METHODS: A retrospective descriptive cohort study on the audiological findings detected during the first hearing assessment done on a child with craniosynostosis using otoacoustic emissions, pure tone audiometry or auditory brainstem response examination. The main aim of this study was to evaluate the type and severity of hearing loss when compared between syndromic and non-sydromic craniosynostosis, and other associated contributory factors.
RESULTS: A total of 31 patients with 62 ears consisting of 14 male patients and 17 female patients were evaluated. Twenty two patients (71%) were syndromic and 9 (29%) were non-syndromic craniosynostosis. Amongst the syndromic craniosynostosis, 9 (41%) had Apert syndrome, 7 (32%) had Crouzon syndrome, 5 (23%) had Pfieffer syndrome and 1 (4%) had Shaethre Chotzen syndrome. Patients with syndromic craniosynostosis were more likely to present with all types and severity of hearing loss, including severe to profound sensorineural hearing loss while children with non-syndromic craniosynostosis were likely to present with normal hearing (p
AIMS: This qualitative study aims at identifying and analysing the coping strategies adopted by the family caregivers in dealing with their mentally ill family members.
METHOD: A total of 15 family caregivers from the state of Kedah, Malaysia participated in the face-to-face semi structured interview.
RESULTS: The study findings identified an array of coping strategies used by the family caregivers, including religious coping, emotional coping, acceptance, becoming engaged in leisure activities, and the use of traditional healing to help them cope with their mentally ill members. Suggestions and conclusions: Study suggests that the family caregivers should engage themselves in social support groups to learn about and obtain the positive coping strategies used by other caregivers who have similar experiences in caring for the mentally ill. Study also suggests that they should get appropriate training from the mental health professionals in order to enhance the caregivers' coping skills.
METHODS: This is single centre cross-sectional study involved 105 traumatic head injury patients under the Neurosurgical Department Hospital Sultanah Aminah, Johor Bahru, Malaysia. The primary investigator will do an interview and the patients will be asked question to complete a questioner from SF-36 (36 questions). Subsequently, consent for participation will be taken and blood sampling will be done.
RESULTS: Thirty-three patients were noted to have anterior pituitary dysfunction. The mean age was 36.97 ± 12.96 years old. Twenty-seven patients (32.5%) were male and six patients were female (27.3%). Chronic anterior pituitary dysfunction in patients with a severe traumatic head injury around 47.1% (23 patients), as compared to a moderate head injury (8 patients, 38.1%) and 2 sustained mild head injury (5.6%). The mean duration after the onset of trauma was 10.3 ± 1.79 months. All patient with anterior pituitary dysfunction had positive CT brain findings with 22 had subarachnoid haemorrhage (SAH) at the basal cistern and 27 patients had a base of skull fracture, where 52.1% of the patient underwent surgical intervention, 84.8% involved one axis and another 5 patients had two axes involved. Severity of the head injury (P < 0.001), prolonged duration of hospital stay (P = 0.014), radiological findings of a base of skull fracture (P < 0.001) and presence of SAH at basal cistern (P < 0.001) was significantly associated with pituitary dysfunction. The patient with anterior pituitary dysfunction has the lower 36-item Short Form Survey (SF-36) marks 56.3 ± 10.3.
CONCLUSION: The prevalence of hypopituitarism was 31%. Indicators are increased TBI severity, prolonged hospitalisation and positive finding in radiological assessment. Post-traumatic chronic anterior pituitary dysfunction also related with poor quality of life as showed by low SF-36 marks.
Methods: This study was conducted to compare the outcomes of early and late tracheostomies in severe TBI. Only severe TBI patients who were admitted to the Neurosurgery High Dependency Unit (NHDU), Hospital Sultanah Aminah (HSA), Johor Bahru, Johor, Malaysia and who had underwent a tracheostomy were recruited. Three main outcomes noted: duration on ventilation, length of NHDU stay and rate of ventilator associated pneumonia (VAP).
Results: Out of 155 patients, 72 (46.5%) were in early tracheostomy group (ETG) and 83 (53.5%) were in late tracheostomy group (LTG). The majority of the participants, 95 (61.3%) were ethnic Malays. The mean duration on ventilator use was 2.65 days (1.57) for ETG and 5.63 days (2.35) for LTG. While, mean NHDU stay was 4.75 days (1.98) for ETG and 9.77 days (2.70) for LTG. Upon independent t-test, early duration of tracheostomies had shown significant outcome in reducing length of NHDU stay, (P < 0.001) and had shortening participants' time on mechanical ventilator (P < 0.001). Then, based on forward multiple logistic regression test, there were significant association between comorbid (P = 0.003) and tracheostomy (P = 0.020) towards presence of VAP when adjusted for other variables.
Conclusion: In this study it was found that early tracheostomy was significant in shortening the duration on ventilator, reducing the length of NHDU stay and reducing the rate of VAP.
Method: This randomised controlled trial enrolled 200 patients who underwent emergency open appendicectomy. Permuted block randomisation was used to assign subjects to either mechanical retraction or double ring WEP. The primary endpoints were SSI rates and cost analysis between the methods.
Results: The incidence of SSI was similar, n = 7 (7.4%) in the control group and n = 8 (8.4%) in the WEP group, and demonstrates no statistically significant difference (p > 0.05). Cost analysis showed a statistically significant (p