Cutting down errors in root canal procedures

the star
BY LOH FOON FONG

Revolutionary: Dr How showing three cross sections from a set of teeth using dental imaging at the Imperial Dental Specialist Centre in Kuala Lumpur.

KUALA LUMPUR: A new revolution in dental imaging is allowing root canal procedures to be carried out on patients with less errors and complications, said experts.

Consultant in orthodontics, implantologist and laser dentistry Datuk Dr How Kim Chuan said a patient might still experience persisting pain after a root canal treatment due to limitations of regular X-ray.

“One of the four root canals could have been missed out in the X-ray, and hence treatment. However, with the digital technology, it is very unlikely to miss out on anything,” he said.

Dr How said a dentist using the latest ima­ging technology could look at a whole set of teeth and jaw structure in three dimension as well as zoom in onto the section of the tooth needing the implant.

“I will be able to rotate the image 360° and do slices of the images and see what I want to see and measure bone quality or density – all from just one exposure,” he said.

For X-ray, another re-take would have been necessary for a more detailed image, added Dr How.

Detailed information was important because it would determine the size of the implant, the best technique to be used based on the bone density and how it should be placed, he said.

“The implant surgery will take only 10 mi­nutes compared with a one-and-a-half hour of surgery because we are so prepared with details from the imaging,” he said.

Dr How, who is also International College of Dentists (ICD) Section XX Asia president, said the use of digital diagnostic tools in dentistry was still low in the country despite giving more detailed images and accurate diagnosis than regular X-rays.

It is estimated that only 20% to 25% of some 5,000 dentists in the country are using the technology.

Since many dentists do not know how to use the technology, Dr How said he wanted to introduce this during his keynote lecture at the ICD Section XX International Scientific Conference and Trade Exhibition at the Aloft, Kuala Lumpur Sentral on March 29.

On March 28, MCA president Datuk Seri Liow Tiong Lai would also confer the ICD Award of Honorary Fellowship with president citation to Bina Puri Holdings Bhd group mana­ging director Tan Sri Tee Hock Seng.

For more information call Wong at 012-686 1801 or Chan at 012-522 6053.

Ongkili: Selangor MB has been ill-advised over water deal

the star
BY LOH FOON FONG AND WANI MUTHIAH

 

KUALA LUMPUR: The Selangor Mentri Besar has been ill-advised when he claimed that the Federal Government wanted free land as part of the water restructuring deal in the state, said Energy, Green Technology and Water Minister Datuk Seri Dr Maximus Ongkili (pic).

Dr Ongkili said it was stated in the water agreement signed last Sept 12 that the assets would go together with the land and even on that matter, the Federal Government had compromised.

Selangor, he said, claimed that it had over RM14bil worth of assets – RM10bil worth of pipes and RM4bil worth of treatment plants and reservoirs.

“If that is the case, they should go with the land because if the new concessionaires want to lay new pipes, they need access to them.

“So, we compromised and said, ‘Never mind, even if you cannot give us the land, you can assign to us rights to the land,’” he said after launching the Second International Water Association Malaysia Young Professionals Conference here yesterday.

Mentri Besar Azmin Ali had reportedly said that Selangor decided not to go ahead with the water restructuring deal because the Federal Government wanted “free land”, particularly in relation to the transfer of ownership of land involving 26,000km of pipes.

He had also claimed that land was not part of the main agreement but only the handing over of assets by the concessionaires.

Dr Ongkili also denied Azmin’s claim that the Federal Government would take over the land after the 45-year lease, describing it as “nonsense”.

“Under our lease agreement, the land goes back to the state government. He has not been properly advised,” he said.

Dr Ongkili said he had written to Azmin about the outstanding issues and confusion, and suggested that their officers meet as soon as possible.

“And thereafter, we two can meet,” he said, adding that he was still looking forward to finding a solution or the “option would be tougher. There is no need for re-negotiation”.

However, in Shah Alam, Azmin said he had received Dr Ongkili’s letter stating that the Federal Government was prepared to go back to the negotiation table.

“If they are willing to return to the terms stipulated in the master agreement (signed on Sept 12), we are prepared.

“The problem is that the Federal Government started coming up with new suggestions that are not in the original agreement,” said Azmin.

