Introduction: Orang Asli refers to the indigenous people of Peninsular Malaysia, representing 0.6% of the Malaysian population. Vast inequality was observed regarding oral health beliefs, behaviour, and utilisation of oral health services between the Orang Asli and non-Orang Asli. The aim of the study was to explore the oral health beliefs, perceptions, and oral health service utilization behaviour among Orang Asli in the district of Bera, Pahang, Malaysia. Methods: Orang Asli’s oral health beliefs and perceptions of oral healthcare service were ascertained through four FGDs. Nineteen participants from Bera’s semi-urban and rural Orang Asli communities were convened. Emerging themes from the qualitative data were analyzed using thematic analysis. Results: Orang Asli believed that oral health is essential for an individual’s function and aesthetics. They are also aware that inadequate oral hygiene care will result in tooth decay and gum disease. Most of the Orang Asli that chewed betel nuts believed that limestone paste could cause oral cancer. The main barriers to Orang Asli accessing oral healthcare services were time constraints and distance to the nearby clinic. Conclusion: The Orang Asli believed oral health care is essential in ensuring a healthy oral condition. Despite their generational belief towards traditional healers and medication, Orang Asli in Bera had a perceived positive acceptance towards oral healthcare services.

Bimaxillary hyperhypodontia (BHH) is a very rare numeric anomaly with a prevalence of 0.002% to 3.1% described by the presence of a supernumerary tooth in the premaxilla region and a missing mandibular incisor tooth. This case highlights the multidisciplinary management of a child presenting with BHH who complies with the recommended protocol by surgically removing the supernumerary tooth and then proceeding with orthodontic treatment for function and aesthetics. A 9-year-old healthy Malay boy presented with a fully erupted tooth 21, a labially palpable bulge of unerupted tooth 11, a missing tooth 32, and a tendency for an anterior and posterior crossbite. The radiographs showed an inverted, unerupted, conical-shaped supernumerary tooth overlapping the unerupted tooth 11 and hypodontia of tooth 32. The management was surgical removal of the supernumerary tooth and the placement of an upper removable appliance with a palatal expansion screw followed by comprehensive fixed orthodontics.
Case Reports [Publication Type]

Introduction: To combat the COVID-19 pandemic, Malaysia started vaccination of front-liners and adults in the community. The latter group might have insufficient knowledge to accept COVID-19 vaccination, therefore this research was to assess the knowledge and acceptance of COVID-19 vaccination among youths, specifically students in a Malaysian college. Methods: A cross-sectional study was conducted among 481 foundation students in Kolej MARA Kulim (KMKU). The minimum sample size, using Epi Info was 214. Students answered an online questionnaire using google form which included demographic data (age, gender) and ten questions on knowledge and acceptance of COVID-19 vaccination. For knowledge questions, students answered “yes”, “no” or “don’t know”, correct answer scoring 1. For acceptance questions, a 5-point Likert scale was used ranging from “strongly disagree” to “strongly agree”. EXCEL and SPSS version 23 were used for analysis with Chi-square test done to test association (significant for p-value <0.05). Results: The response rate was 65.1% with 313 students, (45.4% males, and 54.6% females) aged 18-19 years. The majority (83.7%) had satisfactory to excellent knowledge scores (mean = 6.66 (SD=2.299, 95% CI 6.40-6.91), median = 7 (± IQR =3), while 16.3% obtained poor scores (≤ 4). The majority (90%) accepted vaccination. Higher knowledge scores were associated with higher acceptance rates in both genders (p-value= 0.000). Significantly more females (90.6%) than males (80.3%) had positive attitude towards vaccination (p-value = 0.009). Conclusions: The majority of the foundation students in KMKU were knowledgeable on COVID-19 vaccination and willing to receive the vaccination against the novel coronavirus.

