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  1. Khairul Hasni NA, Anual ZF, Rashid SA, Syed Abu Thahir S, Veloo Y, Fang KS, et al.
    Environ Pollut, 2023 May 01;324:121095.
    PMID: 36682614 DOI: 10.1016/j.envpol.2023.121095
    Contamination of water systems with endocrine disrupting chemicals (EDCs) is becoming a major public health concern due to their toxicity and ubiquity. The intrusion of EDCs into water sources and drinking water has been associated with various adverse health effects on humans. However, there is no comprehensive overview of the occurrence of EDCs in Malaysia's water systems. This report aims to describe the occurrence of EDCs and their locations. Literature search was conducted electronically in two databases (PubMed and Scopus). A total of 41 peer-reviewed articles published between January 2000 and May 2021 were selected. Most of the articles dealt with pharmaceuticals (16), followed by pesticides (7), hormones (7), mixed compounds (7), and plasticisers (4). Most studies (40/41) were conducted in Peninsular Malaysia, with 60.9% in the central region and almost half (48.8%) in the Selangor State. Only one study was conducted in the northern region and East Malaysia. The Langat River, the Klang River, and the Selangor River were among the most frequently studied EDC-contaminated surface waters, while the Pahang River and the Skudai River had the highest concentrations of some of the listed compounds. Most of the risk assessments resulted in a hazard quotient (HQ) and a risk quotient (RQ)  1 in the Selangor River. An RQ > 1 for combined pharmaceuticals was found in Putrajaya tap water. Overall, this work provides a comprehensive overview of the occurrence of EDCs in Malaysia's water systems. The findings from this review can be used to mitigate risks and strengthen legislation and policies for safer drinking water.
    Matched MeSH terms: Environmental Monitoring/methods
  2. Mustafa ZU, Majeed HK, Latif S, Salman M, Hayat K, Mallhi TH, et al.
    Disaster Med Public Health Prep, 2023 Feb 14;17:e298.
    PMID: 36785528 DOI: 10.1017/dmp.2022.252
    OBJECTIVE: Infection prevention and control (IPC) measures are easily adoptable activities to prevent the spread of infection to patients as well as among health-care workers (HCWs).

    METHODS: This cross-sectional study evaluated the adherence to IPC measures among HCWs working at coronavirus disease 2019 (COVID-19) treatment centers in Punjab, Pakistan. HCWs were recruited by means of convenient sampling through Google Form® using the World Health Organization risk assessment tool. All data were analyzed using SPSS 20.

    RESULTS: A total of 414 HCWs completed the survey (response rate = 67.8%), and majority of them were males (56.3%). Most of the HCWs were nurses (39.6%) followed by medical doctors (27.3%). Approximately 53% reported insufficiency of personal protective equipment (PPE), 58.2% did not receive IPC training and 40.8% did not have functional IPC team at their health facilities. The majority of HCWs (90%) used disposable gloves and N95 facemasks while interacting with COVID-19 patients. Nearly 45% used protective face shields and gowns before providing care to their patients. Hand hygiene practices while touching, and performing any aseptic procedure was adopted by 70.5% and 74.1% of HCWs, respectively.

    CONCLUSIONS: In conclusion, the adherence to IPC measures among Pakistani HCWs working in COVID-19 treatment centers is good despite the limited availability of PPEs. Their practices can be optimized by establishing institutional IPC teams, periodic provision of IPC training, and necessary PPE.

    Matched MeSH terms: Infection Control/methods
  3. Sim SZ, Gupta RC, Ong SH
    Int J Biostat, 2018 Jan 09;14(1).
    PMID: 29306919 DOI: 10.1515/ijb-2016-0070
    In this paper, we study the zero-inflated Conway-Maxwell Poisson (ZICMP) distribution and develop a regression model. Score and likelihood ratio tests are also implemented for testing the inflation/deflation parameter. Simulation studies are carried out to examine the performance of these tests. A data example is presented to illustrate the concepts. In this example, the proposed model is compared to the well-known zero-inflated Poisson (ZIP) and the zero- inflated generalized Poisson (ZIGP) regression models. It is shown that the fit by ZICMP is comparable or better than these models.
    Matched MeSH terms: Biostatistics/methods*
  4. Velo P, Ismail MI, Mohandas KK, Kasilingam L
    J Med Imaging Radiat Sci, 2023 Mar;54(1):43-50.
    PMID: 36402716 DOI: 10.1016/j.jmir.2022.09.010
    INTRODUCTION: The aim of present study is to estimate effective dose in patient undergoing 18F-FDG for whole body PET/CT imaging with diagnostic CT parameters and identify the lowest achievable total effective dose.

