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  1. Kaur K
    BMJ Case Rep, 2023 Feb 14;16(2).
    PMID: 36787931 DOI: 10.1136/bcr-2022-251154
    Long-term prognosis of complicated traumatic injuries depends on precise treatment planning. Establishing a balance between a patient's age, prognosis, financial hurdles, and treatment needs is challenging. This case highlights the need for meticulous and realistic treatment planning to achieve long-term favourable outcomes in traumatic injuries in young adults.A young child sustained a traumatic injury that caused avulsion of #21 and intrusion along with palatal luxation of #11. The child reported to the dental clinic with intraoral swelling and pain a week after the injury. Socket preservation was done so that uniform bone contour could be achieved for implant placement at a later stage. We modified a 'Hollywood appliance' as an interim prosthesis to ensure that the ridge was not immediately loaded where socket preservation was done.After a follow-up of 3 years, there is significant bone deposition and the child is satisfied with aesthetics.
  2. Balagopal S, Nekkanti S, Kaur K
    J Contemp Dent Pract, 2021 Feb 01;22(2):134-139.
    PMID: 34257171
    AIM: The aim of this study was to examine and compare the flexural strength, shear bond strength, and fluoride-releasing ability of glass ionomer cement (GIC), Fuji IX GIC®, and a new alkasite filling material, Cention N®.

    MATERIAL AND METHODS: The materials were divided into two groups, Fuji IX GIC® (n = 30) and Cention N® (n = 30) and further divided (n = 10) to test three parameters, the fluoride releasing ability, flexural strength, and shear bond strength. Fluoride release was checked using fluoride ion-selective electrode, and flexural strength and shear bond strength were tested using universal testing machine (Intron 3366, UK).

    RESULTS: Fluoride release of Fuji IX GIC® was significantly higher compared to that of control Cention N® over a period of 21 days. Flexural strength of Cention N® was significantly higher compared to Fuji IX GIC® and there were no significant differences in shear bond strength of both the materials.

    CONCLUSION: From the results of the study, it can be concluded that Cention N® is an alkasite filling material for the complete and permanent replacement of tooth structure in posterior teeth and can be a good alternative when compared to GICs on the basis of their superior mechanical properties.

    CLINICAL SIGNIFICANCE: Cention N® is an innovative filling material for the complete and permanent replacement of tooth structure in posterior teeth and can be a good alternative when compared to GICs on the basis of their superior mechanical properties.

  3. Wilson S, Mogan S, Kaur K
    Int J Nurs Pract, 2020 Aug;26(4):e12833.
    PMID: 32189457 DOI: 10.1111/ijn.12833
    AIMS: To examine the pertinent issues discussed by endometriosis patients in Malaysia on MyEndosis Facebook group as an alternative platform for online support.

    METHODS: Using thematic analysis based on three frameworks, 120 posted messages and comments were examined from MyEndosis Facebook group-a support group for women with endometriosis from January to July 2014.

    RESULTS: Results showed the issues discussed were (a) personal struggles, (b) medication and treatment, (c) alternative medication, (d) side effects, and (e) medication recommended by doctors. While using this social medium, users found (a) emotional support, (b) esteem support, (c) information support, (d) network support, and (e) tangible assistance in their engagement with others.

    CONCLUSION: The analysis suggested that users' interactions were structured around information, emotion, and community building, which many doctors and nurses were not aware of. The group was shaped as a social network where peer users share social support, cultivate companionship, and exert social influence.

  4. Nekkanti S, Kaur K, Balagopal S, Agarwal P
    J Int Soc Prev Community Dent, 2020 11 24;10(6):759-765.
    PMID: 33437710 DOI: 10.4103/jispcd.JISPCD_339_20
    Aim and Objectives: Toothbrushing is one of the most important factors in controlling plaque accumulation and dental caries. There are vast varieties of toothbrushes available in the market. This study was designed to evaluate the effectiveness of novel chewable toothbrushes as compared to manual toothbrushes in plaque removal among 10-12-year-old children.

    Materials and Methods: This randomized controlled trial was conducted on 40 healthy children aged between 10 and 12 years of age who were randomly assigned to either of the groups: Group I--Chewable Toothbrushes and Group II--Manual Toothbrushes. Following oral prophylaxis, baseline records of oral hygiene indices (Simplified oral hygiene index (OHI-S) in indexed teeth and Turesky modification of Quigley Hein plaque index (TMQHI) were taken. Baseline Saliva samples were collected and sent for Streptococcus mutans counts. Children were then instructed to use their respective toothbrush twice daily for a week. Oral hygiene indices and S. mutans counts were repeated after 1 week.

