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Background: Blockchain technology provides a secure and decentralized platform for storing and transferring sensitive medical data, which can be utilized to enable remote medical consultations., Aim: A theoretical framework for creating a blockchain-based digital system created to facilitate telemedicine system., Results: This paper proposes a theoretical framework based on Hyperledger fabric for creating a blockchain-based digital entity to facilitate telemedicine services. The proposed framework utilizes blockchain technology to provide a secure and reliable platform for medical practitioners to interact remotely with patient transactions., Conclusion: The blockchain will serve as a one-stop digital service to secure patient data, ensure privacy, and facilitate payments. The proposed framework leverages the existing Hyperledger fabric platform to build a secure blockchain-assisted telemedicine platform., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Objective: The objective of this review is to determine the utilisation and adoption of teledentistry based solutions and technologies during the Covid-19 Pandemic in the Asean region., Background: Teledentistry is a branch of telemedicine that has rapidly advanced in the last few years and has the potential to provide solutions to oral health problems of patients and locations that do not have prompt and immediate access to a dentist or dental services. The Covid-19 has increased the adaption of all digital health technologies and teledentistry is no exception., Methodology: The study utilized online databases such as Pubmed (Medline), Scopus (Embase) and CINAHL for the purpose of document search. Newcastle Ottawa (NOS) scale was used to determine the quality of the studies included in our systematic review. PRISMA guidelines were used as the criteria for reporting items in the systematic review., Results: A total of 1297 documents were found after applying the search criteria and the keywords for the selected study. After applying the Prisma guidelines, removal of duplicates and irrelevant entries, 10 studies that were conducted during the Covid-19 pandemic were selected, fitting the inclusion criteria. All the studies included were evaluated for quality and risk of bias through the Newcastle Ottawa scale. Only high-quality studies were included for the final review., Conclusion: Teledentistry is a cost-effective solution to screen, diagnose and treat dental patients from a distance. Teledentistry also has the potential to continue seamless continuation of dental education to dental students, during disruptive and non-disruptive periods. ASEAN countries should fully utilise the potential of teledentistry, however sound and effective legislation would be the key first step to achieving that potential., (© 2024. The Author(s).)

Aim: Empathic behaviour has a direct link to the positive clinical outcomes. Health professionals, which include dietitians, are increasingly expected to demonstrate the impact of their care on patient outcomes. To date, there is limited research exploring the empathic behaviour of dietetics students., Methods: This cross-sectional study evaluated the psychometric properties of Jefferson Scale of Empathy-Healthcare Provider Student (JSE-HPS) and empathic behaviour of dietetics students., Results: Undergraduate dietetics students from one private and two public universities in Malaysia participated (n = 455). Item and scale psychometric properties were examined using principal component analysis and differences in mean empathy scores for students were assessed across years of study and types of universities. A 3-factor solution emerged in the results, accounting for 26.76%, 10.75% and 6.3% of the variance. The JSE-HPS demonstrated good internal consistency (α = 0.83). Despite students enroled at public universities scoring higher mean empathy scores than students enroled at the private university, the difference was not significant. The only significant difference was between the empathy level of first and third year students (p = 0.033)., Conclusion: As empathy underpins patient-centred management in the nutrition care process, it should be well integrated into curriculum delivery so that appropriate levels of empathy can be developed to prepare work-ready healthcare professionals., (© 2023 John Wiley & Sons Ltd.)

