Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia

<p>Abstract</p> <p>Background</p> <p>The aims of this study were to determine factors associated with dental visit and to describe barriers to utilisation of oral health care services among antenatal mothers attending the Obstetric and Gynaecology Specialist clinic in Hospital Universiti Sains Malaysia.</p> <p>Methods</p> <p>A structured, self-administered questionnaire was used obtain information on the variables of interest pertaining to the current pregnancy from 124 antenatal mothers.</p> <p>Results</p> <p>The majority of the mothers claimed that their oral health status was good (67.0%) or very good (2.4%). On the contrary, most of them admitted of having had at least one oral health problem (59.7%) including cavitated (43.5%) and painful teeth (15.3%), bleeding gum (21.0%), and bad breath (10.5%). However, only 29% of the mothers visited dentist during the current pregnancy. Factors associated with the mothers' dental visit were exposure to oral health education before the pregnancy and awareness of relationship between poor maternal oral health and adverse pregnancy outcomes with odds ratio of 4.06 (95% CI: 1.67-9.78) and 3.57 (95% CI: 1.30-9.77) respectively. Common excuses given by most mothers include perceptions of not having any oral health problems (65.9%), long waiting time at the clinic (71.6%), and no immediate treatment given by the dentist (64.8%).</p> <p>Conclusions</p> <p>Utilisation of oral health care services among antenatal mothers was low. Mothers who reported dental visit were more likely to be those who had received oral health education before the current pregnancy and knew of the association between poor maternal oral health and adverse pregnancy outcomes. Dissatisfaction with the services rendered and perceptions of not having any oral health problems were the main barriers.</p

Oral health knowledge and practices of antenatal mothers in Hospital Universiti Sains Malaysia

Mothers play a very significant role in influencing the oral health status of the family. Many studies have highlighted the importance of good oral health during pregnancy. This study aimed to assess knowledge, self-perceived oral health status, and practices of antenatal mothers in Hospital Universiti Sains Malaysia, Kelantan, Malaysia. A total of 76 antenatal mothers visiting Obstetrics & Gynaecology specialist clinic at Hospital USM were involved in this cross-sectional survey study. The questionnaires contained items related to oral health knowledge, self-perceived dental problems, barriers to seeking dental care, oral hygiene habits, perceptions of oral health, and access to dental care. Majority (98.7%) agreed that their oral health was important as part of general health. About 58% of them had answered correctly regarding oral health knowledge. Most respondents had self-perceptions of having dental problems during pregnancy, including cavitated teeth (34.4%) and sensitive teeth (20.5%). Regarding practice, only 35.3% visited a dentist in the last six months. Time constraints (52.4%) and safety concerns regarding dental treatment (26.2%) were the main barriers to seek dental care. Many (90%) brushed their teeth at least twice daily with adult fluoridated toothpaste, while some used mouthwash daily (36.8%) and flossed their teeth (11.8%). Antenatal mothers had an average level of knowledge regarding oral health, experienced dental problems during pregnancy and lacked awareness of a regular dental visit. Hence, there is a need for more vigorous oral health promotion, which also include antenatal care providers, to improve oral health awareness among antenatal mothers

Oral Health-related Quality of Life Among Pregnant Women at Hospital Universiti Sains Malaysia

This cross sectional study aimed to determine oral health-related quality of life in pregnant women. A total of 100 pregnant women seen at the Obstetrics and Gynaecology Clinic at Hospital Universiti Sains Malaysia participated in this study. The short version of the Malaysian Oral Health Impact Profile (S-OHIP(M)) questionnaire with five-point ordinal scale that ranges from ‘never' to ‘very often' was used to assess the frequency of oral impacts during the previous 12 months. The majority of the respondents were Malay (96.0%), with a mean age of 29.9 years (SD 5.78). The highest education level attained by most respondents was post-secondary qualification or Diploma (39.0%). Some had formal tertiary education (27.0%). The majority of them were income earners (74.0%) and contributed to the household income. Half of the respondents were in their third trimester of pregnancy while the remaining half was either in the first or second trimester. The severity of impact experienced by the women, which is the mean S-OHIP(M) score was high at 10.43 (95% CI = 8.96, 11.90). The prevalence of impact, which is the percentage of respondents reporting ‘fairly often' or ‘very often' to one or more impacts, was 36.0%. Common impacts experienced by the respondents include feeling uncomfortable because food got stuck in between teeth or dentures (22.0%), feeling that oral health problems had caused bad breath (13.0%), and feeling shy because of problems with teeth, mouth or dentures (9.0%). The results also demonstrated that neither the severity nor the prevalence of impact was influenced by the women's socio-demographic background. This study concluded that pregnant women suffered from high impact of oral diseases that could affect their quality of lif

