Methods: This study analyzed all suspected ADEs related to favipiravir reported from 2015. The reports were analyzed based on age, gender, and seriousness of ADEs at the System Organ Classification (SOC) level and the individual Preferred Term (PT) level.
Results: This study is based on 194 ADEs reported from 93 patients. Most frequent ADEs suspected to be caused by the favipiravir included increased hepatic enzymes, nausea and vomiting, tachycardia, and diarrhea. Severe and fatal ADEs occurred more frequently in men and those over the age of 64 years. Blood and lymphatic disorders, cardiac disorders, hepatobiliary disorders, injury poisoning, and procedural complications were more common manifestations of severe ADEs.
Conclusion: This study revealed that favipiravir appears to be a relatively safe drug. An undiscovered anti-inflammatory activity of favipiravir may explain the improvement in critically ill patients and reduce inflammatory markers. Currently, the data is based on very few patients. A more detailed assessment of the uncommon ADEs needs to be analyzed when more information will be available.
Setting and Design: Retrospective observational cohort study in the State of Johor, Malaysia.
Subjects and Methods: All infants born between January 2006 and December 2015 with a diagnosis of CCHD, defined as infants with duct-dependent lesions or cyanotic heart disease who may die without early intervention. The late diagnosis was defined as a diagnosis of CCHD after 3 days of age.
Results: Congenital heart disease was diagnosed in 3557 of 531,904 live-born infants and were critical in 668 (18.7%). Of 668, 347 (52%) had duct-dependent pulmonary circulation. The birth prevalence of CCHD was 1.26 (95% confidence interval: 1.16-1.35) per 1000 live births, with no significant increase over time. The median age of diagnosis was 4 days (Q1 1, Q3 26), with 61 (9.1%) detected prenatally, and 342 (51.2%) detected late. The highest rate of late diagnosis was observed in coarctation of the aorta with a rate of 74%. Trend analysis shows a statistically significant reduction of late diagnosis and a significant increase in prenatal detection. However, Cox regression analysis shows the timing of diagnosis does not affect the outcome of CCHD.
Conclusions: Due to limited resources in the MIC, the late diagnosis of CCHD is high but does not affect the outcome. Nevertheless, the timing of diagnosis has improved over time.
Case presentation: 50-year-old male had his chemoport inserted for adjuvant chemotherapy 3 years ago. During the removal, remaining half of the distal catheter was not found. There was no difficulties during the removal. Chest xray revealed that the fractured catheter had embolized to the right ventricle. Further history taking, he did experienced occasional palpitation and chest discomfort for the past six months. Electrocardiogram and cardiac enzymes were normal. Urgent removal of the fractured catheter via the percutaneous endovascular approach, under fluoroscopic guidance by an experience interventional radiologist was done. The procedure was successful without any complication. Patient made an uneventful recovery. He was discharged the following day, and was well during his 3rd month follow up.
Conclusion: Early detection and preventive measures can be done to prevent pinch-off syndrome. Unrecognized POS can result in fatal complications such as cardiac arrhythmia and septic embolization. Retrieval via the percutaneous endovascular approach provide excellent outcome in the case of embolized fractured catheter.
OBJECTIVE: This study was intended to assess the knowledge and attitude towards OSA and compare it among dental and medical undergraduate students of University Sains Malaysia (USM).
METHODS: In this study, a total of 216 clinical undergraduate students (36 from each year; 108 from medical and 108 from dental school) of University Sains Malaysia (USM) Health campus were recruited for the study by non-probability stratified random sampling method. Total study period was October 2017 to October 2018. A self-administered questionnaire was used to assess the sociodemographic status and OSAKA questionnaire was used to assess knowledge and attitude regarding sleep apnoea of the respondents. Descriptive analysis was carried out to assess the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM. The Mann-Whitney U test was carried out to compare the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM.
RESULTS: Our study findings revealed that 0.9 %and 6.5 %of the dental undergraduate students and medical undergraduate students could answer all the questions correctly regarding knowledge of OSA. Based on the assessment of the difference between medical and dental students in terms of knowledge towards OSA patients, significant difference was observed at the significance level of 95%, where p
OBJECTIVE: The aim of this systematic review and meta-analysis is to compare the effectiveness of amiodarone, dexmedetomidine and magnesium in preventing JET following congenital heart surgery.
METHODS: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, where 11 electronic databases were searched from date of inception to August 2020. The incidence of JET was calculated with the relative risk of 95% confidence interval (CI). Quality assessment of the included studies was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
RESULTS: Eleven studies met the predetermined inclusion criteria and were included in this meta-analysis. Amiodarone, dexmedetomidine and magnesium significantly reduced the incidence of postoperative JET [Amiodarone: risk ratio 0.34; I2= 0%; Z=3.66 (P=0.0002); 95% CI 0.19-0.60. Dexmedetomidine: risk ratio 0.34; I2= 0%; Z=4.77 (P<0.00001); 95% CI 0.21-0.52. Magnesium: risk ratio 0.50; I2= 24%; Z=5.08 (P<0.00001); 95% CI 0.39-0.66].
CONCLUSION: All three drugs show promise in reducing the incidence of JET. Our systematic review found that dexmedetomidine is better in reducing the length of ICU stays as well as mortality. In addition, dexmedetomidine also has the least pronounced side effects among the three. However, it should be noted that this conclusion was derived from studies with small sample sizes. Therefore, dexmedetomidine may be considered as the drug of choice for preventing JET.
MATERIAL AND METHODS: A prospective, quasi-experimental physiological study. Selected healthy subjects were observed electrocardiographically for 60 s continuously in three equal phases of 20 s each - baseline phase, nasoendoscopic phase, and recovery phase (post-nasoendoscopy). Heart rate fluctuations were charted, followed by identification of a positive nasocardiac reflex group of subjects and a negative group. Analyses against multiple variables were done.
RESULTS: A total of 53 subjects were analysed. Heart rate during the baseline phase was 81.0 ± 9.9, nasoendoscopic phase was 72.7 ± 10.1, and recovery phase was 75.2 ± 9.6. Sixteen subjects (30.2%) had a positive nasocardiac reflex, and they remained in sinus rhythm with no occurrences of skipped beats, atrioventricular blocks or asystoles. One subject (1.9%) developed temporary ectopic premature ventricular contractions after nasoendoscopy. No variables were found affecting the incidence of a nasocardiac reflex in our study.
CONCLUSIONS: The pattern of heart rate dynamics was consistent as heart rates drop rapidly upon endoscope insertion and recover in some measure after its withdrawal. Although all our subjects remained asymptomatic, clinicians should not overlook the risks of a severe nasocardiac reflex when performing nasoendoscopy. We recommend that electrical cardiac monitoring be part of the management of vasovagal responses during in-office endonasal procedures.
Results: The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group.
Conclusion: The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, "little lovely dentist," and "dental songs" can alleviate dental anxiety experienced by paediatric patients. The "tell-show-do" technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.