METHOD: A total of 2218 PWE were recruited retrospectively into this study. Deceased cases from 2009-2018 were identified from the National Registry Department of Malaysia. Age-, gender-, and ethnic-specific SMR were calculated.
RESULT: There was a total of 163 deaths, of which 111 (68.1%) were male. The overall case-fatality rate (CFR) was 7.3%. Male PWE had higher CFR (9.2%) compared to females (5.1%, p<0.001). The annual death rate of PWE was 867 per 100, 000 persons. The overall all-cause SMR was 1.6 (CI 95% 1.3-1.8). The SMR for younger age groups (15-19 and 20-29 years) were higher (5.4-5.5) compared to other age groups (0.4-2.5). Overall SMR for male PWE (1.8, 95% CI 1.5-2.1) was higher than females (1.2, 95% CI 0.9-1.6). However, the SMR for female PWE in the younger age groups (15-19, 20-29 and 30-39 years) was higher. SMR among the Indian PWE was the highest (1.6, 95% CI 1.2-2.0) compared to the Chinese (1.5, 95% CI 1.2-1.9) and the Malays (1.4, 95% 1.0-1.9). The CFR was higher in those with focal epilepsy (8.5% vs. 2.5-3.7% in genetic and other generalized epilepsies, p=0.003), epilepsy with structural cause (9.5% vs. 5.9% in others, p=0.005) and uncontrolled seizures (7.9% vs. 5.2% in seizure-free group, p<0.001).
CONCLUSION: The mortality rate of PWE in Malaysia is higher than that of the general population but lower compared to other Asian countries. Specifically, the rates are higher in the younger age group, male gender, and Indian ethnicity. Those with focal epilepsy, structural causes and uncontrolled seizures have higher mortality rates.
PATIENT CONCERNS: A 64-year-old man with underlying well controlled diabetes mellitus was treated with 2 weeks' course of intravenous antifungal fluconazole for pyelonephritis as his blood culture grew Candida albicans. Concurrently, he complained of 3 months of bilateral painless progressive blurring of vision. At presentation, his visual acuity (VA) was light perception both eyes. Ocular examination revealed non granulomatous inflammation with dense vitritis of both eyes.
DIAGNOSIS: He was diagnosed with EFE but the condition responded poorly with the medications.
INTERVENTIONS: He was treated with intravitreal (IVT) amphotericin B and fluconazole was continued. Vitrectomy was performed and intraoperative findings included bilateral fungal balls in the vitreous and retina with foveal traction in the left eye. Postoperatively, vision acuity was 6/24, N8 right eye and 2/60, N unable for left eye with extensive left macular scar and hole. Vitreous cultures were negative. He received multiple IVT amphotericin B and was started on topical steroid eye drops for persistent panuveitis with systemic fluconazole. Ocular improvement was seen after switching to IVT and topical voriconazole. Despite this, his ocular condition deteriorated and he developed neovascular glaucoma requiring 3 topical antiglaucoma agents. Panretinal photocoagulation was subsequently performed.
OUTCOMES: At 3 months' follow-up, his vision acuity remained at 6/24 for right eye and 2/60 for the left eye. There was no recurrence of inflammation or infection in both eyes.
LESSONS: Voriconazole could serve as a promising broad spectrum tri-azole agent in cases of failure in first-line treatment or drug-resistant fungus.
METHODS: A survey was distributed to medical students in three consecutive years: 2017-2019. The survey contains items regarding student perception of various types of blended learning techniques applied in the course. The survey was administered using i-Clicker; an interactive device that enables students to answer survey questions. Descriptive statistics were used to examine the perception of students on these blended learning dimensions investigated.
RESULTS: Seven-hundred and one student responded to the questionnaire (male; 69.5%, female 30.5%). Out of which, 59.1% of students found team interactions positively supported discussions and asked questions freely, and 48.1% expressed that working in groups facilitated their learning process. However, 56.0% of students chose face-to-face lectures as the most preferred class activities followed by discussion 23.8%. More than 78% of participants agree that online quizzes are good experience and enjoyable. Grade center where students can check for marks and attendance also received high perception (66.3%).
