AIM: To evaluate the cytotoxic effects of nano-hydroxyapatite-silica incorporated glass ionomer cement (HA-SiO2-GIC) on human Dental Pulp Stem Cells (DPSC) and compare it with conventional GIC and resin modified GIC.
MATERIALS AND METHODS: Material extracts of Fuji IX, Fuji II LC and HA-SiO2-GIC were prepared into seven serial concentrations and applied to 96-well-plates seeded with DPSC. The 96-well-plates were incubated for 24 and 72 hours. The morphology of DPSC was observed under the inverted phase contrast microscope, and the cell viability was determined using MTT assay at both time intervals. Kruskal-Wallis test was performed for statistical analysis.
RESULTS: At maximum concentration, DPSC appeared fewer in number, but the normal spindle morphology was maintained in all groups except for Fuji II LC. At lower concentrations, DPSC appeared normal and more confluent in all groups. The cytotoxic effects of all groups were dose dependent. Fuji IX demonstrated the lowest cytotoxicity, followed by HA-SiO2-GIC. Fuji II LC demonstrated the highest cytotoxicity. The difference was significant between all groups at 200 mg/ml concentration (p<0.05). At concentration <100 mg/ml, cytotoxicity of HA-SiO2-GIC was comparable to that of Fuji IX and lower than that of Fuji II LC.
CONCLUSION: HA-SiO2-GIC showed a favourable cytotoxicity response and thus holds promise as a future potential restorative material in clinical dentistry.
AIM: To evaluate resting tongue position in recently extracted and long term completely edentulous patients, and to evaluate the efficacy of achieving retracted tongue position by simple modification in complete denture along with certain tongue exercises.
MATERIALS AND METHODS: A total of 62 study subjects were classified into two groups based on duration of edentulousness. Group A: Recently extracted completely edentulous subjects (<1 year), Group B: Long term completely edentulous subjects (>1-10 year). The patients with retracted tongue position were subjected to a simple modification in complete denture along with inclusion of certain tongue exercises. After eight months patients were recalled and evaluated. The data was analysed using SPSS statistical tests like mean, standard deviation, proportion, Chi square test and McNemar Test.
RESULTS: Among the study subjects, 54.9% had retracted tongue position. Group B showed high proportion of retracted tongue position (68.8%) as compared to Group A. After the intervention, 42.8% study subjects gained normal resting tongue position.
CONCLUSION: Long term completely edentulous subjects presented retracted tongue position in higher percentage when compared to the recently extracted group. The interventional method employed for the subjects with retracted tongue position, played a significant role to assume normal resting tongue position and showed improvement in denture stability and retention.
AIM: To evaluate the fracture resistance and failure pattern of three different cavity designs restored with monolithic zirconia.
MATERIALS AND METHODS: Human maxillary premolars atraumatically extracted for orthodontic reasons were chosen. A total of 40 teeth were selected and divided into four groups (n=10). Group I-Sound teeth (control with no preparation). Group II-MOD Inlay, Group III-Partial Onlay, Group IV-Complete Onlay. Restorations were fabricated with monolithic partially sintered zirconia CAD (SAGEMAX- NexxZr). All the 30 samples were cemented using Multilink Automix (Ivoclar) and subjected to fracture resistance testing using Universal Testing Machine (UTM) (Instron) with a steel ball of 3.5 mm diameter at crosshead speed of 0.5 mm/minute. Stereomicroscope was used to evaluate the modes of failure of the fractured specimen. Fracture resistance was tested using parametric one way ANOVA test, unpaired t-test and Tukey test. Fracture patterns were assessed using non-parametric Chi-square test.
RESULTS: Group IV (Complete Onlay) presented highest fracture resistance and showed statistical significant difference. Group II (MOD Inlay) and Group III (Partial Onlay) showed significantly lower values than the Group I (Sound teeth). However, Groups I, II and III presented no significant difference from each other. Coming to the modes of failure, Group II (MOD Inlay) and Group III (Partial Onlay) presented mixed type of failures; Group IV (Complete Onlay) demonstrated 70% Type I failures.
CONCLUSION: Of the three cavity designs evaluated, Complete Onlay had shown a significant increase in the fracture resistance than the Sound teeth.
