.71 (SD=1.45) and 3.10 (SD=4.41), respectively. Most common impact reported in CIS was ‘oral pain’ (26.2%) whereas in FIS, ‘parents felt guilty’ (7.4%). None of feeding patterns were found significantly different in terms of ECOHIS score median (p-value>0.05). Children OHQoL reporting by proxy should be treated as complementary. Conclusion: Many preschool children were involved in prolonged, frequent and nocturnal bottle-feeding. No significant difference in median ECOHIS scores found according to feeding patterns.

Mediating Role of Job Satisfaction in the Relationship between Job Performance and Organizational Commitment Components: A Study among Nurses at One Public University Hospital in Malaysia

@#Introduction: In light of the importance of the nurses’ performance in health services, this study was established to examine the relationship of job performance with organizational commitment components and job satisfaction among nurses. It is also, to examine the mediating effect of job satisfaction in the relationship between organizational commitment components and job performance among nurses. Methods: This was a cross-sectional study conducted among nurses at Hospital Universiti Sains Malaysia. A sample size of 192 staff was selected using stratified and systematic random sampling methods. The study data were collected using a questionnaire consists of three scales: the organizational commitment scale of Allen and Meyer, the job satisfaction scale of Van Wood, and the task performance scale of Williams and Anderson. Besides, respondents were asked about their demographic profiles. The response rate was 92% (n= 176). Regression analysis according to Baron and Kenny technique and Pearson correlation were conducted to get the study results. Results: The study results showed that all organizational commitment components positively and significantly correlated with job satisfaction and job performance. Further, there is a positive relationship was found between job satisfaction and job performance. Moreover, findings of regression analysis showed that job satisfaction partially mediates the relationship between all organizational commitment components and job performance. Conclusion: Improving organizational commitment and job satisfaction among nurses could increase their performance. Nurses’ managers should create suitable approaches and strategies to promote the organizational commitment and job satisfaction of nurses to the highest level, which in turn enhancing their job performance and the quality of care.

Serological and Molecular Detection of Toxoplasmosis among Blood Donors in Tertiary Hospital of Malaysia

@#Introduction: This preliminary cross-sectional study aimed to investigate the prevalence of toxoplasmosis among blood donors in Kelantan, Malaysia. Methods: A total of 56 blood donors were screened by an enzyme-linked immunosorbent assay (ELISA) for anti-T. gondii Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies. Positive T. gondii IgG and IgM were further tested for IgG avidity ELISA. All extracted deoxyribonucleic acids (DNAs) from whole blood samples were analyzed for the presence of the Toxoplasma B1 gene and the ITS1 region by polymerase chain reaction (PCR). The socio-demographic data of donors was assessed using a data collection form. Results: Out of 56 blood donors, 24 (42.86%) donors were IgG+/IgM-, and 2 (3.57%) donors were IgG+/IgM+ with one of them having a high avidity index indicating as past infection for more than 20 weeks and the other with a low avidity index indicating as recent infection within 20 weeks. None of the samples tested positive for the presence of the Toxoplasma B1 gene and the ITS1 region. A univariate analysis showed that only employment status was significantly associated with Toxoplasma seropositivity. Conclusion: The seroprevalence of toxoplasmosis among blood donors in Kelantan, Malaysia, was 46.43%. Nevertheless, direct detection by PCR showed that this parasite was absent in the blood. These results highlight that the blood donors in this study had previously been exposed to T. gondii infection. The parasite may still remain in certain tissues but does not freely circulate in the blood.

Preliminary Result of Randomised Controlled Trial of Three Different Coated Archwires Part 1: Tooth Alignment and Coating Loss

@#Introduction: Coated archwires improve aesthetics during orthodontic treatment. However, little is known regarding their clinical benefit. This randomised controlled trial (RCT) compared the tooth alignment (TA), coating loss (CL), colour change (∆E*), and patient perception of coated archwires with their controls. Details of ∆E* and perception were reported in the second part of the articles. Methods: This RCT was done at three centres. Participants were randomised to receive one of four treatment interventions using 0.014” superelastic coated nickel-titanium archwires from Orthocare, RMO, G&H, and conventional uncoated 3M Unitek® archwires. These archwires were ligated during bonding and collected after eighth week and questionnaires were distributed to participants in the experimental groups only. After removal, TA and CL were measured using Little’s Irregularity Index and Autodesk® AutoCAD® software, respectively. At the time of this preliminary reporting, 84 participants had completed the trial. Two archwires fractured and were excluded. Therefore, 166 archwires (n = 166) were analysed. Results: Only non-extraction cases showed statistically significant differences in TA change between all groups (p = 0.005) and RMO showed significantly lowest mean of TA (1.5 mm). RMO and Orthocare showed significant TA change in the upper and lower arches (p = 0.037, 0.048). CL was found to be insignificant for both extraction and non-extraction cases (p >0.05). Comparison between upper and lower arches revealed no significant difference in TA and CL in all groups (p >0.05). Conclusion: From this preliminary analysis, Orthocare provides better TA in non-extraction cases despite highest percentage of coating loss.

