METHODS: The authors evaluated a cohort of adult trauma patients transported to emergency departments. The first vital signs were used to calculate the SI, MSI, and rSIG. The areas under the receiver operating characteristic curves and test results were used to compare the discriminant performance of the indices on short-term mortality and poor functional outcomes. A subgroup analysis of geriatric patients with traumatic brain injury, penetrating injury, and nonpenetrating injury was performed.
RESULTS: A total of 105 641 patients (49±20 years, 62% male) met the inclusion criteria. The rSIG had the highest areas under the receiver operating characteristic curve for short-term mortality (0.800, CI: 0.791-0.809) and poor functional outcome (0.596, CI: 0.590-0.602). The cutoff for rSIG was 18 for short-term mortality and poor functional outcomes with sensitivities of 0.668 and 0.371 and specificities of 0.805 and 0.813, respectively. The positive predictive values were 9.57% and 22.31%, and the negative predictive values were 98.74% and 89.97%. rSIG also had better discriminant ability in geriatrics, traumatic brain injury, and nonpenetrating injury.
CONCLUSION: The rSIG with a cutoff of 18 was accurate for short-term mortality in Asian adult trauma patients. Moreover, rSIG discriminates poor functional outcomes better than the commonly used SI and MSI.
METHODS: This cross-sectional retrospective study conducted in Kelantan involved 104 newly diagnosed female BC patients from 2015 to 2016 who underwent chemotherapy. For statistical analysis, chi-square was used to compare between CIA and non-CIA groups. In addition, simple and multiple logistic regression were used to determine the association of the CIA.
RESULTS: Our study revealed that 34.6% (n=36) of patients had mild anaemia, and 59.6% (n=62) had normal haemoglobin at pre-chemotherapy. The prevalence of anaemia increased from 40.4% to 77% at the end of our study. About 30.8% of patients received PRBC transfusion during chemotherapy with mean haemoglobin before the first transfusion of 7.9 g/dl. CIA was observed in 54.8% of cases. There was no significant association between CIA concerning the patient characteristic, cancer characteristic, or cancer treatment.
CONCLUSION: We concluded that a significant proportion (40.4%) of BC patients was anaemic even before chemotherapy, with the red blood cell requirements up to 30.8% throughout chemotherapy. A larger prospective study is needed to determine the predictors for the CIA and subsequently improve patient management.
CASE REPORT: We report a case of a 45-year-old gentleman who presented with a painless anterior neck swelling and left supraglottic mass for six months. Computed tomography (CT) contrast imaging demonstrated a homogenous enhancing lesion at the left supraglottic and the midline of the anterior neck with erosive changes of the thyroid cartilage. A surgical resection of the anterior neck mass was performed. The diagnosis of Castleman disease plasma cell variant was made by histopathologic evaluation. The patient remained well post-resection.
CONCLUSION: Supraglottic multicentric Castleman disease is the least expected diagnosis in this case. Unicentric disease is treated with surgery. However, limited studies are available in determining the effectiveness of surgery in multicentric diseases. The plasma cell variant requires a multidisciplinary and multimodal approach due to an inclination towards malignancy. Research is needed to determine the role of surgery in multicentric disease and to develop optimum guidelines for managing cases. To date, there is unsubstantial literature describing supraglottic multicentric disease.
MATERIALS AND METHODS: Thirty-two primary caregivers were interviewed via audio-recorded semistructured focus group discussions to investigate their perceived barriers and challenges in caring for IWSNs. The qualitative data were then analyzed via thematic analysis.
RESULTS: Thirty-two participants took part in a total of nine discussion sessions, where the majority were females (n = 29; 90.63%) and from the Malay race (n = 30; 93.75%). Most of the IWSNs under their care had autism (n = 11; 34.38%) and were between 6 and 10 years of age (n = 13; 40.63%). The main themes identified were related to healthcare services, support systems, caregivers' personal factors, and IWSN issues. Within the healthcare services domain, themes regarding the accessibility and appropriateness of healthcare facilities and the attitudes of staff were uncovered, whereas in the support system domain, themes pertaining to community and peer, family, and governmental support were discussed. In the domain of caregivers' personal factors, themes regarding stress with the burden of care and feelings of guilt were noted, and in the area of IWSN factors, the theme of behavioral difficulties exhibited by IWSNs was discussed.
CONCLUSION: Primary caregivers in Malaysia face challenges with healthcare facilities and staff, gaining support from the community, family, and government, burning out, and feeling guilty as well as behavior issues of their IWSN. Thus, understanding these challenges is vital in providing healthcare services that cater to not only IWSNs but also their caregivers to ensure the success and well-being of all involved.
MATERIALS AND METHODS: Semistructured in-depth interviews were conducted with 20 parents of children with ECC. A topic guide was developed, focusing on questions relating to (i) the timing of their seeking information on ECC, (ii) the types of EEC information they seek, and (iii) the resources used to seek information. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was performed, whereby the data were coded and categorized into themes and subthemes.
RESULTS: Four main themes were identified: the immediacy of seeking information, perceived information need, use of resources, and barriers to seeking information. Parents either sought information immediately after detecting changes to the appearance of their child's teeth, with some being aware of the changes after signs and symptoms developed. The types of information parents usually sought covered the disease, its prevention, and management. Common sources of information were friends, family, the internet, and healthcare professionals. Barriers to seeking information discussed by parents were lack of time as well as insufficiency and inaccuracy of the information they received.
CONCLUSION: This study highlighted the need for comprehensive, tailored early education on ECC for parents using reliable information sources. There is also a need to empower other nondental healthcare professionals to provide oral healthcare education for parents.