    METHOD: A total of 2247 PET/CT patients with normal glucose level underwent 18F-FDG-whole body imaging procedures. The 18F-FDG dose of 3.7MBq per kg of patient weight administered via intravenous infusion. For CT parameters, kilovoltage of 140keV and current of 40 mAs were used for all studies. All the acquired images collected retrospectively and the effective dose was calculated for each patient using algorithm adapted from ICRP Publication 106, modified for patient weight and patient blood volume. The estimated effective doses were evaluated for patients' body weight and BMI.

    RESULTS: The mean of total effective dose and standard deviation is approximately 15.08(4.52) mSv using ICRP algorithm. 56% of total patient has normal BMI and their average total effective dose is 13.6mSv. Underweight patients' effective dose can be as low as 9.6mSv even using diagnostic CT protocols.

    CONCLUSION: The effective dose of PET/CT procedure in present study is one of the lowest although using diagnostic parameters for CT acquisition compared to published data worldwide. This is due to the improved sensitivity of PET and complex reconstruction technique that maintains the image quality. A significant association between body weight, BMI and effective dose is reported in present study. Therefore, it is suggested that attention must be given for underweight and ideal BMI patients while prescribing FDG activity and CT imaging parameters in order to minimize the effective dose. The effective dose reported in present study can be considered as an upper limit for effective dose in PET/CT patients with normal BMI. This upper limit can be treated as a standard limit when optimizing imaging parameters, developing algorithm for image reconstruction and prescribing activity for patients. This practice could fulfill ALARA principle that could reduce cancer risk.