Preliminary Result of Randomised Controlled Trial of Three Different Coated Archwires Part 2: Colour Change and Patient Perception

@#Introduction: Coated archwires improve aesthetics because of the tooth-coloured appearance. However, colour change of the coated archwires have been reported in vitro. Nonetheless, little is known to what extent this colour change occurs clinically. This second part of the multi-centre, double-blind, randomised controlled trial evaluated the colour change (∆E*) of three coated archwires with their controls and patient perception. Methods: 84 patients who received treatment with upper and lower fixed appliance treatment were invited. Consented patients were randomised to receive one of four treatment interventions using 0.014” superelastic nickel-titanium archwires from (1) Orthocare (2) RMO (3) G&H, and (4) 3M Unitek® uncoated. These archwires were ligated during bonding and collected after 8th week. After removal, the digital images of the archwires were assessed for colour change using Adobe® Photoshop® software, and the CIE L*a*b* system was used to calculate the ΔE* values. Patient perception was measured using oral aesthetic subjective impact scale (OASIS) questionnaire. Results: For colour change and patient perception assessment, 132 archwires from 66 participants who had been treated with aesthetic archwires were collected. Two fractured archwires were excluded. Initial analysis revealed all three aesthetic archwires groups showed significant mean of ∆E* with the highest was found in Orthocare (23.9), and the lowest is G&H (16.8). Post hoc comparison revealed statistically significant mean of ∆E* in Orthocare when compared with other groups (p <0.001). There was no statistically significant difference for patient perception between archwire groups. Conclusion: Preliminary results revealed that significant ∆E* in Orthocare group and patients showed positive perception following clinical use

seroprevalence of IgM among Iraqi aborted women infected with human cytomegalovirus

Fetal loss and abortion are responsible for significant emotional distress for couples desiring children. There are many documents which support the role of some certain asymptomatic infections such as Cytomegalovirus [CMV] in spontaneous abortion. This study was aimed to evaluate the prevalence of seropositivity of specific IgM antibody for CMV by ELISA in the sera of [108] women with recurrent abortion associated with obstetric complications. This study was carried out in two central hospital in Baghdad [Al-Elwea and Baghdad teaching hospitals] during [2009-2010]. A number of [108] women with definite diagnosis of previous abortion, 35women with recurrent abortion, 30 women with premature delivary and 43women with intra uterine death.compered to [50] women with history of normal full term delivary and negative history of miscarrage as control groups.Serum samples were collected and then tested by using ELISA for detection of anti-CMV IgM antibodies. Cytomegalovirus [CMV] specific IgM antibody was detected in [15.7%] of the 108 women studied, while the women with obstetric complications were positive for CMV specific IgM antibody these comprised of [16.6%] with premature delivary ,[14%] with recurrent abortion and [16.2%] with intra uterine death. these result statistically significant [P<0.05].Our data faild to found asignificant association between the Cytomegalovirus infection with age and residence of patients [p>0.01]. Higher seropositivity for cytomegalovirus [CMV] in women with spontaneous abortion compared to women with normal obstetric history suggests that cytomegalo virus Plays a sigificant role in abortion

audit of inguinal hernia repairs - a PESSI experience

Inguinal hernia repair is the most commonly performed operation in general surgical practice. Advanced techniques like open and laparoscopic mesh repairs are the preferred operations these days. Social Security Health Care System working under PESSI [Punjab Employees Social Security Institute] provides a closed system of surveillance of operated patients. Patients once operated are on record and present for follow up to the relevant surgical unit for over a period of years, unlike the government hospitals, where patients are lost to follow up once they get discharged. Retrospective study. Department of Surgery, Punjab Employees Social Security Hospital, Ferozepur Road, Lahore from January 2001 to December, 2006. To establish the reliability of non-mesh tissue repair technique as a primary procedure in inguinal hernia. About 500 patients underwent surgery for inguinal hernias. In those with primary inguinal hernia, tissue repair techniques [plication of transversalis fascia and darning of posterior wall with prolene No.1] were used while in those patients who had recurrent inguinal hernias, either tissue repair or mesh repair was carried out. Tissue repair techniques gave us excellent results with a recurrence rate of 0.4% [2/500] over a mean follow up period of 4.5 years. The reliability of inguinal hernia repair technique primarily with a mesh is not established whereas the old traditional tissue repair techniques have decades of experience to justify their reliability as far as recurrence is concerned

Aposthia: a birth defect or normal quantitative recessive human genetic trait?

