RESULTS: Only 56 patients with distal radius fractures had concomitant ulna styloid fractures. The mean age was 32 years (range: 18-69; SD: ± 12.7). The majority were men. The mean time from injury was 18.7 months (range: 6-84; SD: ± 13.3). The most common was Frykman 2, followed by 6, type 8, and type 4. All were closed fractures; 60.7% were base, and 39.3% were tip fractures. 50% were treated with casting, 48.3% plating, and 1.8% external fixation. The mean period of casting was 7.67 weeks (range: 4-16; SD ± 3.1). The ulna styloid was united in 35.7%. There is no significant difference in the range of movement between those with ulna styloid union and non-union. The Ballottement test and Piano key sign was statistically insignificant between both groups. All the displacements were dorsal except in 1 case. The mean displacement of ulna styloid is 1.88mm (SD±1.08, Range: 0.20-4.60mm). The mean VAS score at rest and work is not statistically significant. The mean grip strength and functional score (DASH) are similar in both groups.
CONCLUSION: Ulna styloid fractures do not contribute to the DRUJ instability and the status of the union of the ulna styloid and the site of the ulna styloid fracture (tip or base) did not have a bearing on the range of movement and functional status of the affected wrist. Temporary DRUJ immobilization might allow TFCC recovery.
METHODS: In this retrospective cross-sectional study, patients aged ≥65 years intubated at the ED of University of Malaya Medical Centre, Kuala Lumpur, Malaysia, from 2015 to 2019 were studied. The association between age, gender, place of inhabitation, Identification of Seniors at Risk (ISAR) score for frailty, Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score, indication for intubation, and diagnosis on admission with in-hospital mortality (primary outcome) and duration of ventilation, and length of stay (secondary outcomes) were evaluated using univariate analysis and Cox's regression survival analysis.
RESULTS: 889 cases aged 65 years and above were studied (61.5% male). The rate of in-hospital mortality was 71.4%. There was a significant association between age (p < 0.001), nursing home residency (p = 0.008), CCI≥ 5 (p = 0.001), APACHE-II (p < 0.001), pre-intubation Glasgow Coma Scale (GCS) (p < 0.001), cardiac arrest as indication of intubation (p < 0.001), diagnosis on admission (p < 0.001), length of stay (p < 0.001), and length of ventilation (p = 0.003) and in-hospital mortality. Age ≥ 85 years (HR= 1.270; 95%CI=1.074 to 1.502) and 75 to 84 years (HR=1.642; 95%CI=1.167 to 2.076), cardiac arrest as indication of intubation (HR: 1.882; 95% CI: 1.554 - 2.279), and APACHE-II scores 25 - 34 (HR: 1.423; 95% CI: 1.171 - 1.730) and ≥ 35 (HR: 1.789; 95%CI: 1.418 - 2.256) were amongst the independent predictive factors of in-hospital mortality.
CONCLUSION: Nearly three out of four individuals aged ≥65 years intubated at the ED died during the same admission. Older age, cardiac arrest as indication of intubation, and APACHE-II score were independent predictors of in-hospital mortality.
METHODS: The systematic search utilized established databases such as Scopus, Ovid, Web of Science, Medline, Wiley Online, and Cochrane Library. Studies published from inception to December 15, 2022, were selected. Publications describing the development of tools to measure seizure severity among adult epilepsy patients were included. Outcome measures including the tool's content, development methods, validity, and reliability assessments were compared.
RESULTS: The search produced eight publications describing the development of eight seizure severity assessment tools. One of these tools is part of a multidimensional assessment of the overall impact of epilepsy. The frequently used method in the initial development was the qualitative method (n = 6) where two publications reanalyzed the items from previous studies. Face validity was the most common validation test conducted (n = 4). At least one reliability assessment was conducted for each of the tools, most commonly by the test-retest method (n = 6) and inter-rater reliability (n = 5). All of these tools cover the components of pre-ictal (warning/aura), ictal, and postictal (recovery) events.
CONCLUSION: The identified tools described the assessment of seizure severity using various subscales. The emergence of new methods in quantifying seizure severity unfolds opportunities in discovering more comprehensive assessments of seizure severity in both clinical trials and daily clinical practice.
MATERIALS AND METHODS: Three groups of data were analysed from the BDTR over the 10-year period. Epidemiological data, blood parameters and dialysis are key performance indicators.
RESULTS: There are increments in prevalence and incidence of treated ESKD patients in Brunei over 10 years, especially with haemodialysis (HD). The projected prevalence and incidence showed an anticipated annual increase of 42.2 per million population (pmp) and 9.9 pmp respectively. Diabetes mellitus (DM) (79%) was the main cause of ESKD. HD (86%), peritoneal dialysis (PD) (9%) and transplant (5%) were the main modalities of kidney replacement therapy in 2020. Cumulative results over the decade showed significant improvements in serum phosphate, peritonitis rates and HD blood flow rates. PD patients have better survival rates, lower systolic blood pressure and better adequacy. PD survival (patient survival of 91%, 73% and 56% at 1, 3 and 5 years respectively) was superior to HD survival (86% and 64% at 1 and 2 years, respectively), but patient demographics (age and DM status) were different. The 2020 dataset showed satisfactory anaemia management but mineral bone disease management was sub-optimal. Seventy percent of prevalent HD patients had arteriovenous fistula access. Thirty-two percent and fifty-two percent of HD and PD patients, respectively, achieved target dialysis adequacy. Peritonitis rate was 0.3 episodes per patient year.