He also said that Syarikat Pengeluar Air Selangor Sdn Bhd (Splash) had received an operating licence because it was given a year to comply with Selangor’s water restructuring exercise.

The licence given to Splash, he said, was an extraction licence for the concessionaire to tap and treat raw water before this was channelled to consumers.

Former Mentri Besar Tan Sri Khalid Ibrahim had questioned Azmin over the awarding of the licence to Splash at a time when the water deal was at a stalemate.

State-owned Pengurusan Air Selangor Sdn Bhd (Air Selangor) will be taking over the state’s water industry from its four concessionaires – Puncak Niaga Sdn Bhd (PNSB), Syarikat Bekalan Air Selangor Sdn Bhd (Syabas), Konsortium ABASS and Splash.

The first three concessionaires had agreed to the state acquiring them except for Splash.

Experts: GM mosquitoes cannot transmit dengue – they do not bite

the star
BY LOH FOON FONG

PETALING JAYA: Dengue and health experts have refuted claims that genetically-modified (GM) mosquitoes released are inducing a spike in dengue cases.

Institute of Medical Research (IMR) Entomology Unit head Dr Lee Han Lee said only male Aedes aegypti GM mosquitoes were released.

“Male mosquitoes do not bite,” he said. “These mosquitoes cannot transmit dengue and, therefore, will not cause an increase in dengue cases.”

The claims came about following an increase of more than 100,000 dengue cases last year.

On Thursday, the Health Ministry said a study on GM mosquitoes had been shelved as it was not cost effective.

A preliminary study was carried out from Dec 21, 2010, to Jan 5, 2011, to compare the behaviour of GM mosquitoes under natural conditions against their wild counterparts.

In the field trial undertaken by the IMR and Oxitec Ltd, about 6,000 male GM Aedes aegypti mosquitoes were released at an uninhabited forested area near Bentong, Pahang.

The GM mosquito would mate with the females in the wild and the eggs would hatch but the offsprings would die soon.

Deputy health director-general Datuk Dr Lokman Hakim Sulaiman concurred with Dr Lee.

“The reality is the breeding index is still very high, that’s why we are having pro­blems,” Dr Lokman said.

World Health Organisation Collaborating Centre for Arbovirus Reference and Research director Dr Sazaly Abu Bakar said hundreds of thousands of human hosts walking around with the dengue virus unprotected, including those without symptoms, was the likely reason for the increase.

GM mosquito project shelved

the star
BY LOH FOON FONG

KUALA LUMPUR: The Government’s plan to release genetically modified (GM) mosquitoes as a way to fight dengue has been shelved.

Health director-general Datuk Seri Dr Noor Hisham Abdullah said that after the field trials in 2010 and 2011, the ministry did not proceed further as it was not cost effective to be implemented.

“We did not proceed further after the initial study,” he told The Star yesterday.

The purpose of GM mosquito dengue control was to reduce the Aedes Aegyptipopulation – the GM mosquito would mate with the females in the wild and the eggs would hatch but the offspring would die before reaching adulthood.

In the field trial undertaken by the Institute of Medical Research and British-based biotech company Oxitec Ltd, about 6,000 male GM Aedes aegypti mosquitoes were released at an uninhabited forested area near Bentong, Pahang, on Dec 21, 2010.

An equal number of unmodified male mosquitoes were released at the same time for the purpose of studying and comparing the GM mosquitoes under natural conditions against their wild counterparts.

The study ended on Jan 5 and the area was fogged to destroy the mosquitoes the following day.

In response to public outcry over safety concerns at that time, Medical Entomology Unit & WHO Collaborating Centre for Vectors IMR head Dr Lee Han Lim said that the exhaustive studies lasting four years confirmed that the biology, behaviour, mating competitiveness and the capacity to transmit disease of the genetically modified Aedes aegypti were not altered.

Health Ministry vector-borne disease sector head Dr Rose Nani Mudin said Brazil, which had carried out a large-scale GM mosquito testing there, had announced that they would not implement the dengue-control method.

GeneWatch UK director Dr Helen Wallace wrote in the New York Times recently that computer model­ling of the findings showed that 2.8 million genetically engineered adult male mosquitoes would need to be released per week to suppress a wild population of only 20,000 mosquitoes, which was impractical on any scale.

