METHODS: Using the TriNetX network, we identified patients (≥ 18 years old) with AF between 2012 and 2019. Patients were categorized into two cohorts: PVI vs. AAD as first-line therapy for AF. Patients were followed for 5 years, with the primary outcome being a composite of all-cause death, all-cause hospitalization, and heart failure exacerbation. Secondary outcomes included ischemic stroke and major bleeding events (intracranial bleeding/ gastrointestinal bleeding). Subanalyses were performed in the paroxysmal and persistent AF cohorts, respectively.
RESULTS: Among 342,230 eligible patients, 2,638 patients (mean age 64.3 ± 10.6 years) who underwent PVI and 2,638 patients (mean age 64.2 ± 13.1 years) who had AAD as first-line therapy for AF had similar propensity scores and were included in the analysis. At 5-year follow-up, the PVI group had a lower risk of the primary composite outcome compared to the AAD group (42.0% vs. 51.1%; HR 0.76; 95% CI, 0.71-0.83; P
METHODS: We conducted an online cross-sectional survey among movement disorder specialists in SEA. Respondents provided country-level estimates of utilization, targets, financial coverage, and limitations in the utilization of four neurosurgical modalities.
RESULTS: Six out of the seven countries reported neurosurgical treatment for PD. Deep brain stimulation (DBS) was reported to be available in 6 countries, averaging 16.2 ± 4.8 procedures yearly. Radiofrequency thermocoagulation (RFT) and magnetic resonance-guided focused ultrasound (MRgFUS) were reported in three and two countries, respectively, while no respondent reported the use of gamma knife radiosurgery for PD. Funding issues and patient-related factors were the most commonly reported barriers. Out-of-pocket payments remained the primary funding source for surgeries in 66% of countries, with the cost of DBS ranging from USD 32,000.00 to 50,500.00.
CONCLUSIONS: This survey provides preliminary respondent-reported estimates of DBS, RFT, and MRgFUS utilization across participating SEA countries. DBS volumes were lower than the published estimates from neighbors in the Western Pacific Region. The lack of funding and patient factors are commonly reported factors that may limit the use of these neurosurgical treatments.
METHODS: A double-blinded, cluster randomized controlled trial was conducted on 504 schoolchildren aged 8-12 years from ten rural primary schools in Malaysia. The selected schools were randomly assigned into two groups: the experimental group (n = 249) received RPO-enriched biscuits (326.3 µg retinol equivalents/day), while the control group (n = 255) received palm olein (PO)-enriched biscuits for 6 months (4 days/week). Chi-square test and mixed effects logistic regression model were applied to examine the effects of supplementation on the resolution or prevention of xerophthalmia.
RESULTS: After 6-month supplementation, a higher resolution rate of xerophthalmia (31.2%) was observed in the experimental group compared to the control group (24.1%), but this difference lacked statistical significance (p = 0.11). Nevertheless, the experimental group showed a significantly higher prevention rate of xerophthalmia (81.8%) or conjunctival xerosis (82.5%) than the control group (56.5% or 57.6%, respectively) after 6-month supplementation (p