THERAPEUTIC EFFECT OF NATURAL HERBS IN DENTISTRY: A NARRATIVE REVIEW Objectives: Natural herbs have increased attention due to their therapeutic and general health-improving qualities as reported in the literature. This review paper aims to explore the therapeutic effects of natural herbs in dentistry and to describe the various herbal sources, active compounds and its dental applications. Methodology: A literature search was conducted using WoS, Pubmed, and Scopus with the search terms ‘herbal’ AND ‘dentistry’ AND ‘alternative treatment’. Articles related to natural herbs and dental applications from the past 15 years until September 2023 were gathered. The inclusion criteria for this study were in-vitro experiments and clinical studies. Result: 512 articles were extracted from the search with 128 falling under the inclusion criteria (86 in-vitro experiments and 42 clinical studies). It was observed that 15 therapeutic properties were extensively examined, with antimicrobial studies being the most prevalent (50.0%), while the least explored properties were pulp-capping and obturation material (0.8%). Diseases such as denture stomatitis, oral candidiasis, and gingivitis were highly reported to have benefited from natural herbal medicine as an alternative treatment option. Herbals such as propolis, green tea, ginger, Zataria multiflora, chitosan, garlic, Artemisia, Schinus terebinthifolius Raddi, Uncaria tomentosa, Punica granatum, and Ricinus communis were found to be useful in the treatment of denture stomatitis. Rhizoma imperatae extract has been added to oral care products and has shown an excellent effect on reducing gingivitis. Pistacia atlantica extract mouthwash was reported to be effective against dental plaque bacteria and subgingival microorganisms. Conclusion: Numerous natural herbs have been extensively documented to have therapeutic effects in certain dental diseases as supported by laboratory and clinical studies. However, comprehensive guides such as the clinical indications, therapeutic doses and application methods were with minimal evidence that can be derived from the literature. More extensive clinical trials are to be conducted on the therapeutic efficacy of natural herbs in dentistry.

EFFECT OF A LOCALLY MANUFACTURED TOOTHBRUSHING SIMULATOR ON THE MONOMER ELUTION OF CAD/CAM RESIN COMPOSITE BLOCK - A PILOT STUDY Objective: This pilot study aimed to calibrate the high-performance liquid chromatography (HPLC) protocol for detection and quantification of monomer that may be eluted from a computer-aided design and computer-aided manufacturing (CAD/CAM) resin composite block (RCB) when subjected to an abrasion test with a toothbrushing simulator. Materials and methods: CAD/CAM RCB (Shofu Block HC) were sectioned and randomly allocated into two groups made up of Control group (CT) group (n = 4), and Toothbrush Abrasion (TA) group (n = 4). CT group was subjected to no surface treatment and TA group was subjected to a toothbrushing wear test following immersion of both groups in artificial saliva for 7 days. High Performance Liquid Chromatography (HPLC) was used to separate and identify urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA) that were eluted from the slurry produced following the toothbrushing abrasion test of the TA group and from storage solution of artificial saliva of the CT group. Results: After the toothbrush wear test, 6.192 to 16.937 ng/µL of UDMA eluted from the TA group and no UDMA was detected in the CT group. TEGDMA was not detected from both the CT and TA groups. Conclusion and clinical significance: The HPLC protocol has been calibrated and toothbrushing wear resulted in detectable UDMA released from Shofu HC Block at a level that is not harmful to the patient.

Methods: Patients with congenital scoliosis who underwent SSPPCF using a pedicle screw system were reviewed. We identified the following three surgical indications: (1) hemivertebra or wedge vertebra over the thoracic or thoracolumbar region with structural lumbar curves, (2) hemivertebra or wedge vertebra at the lumbar region with significant pelvic obliquity or sacral slanting, and (3) mixed or complex congenital scoliosis. The demographic, perioperative, and radiographic data of these patients were collected. Results: Thirty-four patients were reviewed. The mean patient age was 14.6±3.4 years. There were 13 hemivertebrae, three wedged vertebrae, two butterfly vertebrae, three hemivertebrae with butterfly vertebra, eight unsegmented bars, and five multiple complex lesions. The average surgical duration was 219.4±68.8 minutes. The average blood loss was 1,208.4±763.5 mL. Seven patients required allogeneic blood transfusion. The mean hospital stay duration was 6.1±2.5 days. The complication rate was 11.8% (4/34): one patient had severe blood loss, one had rod breakage, and two had distal adding-on. The Cobb angle reduced from 65.9°±17.4° to 36.3°±15.3° (p<0.001) with a correction rate (CR) of 44.8%±17.4%. The regional kyphotic angle decreased from 39.9°±20.5° to 27.5°±13.9° (p=0.001) with a CR of 19.3%±49.6%. Radiographic parameters (radiographic shoulder height, clavicle angle, T1 tilt, cervical axis, pelvic obliquity, coronal balance, and apical vertebral translation) showed significant improvement postoperatively. Conclusions SSPPCF was a feasible option for adolescent patients with congenital scoliosis who were skeletally matured.

