Dietary pattern, nutrient intake, and oral symptoms in a sample of pregnant women in Malaysia

@#Introduction: Nutritional requirements of pregnant women differ considerably from those of non-pregnant women. Nutritional status during pregnancy is critical to maintain health, including oral health, and to promote growth and development of the baby. This study assessed dietary pattern, nutrient intake, and oral symptoms among pregnant women. Methods: Seventy-one women with singleton pregnancy attending a public healthcare centre in Malaysia participated in this cross-sectional study. Dietary pattern and nutrient intake of the women were assessed using food frequency questionnaire and 3-day 24-hour diet recall, respectively. Information on sociodemographic and obstetric profiles, and oral symptoms were obtained from self-administered questionnaire. Results: White rice, chicken, green leafy vegetables, granulated sugar, and salt were foods most consumed. Intakes of iron, folate, vitamin C, vitamin D, calcium, iodine, zinc, and fluoride for most respondents were below Recommended Nutrient Intake (RNI). Cavitated tooth (46.5%), bleeding gums (35.2%), pain upon eating and drinking (23.9%), and bad breath (23.9%) were common oral symptoms reported. Significant association was found between complaint of brown, yellow, and white spots on tooth surface with vitamin A intake, and between complaint of bleeding gums with zinc intake. Conclusion: Intake of most nutrients by most respondents in this study was below the RNI. Oral symptoms were common and a few were associated with nutrient intakes.

Nutrient intake, oral symptoms, and oral health-related quality of life among antenatal mothers in Sarawak

@#Introduction: This study aimed to determine the association between nutrient intake, oral symptoms, and oral health-related quality of life (OHRQoL) among antenatal mothers in the Sri Aman district, Sarawak. Methods: A total of 124 antenatal mothers in the second and third trimesters, through systematic random sampling, participated in this cross-sectional study. A validated selfadministered questionnaire was used to collect their socioeconomic and obstetric profiles, perceived oral health status, and OHRQoL. Three days 24-hour diet recall assessment involving two weekdays and one weekend day was used for nutrient intake assessment. Results: Most mothers (75.0%) had at least one oral symptom: cavitated tooth (51.6%), bleeding gum (32.3%), halitosis (27.4%), gum pain (13.7%), toothache (12.1%), and swollen gum (6.5%). Most mothers also had inadequate intakes of energy, vitamin D, iodine, calcium, zinc, fluoride, and iron. The most affected OHRQoL domain was psychological discomfort, followed by functional limitation and physical pain. Nutrient intake was not significantly different between antenatal mothers with and without oral symptoms. Antenatal mothers with at least one oral symptom, presence of toothache, cavitated tooth, bleeding gum, and halitosis had significantly lower OHRQoL. Conclusion: Most antenatal mothers had inadequate nutrient intake, particularly vitamin D and calcium. Nutrient intake was not significantly associated with oral symptoms. The oral symptoms of dental caries and periodontal disease were prevalent; and the presence of toothache, cavitated tooth, bleeding gum, and halitosis were associated with poor OHRQoL.

Association of New Generation Anti-CCP Antibodies with Disease Severity and Functional Status in Rheumatoid Arthritis Patients

@#Introduction: Detection of anti-cyclic citrullinated peptide (anti-CCP) antibodies in patients with rheumatoid arthritis (RA) is associated with higher disease activity and lower functional ability. This study investigated the presence of the new generation of anti-CCP antibodies (anti-CCP2 IgG, anti-CCP2 IgA and anti-CCP3.1 IgG/IgA) and their association with disease severity and functional status of RA patients. Methods: A total of 46 RA patients and 40 healthy controls participated in this cross-sectional study that was conducted at the Rheumatology Clinic, Hospital Universiti Sains Malaysia. Blood samples were taken from all participants for anti-CCP2 IgG, anti-CCP2 IgA, and anti-CCP3.1 IgG/IgA analysis. Disease severity and functional status of RA patients were measured using the Disease Activity Score-28 (DAS28) and the modified Health Assessment Questionnaire (mHAQ) respectively. Results: Significantly higher proportion of RA patients were found with positive anti-CCP2 IgG (63.0%), anti-CCP2 IgA (37.0%), and anti-CCP3.1 IgG/IgA antibodies (63.0%) than the healthy controls. No significant association was found between anti-CCP antibodies status and mean DAS28 score of the RA patients. However, RA patients with negative anti-CCP2 IgG status had higher mean mHAQ score than patients with positive anti-CCP2 IgG status. Conclusion: Our study has demonstrated detection of the new generation anti-CCP antibodies in RA patients, supporting the use of autoantibodies in RA diagnosis. While no significant association was found between the presence of anti-CCP antibodies and disease severity of RA patients, the absence of anti-CCP2 IgG was associated with worse function and greater disability of the patients.

