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Investigation of delay in utilization of government dental services in Malaysia

Jaafar N, Jalalluddin RL, Razak IA, Esa R

Community Dent Oral Epidemiol, 1992 Jun;20(3):144-7.
PMID: 1623706

Although delays in seeking dental care among patients are frequently observed in daily practice, this problem has never been investigated in other utilization studies. This study attempts to establish the magnitude and severity of the problem of delay in a delivery system where cost is not a major barrier to utilization. 555 users of Government dental services were interviewed. Only 37% of them came promptly within 6 days of perceiving a dental need. The majority (63%) had delayed their dental visit for more than 1 week. In fact, the highest frequency of delay was for more than 1 month. Prompt attendance was found to be associated with people who regularly came for asymptomatic check-ups. In contrast, more than 50% of those who thought they needed fillings and extractions had delayed their visit for more than a month. The main causes of delays were attributed to work commitments and the lack of perceived need for urgent care. Barriers related to transport or financial problems were ranked very low. The implications of these findings are discussed.
A survey on oral hygiene practices among Malaysian adults

Esa R, Razak IA, Jallaudin RL, Jaafar N

Clin Prev Dent, 1992 Jan-Feb;14(1):23-7.
PMID: 1499238

A survey on oral hygiene practices was conducted on 537 dentate adult patients aged 15 years and over. The aim of this study was to investigate the variation in dental behavior with regards to socio-demographic factors, namely age, sex, ethnicity, income, education and occupational status. Patients attending nine randomly selected government dental clinics were interviewed on their daily oral hygiene practices. The majority (89.7%) of the subjects reported that they brushed their teeth, 68% used toothpaste containing fluoride, but only 8.4% flossed their teeth. Generally the younger group had better oral hygiene habits. The higher the socioeconomic status of the adults, the better their toothcleaning practices. Awareness concerning dental floss was low regardless of all the socio-demographic variables. It was concluded that there is a need to improve the dental health practices of adults in Malaysia.
Age, sex and ethnic trends in tooth loss due to caries

Razak IA, Jaafar N, Nor GM

Odontostomatol Trop, 1989 Dec;12(4):143-5.
PMID: 2638746
Trends in tooth loss due to caries and periodontal disease by tooth type

Jaafar N, Razak IA, Nor GM

Singapore Dent J, 1989 Dec;14(1):39-41.
PMID: 2487474

Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.
Patients' preference for exodontia versus preservation in Malaysia

Razak IA, Jaafar N, Jalalludin RL, Esa R

Community Dent Oral Epidemiol, 1990 Jun;18(3):131-2.
PMID: 2350948

A total of 537 dentate adults from nine randomly selected government dental centers in three states in Malaysia were interviewed to assess their preference for either exodontia or preservation of teeth when they experience toothache, or have carious anterior or posterior teeth. The assumptions tested were i) patients prefer exodontia rather than preservation when they have toothache, and ii) patients are more willing to have posterior teeth extracted than anterior teeth for caries. Both these assumptions were rejected. Even though the majority of the subjects preferred preservation (59%) when having toothache, exodontia was the treatment of choice in a large proportion of subjects (41%). Significant differences in preference were found among the various ethnic, educational, income, and age groups. However, when ethnicity was held constant, binary regression indicated that the variations observed were determined by education, income, and age groups and not by ethnicity.
The social impact of oral and facial pain in an industrial population