MATERIAL AND METHODS: This study is a cross sectional comparative study which was done between Rajayoga meditators and non-meditators. This study was conducted at BKRM Centres at Manipal and Udupi in Karnataka, India. Fifty subjects were selected for this study, which included those practising BKRM in their normal routine life (n=25) and non-meditators (n=25) who were aged 42.95+/15.29 years. Self-reported Oxford happiness questionnaire (OHQ) was administered to all subjects and their happiness scores and status were assessed and compared. Items related to self-satisfaction in life were selected from the OHQ and compared between meditators and non-meditators. Participants completed self-reported OHQ, from which data of happiness status and self-satisfaction in relation to meditation duration and frequency were analyzed by descriptive statistics and test of hypothesis.
RESULTS: Mean happiness scores of BKRM were significantly higher (p<0.001) in meditators as compared to those in non-meditators. The number of meditators experiencing happiness status were significantly higher (p<0.05) in comparison with non-meditators. Additionally, meditators scored significantly higher on self-satisfaction items (p<0.001) as compared to non-meditators. There was no correlation between age and years of meditation practice with happiness score and self-satisfaction score.
CONCLUSION: BKRM helps in significantly increasing self-satisfaction and happiness in life by enhancing positive thinking. Irrespective of age and years of short-term or long-term meditation practice, enhanced positive thinking increases self-satisfaction and happiness in life.
AIM: To evaluate the feasibility of a Dot-EIA method for Ig-class specific salivary antibody detection for diagnosis of typhoid fever.
MATERIALS AND METHODS: Paired saliva and serum samples were collected in the year 2010 from patients and normal volunteers in Hospital Universiti Sains Malaysia, Kelantan, Malaysia, which is endemic for typhoid fever. A total of 11 culture-confirmed typhoid fever patients, 43 non-typhoid fever patients and 53 normal human control subjects were evaluated for antibodies against a 50 kDa antigen specific for Salmonella Typhi using Dot-EIA.
RESULTS: Ig class-specific screening of the test samples showed a higher sensitivity for IgA (90.9%) compared to either IgG (72.7%) or IgM (72.7%) antibodies in saliva, but for serum, IgG (90.9%) had a higher degree of sensitivity compared to IgA (36.4%) and IgM (63.6%). Combining all isotypes (IgA, IgG or IgM), serum showed a higher sensitivity (100.0%) compared to saliva (90.9%). Also, the specificity for serum (100.0%) was much higher than saliva (85.4%).
CONCLUSION: Salivary IgA anti-50kDa antibody was found to be more suitable biomarker for routine screening, whereas serum IgG was more suitable for confirmatory test as it has higher specificity. Nevertheless, salivary IgA Dot-EIA is a convenient method for rapid testing, such as for Point-of-Care Diagnostics (POCD) and field epidemiological studies, due to its non-invasive nature and ease of use.
Aim: To document the CS rate, assess the pain intensity and preoperative factors that may predict post caesarean pain among women in the Obstetric unit of a Hospital Pulau Pinang in Malaysia.
Materials and Methods: A retrospective chart review of 400 caesarean deliveries was conducted between January 2013 and June 2014. The study encompassed patient's demographic data and obstetrics data. The overall pain scores since the time of surgery (2, 4, 8, 12, 24 and 48 hours postoperatively at rest and while moving) were assessed by visual analogue scale (VAS). The data were analyzed by using SPSS software (version 21.0 for Windows).
Results: The results demonstrate that within a 48 hours postoperative period, the average pain at rest and while moving was 0.40±0.013 and 0.83±0.017 (VAS score), respectively. Logistic regression identified that a higher BMI (≥30) (OR 1.056; 95% CI=1.003 to 1.113, p=0.04), an increase in operation time (> 60 minutes) (OR 1.009; 95% CI=1.000 to 1.018, p=0.049), Single women (OR 11.597; 95% CI=1.382 to 97.320, p=0.024), blood group type O (OR 1.857; 95% CI=0.543 to 2.040, p = 0.001) and general anesthesia (OR 3.689; 95% CI=1.653 to 8.232, p=0.001) were found to be independent predictors for postcaesarean pain intensity.
Conclusion: This study concluded that CS rate is 28% among women in the obstetric unit of a Hospital Pulau Pinang and the pain experienced by the study participants was mild. Moreover, the predictive factors for pain intensity may aid in identifying patients at greater risk for postoperative pain. This study concluded that the predictive methods proposed may aid in identifying patients at greater risk for postoperative pain.
AIM: To study the characteristics of pain in cancer patients and its pharmacological management by using a subjective self-assessment questionnaire and the World Health Organization (WHO)analgesic ladder for pain management.