Relationship between 6-n-propylthiouracil (PROP) taster status, dietary intake and dental caries among young adult subjects

@#Introduction: Previous studies have established an association between 6-n-propylthiouracil (PROP) taster and dietary intake. However, those studies mostly emphasised on macronutrients. The present study examined the dietary intake, including macro- and micronutrients, and caries experience among university students according to their PROP taster status. Methods: A total of 158 university students participated in this study. PROP taster status was determined using filter paper method. Dietary intake was collected using 24-hour diet recall method. Oral health examination was conducted to determine dental caries experience. Results: The results showed that majority of subjects were supertasters. No significant differences (p>0.05) were found in the macronutrient intakes among supertasters, medium tasters, and non-tasters. Significant differences (p<0.05) were found in the intakes of micronutrients, namely pantothenic acid, vitamin D, magnesium, manganese, and fluoride. There were no significant differences among group tasters in the dental caries experience scores of decayed (D), missing (M), and filled (F) teeth. Conclusion: In general, this study indicated that all group tasters had no difference in macronutrients intake and caries experience, but supertasters had significantly lower intakes of some micronutrients as compared to non-tasters and medium tasters. This suggested that PROP taster status could have some influence on micronutrient intakes.

Factors Associated with Early Breastfeeding Initiation among Women Who Underwent Cesarean Delivery at Tertiary Hospitals in Kelantan, Malaysia / 가정의학회지

Background@#Cesarean delivery is linked with lower rates of early breastfeeding initiation. This study aimed to determine the prevalence and associated factors of early initiation of breastfeeding among women admitted for elective cesarean delivery in Kelantan, Malaysia. @*Methods@#A total of 171 women admitted for elective cesarean delivery at two tertiary hospitals in Kelantan, Malaysia, participated in this study. On day two after cesarean delivery, face-to-face interviews were conducted with the mothers to get information on feeding practice. Descriptive statistics, including simple and multiple logistic regressions, were used for data analysis. @*Results@#Seventy-three percent of mothers initiated breastfeeding within 1 hour of birth. Approximately 15.8% and 10.5% of mothers initiated breastfeeding within 24 hours and ≥24 hours, respectively. Skin-to-skin contact between mothers and their infants occurred in 77.8% of cases after cesarean delivery. Breastfeeding initiation was significantly associated with skin-to-skin contact (odds ratio [OR], 14.42; 95% confidence interval [CI], 3.58–58.06), mothers who exclusively breastfed during hospitalization (OR, 36.37; 95% CI, 5.60–236.24), and infants who were not sleepy during attempts at breastfeeding (OR, 5.17; 95% CI, 1.32–20.21). @*Conclusion@#Based on our results, it is possible to increase the proportion of mothers initiating breastfeeding within 1 hour among women who undergo elective cesarean delivery. Therefore, it is important that health practitioners educate women beginning in the antenatal period who plan to undergo cesarean delivery by emphasizing the importance of early initiation of breastfeeding.

Factors Associated with Early Breastfeeding Initiation among Women Who Underwent Cesarean Delivery at Tertiary Hospitals in Kelantan, Malaysia / 가정의학회지

Background@#Cesarean delivery is linked with lower rates of early breastfeeding initiation. This study aimed to determine the prevalence and associated factors of early initiation of breastfeeding among women admitted for elective cesarean delivery in Kelantan, Malaysia. @*Methods@#A total of 171 women admitted for elective cesarean delivery at two tertiary hospitals in Kelantan, Malaysia, participated in this study. On day two after cesarean delivery, face-to-face interviews were conducted with the mothers to get information on feeding practice. Descriptive statistics, including simple and multiple logistic regressions, were used for data analysis. @*Results@#Seventy-three percent of mothers initiated breastfeeding within 1 hour of birth. Approximately 15.8% and 10.5% of mothers initiated breastfeeding within 24 hours and ≥24 hours, respectively. Skin-to-skin contact between mothers and their infants occurred in 77.8% of cases after cesarean delivery. Breastfeeding initiation was significantly associated with skin-to-skin contact (odds ratio [OR], 14.42; 95% confidence interval [CI], 3.58–58.06), mothers who exclusively breastfed during hospitalization (OR, 36.37; 95% CI, 5.60–236.24), and infants who were not sleepy during attempts at breastfeeding (OR, 5.17; 95% CI, 1.32–20.21). @*Conclusion@#Based on our results, it is possible to increase the proportion of mothers initiating breastfeeding within 1 hour among women who undergo elective cesarean delivery. Therefore, it is important that health practitioners educate women beginning in the antenatal period who plan to undergo cesarean delivery by emphasizing the importance of early initiation of breastfeeding.

