Knowledge and attitude regarding obstructive sleep apnoea among medical and dental practitioners working in North-Eastern Peninsular Malaysia: A comparative cross-sectional study.

BACKGROUND: Obstructive Sleep Apnea (OSA) is a temporary airflow obstruction during periods of sleep. Patients with OSA often suffer from poor work performance, compromised sleep quality, and low quality of life which may lead to a life-threatening event. Adequate knowledge and a positive attitude toward OSA among medical and dental practitioners are crucial to the initial diagnosis and treatment. OBJECTIVE: This study aimed to identify the differences in knowledge and attitude toward OSA between medical and dental practitioners working in North-Eastern Peninsular Malaysia. METHODS: A comparative cross-sectional study was performed from February 2020 to February 2021. A total of fifty-two medical practitioners and fifty-two dental practitioners working at university-based outpatient clinics, government health clinics, and oral health clinics located in Kelantan State of Malaysia participated in the study, and data were collected by the structured questionnaire including sociodemographic inquiry and OSAKA questionnaire by non-probability stratified random sampling. The Mann-Whitney U test was used to compare knowledge and attitude scores between the two groups. RESULTS: The mean age of the respondents was 34.6 years. The current study shows that 92.3% of medical doctors and 96.1% of dental doctors were able to correctly answer the question "Most of the patients with OSA snore" a significant finding in our study. Only 1% of medical professionals could answer seventeen questions correctly with a median score of 11, and only 1% of dental professionals could answer sixteen questions correctly with a median score of 9. None of them could provide an accurate answer to all the knowledge questions. Medical and dental practitioners exhibited different knowledge levels on OSA (z- statistics=-4.39, U = 827.00 with p <  0.05, and effect size, r = 0.61). However, no significant differences were found in total knowledge score by gender (p-value>0.05), ethnicity (p-value>0.05), total service years (p-value>0.05), and training attended. In addition, significant differences in attitude levels between medical and dental practitioners have been observed (z-statistics=-3.42, U = 725.00 with p <  0.05, and effect size, r = 0.47). Nevertheless, no significant differences have been seen in total attitude score by ethnicity (p-value >  0.05), total service years (p-value >  0.05), attending training on OSA (p-value >  0.05), and professional status (p-value >  0.05) except gender (p-value <  0.05). CONCLUSION: A Significant difference is evident concerning knowledge and attitude toward OSA diagnosis and management between medical and dental practitioners working in North-Eastern Peninsular Malaysia. Medical practitioners in this study recorded a higher knowledge and attitude score compared to dental practitioners.

Effects of Riboflavin Collagen Crosslinker on Dentin Adhesive Bonding Efficiency: A Systematic Review and Meta-Analysis.

The aim of this study was to evaluate published data regarding riboflavin (RF) as a cross-linker for improved adhesive bond strength to dentin and to analyze previous studies for optimal concentration of riboflavin range suitable for dentin bond. Saliva and distilled water were used as storage media and aging time was 24 h and 6 months. Results of meta-analysis were synthesized using a statistical method of inverse variance in random effects with a 95% Confidence Interval (CI). Cochrane review manager 5.4.1 was used to determine results of the meta-analysis. In total, 3172 articles were found from search databases "PubMed", "Scopus", and "Google Scholar". Six of the fifteen studies were eligible for meta-analysis. Micro tensile strength shows significant improvement with the addition of riboflavin (p < 0.05) compared to without the addition of riboflavin from with 95% CI. A significant difference has been found in micro tensile bond strength between use of the riboflavin cross-linker and without use of the riboflavin crosslinker in the dentin adhesive system. With a 95% confidence interval (CI), the I2 for micro tensile strength was 89% with strong heterogeneity, Chi2 = 44.76, df = 5 (p < 0.00001), and overall effect size is Z = 2.22 (p = 0.03) after immediate aging. Chiang et al. 2013 shows maximum mean differences which is 38.50 [17.93-59.07]. After 6 months of aging in distilled water or artificial saliva micro tensile bond strength has been increased with the addition of riboflavin (p < 0.05). It can be clearly seen that pooled effect and 95% CI did not cross the line of no effect. With a 95% confidence interval (CI), the I2 for micro tensile strength was 96% with strong heterogeneity, Chi2 = 117.56, df = 5 (p < 0.00001), and overall effect size is Z = 2.30 (p = 0.02). Subgroup analysis proved a similar effect of distilled water and artificial saliva as storage media on micro tensile bond strength after incorporating riboflavin as a collagen crosslinker. An artificial saliva aged forest plot also showed considerable heterogeneity with I2 = 96%; Tau2 = 257.32; Chi2 = 94.37; df = 2 (p < 0.00001); test for overall effect, Z = 1.06 (p = 0.29). Riboflavin prior to or with bonding is recommended to improve the bonding of different adhesive systems.

