Periodontal Screening, Where Are We Now? A Narrative Review Prevention of diseases begins with screening. An ideal screening tool identifies patients at an early stage to facilitate appropriate treatment modalities with the aim of preventing symptom manifestation, reducing disease severity, and improving health outcomes. Disease screening has been a fundamental component of preventive medicine and dentistry. In the context of periodontal disease, the basic periodontal examination (BPE) is one of the screening tools available. There is a high prevalence of periodontal diseases worldwide, indicating a global issue. Despite the significance of periodontal screening, it remains underutilized both globally and locally. The lack of routine screening contributes to poor assessment and treatment of periodontal disease. This article focuses on the epidemiology of periodontal disease, the associated challenges, current screening practices, and the future directions of periodontal screening. By addressing these issues, early detection and management of periodontal disease can be improved, ultimately enhancing oral health outcomes.

Introduction: Early identification of patients at risk for severe multisystem inflammatory syndrome in children (MIS-C) is essential for favourable clinical outcomes. This study aims to identify the clinical characteristics, factors and outcomes associated with severe MIS-C. Materials and methods: In this retrospective cohort study involving 14 major hospitals in Malaysia, children <15 years who met the United States Centres for Disease Control and Prevention case definition for MIS-C were included. Severe MIS-C was defined as children who required inotropic support, ventilatory support (invasive or non-invasive ventilation), or left ventricular ejection fraction of <55%. The factors investigated for severe MIS-C were demographic characteristics, the presence of comorbidities, clinical characteristics, and laboratory measures. Multivariable logistic regression was used to compute the adjusted odds ratio (aORs) of factors associated with severe MIS-C. Results: Among the 155 patients, 91 (58.7%) presented with severe MIS-C. Severe MIS-C was more likely in patients aged ≥5 years old (aOR 2.13, 95% confidence interval [CI] 1.08-4.21), with dehydration (aOR 3.80, 95% CI 1.53-9.45), lethargy (aOR 2.02, 95% CI 0.97-4.18), tachycardia (aOR 8.33, 95% CI 3.27-21.22), albumin <30g/L (aOR 3.36, 95% CI 1.58-7.13), creatine kinase >200U/L (aOR 3.68, 95% CI 1.57-8.64), D-dimer >3.0µg/mL (aOR 2.11, 95% CI 1.08-4.13), ferritin >500ng/mL (aOR 3.77, 95% CI 1.88-7.55), prothrombin time >12.7 seconds (aOR 3.22, 95% CI 1.61-6.43), and urea >6mmol/L (aOR 5.09, 95% CI 2.04-12.71). Conclusion: Identification of these associated factors of severity in MIS-C could aid in early recognition and prompt escalation of care, leading to better outcomes.

Colorectal cancer (CRC) carries a significant burden in most world regions. However, its screening uptake remains low. This study aimed to explore awareness and perspectives on CRC screening program in a multiethnic population and their preference for CRC screening decision aid. In-depth interviews were conducted until data saturation was reached. All interviews were audiotaped, transcribed verbatim, translated to English and analysed thematically using hybrid inductive and deductive approaches. 17 informants from three main ethnic groups (Malay, Chinese and Indian) with various levels of risk for developing CRC were recruited. Awareness on CRC screening program was found to be low. Majority of informants never heard of CRC screening program. Among 11 eligible informants, only five experienced CRC screening uptake. Thematic analysis of the transcripts yielded six major themes; knowledge on CRC, screening process, authority’s role, curability, willingness to screening and preference for decision aid, and theywere mapped onto the Health Belief Model. Specific multiethnic perspectives found included preference for traditional medicine coming from all ethnics, and reliance in God coming from Malay informants. Majority preferred short videos as CRC screening decision aid, in the form of animation and live-action screenplay. Exploration of perspective of CRC screening helps in producing impactful decision aids. Future efforts should focus on developing short videos that incorporate population’s perspectives and can be disseminated through electronic media.

Accessibility to Oral Health Care Services and Oral Health-Related Quality of Life Among Children with Cerebral Palsy Children with cerebral palsy (CP) are highly dependent on their caregivers to access oral health care services (OHS), which leads to unmet oral health needs that affect their oral health-related quality of life (OHRQoL). This study explored accessibility to OHS and OHRQoL among children with CP attending Community-Based Rehabilitation (CBR) centres in Kelantan by their primary caregivers. A cross-sectional study using Accessibility to Oral Health Care Services (CP2OHS) and Parental-Caregiver Perception Questionnaire (P-CPQ) was conducted on 81 children with CP and their primary caregivers. CP2OHS domains are “ability to perceive”, “ability to engage”, “ability to seek”, “ability to pay”, and “ability to reach”, while PCPQ domains include oral symptoms, functional limitation, emotional wellbeing, and social well-being. Children with CP were mostly males (63.0%), with a mean (SD) age of 10.3 (3.93) years, Gross Motor Function Classification System (GMFCS) Level V (46.9%), and Communication Function Classification System (CFCS) Level III (33.3%). Their caregivers were mainly female (85.2%), aged 43.6 (9.34) years. The mean (SD) total score for CP2OHS was 29.67 (10.81) of –56 to 56 and P-CPQ was 13.21 (5.89) of 8 to 40. There was a significant difference in accessibility scores between tertiary, lower secondary, and primary levels of education (p = 0.009); village and city/ town residents (p = 0.013); and transportation with personal car and motorcycle (p = 0.004). The Pearson analysis revealed a weak positive correlation between accessibility and OHRQoL scores (r = 0.158, p = 0.16) that was not statistically significant. Children with CP posed high CP2OHS scores and low P-CPQ scores, indicating high accessibility to OHS and high OHRQoL. Strengthening OHS utilisation among these children is crucial for a better quality of life for them.

