OBJECTIVE: To determine the association and diagnostic ability of serum and tissue eosinophils in the diagnosis of asthma among CRS patients.
METHODS: A cross-sectional study was conducted involving 24 CRS patients with asthma and without asthma, respectively, from the Otorhinolaryngology clinic of two tertiary hospitals located on the East Coast of Peninsular Malaysia. Serum and tissue eosinophils (obtained from nasal polyp) levels between both groups were compared. Association between serum and tissue eosinophils with asthma was evaluated using logistic regression analysis, adjusting for important sociodemographic characteristics. The diagnostic ability of serum and tissue eosinophil was then evaluated by assessing the receiver operating characteristic curve.
RESULTS: A total of 48 CRS patients with a mean [SD] age of 47.50 [14.99] years were included. Patients with asthma had significantly higher serum [0.48 vs 0.35 × 109/L] and tissue eosinophil [100 vs 8.5 per HPF] levels. Tissue eosinophils were found to be an independent predictor of asthma with adjusted OR 1.05, p 0.375 × 109/L and tissue eosinophil > 58 per HPF.
METHODS: A structured methodological process will be employed to guide the instrument's development and subsequent validation. The instrument aims to encompass comprehensible questions with a simple scoring and interpretation mechanism to foster its daily use. The study will consist of two phases. Phase 1 focuses on the development of the Malaysian instrument. This phase encompasses a literature review, item development tailored to the Malaysian context, content validity through expert panel evaluations, translations, pre-tests and a follow-up stakeholder engagement to ensure the instrument meets their requirements. Incorporating perspectives from experts and comprehensibility by local patients ensures the instrument's relevance to the local context. Phase 2 involves instrument validation through a cross-sectional study. This phase entails a pilot test and field test of the instrument among diabetic patients for validation. Cut-off ranges and their interpretations will also be established in this phase. The study sites encompass a mix of urban and rural public health clinics across Peninsular as well as East Malaysia.
DISCUSSION: By developing a standard validated instrument to assess diabetic foot self-care practices, services provision gaps can be identified, and targeted interventions to improve these gaps in practices can be implemented. Individually tailored diabetes foot care education is crucial in preventing foot ulcers. This instrument can also facilitate the monitoring of improvements in patients' foot self-care practices longitudinally.
OBJECTIVES: To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.
METHODS: A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.
RESULTS: US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.
CONCLUSION: US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.
METHOD: Based on a pre-registered protocol (PROSPERO: CRD42022328485), we searched PubMed, Web of Knowledge/Science, Ovid Medline, Embase and APA PsycINFO up to 5th February 2022, with no language/type of document restrictions. We included observational studies 1) reporting at least one measure of vision in people of any age with a diagnosis of ASD based on DSM or ICD criteria, or ADOS; or 2) reporting the prevalence of ASD in people with and without vision disorders. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Random-effects meta-analyses were used for data synthesis.
RESULTS: We included 49 studies in the narrative synthesis and 46 studies in the meta-analyses (15,629,159 individuals distributed across multiple different measures). We found meta-analytic evidence of increased prevalence of strabismus (OR = 4.72 [95% CI: 4.60, 4.85]) in people with versus those without ASD (non-significant heterogeneity: Q = 1.0545, p = 0.7881). We also found evidence of increased accommodation deficits (Hedge's g = 0.68 [CI: 0.28, 1.08]) (non-significant heterogeneity: Q = 6.9331, p = 0.0741), reduced peripheral vision (-0.82 [CI: -1.32, -0.33]) (non-significant heterogeneity: Q = 4.8075, p = 0.4398), reduced stereoacuity (0.73 [CI: -1.14, -0.31]) (non-significant heterogeneity: Q = 0.8974, p = 0.3435), increased color discrimination difficulties (0.69 [CI: 0.27,1.10]) (non-significant heterogeneity: Q = 9.9928, p = 0.1890), reduced contrast sensitivity (0.45 [CI: -0.60, -0.30]) (non-significant heterogeneity: Q = 9.9928, p = 0.1890) and increased retinal thickness (=0.29 [CI: 0.07, 0.51]) (non-significant heterogeneity: Q = 0.8113, p = 0.9918) in ASD.
DISCUSSION: ASD is associated with some self-reported and objectively measured functional vision problems, and structural alterations of the eye, even though we observed several methodological limitations in the individual studies included in our meta-analyses. Further research should clarify the causal relationship, if any, between ASD and problems of vision during early life.
PROSPERO REGISTRATION: CRD42022328485.