    Matched MeSH terms: Whole Body Imaging/methods
  5. Asadollahi A, Kaveh MH, Saberi LF, Karimi M, Ahmad N
    J Cross Cult Gerontol, 2023 Mar;38(1):97-109.
    PMID: 36792867 DOI: 10.1007/s10823-023-09470-w
    The CAGE questionnaire is an instrument, proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The questionnaire has been more pervasive simple tool than AUDIT and LAST scales to screen in busy medical settings where limited time is considered for adult patient interviews. The present study aimed to determine the reliability and validity of the CAGE questionnaire in Khuzistan province, Iran and evaluate its role in detecting alcohol-related problems. For this purpose, 382 men with mean age of 65 ± 5 were sampled by cluster-random sampling method in convenience model from the medical centers in eight counties of Khuzistan province during 2019 and they responded to the CAGE questionnaire. The coefficients of Cronbach's alpha (α = 0.82), convergent validity (0.73), divergent validity (-0.06), and criterion validity (0.87) were estimated (ρ 
    Matched MeSH terms: Psychometrics/methods
  6. Rahman H, Naik Bukht TF, Ahmad R, Almadhor A, Javed AR
    Comput Intell Neurosci, 2023;2023:7717712.
    PMID: 36909966 DOI: 10.1155/2023/7717712
    Medical image analysis places a significant focus on breast cancer, which poses a significant threat to women's health and contributes to many fatalities. An early and precise diagnosis of breast cancer through digital mammograms can significantly improve the accuracy of disease detection. Computer-aided diagnosis (CAD) systems must analyze the medical imagery and perform detection, segmentation, and classification processes to assist radiologists with accurately detecting breast lesions. However, early-stage mammography cancer detection is certainly difficult. The deep convolutional neural network has demonstrated exceptional results and is considered a highly effective tool in the field. This study proposes a computational framework for diagnosing breast cancer using a ResNet-50 convolutional neural network to classify mammogram images. To train and classify the INbreast dataset into benign or malignant categories, the framework utilizes transfer learning from the pretrained ResNet-50 CNN on ImageNet. The results revealed that the proposed framework achieved an outstanding classification accuracy of 93%, surpassing other models trained on the same dataset. This novel approach facilitates early diagnosis and classification of malignant and benign breast cancer, potentially saving lives and resources. These outcomes highlight that deep convolutional neural network algorithms can be trained to achieve highly accurate results in various mammograms, along with the capacity to enhance medical tools by reducing the error rate in screening mammograms.
    Matched MeSH terms: Mammography/methods
  7. Chirawat P, Kamolthip R, Rattaprach R, Nadhiroh SR, Tung SEH, Gan WY, et al.
    Int J Environ Res Public Health, 2022 Nov 29;19(23).
    PMID: 36497942 DOI: 10.3390/ijerph192315868
    The previous studies found that the Weight Self Stigma Questionnaire (WSSQ) and Perceived Weight Stigma Scale (PWSS) have shown well-established psychometric properties for measuring weight stigma with strong reliability and validity from different languages. However, there is a lack of an appropriate instrument in assessing weight stigma in Thai samples. This study aimed to examine the Thai WSSQ and PWSS among Thai university students. Both instruments were also assessed for their measurement invariance across gender and weight status subgroups. A cross-sectional study was conducted on 801 university students in Thailand between January 2022 and July 2022. All participants completed a demographic questionnaire and a Thai version of the WSSQ, PWSS, and Depression Anxiety Stress Scale-21 (DASS-21) via an online survey. Reliability, validity, measurement invariance, and correlational analyses were performed to investigate whether the Thai versions of the WSSQ and PWSS psychometric properties were acceptable. Both translated questionnaires demonstrated overall acceptable psychometric properties and revealed a two-dimensional structure for the WSSQ, and unidimensional structure for the PWSS. Measurement invariance was obtained across gender and weight status subgroups. Additionally, both translated WSSQ and PWSS were significantly correlated with DASS-21. The Thai-translated WSSQ and PWSS showed strong validity, reliability, and factorial invariance across different subgroups for measuring weight stigma among Thai university students.
    Matched MeSH terms: Psychometrics/methods
  8. Chen HL, Selvam SB, Ting KN, Gibbins CN
    Environ Monit Assess, 2023 Jan 18;195(2):307.
    PMID: 36652034 DOI: 10.1007/s10661-022-10856-5
    Recent increase in awareness of the extent of microplastic contamination in marine and freshwater systems has heightened concerns over the ecological and human health risks of this ubiquitous material. Assessing risks posed by microplastic in freshwater systems requires sampling to establish contamination levels, but standard sampling protocols have yet to be established. An important question is whether sampling and assessment should focus on microplastic concentrations in the water or the amount deposited on the bed. On three dates, five replicated water and bed sediment samples were collected from each of the eight sites along the upper reach of the Semenyih River, Malaysia. Microplastics were found in all 160 samples, with mean concentrations of 3.12 ± 2.49 particles/L in river water and 6027.39 ± 16,585.87 particles/m2 deposited on the surface of riverbed sediments. Fibres were the dominant type of microplastic in all samples, but fragments made up a greater proportion of the material on the bed than in the water. Within-site variability in microplastic abundance was high for both water and bed sediments, and very often greater than between-site variability. Patterns suggest that microplastic accumulation on the bed is spatially variable, and single samples are therefore inadequate for assessing bed contamination levels at a site. Sites with the highest mean concentrations in samples of water were not those with the highest concentrations on the bed, indicating that monitoring based only on water samples may not provide a good picture of either relative or absolute bed contamination levels, nor the risks posed to benthic organisms.
