BackgroundDental fear and anxiety (DFA) refers to the fear of and anxiety towards going to the dentist. It exists in a considerable proportion of children and adolescents and is a major dilemma in pediatric dental practice. As an Internet social medium with increasing popularity, the video-sharing website YouTube offers a useful data source for understanding health behaviors and perceptions of the public.ObjectiveUsing YouTube as a platform, this qualitative study aimed to examine the manifestations, impacts, and origins of DFA in children and adolescents from the public’s perspective.MethodsTo retrieve relevant information, we searched YouTube using the keywords “dental fear”, “dental anxiety”, and “dental phobia”. Videos in English expressing a layperson’s views or experience on children’s or adolescent’s DFA were selected for this study. A video was excluded if it had poor audiovisual quality, was irrelevant, was pure advertisement or entertainment, or contained only the views of professionals. After the screen, we transcribed 27 videos involving 32 children and adolescents, which were reviewed by a panel of 3 investigators, including a layperson with no formal dental training. Inductive thematic analysis was applied for coding and interpreting the data.ResultsThe videos revealed multiple manifestations and impacts of DFA, including immediate physical reactions (eg, crying, screaming, and shivering), psychological responses (eg, worry, upset, panic, helplessness, insecurity, resentment, and hatred), and uncooperativeness in dental treatment. Testimonials from children, adolescents, and their parents suggested diverse origins of DFA, namely personal experience (eg, irregular dental visits and influence of parents or peers), dentists and dental auxiliaries (eg, bad manner, lack of clinical skills, and improper work ethic), dental settings (eg, dental chair and sounds), and dental procedures (eg, injections, pain, discomfort, and aesthetic concerns).ConclusionsThis qualitative study suggests that DFA in children and adolescents has multifaceted manifestations, impacts, and origins, some of which only became apparent when using Internet social media. Our findings support the value of infodemiological studies using Internet social media to gain a better understanding of health issues.

Brucellosis is a world-wide zoonotic disease with a major impact on the public health. Due to the high risk of laboratory acquired infection, limited laboratory investigations were performed on this organism, including detailed identification and susceptibility study. Brucella melitensis is the commonest aetiological agent for human brucellosis in this region. The in vitro susceptibility pattern against selected antimicrobial agents was assessed using E-test. All isolates were noted to be sensitive to all the antimicrobial agents tested except for rifampicin where elevated MIC > 1 μg/mL was noted in 30 out of 41 isolates tested.

Objective This study sought to assess dental students’ training and experiences in addressing traumatic dental injury (TDI), and, more specifically, their knowledge of TDI management in children. Methods All Year 1 to Year 5 dental students (n = 413; response rate = 72.9%) were invited to participate in an online, self‐administered survey, which was based on a validated questionnaire. Quantitative data were analysed via chi‐squared test (p < .05) using the Statistical Package for the Social Sciences software program. Results Only a few students were found to have undergone first‐aid training in TDI (19.3%) and to have encountered TDI incidents (10.6%) before. Almost all preclinical and clinical students agreed that TDI constitutes an emergency (97.8% vs. 99.4%, respectively) and that tooth avulsion requires immediate care (97.1% vs. 99.0%, respectively). However, almost half of the students (48.8%) did not know the management protocols for a fractured tooth. Compared with clinical students, a significantly lower percentage of those in preclinical study knew the following: (1) the main cause of TDI, (2) the teeth that most commonly experience avulsion, (3) the management protocols for an avulsed tooth (e.g., handling, transportation and urgency of professional intervention) and (4) the management protocols for a fractured tooth (e.g., appropriate storage medium and need for immediate treatment). Amongst the clinical students, a significantly lower percentage of those in Year 3 knew how to transport and store avulsed and fractured teeth, and which teeth are most likely to experience avulsion. Conclusion This study identified areas of TDI education in need of further refinement. Revision of the dental curriculum in terms of design, content, teaching method and delivery time may thus be warranted.

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Objectives Behavioural guidance (BG) training is an important component of preparing future dentists to manage paediatric patients, who often exhibit cooperation issues during treatment. This study investigated the acceptance of various BG techniques amongst dental students in a Malaysian institution. Methodology A paper‐based survey was conducted, classroom‐style, on all dental students (Year 1 to Year 5, n = 336, response rate = 84.5%) using a validated questionnaire, developed from previous literature. For each BG technique, students used a visual analogue scale to mark their acceptability score; this figure was later categorised into different acceptance levels. Students’ mean acceptability scores and acceptance of each BG technique were consecutively analysed via independent t test and chi‐square test (significance level, P < 0.01) using Statistical Package for the Social Sciences software. Results Across the academic year, most students cited acceptance of reinforcement techniques (eg positive reinforcement, encouraging child “not to be a coward”, promising a toy) and desensitisation methods (eg tell‐show‐do, music/video distraction, stimulating the child's imagination, using euphemism), but not for aversive interventions (eg hand over mouth, using Papoose Board, active immobilisation) and showing needles (P > 0.01). Percentages of those who accepted communicative techniques involving parents demonstrated significant differences across subjects of different academic years, between pre‐clinical and clinical groups of respondents and amongst clinical students. Other techniques with such significant differences, along with low acceptance, included modelling, voice control and disallowing the child to speak. Conclusion The findings of this study provide useful information for curricular enhancement aimed at equipping dental students with the ability to apply appropriate and effective BG techniques during patient care.

Molecular approaches have been investigated to overcome difficulties in identification and differentiation of Brucella spp. using conventional phenotypic methods. In this study, high-resolution melt (HRM) analysis was used for rapid identification and differentiation of members of Brucella genus. A total of 41 Brucella spp. isolates from human brucellosis were subjected to HRM analysis using 4 sets of primers, which identified 40 isolates as Brucella melitensis and 1 as Brucella canis. The technique utilized low DNA concentration and was highly reproducible. The assay is shown to be a useful diagnostic tool, which can rapidly differentiate Brucella up to species level.

Abstract. We report the largest outbreak of brucellosis in Penang, Malaysia. Brucellosis is not endemic in this region. The index case was a 45-year-old goat farm owner presented with 3 weeks of fever, headache, severe lethargy, poor appetite, and excessive sweating. He claimed to have consumed unpasteurized goat's milk that he had also sold to the public. Tests were negative for tropical diseases (i.e., dengue fever, malaria, leptospirosis and scrub typhus) and blood culture showed no growth. Based on epidemiological clues, Brucella serology was ordered and returned positive. Over a period of 1 year, 79 patients who had consumed milk bought from the same farm were diagnosed with brucellosis. Two of these patients were workers on the farm. Four laboratory staff had also contracted the disease presumably through handling of the blood samples. The mean duration from onset of symptoms to diagnosis was 53 days with a maximum duration of 210 days. A combination treatment of rifampin and doxycycline for 6 weeks was the first line of treatment in 90.5% of patients. One-third of the patients had sequelae after recovering and 21% had a relapse. We highlight the importance of Brucellosis as a differential diagnosis when a patient has unexplained chronic fever.

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