Menawan Gunung Kinabalu: Penyakit Altitud Tinggi dan Langkah-Langkah Pencegahan PengenalanGunung Kinabalu, puncak tertinggi di Malaysia dengan ketinggian 4095 meter, merupakan destinasi popular bagi pendaki tetapi boleh mendatangkan risiko penyakit berkaitan altitud kepada para pendaki. Artikel ini bertujuan untuk membincangkan penyakit altitud tinggi dan langkah-langkah pencegahan yang boleh diambil oleh pendaki sebelum, semasa dan selepas pendakian dari segi perubahan mekanisme fisiologi.MetodologiSatu kajian literatur secara komprehensif telah dijalankan, dengan fokus kepada simptom, gejala, dan pencegahan penyakit altitud dalam kalangan pendaki. Maklumat dikumpulkan dari jurnal yang disemak oleh rakan sejawat, laporan teknikal pendakian, dan kajian lapangan berkaitan dengan Gunung Kinabalu dan pendakian di altitud tinggi.Hasil KajianPenyakit altitud tinggi seperti penyakit ketinggian akut, high-altitude cerebral oedema, high-altitude pulmonary oedema, dan beberapa penyakit lain dikupas dengan lebih mendalam. Selain itu, faktor risiko penyakit altitud tinggi turut dikenal pasti. Strategi pencegahan yang dibahagikan kepada sebelum, semasa, dan selepas pendakian kemudian dibincangkan. Antara langkah pencegahan yang berkesan termasuk persediaan fizikal badan, konsultasi dan penilaian kesihatan komprehensif pra-pendakian, aklimatisasi secara beransur-ansur, mengekalkan hidrasi, dan penggunaan ubat profilaksis seperti acetazolamide dan dexamethasone..KesimpulanSetiap pendaki yang ingin menawan gunung altitud tinggi seperti Gunung Kinabalu perlu fahami risiko penyakit altitud tinggi. Langkah pencegahan yang bersesuaian dan mencukupi bukan sahaja mampu mengurangkan risiko penyakit altitud tinggi, tetapi berjaya menawan puncak Gunung Kinabalu dan pulang dengan selamat.

Socio-Ecological Framework on Risk of Prolonged Dengue Outbreak in Seremban District: A Qualitative Study IntroductionA prolonged duration of a dengue outbreak in a locality poses a detrimental risk to the susceptible population. There have been limited studies looking into the socio-ecological factors that can be modified to break the chain of transmission. Therefore, this study aimed to explore and identify the socio-ecological attributes experienced by the health authority in the Seremban district.MethodsA qualitative study was performed using an in-depth interview (IDI) technique based on semi-structured questionnaires. Results were thematically analysed when theoretical saturation was achieved.ResultsA total of 12 respondents participated in this study, representing various backgrounds and involved in dengue control activities. There were nine modifiable socio-ecological themes generated, namely (1) illegal dumpsite, (2) illegal gardens, (3) illegal man-made structures, (4) old unused items, (5) idle damaged vehicles, (6) construction site, (7) drainage system, (8) physical structure, and (9) lack of community engagement. A model framework was conceptualised from the analysis. The health authority identified that these issues require urgent attention and collaborative action by various stakeholders.ConclusionThe identified socio-ecological factors have been a challenge for the health authority. Nevertheless, identifying these attributes signifies the key to tackling the prolonged duration of the dengue outbreak. Ultimately, a multi-agency approach and community participation are vital to ensure a sustainable vector control program.

Risks, Incidents, Guidelines, and Strategies Pertaining to Chemical Storage and Handling in Primary Healthcare – A Narrative Review Introduction Effective chemical storage and handling are critical in primary healthcare (PHC) to safeguard healthcare workers, patients, and the environment. Despite their importance, PHC facilities face unique challenges due to limited resources, inadequate monitoring, and the absence of tailored guidelines and protocols. This narrative review explores the state of chemical storage and handling practices in PHC. Methods A systematic methodology guided this narrative review, including a comprehensive literature search using PubMed, Scopus and Web of Science with defined inclusion and exclusion criteria. Given the scarcity of PHC-specific studies, a purposive selection approach was employed to incorporate evidence from broader healthcare contexts. Data extraction and thematic analysis identified key risks, documented incidents, and evidence-based strategies for improving chemical storage and handling. Results Findings reveal that improper chemical practices lead to acute health effects such as respiratory distress and chemical burns, chronic conditions like asthma and operational disruptions. Non-compliance with regulations exacerbates financial and reputational risks. Case studies, including an ammonia gas leak in Malaysia and chlorine gas exposure in the United Kingdom, highlight the severe consequences of inadequate practices. Six strategies to improve chemical storage and handling in PHC settings were identified: i) regular monitoring and risk assessments, ii) safe physical storage practices, iii) training and education, iv) use of personal protective equipment (PPE), v) incident management and response plans, and vi) inventory organization and storage efficiency. Conclusions These evidence-based strategies can mitigate risks and enhance safety. The review underscores the urgent need for PHC-specific guidelines and future research to address existing gaps and foster safer PHC environments.

