Aesthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demands of patients for aesthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called “star of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. Before placement of direct composite veneers, a proper diagnosis, available treatment options, cost of treatment, patient’s expectations and duration of treatment should be taken into consideration. This article presents three case reports of aesthetic rehabilitation of anterior teeth using direct composite with satisfactory outcome that mimic the natural dentition.

Purpose: Hybrid learning has been chosen as an alternative method in the conduction of clinical skill lectures during coronavirus disease 2019 (COVID-19) pandemic since students need to learn skills applied in emergency situations. This study aims to analyze students’ attitudes between hybrid and online learning methods. Methods: A non-randomized study was conducted between hybrid group (HG) and online group (OG) on three courses (intravenous [IV]-line insertion, nasogastric tube [NGT] insertion, and neonatal resuscitation). We developed a preformed validated questionnaire to assess students’ attitudes in five domains (willingness, understanding, capacity, self-efficacy, and intended behavior). The questionnaire was applied at the pre- and post-intervention. Results: A total of 100 participants were included (n=49 in HG, n=51 in OG). Post-course attitudes were significantly higher in online (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) and hybrid (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) groups compared to their pre-course. There were no significant differences in post-course attitude between groups (IV-line, p=0.072; NGT, p=0.163; resuscitation, p=0.146). Normalized-gain scores of all subjects were higher in HG (IV-line, p=0.012; NGT, p=0.085; resuscitation, p=0.033). Conclusion In conclusion, hybrid learning could be considered as a better alternative in clinical skill lectures to maximize students’ attitudes, especially during COVID-19 pandemic.

OBJECTIVE: To investigate the traditional antidiabetic uses of some indigenous Sudanese plants on streptozotocin-induced diabetes rats. METHODS: Diabetic rats were treated with a 400 mg/kg dose of aqueous extracts of five plant species orally for 2 h (acute) or 14 days (chronic). In acute model blood glucose levels were monitored at specific intervals. In the chronic model blood samples were collected from overnight fasted diabetic rats on day 15 to estimate blood glucose level. And the body weight, serum lipid profile and activities of liver and kidney enzymes were measured. Histopathological observations of liver sections were also studied. RESULTS: In the case of acute treatment, aqueous extracts of Tinospora bakis (T. bakis), Nauclea latifolia (N. latifolia) and Randia nilotica (R. nilotica) at 400 mg/kg significantly lowered (P < 0.05) blood glucose levels in diabetic rats whereas, chronic treatment of diabetic rats with 400 mg/kg of T. bakis, N. latifolia, R. nilotica and Mitragyna inremis proved to have significant (P < 0.05) antihyperglycemic effect and have the capacity to correct the metabolic disturbances associated with diabetes. Histopathological studies showed that the aqueous extracts of these four plants reinforced the healing of liver. However, Striga hermonthica aqueous extract did not exert any antihyperglycemic effect to diabetic rats. CONCLUSIONS: This study demonstrated that T. bakis, N. latifolia, R. nilotica and Mitragyna inremis have therapeutic value in diabetes and related complications and thus supporting the traditional uses of these plants in Sudanese traditional medicine.

