MATERIALS AND METHODS: A prospective, observational crosssectional survey was conducted from 1st May 2022 to 31st December 2022 at the University of Malaya Medical Centre, Kuala Lumpur. This survey included all neurosurgical patients aged 18 and above requiring urgent and semiemergency surgery. The next of kin were interviewed using a standardised questionnaire to obtain their perspectives on the effectiveness of the current consenting process, as well as to explore potential alternative methods for obtaining consent. Data were analysed using IBM SPSS Statistics.
RESULTS: The survey had 103 responses. The analysis revealed that the most common semi-emergency surgical procedures were craniotomy (22 cases) and external ventricular drain insertion (18 cases), followed by burr hole and drainage (14 cases). The most common primary diagnosis that needed urgent intervention was acute hydrocephalus. Interestingly, more than half of the patients (58 cases, 56.3%) had to wait for over 30 minutes to obtain consent from their next of kin prior to surgery. The next of kin interviewed had an age range of 25 to 72 years. The relationships of the next of kin were children (33 subjects), spouses (26 subjects), siblings (25 subjects), and parents (16 subjects) of the patients. Additionally, 96.1% of the respondents owned a smartphone with a mobile internet data connection, and 85.4% had internet connectivity at home. The most preferred method of telecommunication for this exercise was via WhatsApp. An interesting finding was the association between the level of trust in medical professionals and the preferred consent method. It was discovered that individuals who preferred physical consent had lower trust in the hospital and doctors, while those who preferred remote consent had higher trust.
CONCLUSION: The urban Malaysian population are ready to embrace telecommunication for next-of-kin consent in semiemergency neurosurgical scenarios. These findings form a precursor to further studies to develop algorithms for a secure remote digital surgical consenting platform for urgent or semi-emergency surgical cases.
METHODS: This self-controlled case series study used nationwide health database from Malaysia. The study included individuals aged ≥18 years who were hospitalised between 24 February 2021 and 30 June 2022. Outcomes were composite of MACCE: stroke, acute ischaemic heart disease, and cardiovascular death. Exposures were COVID-19 vaccination and SARS-CoV-2 infection. The risk period was day 1 to day 21 following exposure. Conditional Poisson regression model was used to estimate the incidence rate ratios (IRRs) and 95 % confidence interval (CI) comparing the outcomes in the risk and control periods.
RESULTS: The risk of MACCE within 21 days after vaccination per 100,000 doses administered were 12.0 (95% CI 11.9-12.1) (BNT162b2), 9.2 (95% CI 9.1-9.3) (CoronaVac), and 6.8 (95% CI 6.6-7.0) (ChAdOx1). The incidence rate ratios showed no increased risk of MACCE associated with the first, second, or third doses of BNT162b2, CoronaVac, and ChAdOx1 vaccines for individuals without prior cardiovascular disease (CVD). This finding was consistent for individuals with CVD. Vaccine booster dose, whether in a homologous or heterologous schedule, did not show increased risk of MACCE. Analysis by ethnic groups detected a slightly elevated risk of MACCE in Indian after the first dose of ChAdOx1 (IRR 1.64; 95% CI 1.08-2.48) in those without CVD. No significant association were observed in other subgroup analyses. SARS-CoV-2 infection was associated with significantly increased risk of MACCE in individuals without CVD (IRR 3.54; 95% CI 3.32-3.76) and with CVD (IRR 1.98; 95% CI 1.61-2.34).
CONCLUSIONS: Our findings support the favourable safety profile of these COVID-19 vaccines and indicate that the overall benefit-risk ratio of the COVID-19 vaccines remains positive.
METHODS: From 5115 participants enrolled in 1985-1986 in the Coronary Artery Risk Development in Young Adults Study, 2533 had serial measures of depressive symptoms and subsequent echocardiography to measure normal LV geometry, concentric remodeling, and LVH. The primary exposure variable was trajectories of the Center for Epidemiologic Studies Depression (CES-D) scale score from 1990-1991 to 2010-2011. Multivariable polytomous logistic regression was used to assess associations of trajectories with a composite LV geometry outcome created using echocardiogram data measured in 2010-2011 and 2015-2016. Sex-specific conflicting results led to exploratory models that examined potential importance of testosterone and sex hormone-binding globulin.
RESULTS: Overall CES-D and Somatic subscale trajectories had significant associations with LVH for female participants only. Odds ratios for the subthreshold (mean CES-D ≈ 14) and stable (mean CES-D ≈ 19) groups were 1.49 (95% confidence interval = 1.05-2.13) and 1.88 (95% confidence interval = 1.16-3.04), respectively. For female participants, sex hormone-binding globulin was inversely associated with LVH, and for male participants, bioavailable testosterone was positively associated with concentric geometry.