Jaafar N, Razak IA, Zain RB

Ann Acad Med Singap, 1989 Sep;18(5):553-5.
PMID: 2619246

The aim of this study is to determine the social impact of oral and facial pain in a sample involving an industrial population. Out of a total of 355 subjects interviewed, nearly one-half claimed to have oral and facial pain in the previous one month prior to the survey. The most common type of pain was that related to hot or cold fluids or sweet things followed by toothache. On the average, the pain lasted for 4.2 days (SD = 4.9) per person in the past one-month. About one in five persons with pain reported that it was severe enough to disrupt sleep. About one in ten persons reporting pain had to take sick leave because of the pain. However, only one in four persons with pain consulted a doctor or dentist. More than one-third tried to cope with the pain and did nothing while the rest tried various means of self-cure. It is therefore postulated that in this population, pain per se is a poor predictor of utilisation of dental services. Further research into pain coping behaviour and how this affects of pattern of utilisation of dental services is indicated in order to formulate a strategy to encourage the habit of seeking prompt dental care by the target population.
Longitudinal study of dental caries increment in Malaysian school children: a 5-year cohort study

Masood M, Yusof N, Hassan MI, Jaafar N

Asia Pac J Public Health, 2014 May;26(3):260-7.
PMID: 22218936 DOI: 10.1177/1010539511420704

The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study.
The prevalence of enamel opacities in permanent teeth of 11-12 year-old school children in Kuala Lumpur, Malaysia

Yusoff N, Jaafar N, Razak IA, Chew YY, Ismail N, Bulgiba AM

Community Dent Health, 2008 Mar;25(1):55-8.
PMID: 18435236

To determine the prevalence, distribution, severity and treatment need of enamel opacities among 11-12 year-old school children in a fluoridated urban community.
Fulltext Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

Masood M, Yusof N, Hassan MI, Jaafar N

BMC Public Health, 2012;12:989.
PMID: 23158416 DOI: 10.1186/1471-2458-12-989

This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children.
Fulltext Qat Chewing and Periodontal Pathogens in Health and Disease: Further Evidence for a Prebiotic-Like Effect

Al-Alimi A, Taiyeb-Ali T, Jaafar N, Noor Al-hebshi N

Biomed Res Int, 2015;2015:291305.
PMID: 26351631 DOI: 10.1155/2015/291305

AIM: Qat chewing has been reported to induce subgingival microbial shifts suggestive of prebiotic-like properties. The objective here was to assess the effect of qat chewing on a panel of classical and new putative periopathogens in health and periodontitis.
MATERIALS AND METHODS: 40 qat chewers and 40 nonchewers, equally stratified by periodontal health status, were recruited. Taqman, real-time PCR was used to quantify total bacteria, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Parvimonas micra, Filifactor alocis, Synergistetes, and TM7s in pooled subgingival biofilm samples. Differences in microbial parameters between the study groups were analysed using ordinal regression.
RESULTS: In health, the qat chewers harboured significantly lower relative counts of P. gingivalis, T. forsythia, Synergistetes, and TM7s after adjustment for multiple comparisons (P ≤ 0.007). At nominal significance level, they also carried lower counts of TM7s and P. micra (P ≤ 0.05). In periodontitis, the chewers had lower counts of all taxa; however, only T. denticola withstood correction for multiple comparisons (P ≤ 0.0063).
CONCLUSIONS: Qat chewing is associated with lower proportions of periopathogens, particularly in subjects with healthy periodontium, which supports previous reports of its prebiotic-like properties. This potentially beneficial biological effect can be exploited by attempting to isolate the active fraction.
Utilization, knowledge and attitudes concerning sealants among Malaysian dentists: a national survey

Abdul Razak IA, Esa R, Jalallundin RL, Jaafar N

J Pedod, 1990;14(4):242-5.
PMID: 2098079

The aim of this postal survey was to assess the utilization, knowledge and attitude concerning sealants among Malaysian dentists. A pretested questionnaire was sent to all dentists (1217) who were on the Dentist Register of Malaysia of 1987. A response rate of 61.1% was obtained. The results indicate that 52.6% of the respondents have used sealants, but of these only 13.6% have used them frequently. The two "knowledge" related questions receiving the most support concerned the suitability of the first permanent molars for sealants and the loss of sealants attributable to problems at the time of application. The two "attitudinal" questions receiving the most support concerned the value of sealants in preventing dental caries and the need for the profession to expand more efforts toward increasing public demand for sealants. Only about 50% of the respondents believed that sealants are cost-effective.
Role of Mg(NO3)2 as Defective Agent in Ameliorating the Electrical Conductivity, Structural and Electrochemical Properties of Agarose-Based Polymer Electrolytes

