The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
Use of instruments or questionnaires in different cultural settings without proper validation can result in inaccurate results. Issues like reliability, validity, feasibility and acceptability should be considered in the use of an instrument. The study aims to determine the usefulness of the CIS-R Malay version in detecting common mental health problems specifically to establish the validity. The CIS-R instrument (PROQSY* format) was translated through the back translation process into Malay. Inter rater reliability was established for raters who were medical students. Cases and controls for the study were psychiatric in patients, out patient and relatives or friends accompanying the patients to the clinic or visiting the inpatients. The Malay version of CIS-R was administered to all cases and controls. All cases and controls involved in the study were rated by psychiatrists for psychiatric morbidity using the SCID as a guideline. Specificity and sensitivity of the CIS-R to the assessment by the psychiatrist were determined. The Malay version of CIS-R showed 100% sensitivity and 96.15% specificity at a cut off score of 9. The CIS-R can be a useful instrument for clinical and research use in the Malaysian population for diagnosing common mental disorders like depression and anxiety.
The high morbidity and mortality caused by smoking is a major public health problem today. Smoking prevention has been acknowledged and identified as a long-term measure to overcome this problem. This is a longitudinal knowledge; attitude and practice (KAP) study among form five students over l year. The response rate at follow‘up was 251/337 (74.5 %). The smoking prevalence changed after 1 year (from 29.7% to 26. 7%) after one year. The male to female smoking rates were 52.1% to 3.1% respectively. Students who smoke were found to have a positive attitude as well as poor knowledge of the risks of smoking. The initiation risk factors identified were being male and having a friend who smokes Positive peer influence also contributed to smoking cessation after a period of one year. Holistic measures that stress on micro macro and approaches such as health education programe to enhance knowledge of smoking hazards and community participation ( cooperation of school, family and community member) should be fomtulated in order to reduce initiation of smoking among the adolescents. Quit smoking programmes must also be readily available.
This descriptive cross sectional study was conducted to assess patient's satisfaction by evaluating the waiting time experienced by 27 (54%) inpatients and 23 (46%) outpatients who sought treatment at a private hospital in Selangor from 15th of May 2006 until 3rd of]une 2006. Majority of the patients (78%) were in the range between Z 1 - 40 years old and well»educated. Almost half (48%) were in the human resources employment category, 20% were in administration and marketing and 10% were professionals. Majority of them earned from RM1000-1999 (34%) and RMZ000-3999 (32%). Almost all of them (96%) agreed that the medical care that they had been receiving in the hospital was just about perfect. 98% agreed that the doctors treated them in a very friendly and courteous manner and 96% rated the care given by nurses as g0od/ excellent. 88% to 92% said that their communication with the doctors, nurses and other staff were good/ excellent. 80% waited less than 15 minutes at the registration counter, 52% waited less than 15 minutes to see the doctor and 44% waited less than 15 minutes at other places such as pharmacy and x-ray. Overall, 94% rated the level of services in the hospital as good/ excellent, Almost all (90%) would like to recommend the hospital to their friends and relatives. Our study demonstrated that the majority of the patients were satisfied with the doctors, nurses and environment of the private hospital. The average waiting time of patient before being attended to by a doctor was less than 30 minutes.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
This is a cross-sectional study to determine the association between religious perception and smoking behavior of secondary male students in Kota Bharu, Kelantan. A self-administered questionnaire survey was conducted on 526 secondary four male students from eight randomly selected schools in Kota Bharu. There were 182 (34.6%) students who were current smokers, 12 (2.3%) were ex-smokers and 332 (63.1%) were non·smokers. More than half of the current smokers (53.4%) smoked regularly. Student’s perceptions on the religious opinion on smoking were signihcantly associated with smoking behavior. Other significant risk factors were having close friends who smoke, their perceptions on benefits and negative effects of smoking and the level of
y relationship with their fathers. These factors were also found to be good predictors of student's smoking status. Health education programs to control smoking should include the religious aspect of smoking to improve it’s effectiveness.
