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Background: Iron deficiency anemia is the commonest type of nutritional anemia seen during pregnancy. Despite implementing oral iron prophylaxis in pregnancy,IDA in pregnant women constitute a major health problem. The present study aims to look at the prevalence of IDA in a pregnant population in Seremban, Malaysia and their response to treatment. Methods: This is a retrospective study looking into the prevalence of iron deficiency anaemia among pregnant women who delivered between October 2019 to March 2020 in a state hospital in Seremban, Malaysia and their response to treatment. Main outcome measures were the prevalence of iron deficiency anaemia, associated demographic and clinical factors and response to iron therapy. Results: About 920 patients� records were included for analysis. The prevalence of anaemia in this cohort was 42.8% (N=394). The prevalence of iron deficiency anemia (IDA) was 31.5% (N=124) among the anemic patients or 13.5% of the studied population. The mean hemoglobin level for this group was 10.0�74 g/dl (6.8-10.9 g/dl) and majority had mild anemia (91.9%, N=114). 68.5% IDA patients were successfully treated by 36 weeks pregnancy. Of the remaining 39 patients who were still anemic, 37 (94.9%) had mild anemia with mean hemoglobin level of 10.3g/dl (SD 0.48, range 9.0-10.9 g/dl). Conclusion: Current treatment strategy is inadequate to achieve the set national target. There is a role foran early recourse to parenteral iron therapy to improve treatment outcome.
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ABSTRACT Objective: This study aimed to explore the clinical application of preoperative precise design for 3D printing and thumb reconstruction, which could help manage the patients with thumb defect and achieve better function and appearance. Methods: This was a retrospective study of 20 patients who underwent the surgery of harvesting toe transplant and thumb reconstruction between January 2015 and December 2016. The 3D model of the thumb defect was created and printed. The dimensions of skin and bones from donor site were precisely designed as reference for surgical operation. The surgery was performed according to the model. Results: Perfect repair of defects was achieved with satisfying appearance and function. The reconstructed thumbs all survived (survival rate of 100%). Follow-up was 3-9 months. The maximum dorsiflexion was 8-30° and the maximum flexion was 38-58°. The two-point sensory discrimination was 9-11 mm. In total, 17 patients reposted "Excellent" satisfaction and three "Good", each for the reconstructed thumb and hand function, respectively. The satisfaction rate was 85%. Conclusion: Preoperative digital design and 3D printing according to the donor and recipient sites allowed a tailored operation. The operation was more precise, the appearance of the reconstructed thumb was good. Level of Evidence II, Retrospective Study.
RESUMO Objetivo: Este estudo explorou a aplicação clínica do desenho pré-operatório preciso para impressão 3D e reconstrução do polegar, para ajudar no controle e melhorar função e aparência. Métodos: Estudo retrospectivo de 20 pacientes submetidos à cirurgia de colheita de transplante de dedo do pé e reconstrução do polegar entre janeiro de 2015 e dezembro de 2016. O modelo 3D do defeito do polegar foi confeccionado e impresso. As dimensões da pele e dos ossos da área doadora foram precisamente projetadas como referência para a operação cirúrgica, realizada de acordo com o modelo. Resultados: O reparo perfeito foi alcançado com aparência e função satisfatórias. Todos os polegares reconstruídos sobreviveram (taxa de sobrevivência de 100%). O acompanhamento foi de 3-9 meses. A dorsiflexão máxima foi de 8-30° e a flexão máxima foi de 38-58°. A discriminação sensorial de dois pontos foi de 9-11 mm. No total, 17 pacientes reportaram índice "Excelente" e três índice "Bom" cada para a função reconstruída do polegar e da mão, respectivamente. O índice de satisfação foi de 85%. Conclusão: O design digital pré-operatório e a impressão 3D de acordo com os locais doador e receptor permitiram uma operação customizada. A operação foi mais precisa, com bom aspecto. Nível de Evidência II, Estudo Retrospectivo.