Objective: Entrustable professional activities (EPAs) are tasks that a person who is qualified or is in the process to be credentialed are allowed to engage. There are several levels of entrustment based on degrees of supervision assigned to each EPA. This paper aims to describe the process and outcome of creating EPAs; validate EPAs relevant to undergraduate dental training., Methods: A draft set of EPA statements was developed based on the consensus of an expert panel. These were then mapped to the nationally determined minimum experience thresholds (clinical and procedural experiences/competencies) and aligned to task-based instructional strategy. The EPAs were validated to improve the relevance by using a criterion-based rubric., Results: An end-to-end process workflow led to the development of an EPA-based educational framework to bridge the gaps in the curriculum. The process identified a total of 41 EPAs and out of which, 10 EPAs were notated as core EPAs and will be subjected to structured workplace-based assessment complying to the national standards. The validation exercise rated core EPAs with an overall score matching close to the cut-off of 4.07 (Equal rubric)., Conclusion: The end-to-end process workflow provided the opportunity to elaborate a structured process for the development of EPAs for undergraduate dental education. As validation is a continuous process, feedback from implementation will inform the next steps., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Monkeypox caused by the Monkeypox virus, a member of the Orthopoxvirus genus, is currently considered a major concern among healthcare authorities due to its high transmissibility rate. Currently, no specific treatment is available for this disease, due to which healthcare professionals, specifically Dentists, are required to look out for symptoms at early stages to prevent its spread., Objective: To analyze the role of dentists in identifying Monkeypox cases and limiting its spread., Methods: We conducted a scoping review on monkeypox and its oral manifestation. PRISMA protocols were observed in data collection. The relevant literature search was conducted in relevant databases like PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. Relevant articles related to Monkeypox, and Dentistry were included in the final review. Articles published from March 2022- September 2022 were included in the review. Keywords and Mesh words related to monkeypox, and dentistry were used as part of the search strategy., Results: A total of 1881 articles were reviewed, among which 7 articles were included. Dentists were strongly advised to be on high alert for Monkeypox symptoms due to their close contact with patients. Around 70% of Monkeypox cases reported oral lesions at early stages, which requires a differential diagnosis from other oral lesions. Considering this, dentists should be well-versed in this new and emerging threat., Conclusion: Although dentists have been shown to play an important role in the treatment of monkeypox, there is insufficient data available. More research on dentistry and monkeypox will be needed in the near future.

Objectives: This paper reports on the effect of 6-month dental home visits compared to no dental home visits on 24-month caries incidence in 5- to 6-year-olds., Methods: 5- to 6-year-olds attending kindergartens were randomized to receive either 6-month dental home visits and education leaflets (Intervention group) or education leaflets alone (Control group) over 24 months. To detect a 15% difference in caries incidence with a significance level of 5% and power of 80%, 88 children were calculated to be needed in the Intervention group and 88 in the Control. Baseline clinical data included oral examinations at the kindergartens. Follow-up visits were made on the 6th, 12th and 18th month. At the end of the 24 months, both the Intervention and Control groups were visited for oral examinations. The primary outcome was caries incidence, measured by the number and proportion of children who developed new caries in the primary molars after 24 months. The secondary outcome was the number of primary molars that developed new caries (d-pms). Frequency distributions of participants by baseline socio-demographic characteristics and caries experience were calculated. The chi-square test was used to test differences between the caries experience in the Intervention and Control groups. The t test was used to compare the mean number of primary molars developing new caries between the Intervention Group and the Control Group. The number of children needed to treat (NNT) was also calculated., Results: At the 24-month follow-up, 19 (14.4%) developed new caries in the Intervention Group, compared to 60 (60.0%) in the Control Group (p = .001). On average, 0.2 (95% CI = 0.1-0.3) tooth per child in the Intervention Group was observed to have developed new caries compared to 1.1 (95% CI = 0.8-1.3) tooth per child in the Control Group (p = .001). The number of children needed to treat (NNT) to prevent one child from developing new caries was 2.2., Conclusions: The present study has demonstrated that 6-month home visits to families of 5- to 6-year-olds are effective in caries prevention in 5- to 6-year-olds of low-income families in a middle-income country where access to health services, including oral health promotion services, is limited., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study's objective was to examine L-arginine (L-arg) supplementation's effect on mono-species biofilm ( Streptococcus mutans / Streptococcus sanguinis ) growth and underlying enamel substrates. The experimental groups were 1%, 2%, and 4% arg, and 0.9% NaCl was used as the vehicle control. Sterilised enamel blocks were subjected to 7-day treatment with test solutions and S. mutans / S. sanguinis inoculum in BHI. Post-treatment, the treated biofilms stained for live/dead bacterial cells were analysed using confocal microscopy. The enamel specimens were analysed using X-ray diffraction crystallography (XRD), Raman spectroscopy (RS), and transmission electron microscopy (TEM). The molecular interactions between arg and MMP-2/MMP-9 were determined by computational molecular docking and MMP assays. With increasing arg concentrations, bacterial survival significantly decreased ( p < 0.05). The XRD peak intensity with 1%/2% arg was significantly higher than with 4% arg and the control ( p < 0.05). The bands associated with the mineral phase by RS were significantly accentuated in the 1%/2% arg specimens compared to in other groups ( p < 0.05) . The TEM analysis revealed that 4% arg exhibited an ill-defined shape of enamel crystals. Docking of arg molecules to MMPs appears feasible, with arg inhibiting MMP-2/MMP-9 ( p < 0.05). L-arginine supplementation has an antimicrobial effect on mono-species biofilm. L-arginine treatment at lower (1%/2%) concentrations exhibits enamel hydroxyapatite stability, while the molecule has the potential to inhibit MMP-2/MMP-9.

