APPROACH: Several master templates are initially generated by applying principal component analysis to data obtained from the PhysioNet MIMIC II database. The master template is then updated with each incoming clean PPG pulse. The correlation coefficient is used to classify the PPG pulse into either good or bad quality categories. The performance of our algorithm was evaluated using data obtained from two different sources: (i) our own data collected from 19 healthy subjects using the wearable Sotera Visi Mobile system (Sotera Wireless Inc.) as they performed various movement types; and (ii) ICU data provided by the PhysioNet MIMIC II database. The developed algorithm was evaluated against a manually annotated 'gold standard' (GS).
MAIN RESULTS: Our algorithm achieved an overall accuracy of 91.5% ± 2.9%, with a sensitivity of 94.1% ± 2.7% and a specificity of 89.7% ± 5.1%, when tested on our own data. When applying the algorithm to data from the PhysioNet MIMIC II database, it achieved an accuracy of 98.0%, with a sensitivity and specificity of 99.0% and 96.1%, respectively.
SIGNIFICANCE: The proposed method is simple and robust against individual variations in the PPG characteristics, thus making it suitable for a diverse range of datasets. Integration of the proposed artefact detection technique into remote monitoring devices could enhance reliability of the PPG-derived physiological parameters.
METHOD: Patients with DFUs were selected randomly. Wound size, appearance and presence of infection were recorded at each dressing change.
RESULTS: We assessed five patients in this case series. The use of both nano-colloidal silver and chitosan biopolymer dressings aided wound healing. The patients did not require surgical debridement or amputation. All five cases in this study had a slow healing rate at presentation.
CONCLUSION: Applications of nano-colloidal silver in conjunction with chitosan bioactive as primary dressings in managing DFUs cases are safe and help increase wound healing rates, thus, leading to significant cost savings in the hospital setting.
CASES: Case 1, a 74-year-old diabetic female was treated for bilateral VLUs with micropore dressing for several months, which she noted to be painless and convenient. Case 2, a 49-year-old housewife with a solitary VLU was treated with micropore dressing, leading to good treatment results and high satisfaction.
CONCLUSION: VLUs managed by the micropore dressing resulted in reduced pain and ease of use during dressing changes, as well as noticeable reduction in wound and periwound area maceration. The use of this type of dressing in these cases shows encouraging results and provides a desirable management option. More robust clinical studies are necessary to establish this.
METHODS: Subsidised and self-paying patients were identified at public and private healthcare institutions in three states of Malaysia. Patients were then purposively selected for semi-structured, face-to-face interviews according to their medication adherence status (including adherent and non-adherent patients), which was measured using the Medication Event Monitoring System (MEMS). Adherence was defined as having 80% or more for the percentage of days in which the dose regimen was executed as prescribed. The interview was conducted from January to August 2016 and during the interviews, patients were asked to provide reasons for their medication adherence or non-adherence. The patient interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis with NVivo 11 software.
RESULTS: Thirteen subsidised and 12 self-paying patients were interviewed. The themes found among subsidised and self-paying patients were similar. The factors that influenced adherence to medication include the 'perceived importance of quality of life' and 'perceived benefit or value of the medications'. A unique factor reported by patients in this study included 'perceived value of the money spent on medications'; more specifically, patients adhered to their medications because they valued the money spent to buy/receive the medications.
CONCLUSION: Medication adherence among subsidised and self-paying patients was influenced by many factors, including a unique factor relating to their perceptions of the value of money spent on medications.
Case Report: We report the case of a 58-year-old woman who presented to us with a chief complaint of recurrent right-sided epistaxis and nasal blockage for the past 4 months, which was progressively worsening. Histopathological examination confirmed the presence of a REAH instead of a sinonasal malignancy. The tumor was surgically excised from the lateral nasal wall using electrocautery under endoscopic guidance. The patient was then carefully followed-up after surgery, and the wound was successfully healed 3 months after the initial surgery. There was no evidence of recurrence 6 months after the initial surgery.
Conclusion: This case demonstrates the rare presentation of a REAH, which had arisen from the lateral nasal wall. Clinically, it is difficult to distinguish a REAH from a more notorious mass such as a sinonasal malignancy. Therefore, biopsy is mandatory in all cases of lateral nasal mass in order to rule out malignancy before confirming nasal REAH. Fortunately, as seen in this case, a lateral nasal REAH, once diagnosed, can be safely and easily removed from the lateral nasal wall using electrocautery with good surgical outcomes and a low rate of recurrence.
METHODS: A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained.
RESULTS: A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively.
CONCLUSION: The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.
MATERIALS AND METHODS: A retrospective follow-up study on patients with clinically confirmed stress urodynamic incontinence and urodynamic stress incontinence who had undergone MiniArc or Monarc surgery. Data regarding preoperative evaluation, intraoperative complications and post-operative follow-ups were collated. Main outcome is to determine the change in position of the sling through measurement of the x- and y-axis at rest and during Valsalva maneuver using the 3D introital ultrasound.