Physiological Changes and Recovery After Short-Term High-Altitude Hypoxia: A Narrative Review Introduction Exposure to high altitude induces substantial physiological changes across various systems, enabling humans to withstand hypoxic environments. These physiological changes have been frequently explored and described in the existing literature. In contrast, the process of readjusting to lower altitudes, known as high-altitude de-acclimatization, remains understudied, especially for individuals who spend brief periods at high altitudes. This narrative review aims to consolidate existing research on the physiological alterations and recovery patterns experienced by individuals returning from short-term stays at high altitudes, highlighting the acclimatization and de-acclimatization processes. Methods A total of 29 articles were reviewed to extract insights from current evidence. Results The findings reveal that de-acclimatization is a complex process influenced by various factors. Cardiovascular adaptations, such as increased heart rate, cardiac output, and pulmonary artery pressure, begin to reverse upon descent but demonstrate varying recovery timelines. While heart rate typically normalises within days, stroke volume and pulmonary pressures may take weeks to months to recover fully. Similarly, respiratory adaptations, including ventilatory drive and oxygen saturation, show gradual improvement, although symptoms such as nocturnal hypoxemia and periodic breathing may persist for several days’ post-descent. Haematological parameters, such as haemoglobin and haematocrit levels, decline rapidly, yet full recovery of molecular and systemic markers may extend beyond three months. Metabolic and immune system changes, including increased oxidative stress and immune suppression persist, highlighting the long-term impact of high-altitude exposure. Hormonal fluctuations affecting reproductive health in both sexes further underscore the systemic effects of high-altitude environments. This review also highlights the need for comprehensive public health strategies, including medical consultations prior to travel to high altitude, plans for structured acclimatization and de-acclimatization protocols, and extended monitoring for vulnerable populations such as frequent high-altitude workers or hikers with pre-existing medical conditions. Conclusions Although progress has been made in understanding the physiological challenges of de-acclimatization, substantial gaps remain, particularly in the long-term implications and recovery trajectories. Addressing these gaps through targeted research will enhance guidelines for managing high-altitude transitions and safeguarding the health of diverse populations.

Impact of Compensation on Job Satisfaction Among Healthcare Workers: A Systematic Review Introduction Job satisfaction among healthcare workers is crucial for workforce retention, organizational stability, and healthcare delivery. Compensation, including salary, incentives, and fringe benefits, is a key driver of job satisfaction. This systematic review examines the impact of compensation on the job satisfaction of healthcare workers, providing actionable insights for improving healthcare organizations. Methods This systematic review followed PRISMA guidelines. A comprehensive search of PubMed, ProQuest, and Web of Science was conducted to identify studies published between 2015 and January 2024. Inclusion criteria focused on research examining the relationship between compensation and job satisfaction among healthcare workers. 12 studies met the inclusion criteria. Data were extracted, synthesized, and analyzed to identify themes related to compensation and job satisfaction. Results The review identified compensation as a key predictor of job satisfaction among healthcare workers. Despite its significance, widespread dissatisfaction and low satisfaction with compensation were reported across studies. Salary emerged as a critical factor, influencing satisfaction through its role in recognition of value and perceived equity. Incentives, particularly performance-based financing, demonstrated the potential to improve satisfaction by linking monetary rewards to performance metrics, although their effectiveness depended on robust organizational support. Fringe benefits, particularly opportunities for professional development, were found to enhance job satisfaction. Geographic and occupational differences were observed, with higher dissatisfaction in resource-limited settings and variations by location, nationality, and role. These findings highlight the multifaceted impact of compensation on satisfaction. Conclusions Equitable compensation strategies must address salary, incentives, and fringe benefits. Regular evaluations, stakeholder engagement, and benchmarking against sector standards are essential steps to enhance job satisfaction, retention, and care quality across diverse healthcare settings.

The prevalence of smartphone addiction among university students has raised concerns about its potential implications on their mental health, academic performance, and interpersonal relationships. This review aims to address the existing gap in the literature and shed light on the psychosocial impact of smartphone addiction in this crucial phase of young adults’ lives. A systematic approach was employed to identify and analyse relevant studies from reputable databases. The selection criteria encompassed studies published between January 2009 and December 2022, in university students. The review synthesises findings from 32 selected studies to present a comprehensive analysis of the psychosocial impacts of smartphone addiction. The results indicated significant associations between excessive smartphone use and adverse mental health outcomes, including increased levels of anxiety, depression, and stress among university students. Furthermore, smartphone addiction negatively influences academic performance, decreasing face-to-face communication and social isolation.