Predictors of oral health literacy in pregnant women.

We determined factors associate with oral health literacy of pregnant women. A total of 203 pregnant women attending Hospital Universiti Sains Malaysia (USM) for antenatal care participated in this cross-sectional study. The Malay version of Oral Health Literacy Instrument (OHLI-M) and a structured self-administered questionnaire were used to obtain variables of interest. The mean OHLI-M score was 73.6 (SD 12.59). Only slightly more than half of our participants had adequate oral health literacy (54.2%), while others were marginal (31.0%) and inadequate (14.8%). Our findings revealed that women with adequate oral health literacy were more likely to be those with higher education qualification and were very satisfied or satisfied with their oral health status. The identification of these predictors highlighted the importance to keep oral health education messages simple and clear for the benefit of individuals with low educational attainment.

Differences in Prevalence and Associated Factors of Underweight and Overweight/Obesity among Bangladeshi Adults by Gender: Analysis of a Nationally Representative Survey.

The objective of this study was to find the differences in prevalence and associated factors of underweight and overweight/obesity among Bangladeshi adults by gender, using the nationally representative Bangladesh Demographic and Health Survey 2017-2018 data. To identify the factors associated with underweight and overweight/obesity in both genders, multilevel multivariable logistic regression was conducted. The prevalence of underweight was 19.79% and 15.49% among males and females, respectively. The prevalence of overweight/obesity was 32.67% and 45.60% among males and females, respectively. Among both genders, participants with the highest likelihood of overweight/obesity were aged 30-49 years and 50-69 years, had the highest educational attainment up to primary and secondary level, resided in a household that belonged to the middle, richer, or richest wealth quintiles, and were currently married. On the other hand, among both genders, increased educational attainment and wealth index were inversely associated with being underweight. Health promotion programs in Bangladesh should focus on these high-risk groups to address the burden of underweight and overweight/obesity.

Clinical Applications of Artificial Intelligence and Machine Learning in Children with Cleft Lip and Palate-A Systematic Review.

OBJECTIVE: The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved. MATERIALS AND METHODS: An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied. RESULTS: Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis. CONCLUSIONS: Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.

Color variations during digital imaging of facial prostheses subjected to unfiltered ambient light and image calibration techniques within dental clinics: An in vitro analysis.

BACKGROUND: The study aimed to evaluate 1) the amount of color variations presents within clinical images of maxillofacial prosthetic silicone specimens when photographed under different clinically relevant ambient lighting conditions, and 2) whether white balance calibration (WBC) methods were able to mitigate variations in ambient lighting. METHODS: 432 measurements were acquired from standardized images of the pigmented prosthetic silicone specimens within different ambient lighting conditions (i.e., 2 windowed and 2 windowless clinics) at noon with no light modifying apparatus. The specimens were photographed once without any white balance calibration (raw), then independently alongside an 18% neutral gray card and Macbeth color chart for calibration in a post-processing (PPWBC) software, and once after camera calibration (CWBC) using a gray card. The LAB color values were extracted from the images and color variations (ΔE) were calculated after referring to the corresponding spectrophotometric values as control. RESULTS: Images in windowless and windowed clinics exhibited highly significant differences (p < 0.001) with spectrophotometer (control). CWBC demonstrated no significant differences (p > 0.05) in LAB values across windowed clinics. PPWBC using Macbeth color chart produced no significant differences for a* values (p > 0.05) across all clinics while PPWBC by gray card showed no significant differences (p > 0.05) in LAB values when only similar clinics (either windowed or windowless) were compared. CONCLUSION: Significant color variations were present for maxillofacial prosthetic specimens owing to natural ambient light. CWBC and PPWBC using color charts were more suitable for color correction across windowed clinics while CWBC and PPWBC using gray cards had better outcomes across windowless setups.

The Potential of α-Mangostin from Garcinia mangostana as an Effective Antimicrobial Agent-A Systematic Review and Meta-Analysis.