Aposthia [natural circumcision] is the condition of being born without a prepuce. Usually sporadic cases are reported in the medical literature. In this paper for the first time we present the genetic profile of 3 families with aposthia trait and discuss the possible genetics

Expansile lake of translucency in pericardial effusion. A manifestation of left ventricle to pericardial fistula from rupture of tuberculosis myocardial abscess

A 12 year old boy was admitted to a District hospital with history of abdominal pain, and persistent vomiting of several days duration. Exploratory laparotomy was done and terminal small intestine appearances were suggestive of ileocaecal tuberculosis. During post operative course he was found to have large bilateral pleural effusions on chest x-ray. Subsequently his general condition deteriorated and he was then shifted to tertiary care hospital where chest intubation was done. Echocardiography revealed large pericardial effusion with tamponade which was drained with a pigtail catheter, kept in situ for intermittent drainage. Clinical workup and investigations were consistent with disseminated tuberculosis for which anti-tuberculosis treatment was started. A month later, echocardiography was repeated for removal of pigtail catheter which revealed lake of translucency within the small residual pericardial fluid which was expansile with cardiac cycle. This was further evaluated with colour and colour M-mode. [Panel A,B,C,D]. Findings were suggestive of fistulous communication between left ventricular cavity and pericardial space secondary to tuberculous myocardial abscess rupture confirmed on histopathology post-operatively. What lends novelty to this case is that this serious but apparently innocuous looking finding could easily have been overlooked in a casual examination

Role of deliberate creation of control enterocutaneous fistula in patients of abdominal tuberculosis with perforation of small bowel and matted small intestine

To study the results after forming the controlled enterocutaneous fistula in the patient of abdominal tuberculosis with matted and perforated small bowel. Design, place and duration of study This study based on therapeutic trial and conducted in one and half years from january1999 to june2001 at Mayo Hospital, Lahore. All these 20 patients either operated in emergency or on elective list were malnourished, toxic and their operative findings were almost the same, these patients had extensively matted, friable and perforated gut. In these patients it was technically not possible to perform some definite procedure like right haemecolectomy or ileostomy with out increasing the morbidity or mortality. Under these circumstances, minimal surgical procedure which can be life saving is to oppose the anterior abdominal wall to the perforation and thus create a controlled enterocutaneous fistula. In 11 patients fistula closed on its own and in eight patients fistula remained patient and needed re-exploration and repair. This new method of treatment has yielded excellent results. We were able to cure the disease with no mortality. It is recommended that in cases of TB peritonitis with perforation and matted gut making of a controlled enterocutaneous fistula saves the life of the patient

Effect of mother tinctures of Gymnema sylvestre and Cephalendra indica on diabetes typeII

The mother tinctures of the herbs Gymnema sylvestre and Cephalendra indica have been used in homeopathy for the treatment of diabetes mellitus as hypoglycemic agents. Both of these herbs are found in abundance in the subcontinent. Their hypoglycemic effect is known but the mechanism of action is still controversial. In the present study a total of 41 patients with diabetes type II were selected and administered mother tinctures of Gymnema sylvestre and Cephalendra indica in liquid form. Fasting and random blood glucose levels were taken along with fasting serum insulin levels prior to the medication. Medication to these 41 patients was given for 30 days and their blood glucose levels along with insulin levels were estimated on the 1st, 10th and 30th day. Treatment with Gymnema sylvestre and Cephalendra indica showed a significant decrease in the blood glucose level however, no effect on the serum insulin level was observed

Fine needle aspiration biopsy in conjunction with cell block preparation: a study of 1000 cases at pathology department P.I.M.S. Islamabad

This study is based on an analysis of 1000 fine needle aspiration biopsies in which both cytology smears and paraffin cell block were available. The histology slides from these cell blocks were studied and the cases were divided into 3 categories. In category A 903 [90.3%] cases fall which show a definitive histological diagnosis of the lesion as well as type of the lesion can be made. In category B, included 81 [8.1%] cases, only the presence of lesion could be detected, but the type of lesion was not ascertained. In category C which consisted of 16 [1.6%] cases, the tissue was insufficient for reliable diagnosis. Comparison of the cytologic diagnosis based on aspiration smear with the cell block diagnosis revealed that in 210 [21%] cases only cell block was positive while in another 130 [13%] of cases the diagnosis from the cell block was more precise and specific. These results indicate that cell blocks can enhance the effectiveness of fine needle aspiration biopsy in establishing a pathologic diagnosis. Moreover the cell block preparation in addition to routine FNA cytology smears provide a valuable tool for the evaluation of a lesion and for proper selection of a patient for surgery or for other means of treatment

Some arylsulphonyl derivatives

Several arylsulphonyl derivatives possess useful biocidal activity, e.g. amides as antibacterials diuretics and fungicides; azides as nematicides and hydrazides as fungicides. This paper discusses the chemistry of some novel aryhulphonyl derivatives which were synthesised as candidate biocides