Methods: Forty AIS patients were recruited. Demographic, preoperative, and postoperative data were recorded. The magnitude and characteristics of postoperative pain were assessed using the painDETECT questionnaire through telephone enquiries at intervals of 2, 6, 12, and 24 weeks. Statistical analyses were followed by Pearson correlation test to determine the relationship between pain scores at 6, 12, and 24 weeks with the risk factors. Results: Based on the painDETECT questionnaire, 90% of the patients had nociceptive pain, and 10% had a possible neuropathic pain component at 2 weeks postoperatively as per a mean painDETECT score of 7.1±4.5. Assessments at 6, 12, and 24 weeks showed that no patients had neuropathic pain with painDETECT scores of 4.4±3.2, 2.9±2.9, and 1.5±2.0, respectively. There was a significant correlation between total postoperative morphine use during 48 hours after the surgery and a tendency to develop neuropathic pain (p=0.022). Conclusions Chronic neuropathic pain was uncommon in AIS patients who had undergone PSF surgery. Higher opioid consumption will increase the possibility of developing chronic neuropathic pain.

This article aims to review the scientific data on phytochemical and pharmacological studies of Artocarpus collected from Malaysia as well as to highlight their usage as ethnomedicine worldwide. About 55 Artocarpus species are distributed worldwide and 32 of the Artocarpus species can be found in Malaysia. Artocarpus species are well known worldwide for their edible fruits such as Artocarpus heterophyllus (jackfruit), Artocarpus integer (chempedak), and Artocarpus communis (breadfruit). Aside from its edible fruits, the timber is valued for light constructions, crates, large canoes, and boats. The literature for this review was searched using the term 'Artocarpus', 'Artocarpus Malaysia', 'Artocarpus extracts', 'Artocarpus traditional medicine' and 'Artocarpus ethnomedicine' from published books and scientific journals via various engines such as The Web of Science, PubMed, Science Direct, Scopus, Research Gate, and Google Scholar. The references cited from the retrieved articles were also scanned and cross-checked. All published studies on phytochemical and pharmacological activities of Malaysia's Artocarpus species up to January 2021 were included in this review. Articles on phytochemical studies of Malaysia's Artocarpus revealed the isolation of flavonoids as the major constituents. Research on pharmacological activities of the isolated phytochemicals showed that these compounds exhibited significant disease-linked-enzyme (tyrosinase, cholinesterase, glucosidase) inhibitors as well as antioxidant, anti-inflammatory, antimicrobial, and cytotoxic activities. The ethnomedicinal data gathered are useful to understand and prioritize Artocarpus species that can contribute to potent phytochemicals and possibly new drug leads. This review also provides valuable information for the future development of isolated compounds from Artocarpus species.

Introduction: This study looked into the different anatomical locations of pain and their trajectories within the first two weeks after Posterior Spinal Fusion (PSF) surgery for Adolescent Idiopathic Scoliosis (AIS). Methods: We prospectively recruited patients with Adolescent Idiopathic Scoliosis (AIS) scheduled for PSF surgery. The anatomical locations of pain were divided into four: (1) surgical wound pain; (2) shoulder pain; (3) neck pain; and (4) low back pain. The anatomical locations of pain were charted using the visual analogue pain score at intervals of 12, 24, 36, 48 hours; and from day-3 to -14. Patient-controlled analgesia (morphine), use of celecoxib capsules, acetaminophen tablets and oxycodone hydrochloride capsule consumption were recorded. Results: A total of 40 patients were recruited. Patients complained of surgical wound pain score of 6.2±2.1 after surgery. This subsequently reduced to 4.2±2.0 by day-4, and to 2.4±1.3 by day-7. Shoulder pain scores of symptomatic patients peaked to 4.2±2.7 at 24 hours and 36 hours which then reduced to 1.8±1.1 by day-8. Neck pain scores of symptomatic patients reduced from 4.2±1.9 at 12 hours to 1.8±1.1 by day-4. Low back pain scores of symptomatic patients reduced from 5.3±2.3 at 12 hours to 1.8±1.1 by day12. Conclusions: Despite the presence of different anatomical locations of pain after surgery, surgical wound was the most significant pain and other anatomical locations of pain were generally mild. Surgical wound pain reduced to a tolerable level by day-4 when patients can then be comfortably discharged. This finding provides useful information for clinicians, patients and their caregivers.

Introduction: Atopic eczema (AE) is a common infammatory skin dermatosis that is increasing in prevalence. However, it can present in various clinical presentations, which leads to challenges in the diagnosis and treatment of the condition, especially in a primary care setting. Te Clinical Practice Guidelines on the Management of Atopic Eczema was developed by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2018. It covers the aspects of diagnosis, severity assessment, treatment, and referral.