This systematic review aims to evaluate the antimicrobial activity of α-mangostin derived from Garcinia mangostana against different microbes. A literature search was performed using PubMed and Science Direct until March 2022. The research question was developed based on a PICO (Population, Intervention, Control and Outcomes) model. In this study, the population of interest was microbes, α-mangostin extracted from Garcinia mangostana was used as exposure while antibiotics were used as control, followed by the outcome which is determined by the antimicrobial activity of α-mangostin against studied microbes. Two reviewers independently performed the comprehensive literature search following the predetermined inclusion and exclusion criteria. A methodological quality assessment was carried out using a scoring protocol and the risk of bias in the studies was analyzed. Reward screening was performed among the selected articles to perform a meta-analysis based on the pre-determined criteria. Case groups where α-mangostin extracted from Garcinia mangostana was incorporated were compared to groups using different antibiotics or antiseptic agents (control) to evaluate their effectiveness. A total of 30 studies were included; they were heterogeneous in their study design and the risk of bias was moderate. The results showed a reduction in microbial counts after the incorporation of α-mangostin, which resulted in better disinfection and effectiveness against multiple microbes. Additionally, the meta-analysis result revealed no significant difference (p > 0.05) in their effectiveness when α-mangostin was compared to commercially available antibiotics. α-mangostin worked effectively against the tested microbes and was shown to have inhibitory effects on microbes with antibiotic resistance.

Comparison of knowledge level and attitude towards obstructive sleep apnoea amongst dental and medical undergraduate students of Universiti Sains Malaysia.

BACKGROUND: Sleep apnoea is a diagnosed condition in which appurtenances interrupt breathing whilst sleeping. The consequence of obstructive sleep apnoea (OSA) includes road traffic accidents due to drowsiness, systemic hypertension, heart disease, diabetes mellitus and neurocognitive disorders. This condition extends the duration of recovery phase after traumatic brain injury. OBJECTIVE: This study was intended to assess the knowledge and attitude towards OSA and compare it among dental and medical undergraduate students of University Sains Malaysia (USM). METHODS: In this study, a total of 216 clinical undergraduate students (36 from each year; 108 from medical and 108 from dental school) of University Sains Malaysia (USM) Health campus were recruited for the study by non-probability stratified random sampling method. Total study period was October 2017 to October 2018. A self-administered questionnaire was used to assess the sociodemographic status and OSAKA questionnaire was used to assess knowledge and attitude regarding sleep apnoea of the respondents. Descriptive analysis was carried out to assess the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM. The Mann-Whitney U test was carried out to compare the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM. RESULTS: Our study findings revealed that 0.9 %and 6.5 %of the dental undergraduate students and medical undergraduate students could answer all the questions correctly regarding knowledge of OSA. Based on the assessment of the difference between medical and dental students in terms of knowledge towards OSA patients, significant difference was observed at the significance level of 95%, where p < 0.05 but no difference found in attitude towards OSA. However, significant difference was found towards attitude on treating OSA patients p < 0.05. CONCLUSIONS: A difference was observed in the knowledge and attitude on OSA between dental and medical undergraduate students in USM; however, medical undergraduate students had better knowledge and attitude towards OSA than dental students.

Knowledge and awareness regarding occupational needle stick and sharp injuries among dental personnel in Malaysia.

BACKGROUND: Accidental occupational injuries increase the risk of communicable diseases like hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among dental personnel. Such occupational injuries affect healthcare quality by enhancing dissatisfaction and lack of motivation to work among dental personnel. OBJECTIVE: The present study aims to assess knowledge and awareness regarding needle stick and sharp injury among dental personnel and compared the knowledge and awareness level about needle stick injuries between dental professionals and dental supporting staff working at the School of Dental Sciences, Universiti Sains Malaysia. METHODS: This cross-sectional study was conducted from March 2016 to March 2017. The total sample included 112 registered dental personnel including dental professionals (lecturers, dental officers, and postgraduate students) and dental supportive staff (including staff nurses and dental surgery assistant) who were selected from the School of Dental Sciences, Universiti Sains Malaysia at Kelantan District of Malaysia. Data were collected by a structured questionnaire. RESULTS: In our study 60.7% respondents answered correctly for all the statements regarding knowledge and 51.8% of the respondents answered correctly for the statements regarding awareness on needle stick and sharp injury. No significant difference of knowledge level has been observed between the dental professionals and dental supportive staff (p < 0.819), whereas the awareness level was significantly different between these two groups (p < 0.016). CONCLUSIONS: There is a difference regarding awareness level on needle stick and sharp injury between dental professionals and dental supportive staff in our study but no differences were found in knowledge level between two groups.