CONCLUSIONS: Findings from cross-sectional and longitudinal regression models for female participants, but not male ones, and particularly for Somatic subscale trajectories suggested a plausible link among depression, androgens, and LVH. The role of androgens to the depression-LVH relation requires additional investigation in future studies.
METHODS: The prevalence and attributable burden of each target indicator were estimated by age group, sex, and year in 204 countries and territories from 2012 to 2021 in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, the most comprehensive assessment of causes of death, disability, and risk factors to date. Country-specific relative performance to date was evaluated with a Bayesian meta-regression model that compares prevalence to expected values based on Socio-demographic Index (SDI), a composite indicator of societal development status. Target progress was forecasted from 2021 up to 2050 by modelling past trends with meta-regression using a combination of key quantities and then extrapolating future projections of those quantities.
FINDINGS: In 2021, a few countries had already met some of the GNTs: five for exclusive breastfeeding, four for stunting, 96 for child wasting, and three for child overweight, and none met the target for low birthweight or anaemia in females of reproductive age. Since 2012, the annualised rates of change (ARC) in the prevalence of child overweight increased in 201 countries and territories and ARC in the prevalence of anaemia in females of reproductive age decreased considerably in 26 countries. Between 2012 and 2021, SDI was strongly associated with indicator prevalence, apart from exclusive breastfeeding (|r-|=0·46-0·86). Many countries in sub-Saharan Africa had a decrease in the prevalence of multiple indicators that was more rapid than expected on the basis of SDI (the differences between observed and expected ARCs for child stunting and wasting were -0·5% and -1·3%, respectively). The ARC in the attributable burden of low birthweight, child stunting, and child wasting decreased faster than the ARC of the prevalence for each in most low-income and middle-income countries. In 2030, we project that 94 countries will meet one of the six targets, 21 countries will meet two targets, and 89 countries will not meet any targets. We project that seven countries will meet the target for exclusive breastfeeding, 28 for child stunting, and 101 for child wasting, and no countries will meet the targets for low birthweight, child overweight, and anaemia. In 2050, we project that seven additional countries will meet the target for exclusive breastfeeding, five for low birthweight, 96 for child stunting, nine for child wasting, and one for child overweight, and no countries are projected to meet the anaemia target.
INTERPRETATION: Based on current levels and past trends, few GNTs will be met by 2030. Major reductions in attributable burden for exclusive breastfeeding and anthropometric indicators should be recognised as huge scientific and policy successes, but the comparative lack of progress in reducing the prevalence of each, along with stagnant anaemia in women of reproductive age and widespread increases in child overweight, suggests a tenuous status quo. Continued investment in preventive and treatment efforts for acute childhood illness is crucial to prevent backsliding. Parallel development of effective treatments, along with commitment to multisectoral, long-term policies to address the determinants and causes of suboptimal nutrition, are sorely needed to gain ground.
FUNDING: Bill & Melinda Gates Foundation.
METHODOLOGY: A retrospective cohort study was conducted for patients who underwent treatment for ameloblastoma from 2007 to 2021. All patients with histopathologically proven ameloblastoma and underwent at least 2 years of follow-up were included in the study.
RESULTS: Fifty-one patients met the study's inclusion criteria. The mean age was 39.8 +/- 18.8 years old, and the mean follow-up period was 80 +/- 51 months. A recurrence was observed in 10 patients out of 51 patients (19.6%). There was significant association between histologic pattern and tumor recurrence ( P <0.05). Most of the recurrence cases showed mixed histologic subtypes with the predominant variant lead by acanthomatous-follicular subtypes.
DISCUSSION: The recurrence rate in our study, 19.6% was in line with other studies. (17.2%-24.0%) Conventional ameloblastoma with mixed acanthomatous and follicular subtypes were the most common histologic variant in recurrence cases of our study. In our study, the recurrence rate for enucleation with peripheral ostectomy was 26.7% in conventional ameloblastoma, which was lower than the reported rates, 33.3%.
CONCLUSIONS: Our data indicate that the conservative treatment can preserve the appearance and function well, at the same time keeping the risk of recurrence lower than currently published figures.
METHODS: This study used a descriptive qualitative method with in-depth interviews using a semi-structured interview guide. Ethical clearance was obtained, and fourteen young adults who smoked were recruited by purposive sampling. Before the interview, participants watched five videos with the following categories: 1) the health impact of active smoking, 2) the health impact of passive smoking, and 3) the burden on the family of smokers getting smoking-related diseases. Data analysis was conducted using inductive content analysis.
RESULTS: Five themes describe smokers' perceptions of videos depicting the effects of smoking: a) The video is interesting and can help imagine real condition visualization of the impact of smoking; b) The video deeply resonates with smokers; c) The health impact of the passive smoker and family video is more impactful than the health impact of active smoking video; d) The health impact of active smoking videos make smokers aware of smoking on themselves; e) These videos can increase motivation to quit smoking.
