METHODS: An online cross-sectional survey and modified Delphi study was conducted among healthcare professionals across Malaysia from 22 March to 31 August 2024. A modified Delphi process was used to develop a consensus from existing literature, with two Delphi rounds assessing the relevance, clarity, and importance of each question. Consensus was achieved if 90 % or more participants agreed.
RESULTS: Among 137 responses, 89.1 % of healthcare professionals were aware of rescue medications. However, only 62.0 % recognized the superior absorption and bioavailability of IM midazolam over rectal diazepam, and 78.1 % were aware of its efficacy in terminating seizures. Of those (69.3 %) involved in SE management, 29.5 % (n = 28) were engaged in prehospital management of SE. Only 35.7 % (n = 10) reported that prehospital personnel were permitted to use IM midazolam for SE management and all required physician endorsement. Notably, 78.9 % of participants reported that 25 % or fewer patients with SE were treated with IM midazolam. The main barriers include unfamiliarity (64.2 %) and lack of protocols (62.1 %). A strong consensus was reached on the recommendation of IM midazolam as a first-line treatment for SE management.
CONCLUSION: While Malaysian healthcare professionals are aware of rescue medications for prehospital seizure emergencies, they lack an understanding of IM midazolam's benefits. Key barriers include unfamiliarity and lack of protocols despite strong consensus on its first-line use.
METHODS: This prospective, single-arm, multi-center, observational, real-world registry, included 565 patients with long CAL (length 30 to ≤56 mm) in native coronary arteries (reference vessel diameters: 2.25 mm to 3.50 mm). Based on lesion length, patients were implanted with 30 mm, 40 mm, 50 mm, or 60 mm BioMime™ Morph SES. Primary endpoint was freedom of target lesion failure (TLF) at 6-month and up to 36-month.
RESULTS: Over 65 % of patients had lesions requiring 50 mm and 60 mm stents. The follow-up length was up to 24-month for the whole cohort and up to 36-month only for 211 patients from seven selected centers. The freedom from TLF rate was 97.86 %, 97.26 %, 96.27 %, and 95.15 % at 6-, 12-, 24-, and 36-month follow-ups, respectively. The cumulative rates of major adverse cardiac events (MACE) were 2.74 % at 12-month, 3.73 % at 24-month and 4.85 % at 36-month. Additionally, the rates of ischemia-driven target lesion revascularization were 2.01 % at 12-month, 2.16 % at 24-month, and 3.88 % at 36-month. Lastly, stent thrombosis (ST) was reported in only 2 cases (0.97 %) at 36-month.
CONCLUSION: The lower incidences of MACE and ST up to three-year follow-up indicate BioMime™ Morph SES is an effective and safe option for PCI in long CAL.
METHODS: The number of new incident cases and deaths for all cancers combined and for leading cancers were extracted from the GLOBOCAN 2022 database developed by the International Agency for Research on Cancer for the 11 countries in southeast Asia. For comparison, we extracted estimates from China, India, Japan, Pakistan, South Korea, and the USA. We estimated age-standardised incidence rates (ASIRs) and age-standardised mortality rates (ASMRs) per 100 000 person-years; projections to 2050 were also estimated by multiplying ASIR and ASMR estimates for 2022 by the expected population for 2050. Data on race or ethnicity were not collected.
FINDINGS: Data were extracted on Dec 5, 2024. For the 11 countries in southeast Asia for all cancers combined, 545 725 (47·6%) of a total of 1 146 810 incident cases were estimated in men and 601 085 (52·4%) incident cases were estimated in women in 2022. In the same period, 385 430 (53·8%) of a total of 716 116 deaths were estimated in men and 330 686 (46·2%) deaths were estimated in women. The total cancer ASIR in men and women was highest in Singapore (235·89 per 100 000 and 231·01 per 100 000 respectively), while the corresponding ASMR was greatest in Laos for men (132·91 per 100 000) and Brunei for women (104·20 per 100 000). Breast cancer was the most common cancer among women in all countries (highest ASIRs in Singapore [72·61 per 100 000] and the Philippines [60·34 per 100 000]), and the most common cause of cancer mortality among women in the Philippines (ASMR 21·47 per 100 000), Malaysia (19·30 per 100 000), Singapore (17·82 per 100 000), Viet Nam (14·67 per 100 000), Indonesia (14·35 per 100 000), and Timor-Leste (10·24 per 100 000). Among men, lung cancer was the most frequently diagnosed cancer in the Philippines (ASIR 37·66 per 100 000), Malaysia (23·23 per 100 000), Myanmar (21·59 per 100 000), and Indonesia (21·30 per 100 000), and the leading cause of death due to cancer in the Philippines (ASMR 33·59 per 100 000), Singapore (31·94 per 100 000), Brunei (23·84 per 100 000), Malaysia (20·42 per 100 000), Myanmar (19·91 per 100 000), Indonesia (18·96 per 100 000), and Timor-Leste (12·95 per 100 000). Liver cancer contributed the greatest incidence and mortality in men in Cambodia, Laos, Viet Nam, and Thailand, and was also the leading cause of death due to cancer among women in Laos (ASMR 13·49 per 100 000), Cambodia (13·34 per 100 000), and Thailand (12·14 per 100 000). Cervical cancer was the leading cause of death due to cancer in women in Myanmar (ASMR 13·37 per 100 000); colorectal cancer was the most common cancer in men in Singapore (ASIR 39·41 per 100 00) and Brunei (37·70 per 100 000). By 2050, 2·03 million new cases of cancer are anticipated in southeast Asia annually, an 89·2% increase in men and a 65·6% increase in women, relative to 2022.
INTERPRETATION: The current patterns of cancer incidence and mortality in southeast Asia are primarily driven by breast cancer in women and lung cancer in men, but infection-related cancers (liver and cervix) are common in some countries. Regional collaborations must be strengthened to improve cancer prevention, diagnosis, care, and research in southeast Asia.
FUNDING: National Cancer Institute and the Prostate Cancer Foundation.
METHOD: This prospective cross-sectional study included forty-four adults with OSA. We compared three measurements between LCR and HBL-3DS images: modified facial profile angle (MFPA), nasolabial angle (NLA), and mandibular length (ML). Additionally, the 3D images of thirty-four participants with OSA indices were analysed for seventeen parameters, such as angles, ratios, and linear distances.
RESULTS: This study revealed significant strong correlations (p