Introduction: For necrotic deciduous teeth, pulpectomy is the best treatment option. Even though hand files have long been considered the gold standard, extensive chairside time limits their use. This led to the advent of rotary file systems specifically designed for deciduous teeth. The operator faces a challenge in selecting an appropriate file system due to the increasing number of options available today. This necessitates research on newer available options regarding their clinical efficiency. Materials and Methods: Considering the selection criteria, pulpectomy procedures were performed on thirty deciduous molars in paediatric patients aged 5–8 years. Ten teeth were allotted per group, and the teeth were divided into three groups. Canals were prepared using hand and rotary file systems, with Group 1 utilising the Hand K file, Group 2 employing Pedoflex rotary files and Group 3 utilising Neoendo Pedoflex rotary files. Radiographs were used to assess the quality of obturation as a measure of canal preparation ability, while post-operative pain was recorded using a four-point facial pain intensity scale immediately after the procedure. The collected data were analysed using the Chi-square test, along with Analysis of Variance (One-Way) and the HSD post hoc test. Results: The results revealed that the post-operative pain was least with the Pedo Flex rotary system, followed by the NeoEndo Pedo Flex and hand K files. In addition, Pedo Flex files demonstrated the best quality of obturation, resulting from good canal preparation ability, compared to Neo Endo Pedo Flex files and hand files. Conclusion: Rotary file systems prove to be advantageous over hand file systems in terms of canal preparation and reduced post-operative pain, with an added benefit of reduced treatment time contributing to effective behaviour management.
Introduction: Evaluation of bone height and width is essential for placement of end-osseous implants. Very few studies have been done using diagnostic tools like cone-beam computed tomography and considering the potential implant dimension. This study was undertaken to evaluate the bone height and width in the maxillary anterior region using the Cologne Classification of alveolar ridge defect. Materials and Methods: A total of 201 patients in the age group of 18–55 years with partially edentulous maxillary anterior region were evaluated using BDZ classification. They had reported for replacement of teeth within 6 months after extraction. The severity of defect, if present, in terms of height/width and with respect to augmentation and contour of the ridge was considered. Results: Group comparison was done through an independent-samples t -test. The significance level was kept at P < 0.05. All the statistical analyses were performed with SPSS version 25. The most commonly found defect was mild horizontal deficiency, which can be managed by bone expansion methods along with grading procedures. Conclusion: Within the limitations of this study, it can be concluded that ridge deficiency or defects can be managed with a conservative approach when patients were treated with end-osseous root form implants within 6 months after extraction.
Abstract Anthropogenic climate change is fundamentally reshaping the global transmission landscape of infectious diseases, expanding the spatiotemporal range of spread for three categories of pathogens: vector-borne, water-borne and zoonotic. Traditional public health surveillance, which centers on post hoc responses to confirmed cases, is no longer suited to this new context. There is an urgent need to transition to a new, proactive system adapted to climate conditions and the core barrier to this shift is the fragmented governance structure that keeps the health and meteorological sectors disconnected. Currently, the global integrated field of climate and public health has two core shortcomings: financing mechanisms generally focus on emergency outbreak responses while undervaluing routine preventive preparedness, and the workforce lacks the interdisciplinary training required to support the integration of climate and health efforts. This scoping review adopts a multi-method analytical framework, covers three specific research areas and is structured around two core questions. It posits that strengthening public health surveillance is fundamentally a governance and service delivery issue rather than a purely technical matter. Finally, it develops a three-pillar climate-smart public health framework whose design elements precisely address the aforementioned shortcomings.
Abstract Introduction: Among the population of haemodialysis patients, the clinical harms of catheter-related bloodstream infection (CRBSI) have received widespread attention in clinical practice. CRBSI caused by methicillin-resistant Staphylococcus aureus (MRSA) is highly prone to misdiagnosis due to its atypical manifestations, leading to delays in diagnosis and treatment and thus posing a core clinical challenge. Results: A 64-year-old male patient with comorbid end-stage renal disease and liver cirrhosis, who presented for medical care with abdominal pain and tense ascites. His recurrent MRSA-associated bloodstream infection was initially misdiagnosed as spontaneous bacterial peritonitis. After a confirmed diagnosis was reached via blood culture and peritoneal effusion culture, the cuffed dialysis catheter placed during his previous admission was removed, and he was treated with intravenous vancomycin. Ultimately, his hemodynamic status stabilised, and he recovered smoothly. Conclusion: This case summary puts forward two core clinical diagnoses and treatment warnings: The first applies to patients seeking care who have multiple comorbidities and overlapping symptoms, requiring a differential diagnosis to distinguish between CRBSI and SBP; the second applies to haemodialysis patients with a history of MRSA infection, who require ongoing vigilance against recurrence even after their infection tests return negative.
Abstract Paederus dermatitis is an irritant contact dermatitis that follows accidental crushing of Paederus rove beetles on the skin, releasing the vesicant toxin pederin. In Malaysia, reported outbreaks and case clusters have mainly involved students, hostel residents and communities living near paddy fields, oil palm plantations and other vegetation-rich settings where beetle dispersal into lighted buildings is common. This narrative review summarises Malaysian evidence on the epidemiology, clinical features, diagnosis, management and prevention of Paederus dermatitis. PubMed, Scopus and Web of Science were searched for publications from 1 January 2000 to 31 May 2026, using the terms related to Paederus dermatitis, rove beetle dermatitis, dermatitis linearis, Paederus fuscipes , pederin and Malaysia. Retrieved records were screened for Malaysian primary reports and substantive clinical, epidemiological, entomological, molecular or public health evidence. From 473 records, 13 Malaysian publications met the review criteria, comprising clinical outbreak or case reports, entomological field and laboratory studies, molecular studies and a knowledge-attitude-practice survey. The evidence shows a recurrent pattern of linear or vesiculobullous lesions on exposed skin, frequent periorbital and upper-limb involvement and a generally favourable response to early washing, topical corticosteroids, symptomatic care and treatment of secondary infection when present. Entomological studies identify P. fuscipes behavior, nocturnal light attraction, seasonal agricultural activity, building design and nearby breeding habitats as important exposure drivers. However, Malaysian clinical epidemiological data remain limited and outdated compared with entomological work. Prospective surveillance, standardised clinical reporting and evaluated prevention strategies are needed for schools, hostels and residential areas near agricultural habitats.