Assessment of Parents' Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children.

(1) Purpose: To assess the oral health literacy (OHL) of parents and its association with the caries experience of their preschool children attending the Hospital University Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia. (2) Materials and Methods: This is a descriptive cross-sectional study involving a systematic random sampling method, using a sample of 230 parent/preschool child dyads. Among 230 parents, 24 were males and 206 were females (mean age 31.43 ± 5.82); among 230 children, 92 were boys and 138 were girls (mean age 4.82 ± 1.04) attending the pedodontics clinic, HUSM, who participated and met the inclusion criteria. A structured, self-administered oral health literacy questionnaire including sociodemographic factors was used in this study. A child's oral examination was performed to check the dmft (decayed, missing, filled teeth) status. Statistical analysis was done using descriptive and Spearman's correlation analysis and multivariate regression analysis. (3) Results: The mean dmft score of children in relation to the OHL level of parents showed a significant difference (p < 0.00). The mean dmft score of children in relation to the OHL level of parents showed the following relationships: Inadequate (7.49 ± 4.10) followed by marginal (3.28 ± 2.67) and then adequate (0.55 ± 1.55). The incidence of caries amongst children in relation to parental employment was more associated with unemployed parents (6.11 ± 4.43) than with employed parents (2.79 ± 3.65). The caries experience amongst children in relation to education of their parents revealed a significant difference (p < 0.001), and the mean dmft score was high amongst preschool children with primary school qualified parents (10.7 ± 4.10) followed by high school (7.04 ± 3.68), vocational (5.81 ± 3.57), diploma (2.61 ± 2.81), and university (1.29 ± 2.27), respectively. The results revealed a valid significant difference (negative correlation, rs = -0.753 **) between the OHL of parents with the dmft score of their preschool children. The age and gender of parents was not significantly associated with OHL, whereas ethnicity (positive correlation, rs = 0.283 **), education (positive correlation, rs = 0.865 **), and employment (negative correlation, rs = -0.490 **) were found to be significant. Conclusion: We conclude that there is a significant association between the OHL of parents with the dmft score of their preschool children. The logistic regression showed that after adjustment for sociodemographic factors, parents' gender (OR = 0.067, 95% CI: 0.012-0.360), parents' employment status (OR = 3.247, 95% CI: 0.897-11.754), parents' OHL score (OR = 0.042, 95% CI: 0.016-0.114), and child age (OR = 2.195, 95% CI: 1.249-3.857) were significantly associated with dental caries in children. Our study concluded that parents' employment status, age, gender, OHL, and child's age were significantly associated with the caries experience of their preschool children.

Factors Influencing Oral Health-Related Quality of Life Among Preschool Children in District of Kota Bharu, Malaysia: A Cross-Sectional Study

Abstract Objective: To assess caries experience and its association with oral health-related quality of life (OHRQoL) of preschool children in Kota Bharu, Kelantan, Malaysia. Material and Methods: A sample of 169 preschool children of 5-6-year-old at a private preschool in the district of Kota Bharu, Kelantan was participated and were subjected to an oral examination to determine their caries experience by a single calibrated dentist. The parents were responding to self-administered Malay-ECOHIS and their socio-demographic background. Descriptive, Chi-square test and Spearman correlation were done to analyse the data required in this study. Results: Subjects comprised of girls (55.6%) with most parents (39%) had a secondary level of education, and 47.9% of them had a monthly income of RM1000-RM2999. Caries prevalence was 74.6% with a mean (SD) dmft was 5.27(5.22). The impacts on OHRQoL were more prevalent in the family section of Malay-ECOHIS (12.5%; 95%CI: 7.5%-17.5%) than the child section (4.2%; 95%CI: 1.16%-7.24%). Items related to 'felt guilty' (22.5%; 95%CI: 16%-29%) and 'been upset' (20.2%; 95%CI: 14.1%-26.3%) were the frequently reported on the family impact section. In child impact section, the item related to 'pain' (36.7%; 95%CI: 30%-43%) and 'difficulty eating' (20.8%; 95%CI: 14.7%-26.9%) were reported more frequently. Children with caries experience were significantly associated with the impact on family OHRQoL (p<0.05). Conclusion: The presence of dental caries was a significant predictor of poor OHRQoL.