    Matched MeSH terms: Environmental Monitoring/methods
  9. Mohamad Nor N, Ramli NH, Poobalan H, Qi Tan K, Abdul Razak K
    Crit Rev Anal Chem, 2023;53(2):253-288.
    PMID: 34565248 DOI: 10.1080/10408347.2021.1950521
    Heavy metal pollution has gained global attention due to its high toxicity and non-biodegradability, even at a low level of exposure. Therefore, the development of a disposable electrode that is sensitive, simple, portable, rapid, and cost-effective as the sensor platform in electrochemical heavy metal detection is vital. Disposable electrodes have been modified with nanomaterials so that excellent electrochemical properties can be obtained. This review highlights the recent progress in the development of numerous types of disposable electrodes modified with nanomaterials for electrochemical heavy metal detection. The disposable electrodes made from carbon-based, glass-based, and paper-based electrodes are reviewed. In particular, the analytical performance, fabrication technique, and integration design of disposable electrodes modified with metal (such as gold, tin and bismuth), carbon (such as carbon nanotube and graphene), and metal oxide (such as iron oxide and zinc oxide) nanomaterials are summarized. In addition, the role of the nanomaterials in improving the electrochemical performance of the modified disposable electrodes is discussed. Finally, the current challenges and future prospect of the disposable electrode modified with nanomaterials are summarized.
    Matched MeSH terms: Electrochemical Techniques/methods
  10. Mishra D, Gade S, Glover K, Sheshala R, Singh TRR
    Curr Eye Res, 2023 Feb;48(2):208-218.
    PMID: 36036478 DOI: 10.1080/02713683.2022.2119254
    Purpose: Intravitreal administration of drug molecules is one of the most common routes for treating posterior segment eye diseases. However, the properties of vitreous humour changes with the time. A number of ocular complications such as liquefaction of the vitreous humour, solidification of the vitreous humour in the central vitreous cavity and detachment of the limiting membrane due to the shrinking of vitreous humour are some of the factors that can drastically affect the efficacy of therapeutics delivered via intravitreal route. Although significant research has been conducted for studying the properties of vitreous humour and its changes during the ageing process, there have been limited work to understand the effect of these changes on therapeutic efficacy of intravitreal drug delivery systems. Therefore, in this review we discussed both the coomposition and characteristics of the vitreous humour, and their subsequent influence on intravitreal drug delivery.Methods: Articles were searched on Scopus, PubMed and Web of Science up to March 2022.Results: In this review, we discussed the biological composition and biomechanical properties of vitreous humour, methods to study the properties of vitreous humour and the changes in these properties and their relevance in ocular drug delivery field, with the aim to provide a useful insight into these aspects which can aid the process of development of novel intravitreal drug delivery systems.Conclusions: The composition and characteristics of the vitreous humour, and how these change during natural aging processes, directly influence intravitreal drug delivery. This review therefore highlights the importance of understanding the properties of the vitreous and identifies the need to achieve greater understanding of how changing properties of the vitreous affect the therapeutic efficacy of drugs administered for the treatment of posterior eye diseases.
    Matched MeSH terms: Drug Delivery Systems/methods
  11. Tao H, Al-Hilali AA, Ahmed AM, Mussa ZH, Falah MW, Abed SA, et al.
    Chemosphere, 2023 Mar;317:137914.
    PMID: 36682637 DOI: 10.1016/j.chemosphere.2023.137914
    Heavy metals (HMs) are a vital elements for investigating the pollutant level of sediments and water bodies. The Murray-Darling river basin area located in Australia is experiencing severe damage to increased crop productivity, loss of soil fertility, and pollution levels within the vicinity of the river system. This basin is the most effective primary production area in Australia where agricultural productivity is increased the gross domastic product in the entire mainland. In this study, HMs contaminations are examined for eight study sites selected for the Murray-Darling river basin where the inverse Distance Weighting interpolation method is used to identify the distribution of HMs. To pursue this, four different pollution indices namely the Geo-accumulation index (Igeo), Contamination factor (CF), Pollution load index (PLI), single-factor pollution index (SPLI), and the heavy metal pollution index (HPI) are computed. Following this, the Pearson correlation matrix is used to identify the relationships among the two HM parameters. The results indicate that the conductivity and N (%) are relatively high in respect to using Igeo and PLI indexes for study sites 4, 6, and 7 with 2.93, 3.20, and 1.38, respectively. The average HPI is 216.9071 that also indicates higher level pollution in the Murray-Darling river basin and the highest HPI value is noted in sample site 1 (353.5817). The study also shows that the levels of Co, P, Conductivity, Al, and Mn are mostly affected by HMs and that these indices indicate the maximum HM pollution level in the Murray-Darling river basin. Finally, the results show that the high HM contamination level appears to influence human health and local environmental conditions.
    Matched MeSH terms: Environmental Monitoring/methods
  12. Cimr D, Fujita H, Tomaskova H, Cimler R, Selamat A
    Comput Methods Programs Biomed, 2023 Feb;229:107277.
    PMID: 36463672 DOI: 10.1016/j.cmpb.2022.107277
    BACKGROUND AND OBJECTIVES: Nowadays, an automated computer-aided diagnosis (CAD) is an approach that plays an important role in the detection of health issues. The main advantages should be in early diagnosis, including high accuracy and low computational complexity without loss of the model performance. One of these systems type is concerned with Electroencephalogram (EEG) signals and seizure detection. We designed a CAD system approach for seizure detection that optimizes the complexity of the required solution while also being reusable on different problems.