    Results: Differences in pre-brushing and post-brushing plaque scores and salivary S. mutans counts were statistically significant when compared using paired-sample t test and independent-sample t test. There was a significant reduction in salivary S. mutans counts after using both chewable and manual toothbrushes. However, there was no statistically significant difference between the two groups (P = 0.08).

    Conclusion: Chewable toothbrushes are equally effective in plaque control when compared to manual toothbrushes. These can be a reliable alternative for children who lack manual dexterity.

  5. Mahendra Raj S, Ravindran S, Braganza MC, Kaur K, Kunnath AP
    Med J Malaysia, 2021 Nov;76(6):811-813.
    PMID: 34806665
    BACKGROUND: Coeliac disease, an autoimmune enteropathy related to gluten sensitivity was hitherto thought to be rare in Asia. Recent data however suggests that Celiac disease may be under-diagnosed in Asia.

    OBJECTIVE: The aim of this audit was to determine the frequency of histological changes compatible with Coeliac disease among patients undergoing elective diagnostic oesaphago-gastro-duodenoscopy (OGDS) under the care of a single practitioner in a Malaysian hospital.

    MATERIALS AND METHODS: The archived endoscopically obtained duodenal biopsy specimens of 241 consecutive Malaysian subjects undergoing elective diagnostic (OGDS) were reviewed by a pathologist blinded to the clinical data. Based on intra-epithelial lymphocyte counts, crypt hyperplasia and villous atrophy, each subject was assigned to one of the categories of the Modified Marsh classification for the histological diagnosis of Coeliac disease. The clinical charts of all subjects were reviewed by a single gastroenterologist blinded to the findings of the histological review.

    RESULTS: Of the 241 study subjects, 132 (54.8%) were females. There were 56 (23.2%) Malays, 90 (37.3%) Chinese, 88 (36.5%) Indians and seven (2.9%) from the other category. The median age of the study sample was 49 years (range 15- 88 years). The OGDS was done as part of screening in 15(6.2%) subjects while in the remaining it was part of the investigation of a clinical problem. Based on histological findings, none of the subjects could be assigned to a modified Marsh class of >1. The prevalence of histological changes compatible with Coeliac disease in the study was 0% (binomial exact one-sided 97.5 % confidence interval 0- 1.52%).

    CONCLUSION: In conclusion, this audit provides no evidence that active Coeliac disease is significantly under-detected among symptomatic patients presenting for diagnostic OGDS. The possibility that a significant number may have potential coeliac disease cannot be excluded.

  6. Kaur K, Varghese E, Eswara U, Goh Pei En J
    Saudi Dent J, 2023 Nov;35(7):869-875.
    PMID: 38025601 DOI: 10.1016/j.sdentj.2023.08.002
    BACKGROUND: Reports are found on long-term radiographic follow-up of teeth treated with regenerative endodontic techniques, but scarce literature is observed regarding the tissue formed in the root canal. A four-year radiographic follow-up with histologic findings in an immature mandibular premolar with dens evaginatus that underwent a regenerative endodontic procedure (REP) is presented here. After four years following REP, the tooth was extracted for orthodontic purposes thereby presenting an opportunity to report the histologic findings.

    SUMMARY: The radiographic changes included a slight root lengthening and thickening and apex closure. Histologic evaluation revealed a fibrous connective tissue with an inflammatory infiltrate in the canal space. In the apical region, cementum-like irregular mineralization developed toward the center, giving the appearance of a closed apex. Root thickening, increase in length, and radiographic closure of the apex occurred due to cemental hyperplasia.

    CONCLUSION: After 4 years following REP in an immature mandibular premolar with apical periodontitis, granulation tissue had formed in the root canal, indicating repair and not regeneration.