METHODS: We used data from the UNICEF Innocenti Disrupting Harm survey. The survey included a representative sample of 11,912 internet-using children aged 12-17 in Ethiopia, Kenya, Mozambique, Namibia, Tanzania, Uganda, Cambodia, Indonesia, Malaysia, Philippines, Thailand and Vietnam. We modelled the associations of social connection during lockdown and internet use during the pandemic with six different indicators of wellbeing in each country (excluding Tanzania, where there had been no lockdowns) and in the overall sample using robust linear and logistic regression. We controlled for a range of putative socioeconomic and demographic confounders and handled missing data using multiple imputation.
RESULTS: We did not find clear evidence for any general associations of social connection or internet use with mental health indicators during lockdown across countries. Rather, our results are complex and demonstrate that the relationship depends heavily on an individual's context; not just on the country they are living in but also on their gender, urbanicity and other factors. Nonetheless, our results highlight key focus areas for further research.
CONCLUSION: Extensive further research is needed to identify ways in which technology use, including internet use, might act as a risk or protective factor relevant to mental ill health among young people in the countries of the Global South.
OBJECTIVE: This study aims to estimate task-, age-, and sex-related patterns in correct oral-DDK rate among Mandarin-speaking children and adolescents aged 8 to 17 years; examine associations with medical and physiological measurements; and assess correspondence with parent and teacher observations of everyday speech.
METHODS: A dedicated cross-sectional school study was conducted in Suzhou, Anhui Province, China, from October 2024 to June 2025. Schools were randomly selected, and homeroom teachers invited eligible students from all classes. The 7-stimulus battery comprised conventional alternating motion rate, nonword sequential motion rate (SMR), and Mandarin real-word SMR. All completed performances were digitally recorded. A total of 3 professional modules documented medical and physiological background, task readiness, and 5 oromotor actions. Physicians measured height, weight, and forced vital capacity, and BMI was calculated. Speech-language pathologists administered the readiness and oromotor checks. Readiness included a brief comprehension check using 5W1H (What, Why, Who, When, Where, and How) prompts. Primary guardians and homeroom teachers each completed 3 frequency items about inaccurate speech sounds and speech perceived as too fast or too slow. Eligibility and recording usability determined the analyzable observations. A repeated-task mixed model was used to estimate rate patterns; medical, physiological, and contextual report associations will be examined separately.
RESULTS: Field data collection ended in June 2025. Of 1036 participants, 2 (0.2%) withdrew, 6 (0.6%) experienced technical failures, and 2 (0.2%) could not complete the required screening or oral-DDK procedures; 1026 (99%) participants were retained. Oral-DDK scoring and verification and the primary rate analyses were completed by September 2026. As of October 2026, analyses linking rate to parent and teacher reports had not begun. A major revision of the normative manuscript was completed in early October 2026, but its publication timing is not yet known. This protocol does not present inferential results.
CONCLUSIONS: The protocol links conventional and real-word oral-DDK with separately recorded health, physiological, and everyday speech observations. It specifies how these records enter analyses of correct rate and preserves a standardized digital audio corpus for scoring checks and subsequent task-specific analyses.
METHOD: A cross-sectional comparative study design was used for evaluating 695 PILs (312 multinational, 383 local) across various therapeutic classes (antibiotics, anti-hypertensives, anti-diabetics, NSAIDs, and antidepressants). PILs were assessed against 31 criteria encompassing general information, dosage, indications, administration, interactions, safety information, pharmacokinetics, toxicology, storage, adverse effects, and pregnancy/breastfeeding details. Descriptive statistics, t-tests, chi-square tests, and odds ratios were included in statistical analysis.
RESULT: Several criteria results showed excelling of Multinational PILs over local PILs. Significant differences favouring multinational PILs were observed in providing information on inactive ingredients (p = 0.024), adult-specific dosing (p = 0.0001), renal and hepatic dose adjustments (p = 0.018, p = 0.007 respectively), dosing in haemodialysis patients (p = 0.036), drug-drug interactions (p = 0.029), black box warnings (p = 0.027), clinical effects of toxicity (p = 0.045), and reporting adverse drug reactions (p = 0.04).
CONCLUSION: Multinational and local PILs, both performed well in providing basic information on active ingredients, brand names, contraindications, pregnancy, and lactation details. However, disparities among various aspects including inactive ingredient, specific dosing, dose adjusments and drug interactions between PILS of multinational and local pharmaceutical companies in Pakistan highlights the necessity for regulatory measures and industry initiatives to standardize PIL content. For ensuring patient safety and enhancing the quality of medication use it is essential to improve the comprehensiveness and clarity of PILs.