    METHODS: The methodology is built-in deep data analysis for normalization. In comparison to previous research, the system does not necessitate a feature extraction process that optimizes and reduces system complexity. The data classification is provided by a designed 8-layer deep convolutional neural network.

    RESULTS: Depending on used data, we have achieved the accuracy, specificity, and sensitivity of 98%, 98%, and 98.5% on the short-term Bonn EEG dataset, and 96.99%, 96.89%, and 97.06% on the long-term CHB-MIT EEG dataset.

    CONCLUSIONS: Through the approach to detection, the system offers an optimized solution for seizure diagnosis health problems. The proposed solution should be implemented in all clinical or home environments for decision support.

    Matched MeSH terms: Electroencephalography/methods
  13. Chong JWR, Khoo KS, Chew KW, Ting HY, Show PL
    Biotechnol Adv, 2023;63:108095.
    PMID: 36608745 DOI: 10.1016/j.biotechadv.2023.108095
    Identification of microalgae species is of importance due to the uprising of harmful algae blooms affecting both the aquatic habitat and human health. Despite this occurence, microalgae have been identified as a green biomass and alternative source due to its promising bioactive compounds accumulation that play a significant role in many industrial applications. Recently, microalgae species identification has been conducted through DNA analysis and various microscopy techniques such as light, scanning electron, transmission electron, and atomic force -microscopy. The aforementioned procedures have encouraged researchers to consider alternate ways due to limitations such as costly validation, requiring skilled taxonomists, prolonged analysis, and low accuracy. This review highlights the potential innovations in digital microscopy with the incorporation of both hardware and software that can produce a reliable recognition, detection, enumeration, and real-time acquisition of microalgae species. Several steps such as image acquisition, processing, feature extraction, and selection are discussed, for the purpose of generating high image quality by removing unwanted artifacts and noise from the background. These steps of identification of microalgae species is performed by reliable image classification through machine learning as well as deep learning algorithms such as artificial neural networks, support vector machines, and convolutional neural networks. Overall, this review provides comprehensive insights into numerous possibilities of microalgae image identification, image pre-processing, and machine learning techniques to address the challenges in developing a robust digital classification tool for the future.
    Matched MeSH terms: Image Processing, Computer-Assisted/methods
  14. Li Q, Zhang K, Li R, Yang L, Yi Y, Liu Z, et al.
    Sci Total Environ, 2023 May 10;872:162071.
    PMID: 36775179 DOI: 10.1016/j.scitotenv.2023.162071
    Biomass burning (BB) has significant impacts on air quality and climate change, especially during harvest seasons. In previous studies, levoglucosan was frequently used for the calculation of BB contribution to PM2.5, however, the degradation of levoglucosan (Lev) could lead to large uncertainties. To quantify the influence of the degradation of Lev on the contribution of BB to PM2.5, PM2.5-bound biomass burning-derived markers were measured in Changzhou from November 2020 to March 2021 using the thermal desorption aerosol gas chromatography-mass spectrometry (TAG-GC/MS) system. Temporal variations of three anhydro-sugar BB tracers (e.g., levoglucosan, mannosan (Man), and galactosan (Gal)) were obtained. During the sampling period, the degradation level of air mass (x) was 0.13, indicating that ~87 % of levoglucosan had degraded before sampling in Changzhou. Without considering the degradation of levoglucosan in the atmosphere, the contribution of BB to OC were 7.8 %, 10.2 %, and 9.3 % in the clean period, BB period, and whole period, respectively, which were 2.4-2.6 times lower than those (20.8 %-25.9 %) considered levoglucosan degradation. This illustrated that the relative contribution of BB to OC could be underestimated (~14.9 %) without considering degradation of levoglucosan. Compared to the traditional method (i.e., only using K+ as BB tracer), organic tracers (Lev, Man, Gal) were put into the Positive Matrix Factorization (PMF) model in this study. With the addition of BB organic tracers and replaced K+ with K+BB (the water-soluble potassium produced by biomass burning), the overall contribution of BB to PM2.5 was enhanced by 3.2 % after accounting for levoglucosan degradation based on the PMF analysis. This study provides useful information to better understand the effect of biomass burning on the air quality in the Yangtze River Delta region.
