Objective: The aim of this study was to assess the knowledge, attitude and practice regarding COVID-19 and its transmission, causes and prevention among people living in Malaysia.
Methods: A cross-sectional study was conducted among people living in Malaysia by using an online survey in March and April 2020.
Results: Out of 520 respondents, the mean age was 36.9 ± 14.9, between 19 and 67 years with the majority being female. Most respondents had good knowledge, attitude and practice towards COVID-19 with mean ± sd 18.2 ± 1.7, 5.2 ± 1.1 and 4.1 ± 1.4, respectively. In addition, the majority had good knowledge regarding cause, mode of transmission, signs and symptoms, prevention and treatment and quarantine measures after answering 21 questions.
Conclusion: To date, there is no specific treatment or vaccine for COVID-19, thus staying at home is the best preventive measure to curb the further growth of positive cases in the country. These findings could provide an insight in designing effective preparedness for future pandemic outbreaks.
OBJECTIVE: The aim of this study is to explore a simple, easy, economical method of PRP preparation that is practical for clinical use.
MATERIALS AND METHODS: This cross-sectional study was conducted at the Sports Medicine Clinic at the University of Malaya Medical Centre, Malaysia. Participants were healthy postgraduate students and staff at the Sports Medicine Department. The PRP was prepared using a single centrifugation technique. Leukocyte and platelet levels were compared with that of a whole blood baseline and a commercial preparation kit.
RESULTS: The PRP produced using this technique contained significantly higher mean platelet (1725.0 vs. 273.9 x 109/L) and leukocyte (33.6 vs. 7.7 x 109/L) levels compared with whole blood. There was no significant difference in the mean platelet and leukocyte levels between the PRP produced in this study and by a commercial PRP system.
CONCLUSIONS: A single-centrifugation protocol using readily available materials in a typical clinical setting could produce PRP of comparable quality to those of a commercial PRP production system.
AIMS: The main aim was to systematically evaluate the available evidence regarding the effectiveness of structured patient education on their knowledge, participation, wound healing, and quality of life.
METHODS: The search strategy retrieved studies published between 2009 and 2021 in English across PubMed, MEDLINE, CINAHL, ProQuest, and Cochrane Library. Adult participants aged 18 years and above were included. Randomized controlled trials, quasi-experimental, and interventional studies were all included in this review. Three independent reviewers assessed the methodological quality of the studies, prior to critical appraisal, using standardized tools, that is, the Joanna Briggs Institute checklist for randomized and non-randomized studies. A narrative synthesis was conducted.
RESULTS: A total of eight studies (466 participants) were included in this review. Available evidence indicated improved patient knowledge, participation, and quality of life with structured patient education. However, there was insufficient high-quality evidence to conclude the effect on wound healing.
LINKING EVIDENCE TO ACTION: Structured patient education for PI was deemed to help improve patients' knowledge, participation, and quality of life. More rigorous trials are needed for the effect on wound healing progress. Thus, future educational interventions should include wound care components that describe the patient's role in promoting wound healing. A well-structured patient education program protocol is crucial to ensure the educational intervention was measurable in its effectiveness and reproducibility.
Case Description: We report a 42-year-old man, diagnosed with rosette-forming glioneuronal tumor of the fourth ventricle with a positive isocitrate dehydrogenase 1 mutation, progressed to glioblastoma after 6 years from diagnosis. We discuss the clinical history, radiological findings, and histopathological characteristic with immunohistochemistry findings observed in this unique case.
Conclusions: Despite being acceptable as benign, based on our observations in this case, there is a potential for malignant transformation of rosette-forming glioneuronal tumor. The role of isocitrate dehydrogenase 1 mutation leading to malignant transformation could not be established as our finding is novel and further prospective studies are required to prove this association.
METHODS: Both ictal and interictal ESI were performed by the use of patient-specific realistic forward models and 3 different linear distributed inverse models. Lateralization as well as concordance between ESI-estimated focuses and single-photon emission computed tomography (SPECT) focuses were assessed.
RESULTS: All the ESI focuses (both ictal and interictal) were found lateralized to the same hemisphere as ictal SPECT focuses. Lateralization results also were in agreement with the lesion sides as visualized on magnetic resonance imaging. Ictal ESI results, obtained from the best-performing inverse model, were fully concordant with the same cortical lobe as SPECT focuses, whereas the corresponding concordance rate is 87.50% in case of interictal ESI.
CONCLUSIONS: Our findings show that ictal ESI gives fully lateralized and highly concordant results with ictal SPECT and may provide a cost-effective substitute for ictal SPECT.
OBJECTIVE: We hypothesized that the risk of infections after primary cranioplasty in adult patients who underwent craniectomies for non-infection-related indications are no different when performed early or delayed. We tested this hypothesis in a prospective, multicenter, cohort study.
METHODS: Data were collected prospectively from 5 neurosurgical centers in the United Kingdom, Malaysia, Singapore, and Bangladesh. Only patients older than 16 years from the time of the non-infection-related craniectomy were included. The recruitment period was over 17 months, and postoperative follow-up was at least 6 months. Patient baseline characteristics, rate of infections, and incidence of hydrocephalus were collected.
RESULTS: Seventy patients were included in this study. There were 25 patients in the early cranioplasty cohort (cranioplasty performed before 12 weeks) and 45 patients in the late cranioplasty cohort (cranioplasty performed after 12 weeks). The follow-up period ranged between 16 and 34 months (mean, 23 months). Baseline characteristics were largely similar but differed only in prophylactic antibiotics received (P = 0.28), and primary surgeon performing cranioplasty (P = 0.15). There were no infections in the early cranioplasty cohort, whereas 3 infections were recorded in the late cohort. This did not reach statistical significance (P = 0.55).
CONCLUSIONS: Early cranioplasty in non-infection-related craniectomy is relatively safe. There does not appear to be an added advantage to delaying cranioplasties more than 12 weeks after the initial craniectomy in terms of infection reduction. There was no significant difference in infection rates or risk of hydrocephalus between the early and late cohorts.
METHODS: This was a nonrandomized, prospective observational study conducted from September 2011 to January 2015 on patients with intracranial convexity and parasagittal meningiomas. Preoperative computed tomography brain scans were obtained in all patients to confirm bony hyperostosis. Intraoperatively, part of the hyperostotic bone was sent for histopathologic examination. The rest of the bone flap was refashioned by drilling off the hyperostotic part. The bone flap was put back over the craniotomy site after soaking in distilled water. All patients were followed up for tumor recurrence.
RESULTS: The study included 34 patients with convexity or parasagittal meningioma World Health Organization grade I-II who underwent Simpson grade Ia and IIa excision. Median follow-up was 63.5 months (mean 64.9 ± 9.4 months). The hyperostotic bone flap showed presence of tumor in 35% of patients. There were 2 patients with parasagittal meningiomas after Simpson grade IIa resections who developed tumor recurrences.
CONCLUSIONS: Our study found that meningioma recurrence was unlikely when autologous cranioplasty was done with refashioned hyperostotic bone. This could be done in the same setting with meningioma excision. There was no recurrence in convexity meningiomas at mean 5-year follow-up.
METHODS: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.
RESULTS: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.
CONCLUSIONS: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.