CONCLUSION: Brunei has a high incidence and prevalence of treated ESKD in the last decade, especially DM-related ESKD. This study has identified many specific areas to be targeted for improvements and provided evidence for further proliferation of PD and transplant preference policy.
MATERIALS AND METHODS: The method used a completely randomized design 5 × 4, with five treatments and four replications. The substrate diet consisted of 60% forage and 40% concentrate. The culture mixture was 1.3 × 1011 CFU/mL with a 50%:50% ratio of S. harbinensis LH 991 and P. kudriavzevii B-5P. The inoculum concentrations used in this study were 0% (control), 1%, 2%, 3%, and 4%. Treatments are arranged based on differences in inoculum concentration as follows: T0: control (0%); T1: 1%; T2: 2%; T3: 3%; and T4: 4%.
RESULTS: The T4 group showed a significant increase (p < 0.01) in short-chain fatty acids (SCFA), including acetate, propionate, butyrate, valerate, isobutyrate, and isovalerate acids, compared with the other treatments. Meanwhile, T4 shows that there is no significant (p > 0.01) effect on in vitro digestibility (in vitro dry matter digestibility, in vitro organic matter digestibility, and in vitro crude fiber digestibility). However, a highly significant (p < 0.01) effect was on volatile fatty acid total, NH3, and microbial crude protein synthesis.
CONCLUSION: It is concluded that the treatment with a 4% inoculum concentration (T4) containing a mixture of S. harbinensis LH 991 and P. kudriavzevii B-5P as LAB and yeast isolated from Budu (fermented fish) in 50%:50% ratio increased SCFA and rumen fermentation significantly, whereas it did not affect in vitro digestibility.
METHODS: The study adopted a quantitative, cross-sectional approach with 468 recently unemployed office workers in 2023. The participants ranged from ages 22 to 49 years and worked in different fields including technology, finance, consumer services, and infrastructure services.
RESULT: The results indicated severe to extremely severe mental health symptoms, with 54.5%, 50.9%, and 38.9% of respondents reporting symptoms of depression, anxiety, and stress, respectively. Our results have shown that psychological capital can significantly predict mental health issues including depression, anxiety, stress, and suicidal ideation. Self-esteem was found to play a moderating role in the relation between psychological capital and stress, depression, and suicidal ideation but not anxiety.
CONCLUSIONS: Businesses or government agencies should provide mental health support for unemployed workers. Employees should realize that they must improve their psychological capital and self-esteem to propose mental well-being in the post-pandemic period.
METHODS: This study aims to elucidate the role of REST in DS-astrocytes through comprehensive transcriptomic analysis and experimental validation.
RESULTS: Transcriptomic analysis identified that REST-targeted differentially expressed genes (DEGs) in DS astrocytes are enriched in pathways associated with inflammatory response. Notably, our findings in astrocytes derived from DS human induced pluripotent stem cells (hiPSCs) show that the loss of nucleus REST leads to an upregulation of inflammatory mediators and markers indicative of the presence of reactive astrocytes. Lithium treatment, which restored nucleus REST in trisomic astrocytes, significantly suppressed the expression of these inflammatory mediators and reactive astrocyte markers.
DISCUSSION: These findings suggest that REST is pivotal in modulating astrocyte functionality and reactivity in DS. The loss of REST in DS-astrocytes prompts the formation of reactive astrocytes, thereby compromising central nervous system homeostasis. Lithium treatment possesses the potential to rescue astrocyte reactivity in DS by restoring nucleus REST expression.
OBJECTIVES: To compare the clinical effectiveness of combined therapy using SGLT2 inhibitor and metformin with monotherapy using metformin alone in HbA1c and body weight reduction.
METHOD: A systematic review of the randomized controlled trials has been carried out and Cochrane risk of bias tool was used for the quality assessment. Patient, Intervention, Comparison and Outcomes (PICO) technique is used to select the relevant articles to meet the objective.
RESULTS: The studies used in this article are multicenter, double-blinded randomized controlled trials on SGLT2 inhibitors with methformin, there were a total of 3897 participants, with a range of 182 to 1186 individual study size were included. Studies showed that combined therapy were more effective in HbA1c and body weight reduction as compared to monotherapy.
CONCLUSION: The combined therapy of SGLT2 inhibitor along with metformin is more effective in HbA1c reduction and weight reduction as compared to monotherapy using metformin alone. Among the three SGLT2 inhibitors such as dapagliflozin canagliflozin and empagliflozin do not differ much in the efficiency of weight reduction. However, Empagliflozin 25mg is effective in HbA1c reduction.