Ali NI, Abidin SZZ, Majid SR, Jaafar NK

Polymers (Basel), 2021 Sep 30;13(19).
PMID: 34641173 DOI: 10.3390/polym13193357

Polymer electrolytes based on agarose dissolved in DMSO solvent complexed with different weight percentages of Mg(NO3)2 ranging from 0 to 35 wt% were prepared using a solution casting method. Electrochemical impedance spectroscopy (EIS) was applied to study the electrical properties of this polymer electrolyte, such as ionic conductivity at room and different temperatures, dielectric and modulus properties. The highest conducting film has been obtained at 1.48 × 10-5 S·cm-1 by doping 30 wt% of Mg(NO3)2 into the polymer matrix at room temperature. This high ionic conductivity value is achieved due to the increase in the amorphous nature of the polymer electrolyte, as proven by X-ray diffractometry (XRD), where broadening of the amorphous peak can be observed. The intermolecular interactions between agarose and Mg(NO3)2 are studied by Fourier transform infrared (FTIR) spectroscopy by observing the presence of -OH, -CH, N-H, CH3, C-O-C, C-OH, C-C and 3,6-anhydrogalactose bridges in the FTIR spectra. The electrochemical properties for the highest conducting agarose-Mg(NO3)2 polymer electrolyte are stable up to 3.57 V, which is determined by using linear sweep voltammetry (LSV) and supported by cyclic voltammetry (CV) that proves the presence of Mg2+ conduction.
Fulltext Mirror Therapy Rehabilitation in Stroke: A Scoping Review of Upper Limb Recovery and Brain Activities

Jaafar N, Che Daud AZ, Ahmad Roslan NF, Mansor W

Rehabil Res Pract, 2021;2021:9487319.
PMID: 35003808 DOI: 10.1155/2021/9487319

Background: Mirror therapy (MT) has been used as a treatment for various neurological disorders. Recent application of electroencephalogram (EEG) to the MT study allows researchers to gain insight into the changes in brain activity during the therapy.
Objective: This scoping review is aimed at mapping existing evidence and identifying knowledge gaps about the effects of MT on upper limb recovery and its application for individuals with chronic stroke.
Methods and Materials: A scoping review through a systematic literature search was conducted using PubMed, CINAHL, PsycINFO, and Scopus databases. Twenty articles published between 2010 and 2020 met the inclusion criteria. The efficacy of MT on upper limb recovery and brain activity during MT were discussed according to the International Classification of Functioning, Disability and Health (ICF).
Results: A majority of the studies indicated positive effects of MT on upper limb recovery from the body structure/functional domain. All studies used EEG to indicate brain activation during MT.
Conclusion: MT is a promising intervention for improving upper limb function for individuals with chronic stroke. This review also highlights the need to incorporate EEG into the MT study to capture brain activity and understand the mechanism underlying the therapy.
Fulltext The entrapped twin: a case of fetus-in-fetu

Yaacob R, Zainal Mokhtar A, Abang Jamari DZH, Jaafar N

BMJ Case Rep, 2017 Sep 23;2017.
PMID: 28942402 DOI: 10.1136/bcr-2017-220801

Fetus-in-fetu (FIF) is a rare entity in which malformed parasitic twin grows inside the body of its twin. It is most commonly presented with mass in the abdomen. We present a case of a 15-year-old boy who presented with abdominal mass since infancy. Radiological investigations are suggestive of FIF. Intraoperatively, malformed fetus in a sac was found and excised. Postoperatively the patient recovers well and was put on follow-up.
HIV/AIDS-related knowledge among Malaysian young adults: findings from a nationwide survey