Objective To explore the potential of essential oil, as therapeutic molecule source, from olibanum of Boswellia papyrifera (Burseraceae), leafy stems of Cymbopogon schoenanthus (Poaceae) and Croton zambesicus (Euphorbiaceae) and rhizome of Cyperus rotundus (Cyperaceae) found in Sudan. Respective essential oil was evaluated for anti-proliferative, antibacterial and antioxidant activity. Methods Essential oils were extracted by hydrodistillation and then analysed by gas chromatography coupled to mass spectrometry (GC–MS). Anti-proliferative activity was determined against human cell lines (MCF7 and MDA-MB231, HT29 and HCT116) by the thiazolyl blue tetrazolium bromide (MTT) procedure. Antioxidant activity was evaluated by diphenyl 2 pycril hydrazil (DPPH) assay. Antibacterial activity was determined against two Gram-positive and two Gram-negative bacteria by microdilution method. Results The essential oil from olibanum of Boswellia papyrifera contained mainly alcohol and ester derivatives (46.82%) while monoterpenes (69.84%) dominated in Corton zambesicus oil. Sesquiterpenes were the most highly represented classes of terpene derivatives in Cyperus schoenanthus (71.59%) and Cyperus rotundus (44.26%). Oil of Cymbopogon schoenanthus revealed the best anti-proliferative activity against HCT116 cell line with IC50 value at (19.1 ± 2.0) μg/mL. Oil of Croton zambesicus showed the best antioxidant activity [EC50 (4.20 ± 0.19) mg/mL]. All oils showed good antibacterial activity against Escherichia coli, Bacillus subtilis and Staphylococcus aureus with minimum inhibitory concentration (MIC) value ranged from 16 to 250 μg/mL. Conclusions The results suggest that the essential oils of these plants could be used as a source of natural anti-proliferative, antioxidant and antibacterial agents.

This study is aimed to provide an insight into the types of treatment carried out by postgraduate students in the past 10 years. A retrospective study was carried out between November 2019 and February 2020 by deriving data from postgraduate students’ clinical logbooks of three different cohorts of Master of Clinical Dentistry (Restorative Dentistry in Conservative Dentistry) in 2010, 2013 and 2016. This retrospective data was systematically extracted from the records and tabulated categorically using an Excel spreadsheet (Microsoft Office Excel 2019). A descriptive analysis was carried out to further evaluate the results. Overall, the types of treatment carried out in the field of endodontics and fixed prosthodontics has changed in the past 10 years. An increasing trend is seen in the placement of all ceramic crowns and primary root canal treatment procedures, while a decreasing pattern is evident for secondary root canal procedures and placement of dental bridges.

Chemical constituents and biological activities of the Mitrella kentii leaf oil were investigated in this study. Gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) were used to determine the chemical constituents of the oil. The oil was evaluated for its ability to inhibit prostaglandin E2 (PGE2 ) and thromboxane B2 (TXB2 ) productions in human whole blood using a radioimmunoassay technique. Its inhibitory effect on plateletactivating factor (PAF) receptor binding with rabbit platelets using 3 H-PAF as a ligand and its free radical scavenging effect on DPPH were also investigated. Caryophyllene oxide (33.8%w/w), E,Z-farnesol (6.9%), benzyl benzoate (6.5%w/w) and viridiflorol (6.5%w/w) were among the major components of the oil. Even though weak inhibitory activities were observed in both PGE2 and TXB2 assays, significant results were obtained in both PAF receptor binding inhibition and 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging effect with IC50 value of 6.6 µg/mL and 155.6 µg/mL respectively. These promising activities warrant the development of the oil as an anti-inflammatory agent.

Objective: To gather the fragmented literature on ethnobotany, phytochemistry and in-vitro activities of medicinal plants of Pakistan being used against common infections caused by Staphylococcus aureus (S. aureus). Methods: A large number of published and unpublished research studies related to the ethnomedicinal, phytochemical and anti-S. aureus activity of medicinal flora of Pakistan published from 1990-2018 were reviewed using online bibliographic databases such as PubMed, Web of Science, Science Direct, ResearchGate and libraries. Results: S. aureus can cause many human ailments including endocarditis, staphylococcal scalded skin syndrome, septic arthritis, respiratory problems with an estimated infection rate of 25%-35% across the globe. This review comprised of 86 medicinal plants. Data showed that people mostly used leaves (50%) for the preparation of traditional medicines. Correlation analysis on the reviewed data revealed that methanolic extract concentrations of medicinal plants was highly significantly positive correlated (r=0.8; P<0.01) with the S. aureus zone of inhibitions. S. aureus reportedly showed complete resistant to the commonly used antibiotic erythromycin. Isolated compounds like altheahexacosanyl lactone, cinnamaldehyde, niloticane, gobicusin A, asparacosin A, muzanzagenin, isoagatharesinol, friedelin, inophynone and eugenol were active against S. aureus. This study provided in-vitro proof for the flora of Pakistan used against different infections caused by S. aureus. Conclusions: Antibacterial agents from natural sources could be more effective against bacterial pathogens and will be helpful in minimizing the adverse effects of synthetic drugs, and hence provides a base for the pharmaceutical industries. http://www.apjtm.org/article.asp?issn=1995-7645;year=2018;volume=11;issue=6;spage=355;epage=368;aulast=Adnan;type=2.

