MATERIALS AND METHODS: A cross-sectional study involving bereaved individuals in Palliative Care Unit Hospital Selayang. Participants (n=175) were recruited through telephone, and a validated tool Prolonged Grief Disorder Scale (PG-13) was asked to identify PGD. Further data collected were concomitant stressors in life and support system in the bereaved individual.
RESULTS: Prevalence of PGD was 2.9% (n=5), and subthreshold PGD was 4% (n=7). A model of multiple logistic regression calculated most of the traditional risk factors were not significant except having an increased responsibility as a single parent after passing of a spouse or loved one, had 10 times increased odds of PGD (Odds Ratios: 10.93; 95% Confidence Interval: 2.937, 40.661). Otherwise, immediate family support (80%), religion (60%) and community (40%) support were the top three coping mechanisms of our PGD cohort, although they were not significant in a multiple logistic regression model.
CONCLUSION: Our PGD percentage may not be as high as those of other countries, but nonetheless they exist and their needs are just as important. The authors hope that this paper may create an awareness among the healthcare clinicians about PGD in our society, for a greater access of service to understand them and better public awareness.
METHODS: Data from 585 eligible patients who received palliative radiotherapy between January 2012 and December 2014 were analysed. Median overall survival was calculated from the commencement of first fraction of the last course of radiotherapy to date of death or when censored. 30-DM was calculated as the proportion of patients who died within 30 days from treatment start date. Kaplan-Meier survival analysis was used to estimate survival. Chi-square test and logistic regression was used to assess the impact of potential prognostic factors on median survival and 30-DM.
RESULTS: The most common diagnoses were lung and breast cancers and most common irradiated sites were bone and brain. Median survival and 30-DM were 97 days and 22.7% respectively. Primary cancer, age, treatment course, performance status, systemic treatment post radiotherapy and intended radiotherapy treatment completed had an impact on median survival whereas mainly the latter three factors had an impact on 30-DM.
CONCLUSION: Median survival and factors affecting both survival and 30-DM in our study are comparable to others. However, a 30-DM rate of 22.7% is significantly higher compared to the literature. We need to better select patients who will benefit from palliative radiotherapy in our centre.
METHODS: This is a retrospective study done in neonates and infants up to 3 months of age with duct-dependent pulmonary circulation who underwent DS from January 2014 to December 2015. Post-stenting PA growth, surgical outcomes of PA reconstruction, post-surgical re-interventions, morbidity and mortality were analysed.
RESULTS: During the study period, 46 patients underwent successful DS, of whom 38 underwent presurgery catheterization and definite surgery. There was significant growth of PAs in these patients. Biventricular repair was done in 31 patients while 7 had univentricular palliation. Left PA augmentation was required in 13 patients, and 10 required central PA augmentation during surgery. The mean follow-up period post-surgery was 4.5 ± 1.5 years. No significant postoperative complications were seen. No early or follow-up post-surgery mortality was seen. Four patients required re-interventions in the form of left PA stenting based on the echocardiography or computed tomography evidence of significant stenosis.
CONCLUSIONS: DS provides good short-term palliation and the growth of PAs. However, a significant number of stented patients require reparative procedure on PAs at the time of surgical intervention. Acquired changes in the PAs following DS may be the reason for reintervention following PA reconstruction.