Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer.
Incorporation of silver nanomaterial into polymer matrix can further accomplished their potential usage in real life
applications. In our previous study, silver nanoparticles (AgNPs) and silver-graphene oxide nanocomposites (AgGO)
were prepared via a rapid microwave-assisted method. Hereby, the as-synthesized AgNPs or AgGO was dispersed in a
chitosan solution. Subsequently, the resultant mixture solution was further coagulated in a coagulation bath containing
sodium hydroxide via a neutralization process. This resulted in the formation of spherical-shaped chitosan beads.
The structure of the beads showed that the chitosan beads embedded with AgGO exhibited a more porous structure as
compared to the plain chitosan beads. Furthermore, the chitosan beads containing AgNPs or AgGO were tested for
their antibacterial activity against Escherichia coli and Staphylococcus aureus. The antibacterial results indicated that
the silver nanomaterial contained chitosan beads could effectively inhibit the growth of both E. coli and S. aureus as
compared to the bare chitosan beads. The produced chitosan nanocomposite envisioned that can be potentially employed
for water disinfection purpose.
The effectiveness of combined nanofiltration and disinfection processes was studied by comparing the pre-disinfection and post-disinfection when in combination with nanofiltration. Four types of sulfonamide (sulfanilamide, sulfadiazine, sulfamethoxazole, and sulfadimethoxine) were chosen as substrates, with sodium hypochlorite as a disinfectant. A laboratory-scale nanofiltration system was used to conduct the following sets of experiment: (1) a pre-chlorination system, where the free active chlorine (FAC) was added to the membrane influent; and (2), a post-chlorination system, where the FAC was added to the membrane effluent. Overall, the pre-disinfection nanofiltration system showed higher sulfonamide removal efficiency compared to the post-chlorination nanofiltration system (>99.5% versus >89.5%). In the case of limited FAC ([FAC]0: [sulfonamide]0≤1), the removal efficiency for the post-chlorination nanofiltration system was higher, due to the prior nanofiltration process that could remove 12.5% to 80% of sulfonamide. The flux of the treated feed system was considerably higher than in the untreated feed system; however, the membrane was observed to be slightly damaged due to residual chlorine attack.
In daily practice of dentistry, we use same instruments on many patients. Before use, all instruments must be cleaned, disinfected, and sterilized to prevent any contamination. Pre-cleaning and sterilization of some devices can be difficult because of their small size and complex architecture. Dental burs and endodontic files are such instruments. Dental burs come in a variety of shapes and sizes, all with highly complex and detailed surface features.
Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms' formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.
The lower percentage of water, sanitation and hygiene are the root causes of diarrhoea and cholera. Cholera is a sudden onset of acute watery diarrhoea which can progress to severe dehydration and death if untreated. The current pandemic, Vibrio Cholera O1 started in 1961. This study explores water, sanitation, hygiene and cholera and diarrhoea in three affected villages of Beluran District, Sabah Malaysia to support effective and timely public health intervention. This cross sectional study uses purposive sampling. All (114) households were interviewed and household water samples collected. The study reported lower coverage improved sanitation facilities (35.3% to 52.3%), no latrine at home (37% to 63%), improved water supply (52% to 60%), and prevalence of hand washing after toilet (57% - 74%). For water quality, Ecoli was present in household water (32% to 37%) but Vibrio cholerae was not isolated in any of the water samples tested. Statistically significant associations were found for; 1) occupation−nonagriculture and unimproved sanitation facility and 2) house ownership and correct knowledge of ORS preparation. Predictors for household water quality were: latrine at home, and improved household toilet. Aggressive strategies to improve water supply, sanitation and hygiene−hand washing after toilet−were recommended for future prevention of cholera and diarrhoea in the affected area.
Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.
Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.
Method: A cross- sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.
Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001) . Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.
Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.
