MATERIALS AND METHODS: Retrospective cohort study conducted at Department of ENT and Head & Neck Surgery, Saveetha Medical College Hospital, Thandalam, Chennai, Tamil Nadu, India from September 2022 to March 2024. We included patients presenting with vertigo or dizziness, excluding those with non-vestibular dizziness or incomplete medical records. We analysed demographic data, medical history, and clinical findings from patient records. Data analysis was performed. Continuous variables were compared using independent sample t-tests and categorical variables using chi-square tests.
RESULTS: The study included 268 patients, predominantly females (57.8%) and individuals aged 40-50 years (29.9%). Benign Paroxysmal Positional Vertigo (BPPV) was the most common etiological factor (41.0%), followed by orthostatic dysregulation (17.2%) and vestibular peripheral dysfunction (VPD) (16.0%). Clinical presentations and outcomes varied with the underlying etiology. Overall, 91.0% of the patients showed improvement following treatment, with 7.1% achieving full recovery.
CONCLUSION: This study highlights the complexity of vertigo and dizziness, which are influenced by various factors and demographics. This emphasizes the importance of tailored management strategies and a patient-centered, multidisciplinary approach, emphasizing customized treatments to improve patient outcomes.
METHODOLOGY: The cross-sectional study retrospectively reviewed certified RTA fatalities from 2018 to 2021, individually counting fatalities in accidents and excluding cases with incomplete death profiles. Data were collected from all Forensic Departments in the government hospitals in Perak. RTA fatalities were confirmed by medical officers/physicians following established procedures during routine procedures. A total of 2517 fatal accident and victim profiles were transcribed into data collection form after reviewing death registration records and post-mortem reports. Inferential analyses were used for comparison between pre- and during COVID-19 pandemic. The standard expected YLL was calculated by comparing the age of death to the external standard life expectancy curve taking into consideration of age and gender in Malaysia.
RESULTS: This study included 2207 (87.7%) of the RTA fatalities in Perak State. The analysis revealed a decreasing trend in RTA deaths from 2018 to 2021, with a remarkable Annual Percent Change (APC) of -25.1% in 2020 compared to the pre-pandemic year in 2019 and remained stable with lower APC in 2021. Comparison between pre-pandemic (2018-2019) and pandemic years (2020-2021) revealed a difference in the fatality distribution with a median age rise during the pandemic (37.7 (IQR: 22.96, 58.08) vs. 41.0 (IQR: 25.08, 61.00), p = 0.002). Vehicle profiles remained consistent, yet changes were observed in the involvement of various road users, where more motorcycle riders and pedestrian were killed during pandemic (p = 0.049). During pandemic, there was a decline in vehicle collisions, but slight increase of the non-collision accidents and incidents involving pedestrians/animals (p = 0.015). A shift in accident from noon till midnight were also notable during the pandemic (p = 0.028). YLL revealed differences by age and gender, indicating a higher YLL for females aged 30-34 during the pandemic.
CONCLUSION: The decline in RTA fatalities during COVID-19 pandemic underscores the influence of pandemic-induced restrictions and reduced traffic. However, demographic shifts, increased accident severity due to risky behaviors and gender-specific impacts on YLL, stress the necessity for improved safety interventions amidst evolving dynamics.
METHODS: A retrospective review was conducted on 99 women who underwent Surelift System surgery for advanced POP Stage III and IV between July 2018 to January 2020. Objective evaluation included Pelvic Organ Prolapse Quantification (POP-Q), multichannel urodynamic (UDS), and introital 2D ultrasonographic measurement. Subjective evaluation uses validated questionnaires of Incontinence Impact Questionnaire-7(IIQ-7), Urogenital Distress Inventory-6(UDI-6), Pelvic Organ Prolapse Distress Inventory 6(POPDI-6), Colorectal Anal Distress Inventory-8(CRADI-8) and Pelvic organ prolapse/ Urinary Incontinence Sexual Questionnaire (PISQ-12). Outcomes were examined at 3 months, yearly and at 3 years postoperative. Secondary outcome included de novo or persistent urodynamic stress incontinence (USI) and surgical complications.