Objective: To evaluate the total phenolic content and total antioxidant capacity of ethyl acetate extracts of 21 endophytic fungi isolated from five Sudanese medicinal plants: Calotropis procera, Catharanthus roseus, Euphorbia prostrate, Vernonia amygdalina and Trigonella foenum-graecum. Methods: Crude extracts of endophytic fungi and their host plants were tested by classical Folin-Ciocalteu colorimetric method to determine the total phenolic content, also total antioxidant capacity was estimated using 1,1-diphenyl-2-picrylhydrazyl free radical scavenging in vitro method. Results: Among the endophytes, endophytic fungus Aspergillus sp. from Trigonella foenum-graecum seeds demonstrated the highest both total phenolic content in term of gallic acid equivalent [(89.9 ± 7.1) mg GAE/g] and antioxidant activity for 1,1-diphenyl-2-picrylhydrazyl radical scavenging assay [IC

Introduction: Vaccination is a biological process that improves immunity level of an individual towards certain diseases. Vaccination is generally given to all newborn and kids. Most countries oblige their citizens to be vaccinated as early as new-born age. The aim of this research is to study the perception on vaccination intake and the associated factors that lead to its refusal among parents in east coast and west coast peninsular Malaysia. Methods: Primary data were collected using self-administered questionnaire and were distributed to assess the study objectives. Total 240 questionnaires were distributed equally in west coast and east coast study area. Questionnaire consists of demographic data, perception aspects and factors that may lead to the negative perceptions. Results: There is significant association between perception and religion, education level and side effect factor in east coast with majority of the respondents are Muslims (40.83%) while there is no significant association between education level and side effect factor (p>0.1) in west coast with majority of respondents are Muslims (51.67%) too. This study found that perception regarding vaccination is influenced by the religion restrictions in east coast of peninsular Malaysia and not in west coast region. The other factors associated with vaccination refusal varies according to education level, and regional basis. Conclusion: Most of the respondents who have negative perception regarding vaccination are from East Coast region as they are more prone into Islamic teachings. All the possible factors of vaccination refusal are accepted by the respondents but varies in its prevalence as the leading factor determined that caused the vaccination refusal are religion restriction and the least percentage for the factor is time restriction.

Introduction: Pursuing higher education has always been considered to be stressful as students need to adapt to new social and academic environment. Higher education in recent years has shifted from teacher centred authoritarian approach to student centred learning with amicable learning environment. In this changing scenario, this study aims to identify the indicators of stress and stress levels among 21st century university students and fathom the demographic factors influencing it. Method: A cross-sectional survey was conducted on students attending a private university in Malaysia using Stress Indicators Questionnaire. The data was analysed with descriptive and inferential statistical tests. Results: A total of 1050 university students aged between 18-30 years from different faculties voluntarily participated in the study. All respondents reported stress varying from very low to dangerous levels. Among the indicators of stress, sleep and emotional indicators were at dangerous levels, physical indicators and personal habits were at high level and behaviour indicators were perceived at medium level. A significant difference in total stress score between students of different age groups and ethnicity were observed, while no significant difference was noted with regards to gender. Conclusion: This study reveals that various indicators of stress are prevalent among the present-day university students. It may help guide policy makers and teachers in early identification of stress among their pupils and plan effective strategies aimed at balancing a good quality of life and academic achievement for the learners in institutions of higher learning.