Introduction: This study was designed to determine the effectiveness of combined group Cognitive-Behavioral Therapy (CBT) in improving diabetes distress and glycemic control among 60 adults with type 2 diabetes.
Methods: Half the participants were the experimental group (n = 30), and the other half was the control group (n = 30). Group therapy consisted of eight sessions for three months. Measures obtained at pre-test and post-test included the Diabetes Distress Scale (DDS-17) and blood examination to examine the level of HbA1c.
Result: The results indicated that group CBT had significant effects on the amelioration of diabetes distress and level of HbA1c among the participants of the experimental group.
Conclusion: The effectiveness of group CBT in the maintenance of good diabetic control in people who are suffering from type 2 diabetes was successfully demonstrated.
Study site: Pusat Sejahtera (Universiti Sains Malaysia Clinic), Pulau Pinang, Malaysia
MeSH terms: Adult; Ambulatory Care Facilities; Blood Glucose; Cognition; Diabetes Mellitus, Type 2; Humans; Malaysia; Psychotherapy, Group; Cognitive Therapy; Control Groups
Introduction: Second generation antipsychotic (SGA) was linked to increased risk of metabolic syndrome. The risk varies between different SGA. We aim to study this risk by examining the co-prescription of antihypertensive, antidiabetic and lipid lowering drugs in patients prescribed with either aripiprazole, quetiapine or clozapine.
Methods: This is a retrospective cohort study based on the prescription records of a teaching hospital. Prescription records between January 1, 2013 and December 31, 2014 for
psychiatric unit were extracted. Patients with at least one prescription of any antipsychotic were included. The odds of antihypertensive, antidiabetic and lipid lowering drugs co-prescription in patients with either aripiprazole, quetiapine or clozapine were calculated.
Results: Of the 1742 study subjects, 88 patients were prescribed with aripiprazole, 175 patients with clozapine and 124 patients with quetiapine. Patients prescribed with quetiapine had
higher odds of co-prescribed with antihypertensive (OR = 1.71, 95% CI = 1.11, 2.63), antidiabetic drugs (OR = 1.81, 95% CI = 1.11, 2.95) and lipid lowering drugs (OR = 1.94, 95% CI = 1.19, 3.16). There were higher odds of co-prescription of antihypertensive (OR = 1.54, 95% CI = 1.05, 2.25), antidiabetic drugs (OR = 1.69, 95% CI = 1.10, 2.59) and lipid lowering drugs
(OR = 1.90, 95% CI = 1.24, 2.91) in patients with clozapine. However, there were no increase odds of co-prescription of the three agents in patients with aripiprazole.
Conclusion: We need to monitor the risk of metabolic syndrome in patients treated with SGA. Aripiprazole has lower risk of metabolic syndrome.
Full mouth rehabilitation of the severely collapsed dentition is one of the most challenging procedures in restorative dentistry. The treatment aims are not only to restore function with sustainable restorations and to provide patients with an aesthetic smile, but also to conserve the remaining dentition and maintain the health of supporting structures. This case report describes the complete oral rehabilitation of a patient with severely broken down dentition and loss of posterior support. Loss of posterior support will not only result in breakdown of remaining dentition in the anterior region due to occlusal overload, it also adds years to the patient’s appearance. A complete treatment plan was outlined involving multidisciplinary team treatment included sessions of oral hygiene instructions and re-assessments, a diagnostic stage with provisional overlay denture at an increased occlusal vertical dimension (OVD), endodontic treatment and retreatment, crown lengthening as well as implant surgery. Final restoration involved both fixed and removable prostheses. Maintenance review was carried out periodically after completion of treatment for two years and good outcome was observed.
Aim: Orthodontic treatment duration is variable and associated with many factors Very few studies looks at operator changes influencing treatment duration and outcome. This study aims to evaluate the influence of operator changes on treatment time and quality.
Methodology: This is a 4-year cross-sectional retrospective study of preadjusted Edgewise two-arch appliance cases treated by single/ multiple operators and finished/debonded by the author. 60 singleoperator (Group 1) and 82 multiple-operator (Group 2) cases were selected and the Peer Assessment Rating (PAR) Index was used to measure treatment outcome.
Results: Group 1 (2.31 years, SD.86) had statistically significantly shorter treatment time than Group 2 (3.25 years, SD1.23). Mean % reduction in PAR scores was high (88.7%), although single operators (92%) showed a slightly higher (p=.04) reduction than multiple-operator cases (86.2%). Post-treatment PAR score was slightly higher in Group 2 (4.6, SD5.4) compared with Group 1 (2.6, SD2.9). There was no significant difference in post-treatment PAR scores with operator changes from within and outside the clinic although there was difference in treatment duration (p=.0001). Possible predictors of treatment duration included number of failed/changed appointments, extractions and pre-treatment PAR. Multiple linear regression model showed significant association of treatment time with failed/changed appointments (p=.0001) and number of operators (p=.0001) although this contributed to 57.5% of possible factors (r=.762) .