SETTINGS AND DESIGNS: This study was conducted in the Oncology Wards of Penang Hospital, Penang, Malaysia. A questionnaire was developed to assess the pain characteristics and their effect on the patients' daily life activities and the information on the pharmacological management of the cancer pain. The cancer pain intensity was noted from the patients' medical database.
METHOD AND MATERIAL: By using the validated questionnaire, an observational, cross sectional study was conducted on the cancer patientswho were admitted in the oncology wards of Penang Hospital, Malaysia, for a period of 1 month.
STATISTICAL ANALYSIS: Descriptive statistics like mean, frequency and percentages were used for this study.
RESULTS AND CONCLUSION: A total of 42 patients out of 143, who fulfilled the criteria, were interviewed. The results showed mild pain in 66.7% (28) of the patients, moderate pain in 7.1% (3) and severe painin 26.2% (11). The normal daily life activities were affected by the pain in almost all the patients. Among the interviewed patients, sleep was affected in 88% (37) of the patients and the normal physical activity was affected in 92.9% (39) of the patients. Similarly, the pain decreased the appetite in 78.6% (33) of the patients, it affected the personal relationship in 35.7% (15), it affected the emotion in 71.5% (30) and it affected the visual activity in 33.6% (13) of the patients. Mild pain with distressing symptoms was not treated with any analgesic or adjuvant medications in 40.5% (17) of the patients. In contrast, all the patients with moderate and severe pain were treated with medications. Among them, 66.7% (2) of the patients with moderate pain and 90.9% (10) of the patients with severe pain were treated with analgesics as per the WHO analgesic ladder. The WHO analgesic ladder guide for pain management was followed in a majority of the cases, when analgesics were prescribed. However, there was inadequate treatment of the cancer pain in many patients with mild pain and, consequently, their quality of life was largely affected.
MATERIALS AND METHODS: Total 120 freshly extracted human mandibular incisor teeth were collected and separated into six subgroups of 20 teeth each. Two different wires, a 0.036 inch hard round stainless steel (HRSS) wire sandblasted at the ends and 0.0175 inch multistranded wire bonded onto the lingual surfaces of the incisors with three different types of composite resins of 3M company; Concise Orthodontic (self-cure), Transbond XT (light-cure) and Transbond LR (light-cure). Specimens were further sealed with a nail varnish, stained with 0.5% basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-composite and wire-composite interfaces. Statistical analysis was performed by Kruskal-Wallis and Mann-Whitney U-tests.
RESULTS: For HRSS wire, at the enamel-composite interface, the microleakage was least with Transbond LR followed by Concise Orthodontic and greatest for Transbond XT (p<0.05). At the wire composite interface too, the microleakage was in order of Transbond LR
AIM: The aim of this study was to translate and determine the validity and reliability of the Malaysian versions of Parent and Children Health Survey for Asthma.
MATERIALS AND METHODS: Questionnaires were translated to Bahasa Malayu using previously established guidelines, data from 180 respondents (asthmatic children and their parent) were analysed using Rasch-Model; as, it is an approach that has been increasingly used in health field and also it explores the performance of each item rather than total set score.
RESULTS: The internal consistency was high for the parent questionnaire (CHSA) (reliability score for persons = 0.88 and for items was 0.97), and good for child questionnaire (CHSA-C) (reliability score for persons = 0.83 and for items was 0.94). Also, this study shows that all items measure for both questionnaires (CHSA and CHSA-C) are fitted to Rasch-Model.
CONCLUSION: This study produced questionnaires that are conceptually equivalent to the original, easy to understand for the children and their parents, and good in terms of internal consistency. Because of the questionnaire has two versions one for the child and the other for the parents, they could be used in clinical practice to measure the effect of asthma on the child and their families. This current research had translated two instruments to other language (BahasaMalayu) and evaluated their reliability and validity hence will help researchers from the same country to use these translated instruments in their studies.
MATERIALS AND METHODS: Seventy two probands that were referred to division of Human Genetics, St.John's Medical College, Bangalore with variable complaints and phenotypic features were diagnosed with informed consent as Klinefelter syndrome with a confirmed karyotype. The Karyotype was prepared by peripheral lymphocyte culture and GTG banding method. The parental origin was studied in 9 families of Klinefelter probands with standard protocol for GENE SCAN using X-chromosome specific Short Tandem Repeat markers. The outcome was analyzed to determine the parental origin by GENE MAPPER.
