This cone beam computed tomography (CBCT) study aimed to evaluate the root canal morphology of permanent anteriors in Malaysian population using two classification systems (Vertucci 1984 and Ahmed et al 2017). CBCT images of 856 patients with 10,080 anterior teeth were analysed. Results showed that, except for six mandibular canines, all anterior teeth were single‐rooted. According to Ahmed et al’s system and Vertucci’s classification, code 1MaxA1 and type I were the most common types except in mandibular laterals where 1ManA1‐2‐1 and type III were the most common, respectively. The prevalence of canal variations in mandibular incisors was higher in males and the 20–30 age group than in females and other age groups (P < 0.001). The Malay ethnic group showed more canal variations in mandibular incisors than Chinese and Indians (P < 0.001). Mandibular anteriors showed a wide range of canal variations, and the canal complexity is significantly affected by sex, ethnicity and age. The new classification provides an accurate presentation for root canal morphology.

Antimicrobial resistance (AMR) is a global health issue that plays a significant role in morbidity and mortality, especially in immunocompromised patients. It also becomes a serious threat to the successful treatment of many bacterial infections. The widespread and irrelevant use of antibiotics in hospitals and local clinics is the leading cause of AMR. Under this scenario, the study was conducted in a tertiary care hospital in Lahore, Pakistan, from 2 August 2021 to 31 October 2021 to discover the prevalence of bacterial infections and AMR rates in COVID-19 patients admitted in surgical intensive care units (SICUs). Clinical samples were collected from the patients and we proceeded to identify bacterial isolates, followed by antibiotic susceptibility testing (AST) using the Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC). The data of other comorbidities were also collected from the patient’s medical record. The current study showed that the most common pathogens were E. coli (32%) and Klebsiella pneumoniae (17%). Most E. coli were resistant to ciprofloxacin (16.8%) and ampicillin (19.8%). Klebsiella pneumoniae were more resistant to ampicillin (13.3%) and amoxycillin (12.0%). The most common comorbidity was chronic kidney disease (CKD) and urinary tract infections (UTIs). Around 17 different types of antibiotic, the carbapenem, fluoroquinolones, aminoglycoside, and quinolones, were highly prevalent in ICU patients. The current study provides valuable data on the clinical implication of antibiotics consumed by COVID-19 patients in SICUs and the AMR rates, especially with different comorbidities.

Objective: To determine the maximum occlusal bite force (MOBF) of the complete spectrum of dental caries in first permanent molars (FPMs) in children aged 7–9 years. Study design: A cross-sectional study was conducted on 123 children. The evaluation of the caries spectrum of FPMs was carried out using the Caries Assessment Spectrum and Treatment index (CAST). The MOBF was measured in the FPM region using the portable occlusal force gauze. Independent sample t-test and one-way analysis of variance test were performed to compare MOBF with CAST scores of FPMs. Based on the CAST scores, FPMs were categorized into three groups, group 1: healthy (score 0, 1, 2), group 2: premorbid (score 3), group 3: morbid (score 4, 5). Results: A significantly lower MOBF was observed (167.56 N ± 49.77) in the morbid stage (group 3) than in the premorbid stage (group 2: 291.57 N ± 56.64), and healthy (group 1; 320.93 N ± 54.23). Intergroup comparison also revealed that FPMs in the healthy stage was associated with a higher bite force compared to those in the premorbid and morbid stages (p&lt;0.001). Conclusions: The mean MOBF decreased with the progression of the caries spectrum of FPMs in early permanent dentition.