Conclusion: Change of operator contributes to increased treatment time by 11.3 months. Although standard of treatment was high in both groups there was slightly better outcomes in single operators. The reduction in PAR score can be predicted more accurately in single operators.
MeSH terms: Appointments and Schedules; Cross-Sectional Studies; Dental Care; Humans; Retrospective Studies; Multivariate Analysis; Linear Models; Treatment Outcome
Medical emergencies or unexpected events are situations that all dental practitioners are trained to face, yet none hope they become a reality. Although they occasionally happen, the prevalence is rather low. This special article will touch on three aspects: before, during and after an unexpected event happening in a general dental practice. Emphasis will be given on the ‘during and after’ phases, which includes the activation of basic life support when necessary, and the documentation that a dental practitioner needs to prepare in the event of adverse outcome despite of efforts made to prevent and manage it.
In 2013, the Malaysian Education Blueprint (Higher Education) was developed by the Ministry of Education to guide the transformation process of the education system in this country for the next decade, starting from 2015 (1). The blueprint highlighted core aspirations for Malaysian higher education, which includes rapid expansion of research output and quality (1). This effort is in line with the nation's aspiration to uplift the standard of service provision among healthcare professionals, whose practice should advance on the essence of high quality scientific evidence.(Copied from article)
MeSH terms: Environment; Health Personnel; Humans; Research
Introduction: Cone beam computed tomography (CBCT) has gained interest for improving diagnosis, treatment planning and facilitating better patient’s management in various dental fields. This study is part of the quality assurance programme in Dental Faculty, International Islamic University Malaysia (IIUM). This center offers dental radiography service not only for internal clinics but also act as a referral center for the eastern areas, Pahang, Malaysia. Aims: The aims of this study were; 1) to assess referral pattern for CBCT scans at the Dental Faculty, IIUM, Kuantan, and 2) to evaluate the completeness of the current referral form used by clinicians (for both internal and external referrals). Methods: An audit looking at both the external and internal referral CBCT forms of a four year period of examination (2010-2013) at the Radiology Unit, Dental Faculty, IIUM. Source of referrals, indications for CBCT and the referral forms were examined and analysed. Results: Total CBCT scans taken within the four-year period were 171, in which 96 were referred from internal sources whilst 75 were external referrals. External referrals were mainly from Paediatric Dentistry and Orthodontic clinics (59%), while other referrals were from implant clinic (20%), Paediatrics and Special Needs clinic (15%), Oral MaxilloFacial Surgery clinic (4%) and Periodontic clinic (1%) and Oral Medicine Oral Pathology (OMOP) clinics (1%). All forms from external sources are completely filled. In the Internal referral form, 41% of them came with no indication of why CBCT need to be taken. Out of 59% of cases with indications, 33% came from Paediatric Dentistry and Orthodontic department, followed by Oral Surgery department (10%). Implant treatment planning accounted for 7% of cases, Periodontics 4%, Temporo-Mandibular Joint assessment 2%, 1% for Conservative dentistry and Prosthodontic cases respectively and 1% cleft case. Further analysis of the internal referral forms revealed that only 14% of the forms were filled with complete patients’ details, 40% specified pregnancy status and 67% clearly stated patients’ medical status. Area of interest was not specified in 69% of cases and clinicians’ names were not stated in 94% of the cases. Majority of the forms were completed with clinicians’ signature (99%) and also radiographers’ details (97%). Conclusions: This study indicated that the majority of IIUM CBCT referrals were from internal sources. However, most of the referral forms were not completely filled. The internal form used, therefore, need to be improved and a much firmer referral framework should be in place.
This study was conducted on Royal Malaysian Navy submariners who were having training in France. It was designed to compare the oral health experiences and practices while under water and on land. Methods Eightysix Royal Malaysian Navy (RMN) submariners, who had undergone at least one cycle (288 hours) of under water training, were selected to participate in a self-administered questionnaire survey. Results Seven percent of the respondents reported oro-facial pain and discomfort; 9.3% reported bleeding gums and 12.8% experienced halitosis while under water. Of those experience oral problems, 82% reported disruption of their daily activities while under water. The study showed that 82.5% of them brush their teeth at least twice a day and 94.2% rinse after meals when there were under water. Meanwhile studies on land showed that 90.7% of them brush their teeth at least twice a day and 96.5% rinse after meals. Flossing was not practiced by most of the respondents. Conclusion It is concluded that brushing and rinsing are practiced regularly by submariners regardless whether they are on land or under water but flossing is not a common practice both on land and under water. Dental emergencies, such as toothache, TMJ pain and discomfort do occur during submarine operations and disrupt their daily activities. This might poses a threat to submarine operations.