ABSTRACT Dental caries is a commonly progressive disease that proceeds through various degrees of severity that a dentist can detect. The aims of the in vivo study were to assess the accuracy of the individual model (near-infrared light transillumination [NILT] device, visual and radiographic examinations) in detecting occlusal caries, and to evaluate the performance of visual and NILT device combination for occlusal caries detection in deciding the treatment options. Fifty-two non-cavitated occlusal surfaces from 16 patients were assessed with three different diagnostic devices in random order. Identified lesions were prepared and validated. Logistic regression analysis was performed for each method. The sensitivity and specificity values for each method and the combined models were statistically measured using RStudio version 0.97.551. At the enamel level, visual detection was the most sensitive method (0.88), while NILT was the most specific (0.93). NILT scored the highest for sensitivity (0.93) at the dentine level and visual detection scored the highest for specificity (0.88). Visual detection + NILT model was significantly better (p = 0.04) compared to visual detection or NILT alone (df = 1). The visual-NILT combination is a superior model in detecting occlusal caries on permanent teeth. The model provided surplus value in caries detection hence improving the treatment decision-making in occlusal surfaces.
Dental Caries Activity Tests

Purpose: There are limited data from Asian countries regarding retinal thickness in children with type 1 diabetes mellitus (T1DM). This study aimed to compare the macular and retinal nerve fiber layer (RNFL) parameters between diabetic children without retinopathy and non-diabetic healthy children. We also evaluated the factors associated with RNFL thickness in children with T1DM. Methods: A comparative cross-sectional study was conducted among children with T1DM and healthy children aged 7 to 17 years old in Hospital Universiti Sains Malaysia from 2017 to 2019. Children with retinal disease or glaucoma were excluded. Macular and RNFL thicknesses were measured using spectral-domain optical coherence tomography. Demographic information, duration of diabetes, blood pressure, body mass index, visual acuity, and retinal examination findings were documented. Glycosylated hemoglobin levels, renal function, and blood lipid levels were also collected. Results: Forty-one children with T1DM and 80 age- and sex-matched children were enrolled. Both sexes were affected. Mean duration of diabetes mellitus was 3.66 years. The mean glycated hemoglobin levels in the T1DM group was 9.99%. The mean macular and RNFL thicknesses in children with T1DM were 277.56 (15.82) µm and 98.85 (12.05) µm, respectively. Children with T1DM had a significantly thinner average macula, superior outer macula, nasal outer macula, mean RNFL, and inferior RNFL thickness compared to controls (p < 0.05). There was a significant association between nephropathy and the mean RNFL thickness. Conclusions Children with T1DM had significantly decreased mean macular and RNFL thicknesses. Nephropathy is associated with an increased RNFL thickness.

Purpose: There are limited data from Asian countries regarding retinal thickness in children with type 1 diabetes mellitus (T1DM). This study aimed to compare the macular and retinal nerve fiber layer (RNFL) parameters between diabetic children without retinopathy and non-diabetic healthy children. We also evaluated the factors associated with RNFL thickness in children with T1DM. Methods: A comparative cross-sectional study was conducted among children with T1DM and healthy children aged 7 to 17 years old in Hospital Universiti Sains Malaysia from 2017 to 2019. Children with retinal disease or glaucoma were excluded. Macular and RNFL thicknesses were measured using spectral-domain optical coherence tomography. Demographic information, duration of diabetes, blood pressure, body mass index, visual acuity, and retinal examination findings were documented. Glycosylated hemoglobin levels, renal function, and blood lipid levels were also collected. Results: Forty-one children with T1DM and 80 age- and sex-matched children were enrolled. Both sexes were affected. Mean duration of diabetes mellitus was 3.66 years. The mean glycated hemoglobin levels in the T1DM group was 9.99%. The mean macular and RNFL thicknesses in children with T1DM were 277.56 (15.82) µm and 98.85 (12.05) µm, respectively. Children with T1DM had a significantly thinner average macula, superior outer macula, nasal outer macula, mean RNFL, and inferior RNFL thickness compared to controls (p < 0.05). There was a significant association between nephropathy and the mean RNFL thickness. Conclusions Children with T1DM had significantly decreased mean macular and RNFL thicknesses. Nephropathy is associated with an increased RNFL thickness.

