METHODS: A cross-sectional study via online questionnaire survey was conducted among students from a pre-university college on the East Coast of Malaysia. Convenience sampling was used to recruit the participants. The questionnaire consisted of three parts: i) sociodemographic data, ii) the Parental Authority Questionnaire and Depression, and iii) the Anxiety and Stress Scale (DASS-21). An online invitation to answer the questionnaire was done via the Student Representative Council (SRC). Data were analysed using descriptive statistics and Pearson's chi-square test.
RESULTS: A total of 431 participants responded to the online survey. The prevalence of depression, anxiety and stress was 49.0% (n = 210), 68.0% (n = 293) and 37.6% (n = 162), respectively. In addition, father's educational level (χ2 = 10.332, P = 0.001) and the authoritarian parenting style (χ2 = 10.099, P = 0.006) were significantly associated with mental health disorders among adolescents.
CONCLUSION: The prevalence of mental disorders among pre-university students is relatively high. Pre-university admission mental health screening is vital for early detection and intervention of mental disorders among this vulnerable group. Further research is imperative to establish a comprehensive plan of action that targets parental involvement in managing adolescent mental health disorders.
CASE REPORT: We report a case of 'kissing carotid artery' in a 65-year-old lady who presented with a foreign body sensation felt in the throat for one week. A finding of flexible nasopharyngolaryngoscopy (FNPLS) showed a bilateral paramedian retropharyngeal pulsating mass. Radiological examinations, including Computed Tomography (CT) of the neck and an angiogram, revealed an aberrant course of bilateral carotid arteries. In view of no malignancy and vascular malformations, there was no further intervention done, and the patient was subjected to yearly surveillance.
CONCLUSION: Retropharyngeal carotid arteries are clinically significant anatomic variants. Such anomalies are potentially life-threatening and a risk factor for a severe hemorrhage during the simplest and commonly performed transoral surgeries. Thus, thorough perioperative assessment with accurate imaging techniques and studies are required to evaluate these anomalies and may avoid any disastrous complications.
LEARNING POINTS: Comprehensive hormonal and radiological investigations are important in the management of a young patient with primary amenorrhoea. Coexistence pathology of two separate pathologies should be considered in patient presenting with primary amenorrhoea. Early diagnosis of MRKH or any disorders of sex development should be treated early, providing pharmacological, surgical, psychological and emotional support to the patient and reducing risk of associated complications. Abnormal pituitary hormones, particularly panhypopituitarism, would impose greater impact not only psychologically but also metabolically leading to cardiovascular, morbidity and mortality risks in this patient if not treated early. A multidisciplinary approach is necessary for patients presenting with MRKH to ensure appropriate treatments and follow-up across the lifespan of the patient.
OBJECTIVES: The aim of this study was to assess the economic impact of AML and determine the major cost-driving factors for its treatment in the EU.
METHODS: This systematic review is in accordance with PRISMA guidelines. A systematic search was conducted using PubMed, Embase, ScienceDirect, SCOPUS, and Google Scholar databases to identify relevant studies on the economic impact of AML in various countries of the EU, published before April 15, 2024. Original studies investigating direct costs including expenses for treatment and healthcare services, or resource utilization for AML management were included. The systematic review excluded commentaries, editorials, and pharmacoeconomic modeling studies. Two reviewers independently performed data extraction and quality assessment, and the third reviewer resolved disagreements. We employed the Allison Larg Cost-of-Illness Studies evaluation checklist to assess the risk of bias. The mean cost per patient for induction, consolidation, and transplantation was calculated, and the results were converted into 2024 Euros.
RESULTS: Twenty-eight studies met our inclusion criteria, with the sample size of AML patients ranging from 12 to 39,568. The calculated per-patient direct costs of induction chemotherapy in Spain, France, Netherlands, Germany, and Italy were €92,378, €77,844, €61,643, €46,113, and €20,254, respectively. The mean per-patient direct cost of consolidation chemotherapy in the Netherlands and Germany was €42,137, and €32,220, respectively. The mean per-patient direct costs of transplantation in Sweden, Austria, France, Netherlands, and Spain were €192,628, €188,453, €132,352, €122,760, and €47,968, respectively. The cost-driving factors associated with AML treatment were inpatient hospitalization and medication costs.
CONCLUSION: AML seems to incur substantial direct economic expenses. Reducing the days of hospitalization can significantly decrease the economic burden of AML in the European Union. Moreover, there is a necessity for studies that comprehensively evaluate the economic implications, particularly concerning total and indirect costs.
REGISTRATION: Registered in PROSPERO under the registration number 'CRD42024537725'.
METHODS: Standardized photographs from 18 patients were acquired at baseline, 3 months, and 6 months under controlled imaging conditions, including fixed lighting, camera settings, and color calibration. Images underwent preprocessing involving resizing, color and illumination normalization, noise reduction, and geometric standardization. Expert dermatologists generated binary lesion masks that were used as ground truth for training a one-stage YOLOv11 segmentation model. Model performance was evaluated using patient-wise data splits and 5-fold cross-validation.
RESULTS: The proposed model achieved 95 % accuracy, 92 % precision, 89 % recall, 90 % F1-score, with mAP@0.5 values of 0.878 (bounding box) and 0.892 (mask) from precision-recall analysis. Qualitative review indicated consistent segmentation quality across follow-up visits and moderate illumination variations, though formally stratified quantitative analysis by visit was not performed in this study. Visual assessment demonstrated close agreement between predicted and expert-annotated lesion boundaries, with minor under-segmentation observed mainly in low-contrast peripheral regions.
CONCLUSIONS: Standardized clinical photography combined with a YOLOv11-based segmentation framework enables reliable vitiligo lesion delineation and has potential for integration into quantitative disease monitoring and clinical decision-support systems.