We present the case of a patient with multiple atraumatic osteoporotic vertebral fractures in an adolescent with suprasellar germinoma and also review of relevant literature. The patient suffered from a rare adolescent brain tumour with common complications which are often overlooked and give rise to significant morbidity. Suprasellar germinoma is an intracranial neoplasm, that in addition to its rarity, has variable clinical presentation. Despite appropriate treatment and good outcome, tumour related morbidity is still of concern for these patients.
This fMRI study is about modelling the effective connectivity between Heschl's gyrus (HG) and the superior temporal gyrus (STG) in human primary auditory cortices. MATERIALS #ENTITYSTARTX00026;
Demand and use for oral health-related quality of life (OHRQoL) instruments have increased in recent years in both research and clinical settings. These instruments can be used to measure patient's health status or detect changes in a patient's health status in response to an intervention or changes in disease trajectory. Ensuring universal acceptance of these measures requires easy interpretation of its scores for clinicians, researchers, and patients. The most important way of describing and interpreting this significance of changes in OHRQoL is through the establishment of minimal important difference (MID). The minimally important difference represents the smallest improvement considered worthwhile by a patient. A comprehensive search of published literature identified only 12 published articles on establishment of MID for OHRQoL measures. This scarcity of published studies on MID encourages the need of appropriate interpretation and describing patient satisfaction in reference to that treatment using MID. Anchor- and distribution-based methods are the two general approaches that have been proposed and recommended to interpret differences or changes in OHRQoL. Both of these methods of determining the MID have specific shortcomings; therefore, it is proposed to adopt triangulation approaches in which the methods are combined. The objective of this review is to summarize the need for, importance of, and recommendations for methods of establishing MID for OHRQoL measures.
INTRODUCTION AND AIMS: Patients with sore throats are often treated with oral gargles or oral sprays. Some may rinse instead of gargle, leading to unsatisfactory outcome. The authors studied the efficacy of oral rinses, gargles, and sprays and the effect of Friedman palate position on the outcome.
METHODS: Ten subjects used specially prepared solutions to rinse, gargle, and then spray their oral cavities at 2-hour intervals. The blue dye indicated the areas stained by the solution, which were scored.
RESULTS: Although there was no difference in reaching the oropharynx between the gargles and sprays, they were both better than were the oral rinses (P < .001). The difference in Friedman palate position did not have an effect on the efficacy of the different modalities.
CONCLUSION: Oral gargles and sprays have been shown to be significantly better than are oral rinses if the oropharynx is the targeted site, and the size of the oral airway does not impede their efficacy.
KEYWORDS: Friedman palate position; drug administration; oropharynx
This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of lymphangioma in children and to determine the incidence of complications in the treatment.
The rising epidemic of established modifiable cardiovascular risk factors (CVRF), such as hypertension, dyslipidaemia, diabetes and cigarette smoking, to a large part, are responsible for the clinical events such as acute coronary syndrome (ACS) and cerebrovascular events (strokes, CVE). In our National ACS and percutaneous coronary intervention (PCI) Registries, it has been documented that over 90% of patients have at least one identifiable CVRF.
Congenital cholesteatoma (CC) rarely presents with Luc's abscess. As a result of widespread usage of antimicrobial agents, Luc's abscess is hardly encountered in current clinical practice. Herein, we report a case of Luc's abscess as the first presenting symptom in a 5-year-old boy with underlying CC. Patient's clinical findings, radiological investigations and treatment were also discussed.
BACKGROUND:
Dengue infection has been an important and serious public health concern in Malaysia ever since its first reported case here in 1902. Nevertheless, to our knowledge, no nationwide investigation has been carried out to determine the actual magnitude of dengue endemicity in the Malaysian population. In this study, we describe a cross sectional seroepidemiology study of dengue IgG seroprevalence in the Malaysian adult population.
FINDINGS:
From 1000 subjects (35-74 years old), 91.6% subjects were found to be dengue seropositive. Age is found to be a significant risk factor associated with dengue seroposivity, where the seroprevalence increased with every 10 year increase in age. Nevertheless, gender and ethnicity did not have an effect. Interestingly, there were similar seroprevalence rates between urban and rural samples, showing that dengue is presently not confined to urban areas in Malaysia.
CONCLUSIONS:
High dengue IgG seropositivity found in the population is an indication that dengue might be endemic in Malaysia for a long time into the future. Public awareness, proper vector control and vigilant surveillance are critical to keep the infection rates low and to prevent outbreaks.