Objective: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a face-to-face contact area. Methods: A structured self-administered questionnaire was developed at Najran University and provided to the participants for data collection. The data collected included information on risk perception and incorporation of measures for protection against COVID-19 to gauge the attitude of dentists during this period. Also, clinical implementation of various protective measures was reviewed. Results: Of the n = 322 dentists that answered the questions, 50% were general dentists and 28.9% were dentists working at specialist clinics, while the remaining 21.1% of dentists were employed in academic institutions. Among the newer additions to the clinic, 36.3% of dentists answered that they had added atomizers to their practices, followed by 26.4% of dentists that had incorporated the use of UV lamps for sterilization. We found that 18.9% dentists were using HEPA filters in their clinics, while 9.9% of dentists were making use of fumigation devices to control the risk of infection. One-way ANOVA was also carried out to demonstrate that there was a statistically significant difference (p = 0.049) between groups of dentists utilizing HEPA filters, UV lamps, atomizers, and fumigation devices to prevent the spread of SARS-CoV2 across their workplaces. Conclusion: Dentists are aware of recently updated knowledge about the modes of transmission of COVID-19 and the recommended infection control measures in dental settings. A better understanding of the situation and methods to prevent it will ensure that the dental community is able to provide healthcare services to patients during the pandemic.

Antibiotic resistance rate is rising worldwide. Silver nanoparticles (AgNPs) are potent for fighting antimicrobial resistance (AMR), independently or synergistically. The purpose of this study was to prepare AgNPs using wild ginger extracts and to evaluate the antibacterial efficacy of these AgNPs against multidrug-resistant (MDR) Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis. AgNPs were synthesized using wild ginger extracts at room temperature through different parameters for optimization, i.e., pH and variable molar concentration. Synthesis of AgNPs was confirmed by UV/visible spectroscopy and further characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy analysis (EDXA), and Fourier-transform infrared spectroscopy (FTIR). Disc and agar well diffusion techniques were utilized to determine the in vitro antibacterial activity of plant extracts and AgNPs. The surface plasmon resonance peaks in absorption spectra for silver suspension showed the absorption maxima in the range of 400–420 nm. Functional biomolecules such as N–H, C–H, O–H, C–O, and C–O–C were present in Zingiber zerumbet (Z. zerumbet) (aqueous and organic extracts) responsible for the AgNP formation characterized by FTIR. The crystalline structure of ZZAE-AgCl-NPs and ZZEE-AgCl-NPs was displayed in the XRD analysis. SEM analysis revealed the surface morphology. The EDXA analysis also confirmed the element of silver. It was revealed that AgNPs were seemingly spherical in morphology. The biosynthesized AgNPs exhibited complete antibacterial activity against the tested MDR bacterial strains. This study indicates that AgNPs of wild ginger extracts exhibit potent antibacterial activity against MDR bacterial strains.

In addition to the pathogenesis of SARS-CoV-2, bacterial co-infection plays an essential role in the incidence and progression of SARS-CoV-2 infections by increasing the severity of infection, as well as increasing disease symptoms, death rate and antimicrobial resistance (AMR). The current study was conducted in a tertiary-care hospital in Lahore, Pakistan, among hospitalized COVID-19 patients to see the prevalence of bacterial co-infections and the AMR rates among different isolated bacteria. Clinical samples for the laboratory diagnosis were collected from 1165 hospitalized COVID-19 patients, of which 423 were found to be positive for various bacterial infections. Most of the isolated bacteria were Gram-negative rods (n = 366), followed by Gram-positive cocci (n = 57). A significant association (p < 0.05) was noted between the hospitalized COVID-19 patients and bacterial co-infections. Staphylococcus aureus (S. aureus) showed high resistance against tetracycline (61.7%), Streptococcus pyogenes against penicillin (100%), E. coli against Amp-clavulanic acid (88.72%), Klebsiella pneumoniae against ampicillin (100%), and Pseudomonas aeruginosa against ciprofloxacin (75.40%). Acinetobacter baumannii was 100% resistant to the majority of tested antibiotics. The prevalence of methicillin-resistant S. aureus (MRSA) was 14.7%. The topmost symptoms of > 50% of COVID-19 patients were fever, fatigue, dyspnea and chest pain with a significant association (p < 0.05) in bacterial co-infected patients. The current study results showed a comparatively high prevalence of AMR, which may become a severe health-related issue in the future. Therefore, strict compliance of antibiotic usage and employment of antibiotic stewardship programs at every public or private institutional level are recommended.