The main objective of this study was to assess knowledge on tooth bleaching among patients visiting dental health care centres in Klang Valley. A total of 200 patients were conveniently selected and interviewed using structured questionnaires. Among the 200 respondents, 75.5% knew about bleaching. There was no statistically significant difference in knowledge of bleaching in relation to age, gender, ethnic group and income level of the patients interviewed (p>0.05) but the education level had a significant influence (p=0.049). Respondents with tertiary education had better knowledge about tooth bleaching as compared to those respondents without tertiary education. The sources of information about bleaching came from advertisements on electronic media (65.5%), articles in newspapers and magazines (14.7%), dentists (10.9%) and family and friends (8.8%). Out of the 75.5% of respondents who knew about bleaching, 18.2% had tried bleaching their teeth using either over-the-counter products or had undergone professional bleaching treatment. The commonest reasons cited for bleaching treatment were to remove coffee and tea stains (70%) and cigarette stains (16.7%). 73.3% of these patients were satisfied with the results achieved after bleaching. However, the majority of these patients (59.6%) were unsure of the safety of these bleaching products/procedures. In conclusion, 75.5% of patients interviewed in this study knew that bleaching is one of the treatment options available to improve dental aesthetics but only 18.2% have tried bleaching their teeth. Their main source of knowledge about bleaching came from advertisements on electronic media.
A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.
The aims of the study were to investigate patient satisfaction and perceived psychosocial benefit from orthodontic treatment and to relate them to factors ajfecting treatment duration and treatment standards. A total of 130 patients (mean age I5 years) who had just completed full fixed appliance therapy (removable appliance) filled questionnaires. There was high proportion of satisfaction with dentofacial appearance (98.5 %), alignment of teeth (100 %), improved mastication (99.2%) and cleaning of teeth (98.5%). About 89.2% would recommend orthodontic treatment to their friends. All surveyed were satisfied with the services provided by the orthodontic staff and kw patients were dissatisfied with the length of each appointment (3.] %), number of appointments (l.5%) and total treatment time (5.4%). The main dissatisfaction appeared to be the long waiting time to be treated during their appointments (10%}. The mean duration of treatment to complete two-arch fixed appliance was I 7.6 months (S.D. 6.8 months) and 89.2% of cases were completed within 24 months. Treatment duration was also associated with pre-treatment ovemet (r=0.23 5), ovetjet d%rence_h·om pre-treatment to post-treatment 0·=0.204} and number of extractions (r=0.305}. Multmle linear regression anahtsis of duration of treatment with these factors accounted for about 7.8% ofthe variability.
Study site: Dental clinic, Kota Kinabalu, Sabah, Malaysia
This paper looks at some of the problems encountered when cases of abuse and injuries occur in children placed in child care in an urban community in Malaysia. It is based on the study of 37 children referred to our hospital's Child Protection Services over the past four years for injuries and incidents where the child-minders came under suspicion. They constituted 12% of the 285 children referred to the Child Protection Team during that period for evaluation of suspected child abuse. Twenty six children had experienced physical trauma. Fifty eight percent of these were young infants with cranial injuries or limb fractures but no history to explain their occurrence. Four had superficial injuries from accidents secondary to inadequate supervision. The other 11 children had been sexually abused. The perpetrators in 73% of cases were either the husbands or sons of the child-minder. Ninety five percent of the incidents occured at home-based nurseries. Prospects of any punitive measures were remote in most instances due to uncertainty about the perpetrator, or insufficient corroborative evidence required in sexual abuse cases. There were three documented cases where the family refused to lodge a police report or co-operate with investigations out of a reluctance to implicate or offend the child-minders who were mainly neighbours, relatives or friends in 58% of cases. Ninety seven percent of the facilities were unregistered, making surveillance for recurrent incidents and adherence to safety standards difficult. These incidents were almost certainly an underestimate of the problem. Training of child-care providers, improved legislation and enforcement as well as education of parents to choose suitable facilities are issues which need to be tackled.
The aim of the study was to determine the characteristics and pattern of the betel/tobacco quid chewing habit in the estate Indian community. The study was conducted in 6 randomly selected estates. It involved oral mucosal examination and an interview to solicit personal data as well as history and details of oral habits. Of a total of 618 subjects studied, 19.3 % (n= 119; 89 females and 30 males) were betel !tobacco quid chewers. The youngest age of onset of betel quid chewing is 10 years. The mean frequency of chewing quid is 4.3 times/day and the mean duration of chewing is 8.1 minutes. Initiation to the habit occur at a young age and a major role is played by family and friends in initiation to the habit. Practises of adding tobacco and lime appear to have adverse effects and are associated with higher occurrences of precancer lesions in this study (p