MeSH terms: Emergencies; Facial Pain; France; Gingival Hemorrhage; Halitosis; Military Personnel; Oral Health; Surveys and Questionnaires; Temporomandibular Joint; Toothache; Toothbrushing; Water
Forensic odontology has been an interdisciplinary part of forensic science for many years. In Malaysia, this forensic discipline has been practiced for more than two decades however it is still considered a new discipline as there are a limited number of specialists. To date, there are less than ten practicing forensic odontologists in Malaysia. Many dentists do not have a clear perception of this field, thus forensic odontology rarely becomes a career of choice. The purpose of this article is to highlight the attributes of a competent forensic odontologist and encourage dentists towards this challenging career path.
The complement cascade is a unique sequence of molecular events occurring within the vascular system in which inactive plasma proteins synthesised by the liver are activated following tissue injury (Figure ) (McGavin and Zachary, 2007). The increase permeability of blood vessels during inflammation is stimulated, at least in part, by the complement system. The complement system is a complex system of 30 serum proteins. Many early components are serine proteases that are activated sequentially to form a cascade. The complement cascade is activated through any one, or more, of four pathways: the classical, the mannan-binding lectin (MBL), the alternative and the extrinsic protease pathways (Guo and Ward, 2005; Monk et al., 2007; Ricklin and Lambris, 2007). For further information, refer (Manthey et al., 2009). (Copied from article)
Oesophageal strictures associated with doxycycline therapy in cats are a rare occurrence but several cases have been reported. A 3-month-old kitten was presented to University Veterinary Hospital, Universiti Putra Malaysia (UVH-UPM) with the primary complaint of persistent vomiting. The kitten was prescribed with doxycycline two weeks prior to presentation. Regurgitation was observed during hospitalisation. Radiographs and endoscopy performed revealed findings consistent with a megaesophagus cranial to an oesophageal stricture located at the region of the second thoracic vertebrae.
A six-year-old Thoroughbred race horse was presented with left unilateral mucopurulent nasal discharge. Endoscopic examination revealed atypical mycotic lesion within the guttural pouch in which the fungal mass was not located on any neurovascular structures. This case was successfully treated by the combination of manual debulking of fungal diphtheritic plaques and medical treatment that included daily local irrigation and systemic medication. There were no complications and the horse returned to race three weeks later.
Pelvimetry is the measurement of the dimensions of the pelvis, measured internally or externally, and is typically conducted with the aid of a pelvimeter. Intrapelvic dimensions, namely the intrapelvic height and width, are used to calculate pelvic area which has a moderate to high degree of heritability. Pelvic area measurements are associated with calving difficulty and have been used by producers to select for heifers to be included in their breeding herd.
The energy price increased significantly since the early 1970’s and it shows the pattern of all over the world.
According to the estimation of International Energy Agency (IEA), 53% global energy consumption will be increased
by 2030, with 70% of the growth in demand coming from developing countries. Malaysia is one of the most developing
countries among ASEAN countries next to Singapore, with GDP of US$15,400 per capita (PPP basis), and steady
GDP growth of 4.6% in 2009. Malaysia as a developing country focuses on the energy efficiency approach. At this
moment a lot of number of fire and electrical incident more towards overload current and the issues has been faced
trough out the year. This paper highlight the issue on how to avoid the overload current by introducing the method
establish by Energy Commission. The star (*) rating will help us to estimate the current use and the energy efficiency
approach by calculate the current load. The data collected from home appliances are the very basic information rather
than predict in a large scale as industrial and commercial building since the tariff also different in the category. The
equipment such as amp meter, volt meter and the current load data logger will help the current consumption in every
home appliances and it will show the direct reading as well. The issue on electrical safety should be response by
consumer to prevent safety and health risk.
In this research, the biodiesel from WCO is used in order to reduce the exhaust emission and to investigate the
community perception regarding to the human health. Biodiesel production is conducted using trans-esterification
process with holding time of 2 hours, temperature of 60 oC and conventional frequency of 20 kHz and then followed
by washing process with holding time of 1 hours, temperature of 50 oC and the frequency of 5 kHz. Biodiesel can
reduce exhaust emission of NOx up to 55%, NO gas up to 57%, increase CO gas up to 25% and increase CO2 gas up
to 43.18% as compared to diesel fuel. In addition, biodiesel is achieve good responds from 35 respondents about the
biodiesel importance.