Citation frequencies represent the most significant contributions in any respective field. This bibliometric analysis aimed to identify and analyze the 100 most-cited publications in the field of antibiotics and to highlight the trends of research in this field. “All databases” of Clarivate Analytics’ Web of Science was used to identify and analyze the 100 publications. The articles were then cross-matched with Scopus and Google Scholar. The frequency of citation ranged from 940 to 11,051 for the Web of Science, 1053 to 10,740 for Scopus, and 1162 to 20,041 for Google Scholar. A total of 513 authors made contributions to the ranked list, and Robert E.W. Hancock contributed in six articles, which made it to the ranked list. Sixty-six scientific contributions originated from the United States of America. Five publications were linked to the University of Manitoba, Canada, that was identified as the educational organization, made the most contributions (n = 5). According to the methodological design, 26 of the most cited works were review-type closely followed by 23 expert opinions/perspectives. Eight articles were published in Nature journal, making it the journal with the most scientific contribution in this field. Correlation analysis between the publication age and citation frequency was found statistically significant (p = 0.012).

(1) Purpose: To assess the oral health literacy (OHL) of parents and its association with the caries experience of their preschool children attending the Hospital University Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia. (2) Materials and Methods: This is a descriptive cross-sectional study involving a systematic random sampling method, using a sample of 230 parent/preschool child dyads. Among 230 parents, 24 were males and 206 were females (mean age 31.43 ± 5.82); among 230 children, 92 were boys and 138 were girls (mean age 4.82 ± 1.04) attending the pedodontics clinic, HUSM, who participated and met the inclusion criteria. A structured, self-administered oral health literacy questionnaire including sociodemographic factors was used in this study. A child’s oral examination was performed to check the dmft (decayed, missing, filled teeth) status. Statistical analysis was done using descriptive and Spearman’s correlation analysis and multivariate regression analysis. (3) Results: The mean dmft score of children in relation to the OHL level of parents showed a significant difference (p < 0.00). The mean dmft score of children in relation to the OHL level of parents showed the following relationships: Inadequate (7.49 ± 4.10) followed by marginal (3.28 ± 2.67) and then adequate (0.55 ± 1.55). The incidence of caries amongst children in relation to parental employment was more associated with unemployed parents (6.11 ± 4.43) than with employed parents (2.79 ± 3.65). The caries experience amongst children in relation to education of their parents revealed a significant difference (p < 0.001), and the mean dmft score was high amongst preschool children with primary school qualified parents (10.7 ± 4.10) followed by high school (7.04 ± 3.68), vocational (5.81 ± 3.57), diploma (2.61 ± 2.81), and university (1.29 ± 2.27), respectively. The results revealed a valid significant difference (negative correlation, rs = −0.753 **) between the OHL of parents with the dmft score of their preschool children. The age and gender of parents was not significantly associated with OHL, whereas ethnicity (positive correlation, rs = 0.283 **), education (positive correlation, rs = 0.865 **), and employment (negative correlation, rs = −0.490 **) were found to be significant. Conclusion: We conclude that there is a significant association between the OHL of parents with the dmft score of their preschool children. The logistic regression showed that after adjustment for sociodemographic factors, parents’ gender (OR = 0.067, 95% CI: 0.012–0.360), parents’ employment status (OR = 3.247, 95% CI: 0.897–11.754), parents’ OHL score (OR = 0.042, 95% CI: 0.016–0.114), and child age (OR = 2.195, 95% CI: 1.249–3.857) were significantly associated with dental caries in children. Our study concluded that parents’ employment status, age, gender, OHL, and child’s age were significantly associated with the caries experience of their preschool children.