Background: The aim of this cross-sectional study was to evaluate the effect of family functioning on oral health related quality of life (OHRQoL) and dental caries status among 4- to 6-year-old Chinese pre-school children in Malaysia., Methodology: This study was approved by the institutional Joint Research and Ethics Committee, International Medical University, Malaysia (number 373/2016); consisted of 180 eligible pre-school children from a private school. Study tools included demographic, clinical oral health data form, the Early Childhood Oral Health Impact Scale (ECOHIS) and family functioning-12-item general functioning subscale. Written consent was sought prior to data collection. Data were analysed by SPSS v.22.0; descriptive statistics for socio-demographic details, clinical information, HRQoL and FAD scores. The parametric tests included independent sample t test and ANOVA to evaluate the associations between the dependent variable. Binary logistic regression models were applied to assess the impacts on OHRQoL (P value < 0.05)., Results: A response rate of 80.5% was achieved. Sample means for FAD-GF12 scores ranged < 2, indicating normal family functioning. The ECOHIS scores mean was 0.52 (SD = 0.68). In the children impact section the highest score of impacts 20 was noted followed by family impact section with the score of 12. It was observed that children with dental caries had a significant (P = 0.014) negative impact on OHRQoL (mean 0.72, SD = 0.50) as compared to children with no caries (mean 0.34 SD = 0.39). The bivariate regression analysis after getting adjusted indicated three predictors associated to poor HRQoL: having two or more siblings (OR = 4.73, P = 0.013), relationship (mother) of the respondent to the child (OR = 2.86, P = 0.013) and having dental caries (OR = 8.12, P ≤ 0.001)., Conclusion: Findings of this study indicates that number of siblings, relationship of the respondent to the child and dental caries status are independently associated with health-related quality of life. However, family functioning does not mediate poor HRQoL in association to dental caries., (© 2021. The Author(s).)

Introduction: Medical schools have reported on the integration of humanities, through literature, which offer diverse content and approaches that can be used to enhance patient care. The integration of humanities in dental education is a recent development. At the International Medical University (IMU) Malaysia, a literature module which focused on perspective taking activities was offered to the Bachelor of Dentistry program. We aimed to study if the module impacted dental students' understanding of patient care., Methods: Third-year undergraduate dental students were facilitated to discuss stories, engage in perspective taking activities and keep a portfolio for assessment in the Stories and Perspectives selective. Thematic analysis was used to analyze the data in their portfolios., Results: The dental students identified key learning points that would better prepare them for patient-centered care. Three themes emerged: (1) facilitate empathy in students, (2) stimulate self-awareness in students, and (3) motivate students to be perceptive communicators. Students were able to appreciate the complexities of care giving as it involved taking into account the thoughts and feelings of the other while recognizing their own mental state. They further valued the choice of appropriate words and actions in mediating this process., Conclusion: The potential for incorporating humanities based approaches to teach patient care to dental students is favorable. Reading stories and extending this to perspective taking activities to induce creative ways to shift between experiences of self and other is a positive approach in preparing health professionals for care giving encounters.