Wong LP, Chin CK, Low WY, Jaafar N

Medscape J Med, 2008 Jun 24;10(6):148.
PMID: 18679535

PURPOSE: HIV/AIDS poses a serious threat to young people, both in Malaysia and throughout the world. A nationwide cross-sectional survey was conducted to assess the knowledge, attitudes, and beliefs about HIV/AIDS among the Malaysian public. This article reports the findings of knowledge about HIV/AIDS among young adults.
METHODS: A total of 1075 young adult respondents aged 15-24 years participated in this survey. The response rate was 82.2%.
RESULTS: The data indicated that HIV/AIDS knowledge among the respondents was moderate, with a mean knowledge score of 20.1 out of 32 points. The great majority had adequate knowledge of the major routes of HIV transmission, but fewer were aware of other modes of transmission, such as tattooing and piercing, sharing personal items, and breast-feeding from an infected mother. The great majority knew that HIV is not transmitted by mosquito bites, sharing meals, casual contact, and using public swimming pools and toilets.
CONCLUSIONS: Misconceptions about HIV/AIDS exist although generally knowledge on HIV/AIDS transmission and prevention was accurate. Education and intervention programs are needed to increase the level of knowledge and awareness of HIV/AIDS. The findings have important implications for the development of primary HIV/AIDS prevention programs for young adults in Malaysia.
Fulltext HIV/AIDS-Related Knowledge Among Malaysian Young Adults: Findings From a Nationwide Survey

Wong LP, Chin CK, Low WY, Jaafar N

J Int AIDS Soc, 2008 Jun 24;10(6):148.
PMID: 19825143 DOI: 10.1186/1758-2652-10-6-148

PURPOSE: HIV/AIDS poses a serious threat to young people, both in Malaysia and throughout the world. A nationwide cross-sectional survey was conducted to assess the knowledge, attitudes, and beliefs about HIV/AIDS among the Malaysian public. This article reports the findings of knowledge about HIV/AIDS among young adults.
METHODS: A total of 1075 young adult respondents aged 15-24 years participated in this survey. The response rate was 82.2%.
RESULTS: The data indicated that HIV/AIDS knowledge among the respondents was moderate, with a mean knowledge score of 20.1 out of 32 points. The great majority had adequate knowledge of the major routes of HIV transmission, but fewer were aware of other modes of transmission, such as tattooing and piercing, sharing personal items, and breast-feeding from an infected mother. The great majority knew that HIV is not transmitted by mosquito bites, sharing meals, casual contact, and using public swimming pools and toilets.
CONCLUSION: Misconceptions about HIV/AIDS exist although generally knowledge on HIV/AIDS transmission and prevention was accurate. Education and intervention programs are needed to increase the level of knowledge and awareness of HIV/AIDS. The findings have important implications for the development of primary HIV/AIDS prevention programs for young adults in Malaysia.
Fulltext Outcome of Endoprosthesis used in Limb Salvage Surgery in a Malaysian Orthopaedic Oncology Centre

Ng YH, Chai YC, Mazli N, Jaafar NF, Ibrahim S

Malays Orthop J, 2024 Mar;18(1):60-65.
PMID: 38638655 DOI: 10.5704/MOJ.2403.008

INTRODUCTION: To describe the duration of survival among bone tumour patients with endoprosthesis reconstruction and to determine frequency of implant failure, revision of surgery, and amputation after endoprosthesis reconstruction.
MATERIALS AND METHODS: A retrospective cross-sectional review of all patients with either primary bone tumour or secondary bone metastases treated with en bloc resection and endoprosthesis reconstruction from January 2008 to December 2020.
RESULTS: A total of 35 failures were recorded among the 27 (48.2%) patients with endoprostheses. Some of the patients suffered from one to three types of modes of failure on different timelines during the course of the disease. Up to eight patients suffered from more than one type of failure throughout the course of the disease. Out of all modes of failure, local recurrence (type 5 failure) was the most common, accounting for 25.0% of all failure cases. Four patients (7.1%) eventually underwent amputation, which were either due to infection (2 patients) or disease progression causing local recurrence (2 patients).
CONCLUSION: The overall result of endoprosthesis reconstruction performed in our centre was compatible with other centres around the world. Moreover, limb salvage surgery should be performed carefully in a selected patient group to maximise the benefits of surgery.
Fulltext Analysis of human bradykinin receptor gene and endothelial nitric oxide synthase gene polymorphisms in end-stage renal disease among malaysians

