Analytical price of amygdala amount in structurel permanent magnetic resonance photo within Alzheimers

No abstract provided.Subspecialty surgical training is an integral part of continuous professional development. It represents a unique opportunity for surgeons to enhance and develop specific advanced skills in their sub-disciplines. Hence, hands-on training in an international training centre abroad allows one to bring home new technical and management skills in the expansion of Malaysian surgical services to raise to be on par with the international standards. The unexpected onset of the COVID-19 pandemic brought in previously unknown hindrances to the training both locally and abroad but our success in engagement with international centres despite the pandemic restrictions serves as a valuable experience towards maintaining international networking for future collaborations.While specific bedside examinations are known to be sensitive in identifying stroke among acute vestibular syndrome patients, complementary quantitative vestibular function testing can be helpful to quantify vestibular loss due to stroke. In contrast to peripheral vestibular dysfunction, diagnosis of central vestibular dysfunction can be challenging for unskilful clinicians. This article presents a comprehensive overview of quantitative vestibular function test findings such as the video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMPs), ocular vestibular evoked myogenic potentials (oVEMPs), videonystagmography (VNG) and caloric test among stroke patients. Vestibulo-ocular reflex (VOR) gain is usually found normal among posterior inferior cerebellar artery (PICA) stroke patients but varies among anterior inferior cerebellar artery (AICA) stroke patients. Abnormal contralesional posterior semicircular canal VOR gain can be observed due to lesions in the medial longitudinal fasciculus (MLF). AICA and PICA stroke can impair cVEMPs, oVEMPs, and VNG (i.e., smooth pursuit and saccade functions). Strokes, particularly those involving the vestibular nucleus, including both upper, lower brainstem and cerebellum, can result in various abnormalities of smooth pursuit, saccade or calorics testing. The combined evaluations of VNG, vHIT, and VEMPs can be accurately used to complement and quantify bedside vestibular evaluation in diagnosing central vestibular dysfunction. In addition, as most studies were conducted amongst acute vestibular syndrome (AVS) patients, future studies that investigate the prevalence of vestibular dysfunction in recovering stroke patients are required.Hypertension is a risk factor for coronary artery disease and stroke. Only about half of the patients with hypertension are adequately controlled on medical therapy, and about a quarter may develop severe or resistant hypertension. Resistant hypertension is defined as failure to achieve target blood pressure of less then 140/90mmHg while on full doses of an appropriate three-drug regimen that includes a diuretic. Increasingly more attention has been paid to the potential of renal denervation (RDN) as treatment for resistant hypertension, guided by a better understanding of renal nerve anatomy. RDN is undergoing transformation as a technology for the treatment of resistant hypertension. Early studies demonstrated efficacy in treating resistant hypertension patients with significant reduction in office blood pressure (BP). However, the randomised sham-controlled trial, Symplicity HTN-3, did not demonstrate any significant difference in BP reduction between the RDN and the sham control arm. see more Since then, further renal arteries. The RDN procedure has a low complication rate and may provide an approach that could potentially reduce the morbidity and mortality risks associated with resistant hypertension in Malaysia.
Few studies have reported the impact of preoperative interocular discrepancy in optical biometry (axial length, corneal power, white-to-white, central corneal thickness) on postoperative refractive outcomes. This study aims to investigate any predictive value of preoperative optical biometry differences between eyes on postoperative refractive outcomes.
A retrospective cohort study of patients who have undergone optical biometry measurement before unilateral phacoemulsification in the Queen Elizabeth Hospital, Sabah, Malaysia from 2018 to 2020. Biometry data of interest includes axial length (AL), keratometry(K), white-to-white (WTW) and central corneal thickness (CCT). The postoperative outcomes of interest were the patient's preoperative refractive target, postoperative best-corrected visual acuity (BCVA), postoperative refractive outcomes, and optical biometry prediction error.
The interocular biometry discrepancies which were associated with higher odds of prediction error >0.5D from the refracti help clinicians to identify which patients have a higher risk of refractive shift post-cataract surgery and counsel the patient before cataract operation.
The COVID-19 pandemic has prompted the medical world to look at factors that may influence outcomes. There have been connections made between vitamin D and COVID-19, as vitamin D has previously been shown to play a role in the maintenance of immune homeostasis.
We performed a prospective cohort study on 103 patients at Wigan Wrightington and Leigh NHS Foundation Trust looking at serum vitamin D levels of patients with positive COVID-19 swabs. Results were collated and correlations were made to compare vitamin D levels with age; severity of illness; hospital outcomes; and frailty. Comparisons were also made between frailty and outcome.
The results showed that there was a significant statistical difference between vitamin D levels and severity of infection those who were treated in the intensive care units (ICU) (severe symptoms) had lower vitamin D levels than those treated on the ward (p=0.0446). There was also a correlation between vitamin D levels and frailty those who were more frail had higher vitamin D levels than fitter patients (P=0.005). Vitamin D and frailty had no effect on hospital outcomes of COVID-19 infection.
Ultimately, we concluded that low vitamin D can increase susceptibility of contracting COVID-19, increase severity of infection but does not affect mortality.