  7. Singh S, Zaki RA, Farid NDN, Kaur K
    Prev Med Rep, 2021 Dec;24:101585.
    PMID: 34976645 DOI: 10.1016/j.pmedr.2021.101585
    Depression is a common mental disorder that affects many adolescents worldwide. Therefore, there is a need for reliable instruments to screen for depression symptoms among adolescents. This study aims to determine the reliability of the Malay version of the Centre of Epidemiological Studies Depression Scale (CESD) among adolescents in Malaysia. A cross-sectional study was conducted among 65 adolescents ages between 12 and 14 years from two secondary schools in the Federal Territory of Kuala Lumpur from May 2017 to July 2017. Cronbach's alpha (α), McDonald's omega (ω), Spearman Brown split half reliability (rSB), and Intra-class Correlation Coefficient (ICC) were examine to determine the internal consistency and two week test-retest reliability. The overall CESD scale was found to have good internal consistency with α = 0.882 (95% CI 0.837, 0.914), ω = 0.886 (95% CI 0.837, 0.916) and rSB = 0.909. The CESD subscales, Somatic symptoms (α = 0.824; 95% CI 0.739, 0.878; ω = 0.828; 95% CI 0.738, 0.885; rSB = 0.825), Depressive affect (α = 0.822; 95% CI 0.745, 0.880; ω = 0.834; 95% CI 0.750, 0.884; rSB = 0.847) and Positive affect (α = 0.610; 95% CI 0.326, 0.721; ω = 0.612; 95% CI 0.379, 0.723 and rSB = 0.608) indicated acceptable to good internal consistency. The 2-week test-retest reliability ICC was 0.926 (95% CI 0.851, 0.961) for the total score reliability. The reliability analysis of the Malay version of CESD shows satisfactory α, ω, rSB and ICC values, therefore making it a reliable instrument to screen for depression among adolescents in Malaysia.
  8. Shanmugasiva VV, Ramli Hamid MT, Fadzli F, Shaleen Kaur KS, Abd Rahman N, Rahmat K
    Malays J Pathol, 2018 Dec;40(3):349-353.
    PMID: 30580368
    INTRODUCTION: Myofibroblastoma is a rare benign mesenchymal tumour arising from the stromal elements of the breast tissue. Histopathological variants such as classic, cellular, collagenous / fibrous, lipomatous, infiltrative, myxoid and epithelioid have been identified. Most myofibroblastomas are immunoreactive for CD34, actin, CD10 and desmin, usually express oestrogen receptor (ER), progesterone receptor (PR) and variably express androgen receptor (AR).

    CASE REPORT: We report a case of myofibroblastoma in an octogenarian male presenting with painless solitary breast lump. Mammography (digital tomosynthesis) and ultrasound showed a well-circumscribed hyperdense mass and hypoechoic, solid, oval mass with peripheral vascularity respectively. Patient underwent wide local excision.

    DISCUSSION: Diverse characteristics of myofibroblastoma on imaging necessitates histopathological analysis for an accurate diagnosis. Myofibroblastoma are often confused with fibroadenomas due to the benign imaging characteristics and with malignant neoplasia due to their wide morphological spectrum. Surgical excision is considered curative.

  9. Ng CG, Mohamed S, Kaur K, Sulaiman AH, Zainal NZ, Taib NA, et al.
    PLoS One, 2017;12(3):e0172975.
    PMID: 28296921 DOI: 10.1371/journal.pone.0172975
    BACKGROUND: Breast cancer patients often experience a high level of distress. Psychological distress is a broad construct encompass both depression and anxiety. Previous studies in examining which of these psychological symptoms (either anxiety or depression) were more significantly associated with the distress level in breast cancer patients is lacking. This study aims to compare the level of depression and anxiety between patients with different level of distress. The correlation between the changes in distress level with depression or anxiety over 12 months was also examined.

    METHODS: This study is from the MyBCC cohort study. Two hundred and twenty one female breast cancer patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS) and distress thermometer. The information on age, ethnicity, treatment types and staging of cancer were collected.

    RESULTS: 50.2%, 51.6% and 40.3% of patients had perceived high level of distress at baseline, 6 months and 1 year after diagnosis. Those with high perceived level of distress had significant higher anxiety scores even after adjusted for the underlying depressive scores (Adjusted OR at baseline = 1.28, 95% CI = 1.13-1.44; adjusted OR at 6 months = 1.27, 95% CI = 1.11-1.45; adjusted OR at 12 months = 1.51, 95% CI = 1.29-1.76). There were no significant differences in the depressive scores between the subjects with either low or high distress level. There was reduction in perceived level of distress, anxiety and depression scores at 12 months after the diagnosis. The decrease of distress was positively correlated with the reduction of anxiety scores but not the changes of depressive scores (r' = 0.25).