STATISTICAL ANALYSIS: STATISTICAL ANALYSIS was conducted to ascertain the significance of parental origin of supernumerary X with the phenotypic profile with confirmed karyotype.
RESULTS: Seven of nine probands had 47, XXY karyotype and 2 were mosaic with 47,XXY/46,XY karyotype. Five probands had their supernumerary X from maternal side and four were paternally derived. Sixteen features as framed proforma were tabulated against the originated X in Klinefelter probands. 55.56% of Klinefelter stigmata were seen in prob and who had maternally derived X and the rest were with paternal X.
CONCLUSION: The findings of the present study points on parent-of-origin effect on clinical profile and indicate that the imprinted X chromosome genes show differential effect general and systemic traits.
MATERIALS AND METHODS: Sixty human premolar teeth were selected and were randomly grouped, with 20 specimens in each group: group 1 - fluoride releasing dentin bonding agent; group 2 - antibacterial containing dentin bonding agent; and group 3 - one step conventional self etch adhesive. Each group was treated with its respective bonding agents, composite resin build up was done, and shear bond strengths were tested using Instron Universal testing machine. Few of the specimens were tested under SEM.
RESULTS: The results were statistically analysed using One-way ANOVA and paired t-test. It was observed that group 3 has the highest shear bond strength followed by group 2, and then group 1. Adhesive failures and mixed failures were most frequent types of failures as seen under SEM.
CONCLUSION: Addition of antimicrobial agent decreases the bond strength of dentin bonding agent and addition of fluoride further decreases the bond strength. From SEM results it can be concluded that the zone of failure could not be defined and also that the failure mode was independent of the dentin bonding agent used.
AIM: The study aimed to explore the prevalence of osteoporosis conditions in Malaysians with chronic warfarin patients using calcaneal quarter of Quantitative Ultrasound (QUS) machine and to investigate whether long-term sodium warfarin therapy that antagonizes vitamin K is affecting the increasing rate of osteoporosis in Penang and to find the risk factors of getting osteoporosis among warfarin users and its non users.
MATERIALS AND METHODS: A case-control study was conducted among 130 patients using warfarin, attending the outpatient clinic at Hospital Pulau Pinang. A convenience sampling method was used to recruit the required sample. Another 140 subjects were selected from the community as a control group (non-users of warfarin).
RESULTS: This study showed that more than three-quarter patients (82%) were at high risk of abnormal BMD. The warfarin users were two times more likely to have a higher osteoporosis risk compared to control group. Moreover, BMD has a negative correlation with age, but has a positive correlation with Body Mass Index (BMI). Patients showed a negative correlation with a higher dose of warfarin intake.
CONCLUSION: This study concluded that osteopenia and osteoporosis are serious problems between users and non-users warfarin in Penang. Therefore, it should be taken into consideration in the Malaysian Health Ministry's agenda.
AIM: The main aim of this study was to translate and validate the Malaysian versions of Perceived Diabetes Self-Management Scale (PDSMS), Medication Understanding and Use Self-Efficacy Scale (MUSE), and to revalidate 8-Morisky Medication Adherence Scale (MMAS-8) by Partial Credit Rasch Model (Modern Test Theory).
MATERIALS AND METHODS: Permission was obtained from respective authors to translate the English versions of PDSMS, MUSE and MMAS-8 into Malay language according to established standard international translation guidelines. In this cross-sectional study, 62 adult DM patients were recruited from Hospital Kuala Lumpur by purposive sampling method. The data were extracted from the self-administered questionnaires and entered manually in the Ministeps (Winsteps) software for Partial Credit Rasch Model. The item and person reliability, infit/outfit Z-Standard (ZSTD), infit/outfit Mean Square (MNSQ) and point measure correlation (PTMEA Corr) values were analysed for the reliability analyses and construct validation.
RESULTS: The Malay version of PDSMS, MUSE and MMAS-8 found to be valid and reliable instrument for the Malaysian diabetic adults. The instrument showed good overall reliability value of 0.76 and 0.93 for item and person reliability, respectively. The values of infit/outfit ZSTD, infit/outfit MNSQ, and PTMEA Corr were also within the stipulated range of the Rasch Model proving the valid item constructs of the questionnaire.
CONCLUSION: The translated Malay version of PDSMS, MUSE and MMAS-8 was found to be a highly reliable and valid questionnaire by Partial Credit Model. The Malay version was conceptually equivalent to original version, easy to understand and can be used for the Malaysian adult diabetic patients for future studies.