Objective: Tooth pain among adolescents is a common event that impacts substantially on quality of life. The purpose of this paper is to explore the role of race in the tooth pain experience and associated care-seeking., Design: A cross-sectional questionnaire survey was conducted on 14-18 years from four different public schools in Kuala Lumpur. Socio-demographic, pain symptoms, and social impacts data were collected as well as medication use and visiting a dentist for tooth pain., Results: Of 1473 questionnaires distributed, 1452 (98.6%) completed questionnaires were returned, with 269 (18.5%) reported having experienced tooth pain in the past 1 month. Those who identified as Indian (26.1%) were more likely to report tooth pain compared to Chinese (16.5%) and Malay (20.9%). In regression analysis, no factors were identified as independently associated with medication use, but Chinese and Indians compared to Malays, and those expressing difficulty sleeping were more likely to report visiting a dentist for treatment., Conclusion: Racial variations in the tooth pain experience and care-seeking have been identified. This may be related to socio-economic status, but further research is needed on the role of culture-related care-seeking and accessibility of dental services.

Background and Objectives: Various devices have been used to maintain oral hygiene. These include toothbrush and toothpaste, mouthwash, dental floss, miswak, and toothpick. This study attempts to investigate the use of various oral cleaning devices and their perceived benefits among Malaysians., Methods: A quantitative cross-sectional study conducted in two different cities of Malaysia. A convenience sampling approach was adopted. A total of 787 participants agreed to participate in the current research. A validated questionnaire translated into national language was used for data collection., Statistical Analysis Used: Data analysis was performed using Statistical Package for Social Sciences version 20., Results: About 302 respondents were in the age range of 18 - 25 years old (38.4%). There were marginally more females (55.7%) than males (44.3%). Although 99.9% of the participants used a toothbrush, a significant majority ( n = 590, 75%) used more than a single device to maintain their oral hygiene. Only 311 respondents knew that toothpicks were inappropriate to use to remove food between teeth and gums, while a majority ( n = 592, 75.2%) did not realize that some mouthwashes can stain the teeth. Less than half (42.1%) knew that improper use of miswak might harm the teeth., Conclusions: Although their oral hygiene behaviors are relatively at a higher level, their perceived oral health benefits did not compare well.

Empathy has been identified as a crucial foundation in building an effective dentist-patient relationship. The aim of this study was to assess patients' perceptions of dental students' empathic care in the primary oral health care clinic at International Medical University in Kuala Lumpur, Malaysia in May-October 2014. The study also assessed the validity and reliability of the Consultation and Relational Empathy (CARE) Measure in this setting; the association between number of encounters and students' CARE Measure scores; and the association between students' empathy (measured by the Toronto Empathy Questionnaire) and CARE Measure scores. Participants were 283 patients (aged ≥18 years) who were asked to self-complete the ten-item CARE Measure immediately after their clinical encounter with students who provided care under supervision of the teaching staff. The results showed that the CARE Measure demonstrated good internal consistency (Cronbach's α=0.95). A single factor solution emerged, accounting for 69% of the variance. The mean CARE Measure score in the consultations was 43.55±6.14, and 26% of the students achieved the maximum possible score of 50. The mean number of encounters with each student was 2.33±2.78. An increase of one episode was associated with an insignificant average CARE score decrease of 0.05 (-0.28, 0.38), whereas students' empathy was associated with a small increase in average CARE Measure score of 0.63 (0.08, 1.18). These results provide evidence of the measure's ability to support feedback to dental students on their empathy when interacting with patients.