    Matched MeSH terms: Environmental Monitoring/methods
  15. Hena S, Rozi R, Tabassum S, Huda A
    Environ Sci Pollut Res Int, 2016 Aug;23(15):14868-80.
    PMID: 27072032 DOI: 10.1007/s11356-016-6540-5
    Cyanotoxins, microcystins and cylindrospermopsin, are potent toxins produced by cyanobacteria in potable water supplies. This study investigated the removal of cyanotoxins from aqueous media by magnetophoretic nanoparticle of polypyrrole adsorbent. The adsorption process was pH dependent with maximum adsorption occurring at pH 7 for microcystin-LA, LR, and YR and at pH 9 for microcystin-RR and cylindrospermopsin (CYN). Kinetic studies and adsorption isotherms reflected better fit for pseudo-second-order rate and Langmuir isotherm model, respectively. Thermodynamic calculations showed that the cyanotoxin adsorption process is endothermic and spontaneous in nature. The regenerated adsorbent can be successfully reused without appreciable loss of its original capacity.
    Matched MeSH terms: Water Purification/methods*
  16. Yaacof N, Qamaruz Zaman N, Yusup Y, Yusoff S
    Environ Sci Pollut Res Int, 2019 Aug;26(23):24286-24299.
    PMID: 31214886 DOI: 10.1007/s11356-019-05517-z
    Malaysia is the second-largest producer and exporter of palm oil amounting to 39% of world palm oil production and 44% of world exports (MPOB, 2014). An enormous amount of palm oil mill effluent is released during palm oil milling, and the effluent causes a major odor problem. Many methods, such as biofiltering, can be adopted to manage the malodor. However, these methods are expensive and require high maintenance. The separation distance method can be used as an alternative due to its low cost and effectiveness. This research was conducted to verify the performance of three different methods, namely, in-field monitoring by using an olfactometer, CALPUFF model, and Gaussian plume model. Given that no research has compared the three methods, this study examined the effectiveness of the methods and determined which among them is suitable for use in Malaysia. The appropriate separation distances were 1.3 km for in-field monitoring, 1.2 km for the CALPUFF model, and 0.5 for the Gaussian plume model. These different values of separation distance were due to the various approaches involved in each method. This research determined an appropriate means to establish a proper separation distance for reducing odor nuisance in areas around palm oil mills.
    Matched MeSH terms: Waste Management/methods*
  17. Som AM, Ramlee AA, Puasa SW, Hamid HAA
    Environ Sci Pollut Res Int, 2023 Feb;30(7):17108-17121.
    PMID: 34841489 DOI: 10.1007/s11356-021-17633-w
    In exploring the application of natural coagulants in industrial wastewater treatment, plant-based coagulants have been gaining more interests due to their potential such as biodegradability and easy availability. Hylocereus undatus foliage as a plant-based coagulant has been proven to be efficient during the coagulation-flocculation process; however, limited research has been reported focusing only on palm oil mill effluent (POME) and latex concentrate wastewater. In addition, no previous study has been carried out to determine the performance evaluation of Hylocereus undatus foliage in treating different types of wastewater incorporating different operating conditions using optimization techniques. Hence, this study employed response surface methodology (RSM) in an attempt to determine the performance evaluation of the coagulant in paint wastewater treatment. Four independent factors such as the pH value, coagulant dosage, rapid mixing speed and temperature were chosen as the operating conditions. Three water parameters such as turbidity, chemical oxygen demand (COD) and suspended solids (SS) were chosen as responses in this study. Results revealed that through central composite design (CCD) via Design Expert software, the optimum conditions were achieved at pH 5, coagulant dosage of 300 mg/L, rapid mixing speed of 120 rpm and temperature at 30 °C. The experimental data was observed to be close to the model predictions with the optimum turbidity, COD and SS removal efficiencies found to be at 62.81%, 59.57% and 57.23%, respectively.
    Matched MeSH terms: Waste Disposal, Fluid/methods
  18. Wong WJ, Affendi NANM, Siow SL, Mahendran HA, Lau PC, Ho SH, et al.
    Surg Endosc, 2023 Mar;37(3):1735-1741.
    PMID: 36214914 DOI: 10.1007/s00464-022-09680-2
    INTRODUCTION: Per-Oral Endoscopic Myotomy (POEM) is an effective treatment for Esophageal Achalasia Cardia (EAC) but the endoscopic technique required is complex. As competency is crucial for patient safety, we believe that its' competency can be demonstrated when the complication rate equals that of an established procedure such as Laparoscopic Heller's Myotomy with Fundoplication (LHM + F).