As cognition declines with age, cognitive impairment rates are expected to increase ranging from 100% to 300% in this region. It could be higher among elderly who had any chronic diseases. The aim of the present work was to determine the prevalence and associated factors of cognitive impairment among elderly with hypertension. A clinic-based, cross-sectional study was conducted at several community clinics in Sabak Bernam and Hilir Perak districts from July to December 2015. A total of 480 patients were recruited. The prevalence of cognitive impairment was 13.13% (95%CI: 13.11, 13.15). Factors associated with cognitive impairment among elderly hypertensive were no formal educational level [OR: 3.95 (95%CI: 1.80, 8.67)]; history of high cholesterol [OR: 3.24 (95%CI: 1.15, 9.16)]; underweight [adj. OR: 4.88 (95%CI: 1.34, 17.67)]; and increasing age [OR: 1.03 (95%CI: 1.01, 1.06)]. Public health policy makers and geriatric practitioners should emphasise on early cognitive function assessment among elderlies who are hypertensive, unemployed, poor educational background, males, high cholesterol level and underweight to enhance the quality of geriatric services. Earlier establishment of diagnosis may prevent from greater rate of decline in cognitive functioning among this vulnerable group.

STUDY DESIGN: Prospective study. PURPOSE: To compare Patients' and parents’ perceptions of physical attributes (PAs) of adolescent idiopathic scoliosis (AIS) patients and to report any correlations between their perceptions and Scoliosis Research Society-22r (SRS-22r) scores. OVERVIEW OF LITERATURE: Few studies have looked into the differences between Patients' and parents’ perceptions of their appearance. METHODS: AIS patient–parent pairs (n=170) were recruited. The Patients' and parents’ perceptions of six PAs were evaluated: waist asymmetry (WA), rib hump (RH), shoulder asymmetry (SA), neck tilt, breast asymmetry (BrA), and chest prominence. These PAs were ranked, and an aggregate PA (Agg-PA) score was derived from a score assigned to the attribute (6 for the most important PA and 1 for the least important). The patients also completed the SRS-22r questionnaire. RESULTS: Ninety-nine patients (58.2%) and 71 patients (41.8%) had thoracic and lumbar major curves, respectively. WA was ranked first by 54 patients (31.8%) and 50 parents (29.4%), whereas RH was ranked first by 50 patients (29.4%) and 38 parents (22.4%). The overall Agg-PA scores were similar for patients and parents (p>0.05). However, for thoracic major curves (TMCs) >40°, a significant difference was noted between the Agg-PA scores of patients and parents for SA (3.5±1.6 vs. 4.2±1.6, p=0.041) and BrA (3.0±1.6 vs. 2.2±1.3, p=0.006). For TMCs <40°, a significant difference was found between the Agg-PA scores of patients and parents for WA (3.7±1.6 vs. 4.4±1.5, p=0.050). BrA was negatively correlated with total SRS-22r score. CONCLUSIONS: There were no significant differences between patients and parents in their ranking of the most important PAs. For TMCs >40°, there were significant differences in the Agg-PA for SA and BrA. Pa¬tients were more concerned about BrA and parents were more concerned about SA. Patients' perception of the six PAs had weak correlation with SRS-22r scores.
Adolescent ; Awards and Prizes ; Body, Physical Appearance ; Breast ; Humans ; Neck ; Parents ; Prospective Studies ; Ribs ; Scoliosis ; Shoulder ; Thorax

Pharmacology teaching during preclinical years is important for medical students to make rational choices in choosing suitable treatment for patients in future. Therefore, the present study determined the adequacy and effectiveness of pharmacology teaching in the undergraduate medical program at the Universiti Kebangsaan Malaysia Medical Center (UKMMC). Suggestions for improvement of the curriculum were also identified. An online questionnaire on the perceptions of pharmacology teaching methodology was distributed to a total of 459 medical students in 4th and 5th year at UKMMC. The questionnaire covered demographics, perceptions about pharmacology teaching, the ideal teaching learning methodology for learning pharmacology, pharmacology topics which are useful for future clinical practice, the pharmacology topic which was most interesting and recommendations for improvement. The response rate was 46.4% and majority of the participants were females (65.7%). Most of the students agreed that interactive learning was more helpful than didactic lectures (88.0%). Seventy percent of the students reported that pharmacology lectures in the preclinical years were helpful during the clinical years. Percentage of students who agreed that pharmacology teaching in their preclinical was adequate for their clinical practice was 47.0%. There was no association between demographic variables (gender, race, year of study and medical family background) and interest in pharmacology (p>0.05). In conclusion, the pharmacology teaching during preclinical years was perceived to be effective and useful for students’ clinical practice. More pharmacology teaching sessions in clinical years was suggested which may improve adequacy of pharmacology teaching.