MeSH terms: Air Pollutants; Vehicle Emissions; Carbon Dioxide; Esterification; Gasoline; Surveys and Questionnaires; Research; Temperature; Biofuels
In the recent years, an extensive number of scientific researches on occupational diseases have been done to
identify occupations at high risk of inducing diseases. There are many categories of occupational diseases, and unitary
of them are occupational respiratory diseases. This study was conducted in a tea factory located in Cameron Highlands,
Malaysia, with an output of 600,000.00 kg per annum. Its objective was to evaluate respiratory diseases among the
workers, conducted via questionnaires, interviews and lung functional tests. A total of 38 workers participated in this
study, 19 in the exposed group and 19 in the control group. The most common chronic symptoms for the exposed
group are wheezing, dyspnea (short of breath) and phlegm. The result shows that, among the tea processing workers,
the exposed group suffer from respiratory diseases.
MeSH terms: Dyspnea; Malaysia; Occupational Diseases; Occupations; Surveys and Questionnaires; Respiration Disorders; Respiratory Sounds; Respiratory System; Tea; Control Groups
Indoor Air Quality (IAQ) is a subset of Indoor Environmental Quality (IEQ), where IAQ is about what we
breath. Poor indoor air quality (IAQ) can cause health problems to the residents. Air conditions in the shelter must
be preserved, in order to ensure the safety and health of the residents. Certain indoor plants can filter out toxin found
in the air. Other than that, indoor plants can help clean the air. In this study, seven types of indoor plants that can live
in equatorial climate like Malaysian environment will be selected. At the initial stage, planting of all types of indoor
plants will be done, from sowing seed until all plants grow up. In the next stage, all plants will be tested to determine
their effectiveness to improve indoor air quality. The comparison of data before and after installation of indoor plants
is made. To gain the benefits of indoor plants, detailed study should be done in terms of response and monitoring of
indoor air. The reason of this study is to provide benefits to building occupants. Besides, having the interior plants as
part of decoration items may improve workers’ productivity and reduce stress.
Indoor air pollution is rapidly becoming a major health issue worldwide. The quality of indoor air inside building
is important not only for occupants’ comfort but also for their health. Although researches are still under way to
better define the nature and extent of the health implications for the general population, recent studies have shown
significant amounts of harmful pollutants in the indoor environment. Poor indoor air quality (IAQ) has been tied to
symptoms like headaches, fatigue, trouble concentrating and irritation of the eyes, nose, throat and lungs. In this study,
occupants’ comfort satisfaction on IAQ of a museum building environment in a tropical climate will be studied. IAQ
aspects which will be considered as parameters are chemical contaminants, gaseous pollutant and comfort factors
(temperature, humidity and air movement). Museum, archives, library, heritage building and gallery are the types of
buildings that can be considered as heritage building environment. At the initial stage, a pilot study will be conducted
to identify the current IAQ conditions inside those selected buildings.
Indoor air quality has been a major public concern recently. Several health effects are related to this problem.
Findings from several studies have shown MVAC system as the main contributor for IAQ problem. Good practice of
maintenance and servicing is important to maintain MVAC system, especially the filter. Good air filtration for MVAC
system is needed to make sure adequate air is received by the occupants. This paper illustrated a recent study of air
filtration for MVAC system especially for several industries that used MVAC system in their premises. This paper also
proposed an air filtration study for a better air quality. Several Acts and Regulations related to Safety and Health were
identified to create the framework for the proposed study. Air filtration technique was used in this preliminary study
to set up guidelines to create safe and clean indoor spaces for workers and occupants.
MeSH terms: Air Pollution; Filtration; Maintenance; Air Pollution, Indoor
Ergonomics can be viewed as an approach to reduce injury and illness rates to improve the overall working
conditions for employees by addressing risk factor exposure that may occur during manual tasks. The objective
of this research was to analyze ergonomics risk factors by associating the perception of employer and employees
towards their workplace condition in quarry and mining industry. A Questionnaire on Ergonomics Risk Assessment
was used to determine the comparison level awareness and perception analysis among quarry and mining industry in
Malaysia. The findings of this research prove that the exposure of ergonomics risk factors towards the workers is in
a moderate level with a mean of 3.59 for the overall respondent review about the ergonomics risk among workers at
their workplace. Besides, the most concern in ergonomics is about the awkward posture at work. Some 8.8% of them
agreed and 6.6% of them totally agreed that they were in awkward posture while doing their work. As a conclusion,
assessment of ergonomics in quarry and mining industry will be a platform to provide a safe and healthy working
environment.