Biofilms are a complex group of microbial cells that adhere to the exopolysaccharide matrix present on the surface of medical devices. Biofilm-associated infections in the medical devices pose a serious problem to the public health and adversely affect the function of the device. Medical implants used in oral and orthopedic surgery are fabricated using alloys such as stainless steel and titanium. The biological behavior, such as osseointegration and its antibacterial activity, essentially depends on both the chemical composition and the morphology of the surface of the device. Surface treatment of medical implants by various physical and chemical techniques are attempted in order to improve their surface properties so as to facilitate bio-integration and prevent bacterial adhesion. The potential source of infection of the surrounding tissue and antimicrobial strategies are from bacteria adherent to or in a biofilm on the implant which should prevent both biofilm formation and tissue colonization. This article provides an overview of bacterial biofilm formation and methods adopted for the inhibition of bacterial adhesion on medical implants.
Extruded bone is a rare complication of high energy open fractures, and there is only a handful of literature on reimplantation of the extruded segment. No clear guidelines exist regarding timing of reimplantation, stabilization of extruded bone segments, and also bone disinfection and sterilization techniques. Previous reports describe sterilization using thermal or chemical methods. We present a case of successful reimplantation of an extruded metaphyseal segment of femur after gamma sterilization in a fourteen- year old boy.
Background: The public health issue of consuming groundwater is a major concern because people often extract groundwater directly from the aquifers either through wells or boreholes without treating it with any form of filtration system or chlorine disinfection. Based on the Malaysian National Drinking Water guidelines the current study was designed to provide a better understanding on the variable factors that are influencing the quality of well-water in an urbanised village in Malaysia. Well water quality assessment of heavy metals, chemicals, microbial and physical parameters were carried out for Sungai Buloh Village in the Klang Valley to ensure it was safe for human consumption.
Materials and Methods: Water samples were collected from wells at four sites (Sites A,B,C,D), a river and a tap inside a house in Sungai Buloh village. Soil was sampled from the riverbed and area surrounding the wells. Samples were collected every two months over a one year duration from all sites. The water samples were processed and examined for viruses, coliforms and protozoa as well as for heavy metal contaminants.
Results: The turbidity and colour ranged in the average of 0.57-0.13 Nephelometric Turbidity (NTU) and 4.16-5.00 Total Conjunctive Use (TCU) respectively for all sites except Site C. At Site C the turbidity level was 2.56 ± 1.38 NTU. The well-water was polluted with coliforms (1.2 to 2.4 x 103 CFU/100 ml) in all sites, E. coli (0.12 - 4 x 102 CFU/100 ml CFU/ 100 ml) and Cryptosporidium oocysts (0.4 cysts/100 ml). All the heavy metals and chemical parameters were within the Malaysian Guidelines’ limits except manganese. The average pH ranged from 5.44 - 6.62 and the temperature was 28 ºC.
Conclusion: In summary, the well water at Sungai Buloh is considered unsafe for consumption due to pollution. Therefore the major thrust will be to provide better quality of drinking water to the residents of the village.
Complete debridement and disinfection of the root canal system are fundamental requirements for successful endodontic treatment. Despite the morphological challenges of the internal root anatomy, root canal irrigants play an important role in the optimization of the root canal preparation, which is essentially a chemo-mechanical procedure. Enterococcus faecalis is one of the most resistant microorganisms that dominants the microbial ecosystem of persistent periradicular lesions in retreatment cases. For that reason, many in vitro and in vivo studies evaluated and compared the antibacterial activity of sodium hypochlorite and chlorhexidine at varying concentrations using different experimental models against this microorganism. However, many controversies with regard to the ideal irrigant and concentration do in fact exist. Hence, this review aims to discuss the antibacterial activity of these two main root canal irrigants against Enterococcus faecalis using the agar diffusion and direct contact methods and the possible modulating factors responsible for inconsistent findings among different studies. In addition, the disinfection potential of both chemical agents on gutta percha and Resilon cones are also discussed. The source of this review was conducted through an electronic literature search using PubMed database from December 1997 until December 2011, which analyze the related laboratory investigations of both irrigants, published in major endodontic journals.