CONCLUSION: This research can be a recommendation in health education and smoking cessation counseling using videos that describe the health impact of smoking, especially with an approach that highlights the effects on passive smokers and families.
Methods: Data were collected during household surveys conducted between 2016 and 2020 in the five surveillance sites in Bangladesh, India, Indonesia, Malaysia and Viet Nam. We defined hypertension as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg or taking blood pressure-lowering medication. We defined hypertension control as systolic blood pressure adults.
Conclusion: While hypertension awareness and treatment varied widely across surveillance sites, hypertension control was low in all sites.
AIM: The mediating role of epistemic justification was investigated regarding its relationship between COVID-19 conspiracy beliefs and COVID-19 vaccine conspiracy beliefs.
METHODS: A cross-sectional study was conducted incorporating a multifactorial correlational design. Using convenience sampling, 690 participants (55.7% females, Mage = 32.24 years, SD = 9.75) from different regions of Türkiye completed an online survey via Google Forms.
RESULTS: The results demonstrated a strong and statistically significant correlation between beliefs in COVID-19 conspiracy theories and beliefs in COVID-19 vaccination conspiracy theories. The mediating effects of justification by authority and personal justification were statistically significant between COVID-19 conspiracy beliefs and COVID-19 vaccine conspiracy theories.
CONCLUSION: Using the COVID-19 pandemic as an example, the present results indicated the complex relationships between conspiracy beliefs and epistemic justification. The present results indicate the importance of authorities in taking early action to provide scientific evidence and information to the public to avoid individuals believing false information.
METHODS: This is a retrospective cohort study among TB with Comorbidities cases in Negeri Sembilan using multiple secondary surveillance databases: National Tuberculosis Registry (NTBR), National Aids Registry (NAR) and National Diabetic Registry (NDR). The data review was from April 2024 until June 2024. All registered TB cases with comorbidities in Negeri Sembilan from the year 2018 to 2023 were analysed to determine the determinants of successful TB treatment among TB with comorbidities patients.
RESULTS: Out of 712 TB cases with comorbidities, 541 (76.0%) achieved a successful TB treatment outcome, and 171 (24.0%) did not. The successful TB treatment among TB with comorbidities showed predominantly among male (72.5%), Malay ethnicity (65.4%), secondary education level (60.3%), and unemployed working status (70.1%). Diabetes mellitus (DM) was the most common comorbidity (70.4%), followed by hypertension (44.8%), dyslipidaemia (36.0%), HIV (19.5%), and viral hepatitis (18.1%). Factors significantly associated with successful TB treatment were those who had a secondary education level (AOR: 2.222; 95% CI: 1.129, 4.374) and a tertiary education level (AOR: 4.474; 95% CI: 1.428- 14.01), were diagnosed with TB in the government hospital (AOR: 0.053; 95% CI: 0.008-0.376), and were not done Acid- Fast Bacillus sputum in the intensive phase of treatment (AOR: 0.191; 95% CI: 0.046, 0.785), cases followed the Directly Observed Therapy at the intensive phase (AOR: 9.045; 95% CI: 4.604, 17.770), and the treatment duration was more than 6 months (AOR: 6.511; 95% CI: 3.383, 12.532).
CONCLUSION: The successful treatment outcome for TB with comorbidities still falls short of the target and, if not treated well, could potentially lead to prolonged disease transmission, higher mortality rates, and increased healthcare costs. Identifying the proportion of successful treatment rates and their determinants provides insight into the disease burden and helps the public health sector and medical professionals assess and take appropriate action to improve local integration and collaborative service approaches for TB patients with concurrent comorbidities.
MATERIALS AND METHODS: This is a retrospective cohort study utilising secondary data from the National Tuberculosis Registry (NTBR). The study was conducted in Selangor among relapsed TB patients who were registered in NTBR from 1 January 2015 to 31 December 2019. TB disease profile, TB treatment profile, comorbidities, and sociodemographic data were examined. The determinants of unsuccessful treatment outcomes among relapsed TB patients were identified using multiple (binary) logistic regression analyses.
RESULTS: 896 patients who experienced relapsed tuberculosis were included in this study. 32.25% were reported to have unsuccessful treatment outcomes. Multiple (binary) logistic regression revealed that the absence of sputum smear examination at 5 months and beyond was a determinant of unsuccessful treatment outcome (AOR 1.70 (95% CI: 1.19, 2.44). Additionally, being treated in government facilities, such as government hospitals and government primary health clinics, was a protective factor (AOR 0.06 (95% CI: 0.03, 0.15) and AOR 0.02 (95% CI: 0.01, 0.04), respectively.
CONCLUSION: The high proportion of unsuccessful treatment outcomes among relapse TB patients stresses the importance of adherence to routine sputum monitoring and public-private partnerships.