“There is no evidence of any reduction in the risk of dengue fever, which can continue even if the number of mosquitoes is reduced,” she said.

Doc: Leptospirosis harder to diagnose

the star
BY LOH FOON FONG

KUALA LUMPUR: Leptospirosis is posing a challenge to doctors as cases diagnosed these days do not conform to the normal profile, says an infectious diseases physician.

Sungai Buloh Hospital consultant infectious diseases physician Dr Suresh Kumar said doctors were seeing more cases of leptospirosis among urban folk who had not visited any waterfall or flood areas.

“The symptoms are also difficult to diagnose as it can range from mild fever to bleeding in the lungs and pneumonia, different from the well-known symptoms of jaundice and renal failure,” he said in an interview.

Dr Suresh who presented a paper on tropical infections in Malaysia at an annual scientific conference yesterday, said 7,806 cases of leptospirosis with 92 deaths were reported nationwide last year.

Getting the infection diagnosed, he said, was challenging as patients tended not to return to hospital for the second blood test after they felt better.

Two blood tests were needed to diagnose leptospirosis – one during hospital examination and the other, a week after patients recovered, he said.

For this reason, hospital staff had to go to their houses to take the second blood sample for testing, he said, adding that the infection tend to be under diagnosed because most common antibiotics were able to treat it without any blood samples taken.

“We don’t really know the true burden of the disease,” he said adding that more research needed to be done in this area.

Dr Suresh also expressed concern that out of the 485 pertussis cases (whooping cough), 82% of infants below one year were diagnosed last year.

“It is dangerous for the infants because they could suffer from breathlessness and lung and bleeding problems,” he said.

The people suspected of transmitting the bacteria to infants were caregivers such as parents, grandparents and domestic helpers.

“Caregivers need to get a booster jab against the disease so that they do not spread it to babies,” Dr Suresh said.

The Health Ministry, he said, was looking into whether the booster jab should be given to pregnant mothers who could transmit the antibody to the foetus.

Get flu jab prior to India visit

the star
BY LOH FOON FONG

PUTRAJAYA: Those intending to visit India, especially children and the elderly, are advised to get the latest seasonal influenza vaccine.

Health director-general Datuk Dr Noor Hisham Abdullah said those with chronic diseases involving the lungs, heart, kidneys as well as those with compromised immune systems should also get the vaccine before visiting India.

The vaccine is available at private health facilities.

“Likewise, those with symptoms such as fever, runny nose, sore throat and cough are advised to seek treatment,” Dr Noor Hisham said in a statement yesterday.

When contacted last week, Dr Noor Hisham said influenza surveillance conducted in 300 government and private health facilities in the country revealed no unusual incidence of seasonal influenza including “swine flu”.

He said that infection control surveillance and measures were in place to monitor swine flu or Influenza A (H1N1) and it would be guided by any World Health Organisation (WHO) global action plan.

News reports have stated that India’s Health Ministry had recorded 16,235 cases of swine flu there with 926 deaths as of Feb 24.

The H1N1 virus that caused the influenza pandemic in 2009-2010 was thought to have originated in swine. WHO estimated that 284,500 died from the time it appeared in April 2009 to mid-2010.

He said countries no longer needed to report Influenza A (H1N1) cases to WHO after it declared a post-pandemic H1N1 in August 2010.

“The virus has since been considered as one of the seasonal influenza viruses that is circulating throughout the world all year round and WHO does not prescribe any special precaution or treatment for it,” he said, adding that there would be a slight increase in cases during the rainy season in tropical countries.

He said the symptoms and severity of the H1N1 virus were similar to other influenza viruses and there was no difference in handling seasonal influenza and H1N1 infection.

He assured that there was an adequate stockpile of antiviral drugs such as Tamiflu in government hospitals to treat seasonal influenza.

“There are seasonal influenza vaccines available in the market and individuals at higher risk of infection such as pregnant mothers, children and those with chronic diseases could ask their doctors about getting vaccinated,” he said.

Universiti Malaya microbiology professor Dr Sazaly Abu Bakar said there was no cause for alarm now.

Dr Sazaly said the 900 deaths were likely due to crowded living conditions and a lack of medical care.