    CONCLUSION: Anxiety is a more significant psychological state that contributed to the feeling of distress in breast cancer as compared with depression. Levels of anxiety at diagnosis in this study would justify screening for anxiety, early identification and therapy for maintaining the psychological well-being of breast cancer patients. Further studies will be needed to measure the effectiveness of therapeutic interventions.

  10. Farhani S, Sulizah S, Siti Khalimah R, Jasrinjeet Kaur K, Nur Hidayah Z, Nur Athirah R, et al.
    Med J Malaysia, 2024 Jan;79(1):68-73.
    PMID: 38287760
    INTRODUCTION: Studies showed that vildagliptin can lower HbA1c levels by 0.8%-1%. However, there is limited data looking at vildagliptin use among suburban populations. The efficacy of vildagliptin use may differ among different populations, especially those with low socio-economic status. Thus, this study aimed to assess the HbA1c reduction after vildagliptin initiation, treatment patterns and the reason for its initiation among patients with type 2 diabetes mellitus attending outpatient clinics in Kuala Selangor District, Selangor.

    MATERIALS AND METHODS: This is a cross-sectional, retrospective study design. All patients who received vildagliptin in the Pharmacy Integrated Health System (PHIS) registry database from 2016 to 2021 were included as study samples. The exclusion criteria were being less than 18 years old and having type 1 diabetes mellitus. Patients' medical records were retrieved after sampling, and data were collected. One medical record was missing, thus SPSS analysis were performed on 144 vildagliptin users.

    RESULTS: In total, 84 females (58.3%) and 60 males (41.7%) with a mean age of 62.1 (±10.1) years were analysed in this study. Mean HbA1c pre-therapy was 8.5 ± 2.1%; while posttherapy 6 months demonstrated a mean HbA1c of 7.9 ± 1.8%. Use of vildagliptin alone or as an adjunct was associated with a mean reduction of 0.6% in HbA1c (p = 0.01). Factors influencing this HbA1c reduction were advancing age, specifically individuals aged 62 years and older (p = 0.02), patients who are already receiving insulin therapy (p=0.00) and those who express a willingness to commence insulin treatment during the counselling session prior to initiating the treatment plan (p = 0.00). Reasons for vildagliptin initiation documented by prescribers were non-insulin acceptance (n = 59, 40.97%), frequent hypoglycaemia (n = 6, 4.1%) and non-compliance with medications (n = 23, 15.9%). There was no association between demographic, medical background and reason for starting vildagliptin variables and HbA1c reduction (p < 0.001).

    CONCLUSION: This study showed that initiating vildagliptin alone or as an adjunct therapy significantly reduced HbA1c and is beneficial for uncontrolled diabetes patients. While advancing age, concurrent administration of insulin and the patients' willingness to accept insulin treatment prior to the commencement of therapy were the factors that influenced HbA1c reduction among patients receiving vildagliptin therapy, we recommend primary care providers prioritise all of the significant variables discovered before initiating vildagliptin for their patients.