Objective: The study objectives were to identify the stress levels and to explore the impact of students' year of study and gender on the perceived sources of stress among Malaysian dental students., Methods: This was a cross-sectional study involving dental students from year one to year five from private and public universities in Malaysia. The study was formally approved by the Research and Ethics Committee, International Medical University Malaysia. Dental Environment Stress (DES) questionnaire was used for data collection and the gathered data were analyzed using SPSS® version 18. The Kruskal-Wallis and the Mann-Whitney U tests were used to compare stress items across various academic years and universities., Results: A total of five hundred and twenty nine (529) students participated in this study. Fear of failing the course at the end of year exams (mean stress level=5.57); concerns regarding completion of clinical work (mean=5.30); and examination results and grades (mean=5.27) were found as top stressors among dental students. Female students had higher stress scores than males with respect to personal issues, academic performance, educational environment and learning of clinical skills. Students from public universities had higher stress scores than their counterparts from private universities., Conclusions: The Malaysian dental students reported higher levels of stress. Present study identified stressors affecting dental students' academic life, and highlights the importance of stress management programs and other measures to minimize the impact of stress on both academic and personal lives of the students.

Background: This study is aimed to explore the types of CAM and reasons of using CAM among elderly Malaysians., Method: This cross-sectional study was conducted on a sample of 256 conveniently selected elderly Malaysians who were residing in the states of Selangor and Kuala Lumpur. A pre-validated interview-administered questionnaire was used to gather information. Data was entered into PASW version 18 and analyzed., Results: A total of 256 questionnaires were included in the study. A response rate of 64% was achieved. Out of 256 respondents, 92 (35.9%) were male while 164 (64.1%) were female. More than half of the respondents (n = 141; 55.1%) agreed that CAM is more effective than allopathic medicine. Chinese respondents showed strong belief in the effectiveness of CAM. In terms of safety of CAM, close to three quarters of respondents (n = 178; 69.5%) believed that CAM is safer than allopathic medicine. A large majority of respondents agreed that CAM has less side effects compared to allopathic medicine (n = 201; 78.5%) and also agreed that CAM is good to maintain overall health and wellbeing (n = 212; 82.8%). A majority of the respondents expressed that they use CAM because allopathic medicine is less effective (n = 113; 44.1%)., Conclusion: The current study reflects the reasons of using CAM among lay public from different ethnicities. There are no reports of adverse effects related to CAM use. Future approaches should be intended for awareness campaigns for consumers, highlighting safety profile of CAM and as well as forbidding their use without the consultation of healthcare professional.

Background: In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia., Methods: This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSS® version 18., Results: Overall, the students tend to disagree that complementary therapies (CM) are a threat to public health (mean score = 3.6) and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7). More than half (57.8%) of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9%) was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM) (21%). Most of the students (74.8%) believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8%) and music therapy (53.8%) to be effective. Majority of them (69.3%) asserted that CAM knowledge is necessary to be a well-rounded professional., Conclusions: This study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit.

Objective: This study aimed to explore the adverse drug reactions (ADRs) reported by patients and to identify drug-drug interactions (DDIs) among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients., Subjects and Methods: This cross-sectional study was conducted at the Medication Therapy Adherence Clinic, Hospital Sungai Buloh, an HIV/AIDS referral centre. The patients were randomly selected and were encouraged to describe ADRs caused specifically by any of the prescribed antiretroviral drugs (ARDs). Sociodemographic characteristics were recorded from the patients' medical records. In addition data on antiretroviral treatment (ART), DDIs and other conventional medication were also documented., Results: A total of 325 randomly selected HIV/AIDS patients with a mean age of 22.94 years participated in the study. The most frequently prescribed ARDs were lamivudine (64.6%), zidovudine (40.6%) and efavirenz (42.5%). Commonly reported ADRs were fatigue (54.8%), allergic reactions (41.5%), weight loss (41.5%), dry mouth (35.1%) and memory loss (35.1%). Female (87.8%), non-complementary and alternative medicine (CAM) users (87.3%) and participants below 50 years old (81.1%) were identified as having a higher prevalence of ADRs compared to males (79.6%), CAM users (78.7%) and participants aged 50 years or more (77.5%). Patient age was found to be significantly associated (p = 0.048) with the ADRs. In addition, a total of 44 cases of DDIs belonging to category D were also found in this study., Conclusions: This study enabled us to identify the most common ADRs and DDIs associated with the use of ART. Safe and effective treatment depends on the healthcare providers' knowledge of the same., (Copyright © 2011 S. Karger AG, Basel.)