CONCLUSION: Introducing modified team-based and blended-learning are considered challenging, and therefore, investigating their perceptions can provide useful insights into how these methods could be used more effectively. The blended-learning technique is highly essential in teaching medical informatics to overcome challenges faced due to a large number of students and the need for various exposures to reach the course's learning goals. Moreover, it is noticed that students were engaged in face-to-face and online activities, furthermore, modified team-based learning reported facilitating learning and asking questions without embarrassment.
METHOD: This research was a descriptive survey. One hundred and sixty aisles in Rappocini and Ujung Tanah Sub-Districts, Makassar were surveyed.
RESULTS: The development of healthy aisles is under maintenance of Puskesmas (Public Health Center) consisting of 20 aisles of 117 aisles in Puskesmas Kassi-Kassi and 3 aisles of 43 aisles in Puskesmas Pattingalloang. Ten healthy aisles indicators were established: aisles's cleanliness, beauty, drainage, garbage transportation, utilization, Siskamling (neighborhood security system), Non-Smoking Area (Kawasan Tanpa Rokok=KTR), active Posyandu (Integrated Health Post), the presence of educational media and the existence of working groups (Pokja).
CONCLUSIONS: Based on 10 healthy aisles indicators, aspects of beauty, educational media, and aisles work group activity need to be strengthened, while others need to be maintained and even improved.
METHOD: The method used in this research was a qualitative method. Data collection was carried out through an extensive literature review, FGD, and in-depth interviews. Data were analyzed using thematic analysis.
RESULTS: This research identified the characteristics of the aisles community. This research also found that empowerment of aisles communities can be built with holistic principles, commitment to alley health, leadership, participation, synergy, independence, equality, and sustainability. The development strategies for the aisle communities can be carried out through regulation, the principles of brains and muscles (thinkers and workers), organizations/work groups, community education, funding, and advocacy.
CONCLUSION: Synergy and convergence action of the aisles program that has the leverage/effect in realizing a clean, comfortable, safe, healthy, and productive aisles is needed.
Methods: This cross-sectional study includes a total sample of 95 Malay children of both early (8-9 years) and late (10-11 years) mixed dentition stages. The comparison was between 49 samples treated by RTB and 46 samples treated by RPFM. Both pre- and posttreatment changes were assessed with Holdaway's analysis using the CASSOS software. In each cephalogram, 71 anatomic landmarks were traced. Descriptive and multiple regression analyses were performed for statistical evaluation.
Results: Statistically significant changes were noticed in soft tissue facial angle, subnasale to H-line, skeletal profile convexity, upper lip strain, H-line angle, lower lip to H-line, and inferior sulcus to H-line measurements. Gender disparity was noticed in upper lip strain. Other significant changes were influenced by the type of appliance. However, the mean differences were minute to notice clinically. Age difference did not have any effect on the treatment changes.
Conclusions: RPFM revealed treatment outcome with more protruded upper lip than RTB.
Methodology: This article is devoted to perform a Systematic Literature Review (SLR) on the security and privacy issues of IoMT and their solutions by ML techniques. The recent research papers disseminated between 2010 and 2020 are selected from multiple databases and a standardized SLR method is conducted. A total of 153 papers were reviewed and a critical analysis was conducted on the selected papers. Furthermore, this review study attempts to highlight the limitation of the current methods and aims to find possible solutions to them. Thus, a detailed analysis was carried out on the selected papers through focusing on their methods, advantages, limitations, the utilized tools, and data.
Results: It was observed that ML techniques have been significantly deployed for device and network layer security. Most of the current studies improved traditional metrics while ignored performance complexity metrics in their evaluations. Their studies environments and utilized data barely represent IoMT system. Therefore, conventional ML techniques may fail if metrics such as resource complexity and power usage are not considered.