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@#Introduction: Polymorphic expression of a CAG repeat sequence in the androgen receptor (AR) gene may influence the activity of the AR and the occurrence of prostate cancer and the TMPRSS2-ERG fusion event. Furthermore, this polymorphism may be responsible for the ethnic variation observed in prostate cancer occurrence and expression of the ERG oncogene. We investigate the expression of AR and ERG in the biopsies of Malaysian men with prostate cancer and in the same patients relate this to the length of the CAG repeat sequence in their AR gene. Materials and Methods: From a PSA screening initiative, 161 men were shown to have elevated PSA levels in their blood and underwent prostatic tissue biopsy. DNA was extracted from the blood, and exon 1 of the AR gene amplified by PCR and sequenced. The number of CAG repeat sequences were counted and compared to the immunohistochemical expression of ERG and AR in the matched tumour biopsies. Results: Of men with elevated PSA, 89 were diagnosed with prostate cancer, and 72 with benign prostatic hyperplasia (BPH). There was no significant difference in the length of the CAG repeat in men with prostate cancer and BPH. The CAG repeat length was not associated with; age, PSA or tumour grade, though a longer CAG repeat was associated with tumour stage. ERG and AR were expressed in 36% and 86% of the cancers, respectively. There was no significant association between CAG repeat length and ERG or AR expression. However, there was a significant inverse relationship between ERG and AR expression. In addition, a significantly great proportion of Indian men had ERG positive tumours, compared to men of Malay or Chinese descent. Conclusions: CAG repeat length is not associated with prostate cancer or expression of ERG or AR. However, ERG appears to be more common in the prostate cancers of Malaysian Indian men than in the prostate cancers of other Malaysian ethnicities and its expression in this study was inversely related to AR expression.
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@#Introduction: Prostate cancer is a heterogenous disease and the mechanisms that drive it to behave differently are not well understood. Tumour expression of the ERG oncogene occurs in the majority of patients with prostate cancer in Western studies. This is considered to be oncogenic as ERG acts as a transcription factor to regulate genes involved in tumour proliferation and invasion. In this study we investigated expression of ERG in Malaysian men with prostate cancer. Methods: Tissues were collected from 80 patients with clinically detected prostate cancer and treated with radical prostatectomy. Cases were tested for ERG by immunohistochemistry using the mouse monoclonal antibody EP111. All blocks on 48 cases were tested in order to determine the extent of heterogeneity of ERG expression within individual cases. ERG expression was analysed in relation to patient age, ethnicity and tumour stage and grade. Results: Forty-six percent of cases were ERG positive. There was no significant association between ERG and tumour grade or stage. Sixty-nine percent of Indian patients had ERG positive tumours; this was significantly higher (p=0.031) than for Chinese (40%) and Malay (44%) patients. Heterogeneity of ERG expression, in which both positive and negative clones were present, was seen in 35% of evaluated cases. Evaluation by tumour foci showed younger patients had more ERG positive tumour foci than older patients (p=0.01). Indian patients were more likely to have the majority of tumour foci with ERG staining positively, compared to either Chinese or Malay patients (P <0.01). Conclusion: In this study, tumour expression of ERG was more likely to occur in patients of Indian ethnicity. @*@#
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Objective To evaluate the clinical application and security of percutaneous endoscopic gastrostomy (PEG) with the Introducer method using ultrathin gastroseopy in dysphagia patients. Methods Clinical data of 22 cases dysphagia patients implemented with PEG with the Introducer method using ultrathin gastroseopy or conventional gastroseopy were retrospectively analyzed, the clinical effect and the complication were observed. Results 22 patients underwent PEG with the Introducer method using conventional gastroscopy (6 cases) or ultrathin gastroscopy (16 cases). Among the 16 patients underwent PEG using ultrathin gastroseopy by transnasal or peroral approach, 2 cases with trimus by received radiotherapy for nasopharyngeal cancer and 14 cases with pharyngeal or esophagus narrowing, could not completed PEG by conventional gastroscopy. The average procedure time of PEG was (12.2 ± 2.9) min in conventional gastroscopy group and (11.8 ± 3.2) min in control group. No complications were observed in these patients, but the patients in ultrathin gastroseopy group reported less discomfort associated with the procedure. 17 patients with advanced nasopharyngeal carcinoma and esophagus cancer who received PEG could completely finished 6 cycles of concurrent chemoradiotherapy. Paired-sample t test of nutrition indicators (hemoglobin, albumin and RBC) before and after the treatment showed significant difference (P < 0.05). Conclusion PEG with the introducer method using ultrathin gastroseopy is a safe and effective method of enteral nutrition, Ultrathin gastroscopy reduces the discomfort of the procedure, especially in patients with serious trimus and pharyngeal or esophagus narrowing. For patients with advanced nasopharyngeal carcinoma, preventative PEG improved the tolerance of chemoradiotherapy,reduce the incidence of adverse events.