A study was conducted to determine personal hygiene knowledge among 25 food handlers at 12 selected primary schools in Klang Valley area, Selangor, Malaysia. A qualitative approach using in-depth interviews was employed and respondents were selected by a convenience sampling. The results showed that the respondents had basic knowledge on personal hygiene practices, mainly on hand washing (30.7%) and glove use (18.7%). The food handlers (90%) practiced various good hand washing practices, with only 36% did not practice washing hands after eating or drinking. Most respondents (>70%) practiced glove use, however more than 50% did not wash hands with every glove change, change gloves when change type of products and after preparing raw material. The study showed that the food handlers have basic knowledge one good personal hygiene practices. However, some discrepancies were revealed in the proper hand washing procedure. This study recommended good hand washing procedure to be reiterated among the food handlers. There is also an immediate need for continuous training among food handlers regarding good personal hygiene practices.
Hand hygiene is the single, most critical measure for reducing the risk of transmitting organisms to patients and health care providers. To our knowledge, none of such study on Malaysian university student exists in the literature. Therefore, the objective was to explore the perceptions and barriers of hand's hygiene practice among university students. Methods: Focus group discussion conducted in January-2010 among 40 medical science students from Management and Science University (MSU). Simple random sampling was used, and the ethics were obtained from participants. The students were divided into five focus groups; the number of each group ranged between 8-10 members. The data obtained were classified into various categories, and the data was analyzed manually. Results: The majority of the participants mentioned that they frequently washed their hands using soap. Some of the participants washed the hands only with plain water. However, the majority of the participants mentioned that the laziness was their main barrier of frequent hand washing, followed by lack of nearby water supply and then the feeling that their hands are not dirty enough to be infected. The majority of the participants agreed that hand washing is clinically significant in reducing the spread of infectious diseases; some of them disagreed. The Majority of the participants knew the hand washing technique in the university. Conclusion: Medical science students still have some misconception and negative attitude towards hand hygiene practice. Multidisciplinary strategies needed to improve hand hygiene among students.
The application of solar disinfection for treating stored rainwater was investigated by the authors using indicator organisms. The multiple tube fermentation technique and pour plate method were used for the detection of microbial quality indicators like total and fecal coliforms, E. coli and heterotrophic plate count. These techniques have disadvantages mainly that these are laborious and time consuming. The correlation of total coliform with that of exposure time is proposed under different factors of weather, pH and turbidity. Statistical tools like root mean square error and coefficient of determination were used to validate these proposed equations. The correlation equations of fecal coliform, E. coli and heterotrophic plate count with total coliform are suggested by using four regression analysis including Reciprocal Quadratic, Polynomial Regression (2 degree), Gaussian Model and Linear Regression in order to reduce the tedious experimental work in similar types of experiments and treatment systems.
BACKGROUND AND OBJECTIVES: Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas.
MATERIALS AND METHODS: Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health.
DISCUSSION: Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas.
CONCLUSION: Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.
The protozoan parasites such as Cryptosporidiumparvum and Giardialamblia have been recognized as a frequent cause of recent waterborne disease outbreaks because of their strong resistance against chlorine disinfection. In this study, ozone and Fe(VI) (i.e., FeO(4)(2-)) were compared in terms of inactivation efficiency for Bacillus subtilis spores which are commonly utilized as an indicator of protozoan pathogens. Both oxidants highly depended on water pH and temperature in the spore inactivation. Since redox potential of Fe(VI) is almost the same as that of ozone, spore inactivation efficiency of Fe(VI) was expected to be similar with that of ozone. However, it was found that ozone was definitely superior over Fe(VI): at pH 7 and 20°C, ozone with the product of concentration×contact time (C¯T) of 10mgL(-1)min inactivate the spores more than 99.9% within 10min, while Fe(VI) with C¯T of 30mgL(-1) min could inactivate 90% spores. The large difference between ozone and Fe(VI) in spore inactivation was attributed mainly to Fe(III) produced from Fe(VI) decomposition at the spore coat layer which might coagulate spores and make it difficult for free Fe(VI) to attack live spores.