    METHODS: A multicentre, ambi-directional, non-randomized comparison of intra-procedural complications during the learning curve of POEM was performed against a historical cohort of LHM + F. Demographic, clinicopathological, procedural data and complications were collected. A direct head-to-head comparison was performed, followed by a population pyramid of complication frequency. Case sequence was then divided into blocks of 5, and the complication rates during each block was compared to the historical cohort.

    RESULTS: From January 2010 to April 2021, 60 patients underwent LHM + F and 63 underwent POEM. Mean age was lower for the POEM group (41.7 years vs 48.1 years, p = 0.03), but there was no difference in gender nor type of Achalasia. The POEM group recorded a shorter overall procedural time (125.9 min vs 144.1 min, p = 0.023) and longer myotomies (10.1 cm vs 6.2 cm, p = 0.023). The overall complication rate of POEM was 20.6%, whereas the historical cohort of LHM + F had a rate of 10.0%. On visual inspection of the population pyramid, complications were more frequent in the earlier procedures. On block sequencing, complication frequency could be seen tapering off dramatically after the 25th case, and subsequently equalled that of LHM + F.

    CONCLUSION: POEM is challenging even for experienced endoscopists. From our data, complication rates between POEM and LHM + F equalize after approximately 25 POEMs.

    Matched MeSH terms: Esophagoscopy/methods
  19. Cheah WH
    Asia Pac J Clin Oncol, 2023 Apr;19(2):e80-e88.
    PMID: 35437926 DOI: 10.1111/ajco.13782
    Rectal cancer is common and accounts for more than one-third of colorectal tumors. It is associated with significant morbidity and mortality. Previously computed tomography scan is the key imaging modality in preoperative assessment to detect local invasion and distant metastasis. However, the advent of magnetic resonance imaging (MRI) has aided in local staging and prognosticates the outcome of rectal tumor. Here, the author briefly explains why rectal MRI has a comprehensive role and provides a simple and easy way in reporting an MRI rectal carcinoma, even for a non-radiologist.
    Matched MeSH terms: Magnetic Resonance Imaging/methods
  20. Chong GTF
    Eur J Dent Educ, 2023 May;27(2):296-303.
    PMID: 35412000 DOI: 10.1111/eje.12803
    INTRODUCTION: The aim of this study is to investigate whether periodontology and cariology receive equal emphasis in dental education at two moments in time, thirteen years apart.

    MATERIALS AND METHODS: An online search was conducted in Nov 2021 of all the dental schools in ten English-language speaking countries (U.S., Canada, U.K., Ireland, South Africa, Australia, New Zealand, Singapore, Hong Kong, and Malaysia) to identify departments/divisions in the disciplines of periodontology, cariology, and conservative/restorative/operative dentistry. The results were then compared against the findings of a similar investigation that was conducted from July to October 2008.

    RESULTS: Of the 126 dental schools identified in 2021, information was available for 93 dental schools. Of these 93 schools, only 10 listed departments/divisions/disciplines of cariology, whereas 83 and 86 schools had listed periodontology and conservative/restorative/operative dentistry, respectively. Despite a doubling of the number of dental schools with a department/division/discipline of cariology from 2008 to 2021, the absolute gap in the number of departments/divisions/disciplines in the other two disciplines compared to cariology had widened during the thirteen years. In 2008, there were 70 more departments/divisions/disciplines in periodontology compared to cariology departments/divisions/disciplines. In 2021, there were 73 more departments/divisions/disciplines in periodontology. Additional information on research output was available for 90 dental schools in 2021, where 30 schools self-identified as undertaking cariology research, whereas 68 and 47 schools undertook research in periodontology and conservative/restorative/operative dentistry, respectively.

    CONCLUSIONS: Dental education does not give equal emphasis to periodontology and cariology, and the discipline of cariology is grossly neglected.

    Matched MeSH terms: Education, Dental/methods
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