Leptospirosis is a common febrile illness in Malaysia. The disease is caused by pathogenic bacteria called leptospires that are transmitted directly or indirectly from animals to humans via contaminated water or soil. It is a potentially serious but treatable disease. Its symptoms may mimic those of other unrelated febrile illnesses such as dengue, influenza, meningitis, hepatitis or viral haemorrhagic fevers. The spectrum of the disease is extremely wide, ranging from subclinical infection to a severe syndrome of multiorgan infection with high mortality. The diagnosis requires high suspicion with history of exposure to water or environment possibly contaminated with infected animal urine. This is a case of a 13 year-oldgirl with no known medical illness, and a history of exposure to outdoor activities. However, paired sera for leptospirosis serology was not diagnostic. She then developed septic shock on day 14 of illness. But due to high suspicion of leptospirosis, antibiotic therapy was upgraded to ceftriaxone and samples were sent for further testing which revealed that leptospires were detected in the urine, using molecular technique. She improved after treated as leptospirosis.

INTRODUCTION: Limited data is available on paediatric orbital cellulitis in Asia. We aimed to describe demographic data, clinical presentation, predisposing factors, identified microorganisms, choice of antibiotics and management in children with orbital cellulitis treated in a tertiary care centre in Malaysia. METHODS: A retrospective review was performed on children with orbital cellulitis aged below 18 years who were admitted to Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2013 and December 2017. RESULTS: A total of 14 paediatric patients fulfilling the diagnostic criteria for orbital cellulitis were included. Their mean age was 6.5 ± 1.2 years. Boys were more likely to have orbital cellulitis than girls (71.4% vs. 28.6%). Involvement of both eyes was observed in 14.3% of the patients. Sinusitis (28.6%) and upper respiratory tract infection (21.4%) were the most common predisposing causes. Staphylococcus aureus (28.6%) was the leading pathogen. Longer duration of hospitalisation was observed in those infected with methicillin-resistant Staphylococcus aureus and Burkholderia pseudomallei. 10 (71.4%) patients were treated with a combination of two or three antibiotics. In this series, 42.9% had surgical interventions. CONCLUSION Young boys were found to be more commonly affected by orbital cellulitis than young girls. Staphylococcus aureus was the most common isolated microorganism. Methicillin-resistant Staphylococcus aureus and Burkholderia pseudomallei caused severe infection. Sinusitis and upper respiratory tract infection were the most common predisposing factors. A majority of the children improved with medical treatment alone. Our findings are in slight disagreement with other published reports on paediatric orbital cellulitis, especially from the Asian region.

PURPOSE: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor. MATERIALS AND METHODS: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. RESULTS: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved. CONCLUSION: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients.
Calibration ; Gutta-Percha ; Health Services ; Humans ; Prevalence ; Radiation Protection ; Radiographic Image Enhancement ; Radiography, Dental, Digital ; Retrospective Studies ; Semiconductors* ; Students, Dental

Aims: The present study is aimed at taxonomic characterization and isolation of active compound MS01 from Streptomyces sp. FACC-A032 which exhibited strong antitrypanosomal activity (IC50 0.02 μg/mL). Methodology and results: Isolate FACC-A032 was characterized based on its cultural, morphological, physiological and genomic properties. Isolate FACC-A032 was tentatively identified as Streptomyces sp. Biochemical analysis of diaminopimelic acid (DAP) isomer of whole-cell hydrolysates further confirmed the isolate FACC-A032 that contained LL-DAP isomer as species belonging to the genus Streptomyces. The inoculum for submerged cultures of isolate FACCA032 was prepared from cultures on ISP2 agar. After eight days of growth at 28  2 °C and 200 rpm in fermentation medium M3, fermentation broth was extracted with butanol and the crude extracts (solvent layer) were separated and dried in vacuo. Further studies were carried out to isolate the active compound from the culture extracts of isolate FACCA032. Using bioassay-guided isolation, crude extract was partitioned based on different polarity. After which, the resulting elutes were tested for antitrypanosomal activity. The active fraction was analyzed with HPLC-DAD analysis. Based on the analysis, major peak in the active fraction was collected using HPLC preparative. Active compound MS01 was isolated and structure elucidated using NMR spectroscopy. Conclusion, significance and impact of study: Bioassay-guided isolation techniques used in this study had discovered an active antitrypanosomal compound, staurosporine, from Streptomyces sp. FACC-A032. This is the first discovery of staurosporine, a protein kinase inhibitor, from Malaysian soil actinobacteria Streptomyces sp. Therefore, the study demonstrated the potential of Malaysian soil actinobacteria as antitrypanosomal therapeutic agent.
Biological Assay ; Actinobacteria