RESULTS: Eighty-five women were included in the final analysis. At 3 years postoperative, the objective cure rate was 94.1 % and subjective cure rate of 91.8 %. Ultrasonography revealed initial mesh elongation and thickening at first year, resolving by the third year, while the distance between the bladder neck and mesh remained stable. Significant improvement in POP-Q components (Aa,Ba,C,Ap,Bp and TVL of p
Methodology: This is a cross-sectional study looking at data over a period of 16 years (2000-2016). Confirmed cases had thyroid scan at the age of 3-years-old and repeated TFT (after 6 weeks off medications). Relevant data was collected retrospectively.
Results: Forty (60% female) children with CHT were included in the study. Thirty (75%) children presented with high cord TSH. Nine (23%) presented after 2 weeks of life. Majority were diagnosed with TDH (42.5%) with TD and TH of 40% and 17.5% respectively. Median cord TSH of children with TD was significantly higher compared to TDH and TH (p=0.028 and p=0.001 respectively). L-thyroxine doses were not significantly different between TD, TDH and TH at diagnosis or at 3 years.
Conclusions: TDH is highly prevalent in our population. TD may present after 2 weeks of life. One in five children treated for CHT had TH. Differentiating TD, TDH and TH before initiating treatment remains a challenge in Malaysia. This study provides clinicians practical information needed to understand the possible aetiologies from a patient's clinical presentation, biochemical markers and treatment regime. Reassessing TH cases may be warranted to prevent unnecessary treatment.
Methodology: IO HAT was a non-interventional, multicentre, 6-month retrospective and 4-week prospective study of hypoglycaemic events among insulin-treated adults with T1D or T2D, including four countries in Southeast Asia (Singapore, Philippines, Indonesia, and Bangladesh). Data were collected using a two-part self-assessment questionnaire (SAQ1 for retrospective and SAQ2 for prospective). The primary endpoint was the percentage of patients experiencing at least one hypoglycaemic event during the 4-week prospective observational period (ClinicalTrials.gov Identifier: NCT02306681).
Results: A total of 2594 patients completed SAQ1. Nearly all patients reported experiencing any hypoglycaemic event in the 4-week prospective period (T1D, 100%; T2D, 97.3%), with all patients reporting higher rates in the prospective versus retrospective period. Severe hypoglycaemia was also reported higher prospectively (57.2% and 76.9%) than retrospectively (33.9% and 12.2%) in both T1D and T2D, respectively. Nocturnal hypoglycaemia was reported higher retrospectively than prospectively.
Conclusion: Incidence of any and severe hypoglycaemia in the Southeast Asian cohort of IO HAT was higher prospectively versus retrospectively, suggesting hypoglycaemia has previously been under-reported in this region.
Methodology: This sub-analysis included Filipino patients with T1DM or T2DM, aged 18 years and older, treated with insulin for more than 12 months, who completed the two-part self-assessment questionnaires (SAQ1 and SAQ2) and patient diaries that recorded hypoglycemia during retrospective (6 months/4 weeks before baseline) and prospective period (4 weeks after baseline) (ClinicalTrials.gov number: NCT02306681).
Results: A total of 671 patients were enrolled and completed the SAQ1 (62 patients with T1DM and 609 patients with T2DM). Almost all patients (100% in T1DM and 99.3% in T2DM) experienced at least 1 hypoglycemic event prospectively. The incidence of any hypoglycemia was also high in the prospective period compared to retrospective period (72.6 [95% CI: 64.8, 80.9] events PPY and 43.6 [95% CI: 37.8, 49.9] events PPY; p=0.001, respectively) in T1DM patients.
Conclusion: Among insulin-treated patients, higher rates of hypoglycemia were reported prospectively than retrospectively. This indicates that the patients in real-life setting often under-report hypoglycemia. Patient education can help in accurate reporting and appropriate management of hypoglycemia and diabetes.
MATERIALS AND METHODS: This is a retrospective unmatched case-control study. The required data was obtained from the medical records maintained by the University Tanjungpura Hospital, Pontianak City, Indonesia. Simple random sampling was used to select and equally divide the 60 chosen respondents into LBW case and normal birth weight control groups.
RESULTS: Mothers with low educational levels had a 1.5 times greater chance of giving birth to LBW babies. The results of the multivariate analysis also revealed a correlation between gestational age (GA), incidence of premature rupture of membranes (PROM), and intrauterine growth restriction (IUGR) and that their combined effects that contributed to 56% of LBWIs.