Vasudevan R, Ismail P, Jaafar N, Mohamad N, Etemad E, Wan Aliaa W, et al.

Balkan J Med Genet, 2014 Jun;17(1):37-40.
PMID: 25741213 DOI: 10.2478/bjmg-2014-0023

The aim of this study was to determine the association of the c.894G>T; p.Glu298Asp polymorphism and the variable number tandem repeat (VNTR) polymorphism of the endothelial nitric oxide synthase (eNOS) gene and c.181C>T polymorphism of the bradykinin type 2 receptor gene (B2R) in Malaysian end-stage renal disease (ESRD) subjects. A total of 150 ESRD patients were recruited from the National Kidney Foundation's (NKF)dialysis centers in Malaysia and compared with 150 normal healthy individuals. Genomic DNA was extracted from buccal cells of all the subjects. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was carried out to amplify the products and the restricted fragments were separated by agarose gel electrophoresis. Statistical analyses were carried out using software where a level of p <0.05 was considered to be statistically significant. The genotypic and allelic frequencies of the B2R gene (c.181C>T, 4b/a) and eNOS gene (c.894G>T) polymorphisms were not statistically significant (p >0.05) when compared to the control subjects. The B2R and eNOS gene polymorphisms may not be considered as genetic susceptibility markers for Malaysian ESRD subjects.
Malaysian dental graduates' competence in holistic care: what do graduates and employers think?

Yusof ZY, Jaafar N, Jallaludin RL, Abu-Hassan MI, Razak IA

J Dent Educ, 2010 Dec;74(12):1380-7.
PMID: 21123505

The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.
Assessing the competency of University of Malaya dental graduates: employers' and graduates' perceptions

Razak IA, Latifah RR, Jaafar N, Abu Hassan MI, Ab Murat N

J Dent Educ, 2008 Mar;72(3):364-9.
PMID: 18316541

A survey was conducted to assess competencies of dental graduates of the Faculty of Dentistry, University of Malaya, as perceived by the graduates and their employers, based on the five-year undergraduate curriculum introduced in 1995. All senior dental officers in the Ministry of Health (MOH), representing employers, and all 164 dental graduates of the years 2000, 2001, and 2002 were sent a self-administered questionnaire covering eight areas of competency. The respondents had to rate these areas on a scale of 1 (very poor) to 4 (very good). The responses for each area were then dichotomized into poor (1 and 2) and good (3 and 4). If less than 60 percent of the respondents rated an area as good, then it was categorized as needing attention; 60-69 percent as satisfactory; and 70 percent and above as excellent. One hundred and six graduates (64.6 percent) and twenty-nine employers (96.7 percent) responded; of the graduates, 73.6 percent were working in the MOH and 22.6 percent in private practice. About 57.1 percent of employers reported that at least five graduates have worked under them. Graduates (85.7 percent) and employers (83.3 percent) agreed that graduates have excellent skills in communication. Although all graduates perceived their competency to be excellent in the four areas (treatment planning; community-based skills; management, administrative skills, and personal management; and professional development skills), employers felt that these are the areas that are of concern and needed attention. In conclusion, whilst generally the graduates' level of competency in almost all areas is acceptable or good, there are areas of concern that need to be addressed to further improve the five-year curriculum at the University of Malaya.

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