RESULTS: A total of 138 patients were evaluated, 82 belonged to Monarc and 56 to MiniArc. At 3years, objective and subjective cure rates for MiniArc and Monarc were comparable (88%, 91%; p>0.05; 83%, 89%, p>0.05 respectively). Ultrasonographic changes between MiniArc and Monarc from 6 months to 3 years, showed MiniArc to exhibit significant movement in both x- [3.0 ±0.4 mm vs. 2.2 ±0.3 mm (p = 0.02) at rest; 2.6 ±0.3 mm vs. 1.6 ±0.3 mm (p<0.001) during valsalva] and y-axis [3.5 ±0.5 mm vs. 2.0 ±0.3 mm (p<0.001) at rest; 3.3 ±0.5 mm vs. 2.9 ±0.3 mm (p = 0.037) during Valsalva]. The mobility of MiniArc was significantly more than Monarc from rest to Valsalva (1.1 ±0.4 mm vs. 0.3 ±0.3 mm, p = 0.001). Tightness of the sling assessed from the major and minor axis of the urethral core had no significant difference in both groups at rest and during Valsalva. Urethral kinking percentage and the location of the sling did not yield statistical difference.
CONCLUSION: Maintenance of continence rates of mid-urethral slings depends on the compressive effect of the sling on the urethra, urethral kinking, and sling fixation. From 6months to 3 years, MiniArc changed its position in both x- and y-axis over time, which the authors attribute to loosening of the anchoring mechanism since no clinical relevance could be sought.
METHODS: We conducted a randomised, double blinded, two-armed parallel study comparing 20 g/day of Tualang Honey versus 20 g/day Honey Cocktail among postmenopausal women aged 45-65 years. The cardiovascular parameters and anthropometrics measurements were assessed at baseline, 6 months, and 12 months of the intervention.
RESULTS: 100 subjects were successfully randomised into the groups. There was a significant decrease in the diastolic blood pressure from 77.92 mmHg at baseline to 73.45 mmHg at 12 months (F-statistic = 2.55, p-value = 0.047) in the Tualang Honey group compared to Honey Cocktail. There was also a significant decrease in the fasting blood sugar from 6.11 mmol/L at baseline to 5.71 mmol/L at 12 months (F-statistic = 4.03, p-value = 0.021) in the Tualang Honey group compared to the Honey Cocktail group. The body mass index remained unchanged at 27 kg/m2 (F-statistic = 1.60, p-value = 0.010) throughout 12 months of the intervention in the Honey Cocktail group.
CONCLUSION: Subjects who received Honey Cocktail showed remarkable effects on body mass index. However, Tualang Honey supplementation showed superior effect in lowering diastolic blood pressure and fasting blood sugar compared to Honey Cocktail. Further studies are required to ascertain the underlying mechanism(s) of Tualang Honey and Honey Cocktail on each observed parameter.
METHOD: A survey was carried out between April 20 and May 30, 2018 by a working group under the Medical Physics Division of the Malaysian Institute of Physics (IFM). The survey form was designed using Google Form and sent to various public and private institutions nationwide that employed MPs registered with IFM.
RESULTS: A total of 106 responses (28% men and 72% women) were analysed. This represented 30% of the medical physics workforce. Majority of them had postgraduate degrees, but their clinical training is mostly obtained on the job with no certification. The number of low-ranking female MPs was disproportionately high. MPs worked long hours and achieving work-life balance (WLB) was a challenge. Factors that improved their WLB included working close to home, having a supportive manager and flexible working hours. Most MPs aspired to become professional and mentor younger compatriots, besides contributing to patient care and research. Gender discrimination was reportedly low.
CONCLUSION: Medical physics in Malaysia is growing and has a strong representation of women. In future, they would probably take over the top management from their male counterparts, whose number had stagnated. A united effort was essential to set up a proper clinical training system to train clinically qualified MPs.
Aim: To evaluate parameters of the proximal tibia geometry amongst the Igbos of South Eastern Nigeria and discuss the clinical implications in total knee replacement.
Methods: The proximal tibia parameters of 558 adult tibiae bones, 300 right-sided and 258 left-sided, collected from the osteological unit of the department of anatomy University of Nigeria Enugu campus were measured using a Venier calipers.
Results: The values of the determined parameters are as follows: anterior posterior dimension (APD): 5.50 cm, medial lateral dimension (MLD):7.53 ± 5.56 cm, proximal length (PL): 7.32 ± 0.67 cm, proximal width (PW) CM: 4.10 ± 0.30 cm, medial tibia posterior slope (MTPS):11.36 ± 4.15° and lateral tibia posterior slope (LTPS):5.65 ± 2.72°. The correlation test between these parameters of the proximal tibia shows a strong significant correlation between LPTS and MPTS (r =0.814, P < .001). The comparison of the means of the MPTS of both sides using independent samples t test shows a mean difference that is not significant (p =0.628). A comparison of the values with other populations shows significant mean difference for MLD with that of Chinese and American populations (p < .05). The mean difference between the APD of this study and the Chinese is significant (p =0.007). A comparison of MPTS and LPTS for Malaysian, Chinese, and white Americans shows a significance difference for all the three populations (p