Ultimately, we concluded that low vitamin D can increase susceptibility of contracting COVID-19, increase severity of infection but does not affect mortality.
The Optimal Health Program (OHP) is a collaborative self-management program that promotes clients to be actively involved in their own healthcare and overall wellbeing. Program Kesihatan Optimum (SANUBARI) is a Malay version of the OHP after a translational process and cultural adaptation by psychiatrists, clinical psychologist and family medicine specialists in 2017. The program is of a low intensity, patient-centred program, advocating self-health management to improve health literacy by enhancing self-efficacy, building strengths and values, and initiating change and planning, ultimately enhancing wellbeing of people. The programme can be used as a form of early psychosocial intervention during the current pandemic in maintaining the general mental wellbeing of COVID-19 patients.
This is an open labelled interventional study of a virtual brief psychosocial intervention, called SANUBARI. The program was conducted among COVID-19 patients hospitalized in the COVID-19 wards of two centres from May 2020 untrom psychological stress and ultimately enhances wellbeing during this coronavirus pandemic.
Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) is effective in treating acute ischaemic stroke. Our primary objective is to assess the outcome of these acute ischaemic stroke (AIS) patients after IV alteplase with the modified Rankin scale (mRS).
This is a cross-sectional study in which patients receiving IV alteplase in Hospital Universiti Sains Malaysia, from January 2017 to April 2020 were recruited. Demographical data, National Institutes of Health Stroke Scale (NIHSS) scores, door-to-needle time were recorded. Modified Rankin scale (mRS) scores were evaluated at 90 days after initial therapy. Good and poor functional outcomes were defined as 0-2 and 3-6, respectively.
A total of 30 patients were included in the study with a mean age of 59±11.47 years old. 76.7% of them were male and the rest were female. From the study, onset-toneedle time was 197.47±51.74 minutes, whereas door-toneedle time was 120.93±53.63 minutes. Seventeen (56.3%) patients achieved a favourable score of 0-2 on the mRS at 90 days after treatment. Haemorrhagic transformation occurred in eight (26.7%) of the patients with a mortality rate of 13.3%.
56.7% of our patients showed improvement in the mRS at 90 days post thrombolysis for AIS. Higher baseline NIHSS scores and diabetes mellitus were associated with poorer functional outcomes after thrombolysis.
56.7% of our patients showed improvement in the mRS at 90 days post thrombolysis for AIS. Higher baseline NIHSS scores and diabetes mellitus were associated with poorer functional outcomes after thrombolysis.
This study aimed to determine the coverage of tetanus toxoid vaccination (TT) among pregnant women in Cambodia, and its association with health services and pregnancy factors.
A cross-sectional study was conducted by utilising the data from the Cambodia Demographic Health Survey (CDHS). The records of 5901 pregnant women who fulfilled the inclusion criteria were reviewed. Multiple logistic regression was used to identify the association on the influence of health services and pregnancy factors on incomplete TT vaccination while controlling other covariates. Adjusted odds ratio (aOR) and 95% confidence interval (95%CI) was reported.
More than one-third of the respondents had incomplete TT vaccination (38.25%, 95%CI 37.00, 39.48%). Health services as well as pregnancy factors were statistically associated with incomplete TT vaccination such as received antenatal care (ANC) from other health personnel beside midwife (aOR=1.83; 95%CI 1.49, 2.24), had <ANC visits (aOR=1.76; 95%CI 1.53, 2.03), being late for the first ANC visit (aOR=1.65; 95%CI 1.41, 1.92), unwanted pregnancy (aOR=1.30; 95%CI 1.11, 1.51), aged ≥30 years at delivery (aOR=1.45; 95%CI 1.15, 1.46) while controlling other factors like; including age, occupation, husband's age, occupation, financial status, maternal age at delivery, birth order, wanted pregnancy and accessing health facility.
More than one-third of pregnant women in Cambodia had not completed tetanus toxoid vaccination. Health services and pregnancy related factors had significance role on incomplete tetanus toxoid vaccination.
More than one-third of pregnant women in Cambodia had not completed tetanus toxoid vaccination. Health services and pregnancy related factors had significance role on incomplete tetanus toxoid vaccination.
The World Health Organization (WHO) stated that the incidence of tuberculosis among healthcare workers is increasing yearly and exceeds the incidence of tuberculosis in the community in almost all the countries that report to the WHO. The problem is greater in countries with high burden of tuberculosis disease in the community. The cause of this problem may be contributed by the attitudes of the healthcare workers themselves, such as non-compliance of the procedures at their work tasks meant to prevent them from contracting the disease. Therefore, this study aims to assess the perceptions and the behaviours of healthcare workers in relation to compliance towards prevention activities on tuberculosis at their workplace.
We plan to conduct a two-phase exploratory sequential mixed method study to determine the factors affecting compliance of Malaysian healthcare workers towards tuberculosis prevention programmes in their workplace based on the guidelines of the Ministry of Health, Malaysia. Phase one is a qualitative study with a focus group discussion and questionnaire development and phase two is a quantitative study where data will be collected among healthcare workers in government clinics and hospitals in Selangor.