Hypertension is a very common disease, leading to significant morbidity with reduction in quality of life. In addition to being a major cause of morbidity and mortality, hypertension places a heavy burden on health care systems, families, and society as a whole. In patients with hypertension, the ability to identify a contributing or secondary cause that is potentially curable or amenable to specific forms of management is of great importance. Endocrine hypertension has emerged as one of the common forms of secondary hypertension. Primary aldosteronism, pheochromocytoma and Cushing's syndrome are among the common causes of endocrine hypertension. The application of new clinical, biochemical, and radiologic approaches has significantly advanced our understanding of the pathophysiology and clinical spectrum of these diseases and improved the management strategies of these challenging conditions.
BACKGROUND: Exercise for people with COPD has focused on leg training, such as walking and cycling. The role and effectiveness of arm training has not been investigated in detail. This review was undertaken to examine the literature for the effectiveness of upper extremity exercise on arm exercise capacity and arm strength in people with COPD.
METHODS: Trials relating to arm endurance and strength training in COPD were located by searching electronic databases and screening the reference lists of pertinent articles. Where possible, effect sizes and 95% CI were determined and meta-analysis used.
RESULTS: The search strategy yielded 24 articles. Unsupported arm training improved arm endurance capacity (standard mean difference [SMD] =1.25; 95% CI=0.16 to 2.66) and was the optimal mode of arm endurance training. Combined unsupported and supported arm training was also found to have a large positive effect on peak arm exercise capacity (SMD=1.27; 95% CI=0.59 to 1.94). In addition arm strength training produced moderate improvements in arm strength (SMD=0.46; 95% CI=0.10 to 0.81).
CONCLUSION: This review suggests that in the short term, arm endurance training improves arm exercise capacity and arm strength training improves arm strength. Further research is required, in people with COPD, to investigate the long-term effects of arm training.
KEYWORDS: chronic obstructive pulmonary disease; upper extremity exercise
OBJECTIVE: Postpartum depression (PPD) is a common health problem which affects women in the postpartum period. This is a brief note on its associated factors in women from different cultures.
METHODS: A literature review was performed in MEDLINE and Pubmed from 1991 to 2008 and Magiran from 1991 to 2009. Additional articles and book chapters were referenced from these sources.
RESULTS: The prevalence of postpartum depression has been reported to be from 0.5% to 60% globally, and from 3.5% to 63.3% in Asian countries, in which Malaysia and Pakistan had respectively the lowest and highest rates. One of the factors contributing to PPD in Asian societies can be that women may not have the empowerment to reject traditional rituals that are imposed on them by their caregivers. Unsatisfactory pre-existing relationships between the mothers and their caregivers resulting in mothers experiencing difficulties during their confinement period may be another factor. Thirdly, some features of these traditional rituals may be the cause of tension, stress and emotional distress. Emotional conflicts caused by insistence on practice of traditional rituals during the postpartum period may lead to mental breakdown.
CONCLUSION: Health care professionals should be aware that the phenomenon in Asian cultures is as prevalent as European cultures. Moreover, further research needs to be conducted on the global prevalence of the experiences of childbearing women with depressive symptoms.
KEYWORDS: Cultures; Postpartum depression; Risk factors
Since the discovery of the double-helical structure of DNA, genetic regulation of gene expression has been well elucidated. More recently, another equally, if not more, important scheme of regulation of gene expression, called epigenetics, has emerged to explain the many biological observations that traditional genetic mechanisms have failed to decipher. Epigenetics is a discipline of study on the biological consequences of cellular alterations that do not involve nucleotide changes, as opposed to genetic mutations. Epigenetic changes are reversible and may lead to loss or gain of biological functions. The three most reported mechanisms of epigenetic regulation of gene expression involve changes in: (i) chromatin remodelling, (ii) DNA methylation and (iii) microRNA (miRNA). More importantly, many of the elucidated epigenetic changes are linked to the pathogenesis of human diseases and cancers. In this mini review, core concepts and basic experimental approaches in the study of epigenetic regulation of gene expression are briefly reviewed in relation to disease, with emphasis on cancer. This mini review also intends to highlight the fact that, besides genetics, epigenetics is now a discipline physicians and clinical research scientists can no longer ignore in their pursuit to understand disease and cancer and to develop new therapeutic strategies for treatment.