Cervical cancer and pap smear screening: knowledge, attitude and practice among working women in northern state of Malaysia

@#Cervical cancer is among the most common cancers in women worldwide. The Pap smear test is the primary screening procedure used to detect abnormal cells that may develop into cancer.

Knowledge, Attitude, Exposure, and Future Intentions toward Exclusive Breastfeeding among Universiti Sains Malaysia Final Year Medical and Dental Students / 가정의학회지

BACKGROUND: Breastmilk is the best nourishment for an infant for the first 6 months of life. Health professionals like medical doctors and dentists can help promote and support exclusive breastfeeding. We aimed to assess knowledge, attitudes, exposure, and future intentions toward exclusive breastfeeding among final year medical and dental students at Universiti Sains Malaysia, Kelantan, Malaysia. METHODS: A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest. RESULTS: Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding. CONCLUSION: Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.

Association between Emotional Intelligence and Perceived Stress in Undergraduate Dental Students

Background: This study investigated the association of emotional intelligence (EI) and other factors with perceived stress (PS) in undergraduate dental students. Methods: A total of 234 undergraduate dental students at the School of Dental Sciences, Universiti Sains Malaysia (USM), in the academic year of 2009/2010, participated in this crosssectional study. Self-administered questionnaires, the Assessing Emotions Scale and the Perceived Stress Scale (PSS-10), were used to evaluate EI and PS, respectively. Results: The mean EI score was 121.2 (SD 11.85). The scores were significantly higher in females than males, and in students who chose dentistry based on their own interest rather than in those who were motivated by others to study dentistry. The mean PSS-10 score was 21.2 (SD 5.08). Pearson correlation analysis indicated a significant inverse relationship between EI and PSS-10 scores (r = -0.337). Multi-variable regression analysis also indicated a significant negative linear association between EI and PSS-10 scores (b = -0.156, 95% CI: -0.207, -0.104). PSS-10 scores were significantly higher for students who were in the clinical years rather than the preclinical years. Conclusions: This study of USM undergraduate dental students shows that a low EI, female sex, and being in the clinical years were significant predictors of PS.

Referral of pregnant women to dentists and advice for dental visit by medical nurses

Objective: Dental attendance among pregnant women has been low although they frequently experience oral health problems. Nurses who provide antenatal health care are well positioned to advise and refer their pregnant patients to dentists. this study aimed to assess the practices of medical nurses regarding advice for dental visits and referral of their pregnant patients to dentists. Methods: A total of 202 medical nurses who provide antenatal health care at Ministry of Health facilities in the district of Kota bharu, Kelantan, Malaysia were included in this cross-sectional study. A structured self-administered questionnaire was used to obtain information on variables of interest. Results: Most nurses frequently advised (90.6%) and referred (91.1%) their pregnant patients to dentists, although some (9.4%) advised their patients to defer dental visits until after parturition. Multivariable analysis indicated that individuals who worked as nurses for 10 years or fewer and had their own dental visits within the past year were more likely to advise their patients to see dentists with adjusted OR of 3.98 (95% cI=1.37-11.54) and 2.58 (95% cI=0.99-6.70) respectively. Nurses who visited dentists within the past year were also more likely to make dental referrals (OR=3.46, 95% cI=1.32-9.10). conclusions: Most nurses routinely advise and refer their pregnant patients for dental visits. the time since a nurse’s last personal dental visit was associated with their advice and referral of patients to dentists, and duration employment as a nurse was associated with advising patients for dental visits.

Knowledge and Attitude of Medical Nurses toward Oral Health and Oral Health Care of Pregnant Women

Background: This study assessed the knowledge and attitudes of medical nurses regarding oral health and oral health care of pregnant women. Methods: This cross sectional study of 133 nurses in the district of Tumpat, Kelantan (Malaysia) used self-administered questionnaires. Results: Most nurses knew that dental plaque is associated with periodontal disease (97.7%). However, most nurses erroneously believed that tooth decay (86.5%) and excessive sugar consumption (87.2%) led to periodontal disease. About half of the nurses knew about the relationship between periodontal disease of pregnant women and low birth weight (43.6%) and preterm birth (48.9%). Many nurses had the misconception that the developing foetus draws calcium from the mothers’ teeth (78.2%). Most nurses had good attitudes toward improving their oral health knowledge (97.0%) and agreed they should help to deliver oral health education to pregnant women (94.0%). Age, length of service as a nurse, and length of service in antenatal care had no effect on the scores for the nurses’ knowledge and attitude regarding oral health and oral health care of pregnant women. Conclusion: Medical nurses had limited knowledge about oral health of pregnant women and had some misunderstandings about oral health, although they had good attitudes. Age, length of service as a nurse, and length service in antenatal care had no effect on the knowledge and attitude scores of the nurses.