Background: Nosocomial infection is among the leading problem in many major hospitals resulting in soaring cost expenditure in managing its affect.Hand washing practice is a crucial preventive way to contain such mischief but many ignored its importance. This is perhaps due to lack of appropriate role modeling from senior practitioners.
Subjects and methods: Our study examined the prevalence of hand washing practice among medical students from year 3 to 5 and compared it to their knowledge and level of awareness on its importance in clinical practice. 142 students were randomly observed during their clinical work in the wards on this practice and questionnaires were later distributed to 268 students from all semesters on their knowledge on the technique and awareness on its importance.
Results: Out of 142, almost 80% washed their hands but only 41.6% performed effective hand washing. In contrary, 80 to 90% showed good level of knowledge and awareness as well as perception about its importance in clinical practice.
Conclusions: The contradictory findings between the actual practice of hand washing and knowledge as well as awareness suggest that enforcement on the practice is necessary. This requires motivation and cooperation from all health alliances and higher authority in the health system. Remedial measures are much needed in order to contain high incidence of nosocomial infection in our local practice.
Introduction : The focus of this paper is to evaluate effectiveness of health education material produced and identify effective educational methods in disseminating health-related information. The study explores the knowledge, attitude and practice level among flood victims in Sub-District Sri Medan, Batu Pahat.
Methodology : Convenient sampling method was adopted as a technique to get 195 respondents aged 18 years and above who had stayed in flood relief centres in the district. A set of questionnaire designed to collect data on demography, effectiveness of health education material, accessibility to education materials, preferable educational methods during flood situation, and flood victims knowledge, attitude and practices.
Result : The study found no association between knowledge level and practice of seven steps hand washing. Result showed poster was regarded as most preferable method in disseminating health related information during flood. No association was found in demographic determinants and knowledge. The length of stay in relief centre has significant association with the level of knowledge obtained.
Conclusion : The use of qualitative and quantitative methods together able to determine accurately the effectiveness of the health education materials used during the disaster as well as the impact in behavioral change.
This survey represents an initial examination of contact lens practice in Malaysia. It is based on a questionnaire that was sent to selected members of the Association of the Malaysian Optometrists to survey the prescribing habits of g contact lenses and care products. Questions included types of lenses prescribed, care systems frequently recommended and types of complications seen. Optometrists in Malaysia prescribed an average of 90 new pairs of contact lenses per year. Soft lenses made up 84% of the prescription followed by 14% of rigid gas permeable lenses and 1.5% of polymethymethacrylate lenses. Disposable/frequent replacement lenses accounted for 60% of the soft lenses prescribed. The most commonly prescribed disinfecting system was chemical disinfection. The most common complication seen during aftercare consultation was dry eye-related problems.
Disinfectants are generally used to inactivate microorganisms in solutions. The process of inactivation involves the disinfectant in the liquid diffusing towards the bacteria sites and thereafter reacting with bacteria at rates determined by the respective reaction rates. Such processes have demonstrated an initial lag phase followed by an active depletion phase of bacteria. This paper attempts to study the importance of the combined effects of diffusion of the disinfectant through the outer membrane of the bacteria and transport through the associated concentration boundary layers (CBLs) during the initial lag phase. Mathematical equations are developed correlating the initial concentration of the disinfectant with time required for reaching a critical concentration (C*) at the inner side of the membrane of the cell based on diffusion of disinfectant through the outer membranes of the bacteria and the formation of concentration boundary layers on both sides of the membranes. Experimental data of the lag phases of inactivation already available in the literature for inactivation of Bacillus subtilis spores with ozone and monochloramine are tested with the equations. The results seem to be in good agreement with the theoretical equations indicating the importance of diffusion process across the outer cell membranes and the resulting CBL's during the lag phase of disinfection.