ABSTRACT
@#Introduction: The association between clinical characteristics and endoscopic profile of acute non-variceal upper gastrointestinal bleeding (NVUGIB) patients with red blood cell (RBC) transfusion has not been well explored in Malaysia. Therefore, a retrospective study was performed using a five-years database to analyse the factors clinically and endoscopically for RBC transfusion. Methods: All adult NVUGIB patients who received RBC transfusion within the study period of 2012-2017 in Putrajaya Hospital were enrolled. There were 180 patients selected by systematic random sampling. Our composed clinical data include demography, risk factor, aetiology, presenting symptoms, Glasgow-Blatchford Score (GBS), endoscopic findings according to Forrest Classification and number unit of RBC transfusion. These data were analysed using Mann-Whitney U-Test, Pearson Correlation and Multiple Linear Regression (MLR). Results: Total 180 patients, the mean age was 63.9 (SD 11.6). Their presenting symptoms were melaena (62.8%), haematemesis (38.3%), and haematochezia (10.6%), with the cause of bleeding was gastric erosion (65.6%), duodenitis/duodenal ulcer (26.1%), and oesophagitis (7.8%). The mean GBS score was 10.7, and the number of RBC transfusion unit was 2.8. The Forrest Classification showed Forrest III (36.1%), Forrest IIc (22.8%), Forrest IIb and Ib (14.4%) respectively. Pearson’s Correlation showed a strong correlation between GBS and unit of RBC transfusion (r = 0.922, p-value <0.001). MLR analysis revealed haematochezia (p = 0.022) and higher GBS (p <0.001) were independent factors associated with a higher number of RBC transfusion unit. Conclusion: Haematochezia and higher GBS score were two predictive factors for a higher RBC transfusion unit in NVUGIB patients.
ABSTRACT
@#Introduction: Breast cancer is the most common cause of cancer death among women. The purpose of this study is to determine the 5-years survival rate and prognostic factors among breast cancer patients in a tertiary oncological centre in Penang, Malaysia. Methods: A retrospective cohort study was conducted at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. All 214 cases of breast cancer diagnosed from 1st January 2008 until 31st December 2012 were selected and retrospectively followed-up until 31st December 2017. The survival status for this study was referring to the record of the National Registration of Malaysia. Kaplan-Meier with Log-rank test and Cox regression were used for the univariable and multivariable analysis, respectively. Results: The mean (SD) age at diagnosis was 50.98 (±10.75) years. The majority of the patients were Malay (55.7%) and married (96.5%). After controlling for the effect of underlying comorbidities, lymph nodes involvement, marital status, vascular involvement and adjuvant therapy; it was found that marital status (adj HR= 3.63, 95% CI 1.17-11.24) and lymph nodes involvement (adj HR=2.36, 95% CI 1.17-4.76) were the significant prognostic factors. Conclusion: This study re-emphasizes the role of marital status and lymph nodes involvement as independent predictors of the long-term survival of breast cancer patients. Further studies are needed to assess the promising benefit of personalized treatment and specific supportive care given to the patients with these risk factors for better cancer experience and survival.