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Objective To evaluate the clinical application and security of percutaneous endoscopic gastrostomy (PEG) with the Introducer method using ultrathin gastroseopy in dysphagia patients. Methods Clinical data of 22 cases dysphagia patients implemented with PEG with the Introducer method using ultrathin gastroseopy or conventional gastroseopy were retrospectively analyzed, the clinical effect and the complication were observed. Results 22 patients underwent PEG with the Introducer method using conventional gastroscopy (6 cases) or ultrathin gastroscopy (16 cases). Among the 16 patients underwent PEG using ultrathin gastroseopy by transnasal or peroral approach, 2 cases with trimus by received radiotherapy for nasopharyngeal cancer and 14 cases with pharyngeal or esophagus narrowing, could not completed PEG by conventional gastroscopy. The average procedure time of PEG was (12.2 ± 2.9) min in conventional gastroscopy group and (11.8 ± 3.2) min in control group. No complications were observed in these patients, but the patients in ultrathin gastroseopy group reported less discomfort associated with the procedure. 17 patients with advanced nasopharyngeal carcinoma and esophagus cancer who received PEG could completely finished 6 cycles of concurrent chemoradiotherapy. Paired-sample t test of nutrition indicators (hemoglobin, albumin and RBC) before and after the treatment showed significant difference (P < 0.05). Conclusion PEG with the introducer method using ultrathin gastroseopy is a safe and effective method of enteral nutrition, Ultrathin gastroscopy reduces the discomfort of the procedure, especially in patients with serious trimus and pharyngeal or esophagus narrowing. For patients with advanced nasopharyngeal carcinoma, preventative PEG improved the tolerance of chemoradiotherapy,reduce the incidence of adverse events.
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<p><b>OBJECTIVE</b>To evaluate the effectiveness and safety of L-amlodipine besylate for blood pressure control in patients with mild to moderate essential hypertension.</p><p><b>METHOD</b>A total of 1051 mild to moderate essential hypertensives were recruited from 22 centers and randomized into three groups and were given low-dose L-amlodipine besylate (2.5 mg/d), high-dose L-amlodipine besylate (5.0 mg/d), and amlodipine maleate (5.0 mg/d) on the principle of open-label and parallel control. The study drugs were administered for 8 weeks.</p><p><b>RESULTS</b>After 8 weeks treatments, the response rate of the three groups were 72.4%, 85.6%, and 76.2%, respectively. The rate difference between high-dose L-amlodipine besylate group and the other two groups were statistically significant (P < 0.01), while the rate difference between low-dose L-amlodipine besylate group and amlodipine maleate group was similar (P = 0.28). The event rates of the three groups were similar (4.3%, 4.6%, and 5.1%, respectively, P = 0.84).</p><p><b>CONCLUSION</b>High-dose L-amlodipine besylate is superior to the other 2 groups on blood pressure control. The efficacy profiles of amlodipine maleate and low-dose L-amlodipine besylate are equivalent. Safety profiles of these three groups are comparable.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Amlodipine , Therapeutic Uses , Antihypertensive Agents , Therapeutic Uses , Essential Hypertension , Hypertension , Drug Therapy , Treatment OutcomeABSTRACT
Background: Asthma is a common respiratory disease caused by genetic and environmental factors. It has been suggested that TGF-β1, IL-4 and IL-13 play important roles in asthma. Objectives: We attempted to confirm the roles of TGF-β1, IL-4 and IL-13 polymorphisms in asthma in a Chinese population. Methods: Five SNPs (rs1800469, rs2241712, rs2070874, rs20541 and rs1800925) in TGF-β1, IL-4 and IL-13 were genotyped using the MassArray SNP genotyping system. Allelic and genotypic associations between these SNPs and asthma were evaluated using logistic regression analysis. Results: The CT genotype of rs1800469 and T allele of rs20541 were significantly associated with asthma. Among atopic subjects, the CT genotype of rs1800469 and GA genotype of rs2241712 decreased the risk of asthma, while the CC genotype of rs2070874 showed a decreasing trend of asthma risk with a borderline significance. No significant association was found between rs1800925 and asthma. Conclusion: In the present study, we confirmed the association of rs1800469 in TGF-β1 and rs20541 in IL-13 with asthma and found a trend toward association between rs2241712 in TGF-β1 and rs2070874 in IL-4 with asthma among atopic subjects, suggesting TGF-β1, IL-4 and IL-13 may be associated with the susceptibility and development of asthma in this Chinese population.