MATERIALS AND METHODS: The Second Victim Experience and Support Tool for Recovery (SVEST-R) questionnaire was utilized to conduct an anonymous survey on the healthcare providers in Sarawak General Hospital (SGH) from August to October 2018.
RESULTS: A total of 482 respondents participated in the survey and 46.1% of the respondents reported SVE following their involvement in PSIs. Notably, symptoms such as flashbacks, fear, and stress tend to persist for longer durations compared to other symptoms. It is worth noting that non-work-related support received the highest mean (medical doctors = 3.83; nurses = 3.70), indicating that respondents preferred to seek emotional support from their friends and families. Furthermore, nurses reported a significantly higher experience of absenteeism following PSIs than doctors (p=0.003). In addition, most respondents expressed a desire for discussion or counselling with a respected peer or supervisor following their involvement in PSIs.
CONCLUSION: Present study reported a relatively high prevalence of SVE among healthcare providers at SGH. Hence, proactive measures, including non-work related and supervisor support, are essential in facilitating their overall well-being and successful recovery.
MATERIALS AND METHODS: Candidates shortlisted by three dental schools were invited to participate in a self-administered questionnaire study, featuring a validated instrument containing sociodemographic questions and 16 motivational items grouped into four domains: economic, professional, vocational and personal background reasons. The variations in motivational item scores across sociodemographic factors were assessed using the Mann-Whitney U test (age, sex, ethnicity, having relatives in the dental profession and dentistry as the first choice) and Kruskal-Wallis test (dental school and family income).
RESULTS: A total of 295 dental school candidates participated in the study (Universiti Teknologi MARA: 137; Universiti Kebangsaan Malaysia: 99; MAHSA University: 59). Approximately 95% of participants identified dentistry as their primary career choice, with the vocational motivation of 'I like to help people' being the most prominent motivational factor. Dental school emerged as the critical factor significantly influencing three quarters of the motivational items. Sex, ethnicity and having relatives in the dental profession were the remaining factors significantly associated with variations in certain motivational items. Both dental school and ethnicity significantly affected four motivational domains (economic, professional, vocational and personal background).
CONCLUSION: This study provides an insightful overview of the sociodemographic factors that impact career decision-making among prospective dental students. The scores for most motivational items varied among shortlisted candidates in three dental schools. The findings hold implications for policy development in dentistry by universities and public policymakers.
MATERIALS AND METHODS: A cross-sectional observational study design was used. Patients were recruited through purposive sampling from pulmonology outpatient clinic and inpatient ward at Jemursari Islamic Hospital (RSI Jemursari), Surabaya from July 2023 to December 2023. All enrolled patients should have been previously tested positive or negative for pulmonary TB using AFB staining, Xpert MTB and chest x-ray. Blood samples of the patients were collected and processed using the IchromaTM IGRA-TB diagnostic kit. The results were then compared with gold standard methods for calculating the IGRA-TB diagnostic value.
RESULTS: A total of 56 adult patients were enrolled in this study. The sensitivity, specificity, PPV, NPV and accuracy rate of IGRA-TB using IchromaTM IGRA-TB diagnostic kit were 80.56%, 85%, 90.62%, 70.83% and 82.14%, respectively.
CONCLUSION: IchromaTM IGRA-TB showed reasonably high diagnostic sensitivity and specificity, indicating that this method can be further utilised as a diagnostic and screening tool for pulmonary TB.
METHODS: A total of eight cattle, goat and sheep farms in six states in Peninsular Malaysia participated in a cross-sectional survey between August and October 2013.
RESULTS: A total of 151 (72.2%) out of 209 farmworkers answered the questionnaire. More than half of the farmworkers (n = 91) reported an experience of tick bites. Farms with monthly acaricide treatment had significantly (P<0.05) a low report of tick bites. Tick bite exposure rates did not differ significantly among field workers and administrative workers. The mean total knowledge score of ticks for the overall farmworkers was 13.6 (SD±3.2) from 20. The mean total tick bite preventive practices score for all farmworkers was 8.3 (SD±3.1) from 15. Fixed effect model showed the effects of four factors on tick bite prevention: (1) farms, (2) job categories (administrative workers vs. field workers), (3) perceived severity of tick bites, and (4) perceived barriers to tick bite prevention.
CONCLUSIONS: A high proportion of farmworkers, including administrative workers, reported an experience of tick bites. The effectiveness of monthly acaricide treatment was declared by low reports of tick bites on these farms. Tick bite preventive practices were insufficient, particularly in certain farms and for administrative workers. Our findings emphasise the need to have education programmes for all farmworkers and targeting farms with low prevention practices. Education and health programmes should increase the perception of the risk of tick bites and remove perceived barriers of tick bite prevention.