CONCLUSION: Low maternal education level, low gestational age, IUGR, and premature rupture of membranes contribute to LBW babies. This study recommends that it is necessary to educate women of childbearing age about routine antenatal care checks to identify risk factors that can lead to LBW.
MATERIALS AND METHODS: This descriptive retrospective study featured 221 patients diagnosed with clinically critical COVID-19 from August 2021 to March 2022 in the Intensive Care Unit (ICU) of RSUP Dr. M. Djamil, Padang, Indonesia. The study employed a total sampling technique to collect data from medical records in the hospital. Patients aged 18 years or older who underwent testing for leukocytes, platelets, neutrophils, and lymphocytes were included in the study. We analysed the data using descriptive univariate analysis. Then, the NLR and PLR of the patients were statistically compared based on comorbidities and coincidence.
RESULTS: According to the study, most patients with critically ill COVID-19 exhibited high levels of NLR (88.2%) and PLR (71.1%). The severe COVID-19 patients with comorbidity of kidney disease had the highest NLR (Mean ± SD) of 31.74 ± 27.95 (p-value <0.001) and the highest mean PLR (Mean ± SD) of 469.33 ± 362.95 (p-value 0.001).
CONCLUSION: Our findings showed a significantly higher NLR and PLR in patients with critically ill COVID-19, particularly in patients with comorbidity of kidney disease. Thus, elevated levels of NLR and PLR were identified as potential prognostic markers for predicting disease severity in COVID-19 patients, especially those with kidney comorbidity.
MATERIALS AND METHODS: Over a period of 10 years (1989 to 1999), 34 patients with dentofacial deformities who had orthognathic surgery were reviewed; patients with cleft lip and palate or syndromes were excluded.
RESULTS: The mean age (range, 17 to 35 years) of the patients was 24.3 years and the ratio of female to male was 2.4:1. The predominant ethnic group was Chinese, with females (47.1%) forming the largest group. The main reason for seeking surgery was aesthetic improvement (41%). The majority of the patients had skeletal class III pattern (91%) and bilateral sagittal split osteotomy was the most common surgery done (82%). Postoperative complications were mainly paraesthesia/numbness (56%) and infection (15%). In long-term review, 2 (6%) patients had persistent numbness of the inferior alveolar nerve.
CONCLUSION: The findings suggest that the majority of the patients are young adult female students with skeletal class III pattern and treated for mandibular prognathism. The complication of persistent numbness and higher rate of postoperative infection indicate that longterm reviews and good antibiotic prophylaxis/therapy are necessary.
METHODS: This is a review of the published literature related to the outbreak with the focus on human diseases.
RESULTS: The encephalitis was caused by a newly discovered paramyxovirus related to Hendra virus, later named Nipah virus. There were 265 patients with acute encephalitis. The disease is thought to spread from pig to man through close contact. The risk of human-to-human spread is thought to below. The disease affected mainly adult Chinese males, half of whom had affected family members. The disease presented mainly as acute encephalitis with a short incubation period of less than two weeks, with the main symptoms of fever, headache, and giddiness followed by coma. Distinctive clinical signs include segmental myoclonus, areflexia and hypotonia, hypertension, and tachycardia. Initial cerebrospinal fluid was abnormal in 75% of patients. Serology was helpful in confirming the diagnosis. Magnetic resonance imaging showed distinctive changes of multiple, discrete, and small high signal lesions, best seen with fluid-attenuated inversion recovery (FLAIR) sequences. Mortality was high at 40% and death was probably due to severe brainstem involvement. The main necropsy finding in acute encephalitis was that of disseminated microinfarction associated with vasculitis and direct neuronal involvement. Ribavirin was able to reduce the mortality by 36%. Relapse encephalitis was seen in 7.5% of those who recovered from acute encephalitis, and late-onset encephalitis in 3.4% of those with initial non-encephalitic or asymptomatic diseases. The mean interval between initial illness and the onset of the complication was 8.4 months. The relapse and late-onset encephalitis which manifested as focal encephalitis arose from recurrent infection.
CONCLUSION: Nipah virus, a recently discovered paramyxovirus, causes a unique encephalitis with high mortality as well as relapse and late-onset encephalitis. The infection is mainly spread from pigs to man.