  11. Kaur K, Sulaiman AH, Yoon CK, Hashim AH, Kaur M, Hui KO, et al.
    PMID: 32942770 DOI: 10.3390/ijerph17186730
    Mental health disorders (MHDs) among refugees has been recognized as a major public health issue. However, to date, there is limited evidence on the prevalence of MHDs among Rohingya refugees in Malaysia. This study aimed to examine the prevalence and associated factors of major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) among Rohingya refugees in Malaysia. A total of 220 refugees were randomly selected to participate in this cross-sectional study, conducted from June 2019 to November 2019. Perceived social support, religious orientation, food security, and sociodemographic characteristics were assessed as independent variables. The dependent variables assessed were MDD, GAD, and PTSD. The prevalence of GAD, PTSD, and MDD was reported at 92 (41.8%), 84 (38.2%), and 71 (32.3%). Several factors were significantly associated with MDD following multivariate analysis such as perceived low to moderate social support (AOR = 2.17; 95% CI 1.13, 4.19) and food insecurity (AOR = 2.77; 95% CI 1.19, 6.47). Exposure to violence (AOR = 38.46; 95% CI 16.27, 90.91) and food insecurity (AOR = 3.74; 95% CI 1.41, 9.91) were significantly associated with PTSD. Addressing these risk factors could be key in improving mental health outcomes among this vulnerable population.
  12. Kong YC, Bhoo-Pathy N, Subramaniam S, Bhoo-Pathy N, Taib NA, Jamaris S, et al.
    PMID: 28420149 DOI: 10.3390/ijerph14040427
    Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall survival (OS) of 2767 patients with invasive breast carcinoma diagnosed between 2001 and 2011 in the public hospital were compared with 1199 patients from the private hospital. Results: Compared to patients in the private hospital, patients from the public hospital were older at presentation, and had more advanced cancer stages. They were also more likely to receive mastectomy and chemotherapy but less radiotherapy. The five-year OS in public patients was significantly lower than in private patients (71.6% vs. 86.8%). This difference was largely attributed to discrepancies in stage at diagnosis and, although to a much smaller extent, to demographic differences and treatment disparities. Even following adjustment for these factors, patients in the public hospital remained at increased risk of mortality compared to their counterparts in the private hospital (Hazard Ratio: 1.59; 95% Confidence Interval: 1.36-1.85). Conclusion: Late stage at diagnosis appears to be a major contributing factor explaining the breast cancer survival disparity between public and private patients in this middle-income setting.
  13. Uma E, Nieminen P, Mani SA, John J, Haapanen E, Laitala ML, et al.
    Healthcare (Basel), 2021 Oct 20;9(11).
    PMID: 34828454 DOI: 10.3390/healthcare9111408
    Social media use among students has infiltrated into dental education and offers benefits but may also cause problems. The aim of this study was to explore and compare current social media usage among dental undergraduate students from two countries-Malaysia and Finland. A self-administered structured online questionnaire was used. WhatsApp, YouTube, Instagram, Facebook and Snapchat were the services that were most familiar to the respondents from both countries. There were differences between the students from the two countries among the most preferred platforms. The most frequently used applications were WhatsApp (91.1% of students in Malaysia and 96.1% in Finland used it very frequently) and Instagram (74.3% of students in Malaysia and 70.0% in Finland used it very frequently). Students in Malaysia spent significantly more hours per week using the platforms as study tools than students in Finland. Over 80% of the Finnish dental students reported that lack of knowledge was not an issue in social media usage, while 85% of Malaysian students felt that lack of knowledge prevented them from using social media platforms frequently. The findings offer evidence that dental students used social media extensively.
  14. Dahiya R, Rampersad S, Ramnanansingh TG, Kaur K, Kaur R, Mourya R, et al.
    Iran J Pharm Res, 2020;19(3):156-170.
    PMID: 33680019 DOI: 10.22037/ijpr.2020.15405.13075
    Synthesis of a natural proline-rich cyclopolypeptide - rolloamide A was carried out by coupling of tri- and tetrapeptide units Boc-Phe-Pro-Val-OMe and Boc-Pro-Leu-Pro-Ile-OMe after proper deprotection at carboxyl and amino terminals using carbodiimide chemistry in alkaline environment followed by cyclization of linear heptapeptide segment in the presence of base. The structure of synthesized peptide was confirmed by spectral techniques including FTIR, 1H NMR, 13C NMR, MS analyses. Newly synthesized peptide was subjected to biological screening against pathogenic microbes and earthworms. Cyclopeptide 8 possessed promising activity against pathogenic fungi Candida albicans (ZOI: 24 mm, MIC: 6 μg/mL) and Gram-negative bacteria Pseudomonas aeruginosa (ZOI: 27 mm, MIC: 6 μg/mL) and Klebsiella pneumoniae (ZOI: 23 mm, MIC: 12.5 μg/mL), in comparison to reference drugs - griseofulvin (ZOI: 20 mm, MIC: 6 μg/mL) and ciprofloxacin (ZOI: 25 mm, MIC: 6 μg/mL/ZOI: 20 mm, MIC: 12.5 μg/mL). Also, newly synthesized heptacyclopeptide exhibited potent anthelmintic activity against earthworms Megascoplex konkanensis,Pontoscotex corethruses, and Eudrilus species (MPT/MDT ratio - 8.22-16.02/10.06-17.59 min), in comparison to standard drugs - mebendazole (MPT/MDT ratio - 10.52-18.02/12.57-19.49 min) and piperazine citrate (MPT/MDT ratio - 12.38-19.17/13.44-22.17 min).
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