THE USE OF HYPNOSIS AS AN ADJUNCT TO NITROUS OXIDE/OXYGEN SEDATION: A CASE SERIES It is known that managing patients with dental fear and anxiety is challenging for clinicians and patients. This series of case reports highlights the importance and benefits of dental management under clinical hypnosis as an adjunct to nitrous oxide inhalation sedation for ages six to fifteen. These treatments range from pulp therapy, extraction and minor oral surgery. Customised hypnosis scripts were utilised for each patient, and the metaphors used were tailored to the patient’s interest and preference. The intended treatment was successfully carried out in all the patients. Five cases discussed in this case series were initially indicated for treatment under general anaesthesia, but treatment was successfully carried out using hypnosis and nitrous oxide/oxygen sedation. In the two surgical cases, nitrous oxide was tapered off once local anaesthesia was achieved, and the state of relaxation was maintained using a hypnotic trance, reducing the anaesthetic agent’s utilisation. Hypnosis successfully reduces patients’ anxiety, allowing them to feel more relaxed and confident about accepting future dental treatment without the need for pharmacological intervention.

INTERPRETATION OF EMOJI® IN MALAY LANGUAGE AMONG CHILDREN IN MALAYSIA The existing dental anxiety scales for paediatric patients tend to categorize and label children according to their level of cooperation. However, human emotions are more complex, and each child is unique. Hence, a more dynamic and interactive method should be introduced for a better understanding of the patient’s current state of emotion. The aim of this study was to investigate the interpretation and understanding of children towards frequently used emoji® for the development of an emoji® dental emotional spectrum. Both online and physical surveys were conducted among 147 Malay language-speaking children aged between 4-to-16 years in Malaysia. The children were asked to interpret 30 pre-selected emoji® images in their own words using the Malay Language. The pre-selected emoji® represent happiness, neutral, fear, sadness, and anger. The interpretations were subsequently based on their similar meaning, a process that was validated by two experts in the field of linguistics. The study involved participants with an average age of 9.2 years, with the majority of them being female (61.2%). Of the 30 pre-selected emoji® images used in this study, 13 had respondent agreement exceeding 60% which was the threshold set for suitability for use in evaluating dental emotion. The remaining 17 emoji® images have a remarkable variability in the interpretation which indicates potential misinterpretation by the respondents. The 13 emoji® images range from happiness, neutral, fear, dislike, unhappy, sad, anxious, and angry with the emoji® images which represent “excited” (94.0%), “loudly crying” (97.3%) and “angry” (91.8%) had the highest agreement. Meanwhile, the emoji® images represented “confounded” and “downcast” had the least agreement among respondents (1.3%). Despite the universal meaning imposed by emoji®, the interpretations may vary in different populations and age groups. Emoji® images hold the potential to serve as a valuable tool for identifying and managing children’s behaviour.

The present study used in vitro and in silico techniques, as well as the metabolomics approach to char-acterise α-glucosidase inhibitors from different fractions of Clinacanthus nutans. C. nutans is a medicinal plant belonging to the Acanthaceae family, and is traditionally used to treat diabetes in Malaysia. n-Hexane, n-hexane: ethyl acetate (1:1, v/v), ethyl acetate, ethyl acetate: methanol (1:1, v/v), and methanol fractions were obtained via partitioning of the 80％ methanolic crude extract. The in vitro α-glucosidase inhibitory activity was analyzed using all the fractions collected, followed by profiling of the metabolites using liquid chromatography combined with mass spectrometry. The partial least square (PLS) statistical model was developed using the SIMCA P +14.0 software and the following four inhibitors were obtained:(1) 4,6,8-Megastigmatrien-3-one; (2) N-Isobutyl-2-nonen-6,8-diynamide; (3) 1′,2′-bis(acetyloxy)-3′,4′-didehydro-2′-hydro-β, ψ-carotene; and (4) 22-acetate-3-hydroxy-21-(6-methyl-2,4-octadienoate)-olean-12-en-28-oic acid. The in silico study performed via molecular docking with the crystal structure of yeast isomaltase (PDB code: 3A4A) involved a hydrogen bond and some hydrophobic interactions be-tween the inhibitors and protein. The residues that interacted include ASN259, HID295, LYS156, ARG335, and GLY209 with a hydrogen bond, while TRP15, TYR158, VAL232, HIE280, ALA292, PRO312, LEU313, VAL313, PHE314, ARG315, TYR316, VAL319, and TRP343 with other forms of bonding.