A meta-analysis on the accuracy of dengue diagnostic tests used for point-of-care testing (POCT) in ASEAN patients

Introduction: ASEAN countries are included in the 30 most highly dengue endemic countries in the world. Evaluation of the accuracy of dengue diagnostic tests is essential for clinical management, surveillance, control activities and vaccine development. Aim of this study is to review the accuracy of diagnosis tests used for POCT for dengue infection. Methods: The accuracy results of 31 dengue diagnosis tests in 5308 ASEAN patients except Brunei were extracted from 14 articles published within 2007 and 2014. Rapid diagnosis tests (RDT) and WHO-Clinical criteria were considered for POCT. ELISA tests with/without WHO-Clinical criteria were included in meta-analysis. Pooled sensitivity (SN) and specificity (SP) were computed. Egger-bias was analysed for publication bias. Results: Pooled (range) SN of NS1(RDT) , IgM/IgG(RDT) , NS1+IgM/IgG (RDT) and WHO-Clinical criteria were 65% (44-79), 14% (3-50) ,80% (69-86) and 93% (80-97) while SP (range) of those tests were 99% (96-100), 97% (93-99), 96% (84-98) and 34% (20-57 )respectively. Pooled (range) of SN and SP of NS1 (ELISA) were 64% (45-82) and 99% (93-100. SN /SP (95% CI) of IgM/IgG (ELISA) were 50% (40-60) / 100% (96-100) and those of NS1+IgM/IgG (ELISA) were 94% (89-97)/92 % (81-97) and those of NS1+IgM/IgG (ELISA) with WHO -Clinical criteria were 91% (86-95)/ 94 % (84-98) respectively. Egger-bias was significant (p<0.0001). Discussion and conclusion: Both RDT and ELISA tests have high SP to rule in dengue diagnosis. Wide range of SN value (WHO-Clinical Criteria vs IgM/IgG RDT) highlighted to improve SN of the tests for ruling out. Added value of dengue epidemic information in the accuracy of the tests should be verified. A multi-centred study with a standardized protocol should be conducted for diagnostic test accuracy variation for POCT among ASEAN patients

The effect of educational video intervention on the knowledge of folic acid supplementation among International Islamic University Malaysia (IIUM) female undergraduates

Knowledge regarding folic acid supplementation remains unsatisfactory among women of child-bearing age in Malaysia. Despite official recommendations to begin supplementation prior to conception to prevent Neural Tube Defects (NTD), many women remain unaware until the first antenatal check-up, losing the crucial time window of prevention. Educational videos could be a promising tool to address this issue. The objective of this pilot study was to assess the effectiveness of an educational video in increasing knowledge regarding folic acid supplementation among IIUM female undergraduates. This pilot intervention study was carried out in the IIUM Kuantan campus. IIUM female undergraduates (n=31) were recruited through convenient sampling. Inclusion criteria included being actively enrolled and of childbearing age. Participants were excluded if they were under the age of 18, married, pregnant, or have had experience of pregnancy. The educational video developed for the study was content validated by 6 experts (CVI > 0.83). Participants were first requested to complete a questionnaire to assess baseline knowledge, after which they were shown the educational video. Participants were then requested to complete the same questionnaire one week later to observe changes in knowledge scores post-intervention. Data was analysed in SPSS Version 12.0.1 using descriptive analysis, ANOVA, and Paired t-test (p<0.05). Mean baseline knowledge was found to be poor. Participants’ main source of knowledge was found to be the internet, and no significant difference was found in baseline knowledge between different study backgrounds. The mean knowledge scores significantly increased from 6.61 preintervention to 12.77 post-intervention (p<0.001). The educational video was found to be effective in increasing knowledge regarding folic acid supplementation among IIUM female undergraduates. Our findings point towards the need for intervention among this demography and greater investment in public education regarding folic acid supplementation through online video platforms

Regular dental visits among hemodialysis patients

AIM To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist. METHODS Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ 2 test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups. RESULTS There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups (χ 2 test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05). CONCLUSION Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients

Non-obstructive hypertrohic cardiomyopathy in pregnancy: a clue not to be missed

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disorder caused by mutations in several different genes coding for contractile proteins. It can occur sporadically or in an autosomal dominant pattern of inheritance. It may be first diagnosed during pregnancy and can remain well tolerated. Nevertheless, early diagnosis and referral is crucial to ensure comprehensive management and risk evaluation is being made in order to prevent complications such as arrhythmia, heart failure and sudden cardiac death

The value of c-reactive protein/albumin ratio in the severity and mortality in COVID-19 patients

The continuing coronavirus disease 2019 (COVID-19) pandemic provides several concerns for physicians. Thus, saving maximum lives as possible and finding people at risk of serious problems is essential. This study aimed to determine the association of CRP/albumin ratio with severity, duration of hospital stay and mortality in COVID-19 patients. The patient aged 18 to 80 with positive COVID-19 at Hospital Raja Perempuan Zainab II (HRPZ II), Kota Bharu, Kelantan, with available CRP/albumin ratio data on admission, were retrospectively evaluated from March 2021 to March 2022. Disease severity was categorized based on Annex 2e guidelines by Malaysia's Ministry of Health, which further classified them into mild to moderate disease (Stage 1-3) and severe to critical illness (Stage 4- 5). The CRP/albumin ratio levels on Day 1 admission were archived from the electronic medical record system and compared between the two groups. The study included 141 COVID-19 patients with a mean age of 51.11(SD± 16.66) for mild to moderate and 58.06 (SD± 13.87) for severe to critical. The severe to critical group had significantly higher values of patients’ age (p=0.015). The frequency of patients according to severity, 36(26%) were mild to moderate, and 105(74%) were severe to critical. CRP/Alb ratio was significantly elevated in the severe to critical illness group (p<0.001). 28 (20%) patients died, 113 (80%) survived, and median CRP/albumin ratio values were higher in non-survivors compared to survivors (p<0.001). High CRP/albumin ratio levels were associated with longer hospital stay (correlation coefficients 0.295, p<0.001). Receiver operator characteristic analysis showed that the area under the curve (AUC) for CRP/albumin ratio was 0.755 (95% CI: 0.670- 0.840). The optimal cut-off point of CRP/albumin ratio was 1.494 (sensitivity 60%, specificity 89%, PPV 0.94, NPV 0.43, LR+ 5.41, LR- 0.45, DOR 12). CRP/Alb ratio on Day 1 admission is associated with COVID-19 severity and mortality

HÁBITOS DE HIGIENE E SAÚDE BUCAL DE GESTANTES ATENDIDAS EM UM HOSPITAL UNIVERSITÁRIO

Introdução: Durante a gravidez há um aumento significativo da produção de hormônio sexual feminino estrógeno e progesterona,com concentração de 10 a 30 vezes maior que o ciclo menstrual normal. Esse aumento dos níveis hormonais plasmáticospode exercer um efeito direto nos tecidos periodontais. Objetivo: Avaliar a saúde bucal e os hábitos de higiene oral de gestantesatendidas em um Hospital Universitário. Métodos: Trata-se de um estudo transversal realizado em gestantes com idadeentre 16 e 42 anos. Os dados socioeconômicos, frequência diária de escovação e uso de fio dental foram coletados por meio dequestionário. Avaliou-se a saúde bucal através da coleta do Índice de Placa Visível (IPV) e Índice Gengival (IG), obtida por meio deum exame clínico periodontal. Os dados sobre hábitos de higiene, IPV e IG foram analisados por estatística descritiva. Resultados:Das gestantes entrevistadas, 21 (52,5%) apresentaram renda até 1 Salário Mínimo (SM) e 19 (47,5%) concluíram o ensinomédio. A maioria relatou realizar escovação após as refeições, 38 (95%), porém 24 (60%) relataram que não utilizavam fio dental.Em relação aos índices periodontais, 24 (60%) e 3 (7,5%) apresentaram IPV e IG acima do aceitável, respectivamente. Todaspossuíam pelo menos dois sítios com sangramento gengival. Conclusão: Apesar de terem relatado uma alta frequência deescovação, a maioria das gestantes apresentou um Índice de Placa Visível acima do tolerável, além de sangramento após sondagem.Manter a saúde bucal das gestantes é fundamental durante a gravidez e a visita ao dentista deve ser tão imprescindívelquanto as consultas pré-natais.Palavras-chave: Gravidez. Higiene Bucal. Doenças periodontais

THE UTILIZATION BEHAVIOUR OF DENTAL HEALTH SERVICES AMONG PREGNANT WOMEN IN SEMARANG CITY

Background: Pregnancy had an impact on oral health that cause pregnant women susceptible to dental caries and periodontal disease. Poor oral health conditions of pregnant women could had an impact on the mother herself and also the fetus.Objective: The purpose of this study was to determine the utilization of oral health services among pregnant women in Semarang city, and the factors that associated with it. Method: This study was an analytic observational with case controlled design using a questionnaire involving 96 pregnant women. The questions including respondent characteristics, knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy regarding the used of oral health services. Results: The results showed that more than half of respondents (54.2%) already used oral health services during pregnancy. The variables which together had an effect on the utilization of oral health services are knowledge (p value=0.000, OR=17.343) perceived severity (p value=0.001, OR=10.416) and cues to action (p value=0.007, OR=7.403). Conclusion: This studied concluded that the knowledge, perceived severity and cues to action affect significantly affect to utilization of oral health services among pregnant women.Keywords: Pregnant women, dental health, utilizatio