COVID-19 symptom duration: associations with age, severity and vaccination status in Brunei Darussalam, 2021

@#Objective: This retrospective, cross-sectional, observational study assessed the duration of coronavirus disease 2019 (COVID-19) symptoms during the second wave in Brunei Darussalam. Methods: Data from COVID-19 cases admitted to the National Isolation Centre during 7–30 August 2021 were included in the study. Symptom onset and daily symptom assessments were entered into a database during hospitalization and disease was categorized by severity. The time between symptom onset and hospital admission, the duration of symptoms and length of hospitalization were assessed separately by age group, disease severity and vaccination status using one-way analysis of variance with Bonferroni post hoc corrections. Results: Data from 548 cases were included in the study: 55.7% (305) of cases were male, and cases had a mean age of 33.7 years. Overall, 81.3% (446) reported symptoms at admission (mean number of symptoms and standard deviation: 2.8 ± 1.6), with cough (59.1%; 324), fever (38.9%; 213) and sore throat (18.4%; 101) being the most common. Being older, having more severe disease and being unvaccinated were significantly associated with the time between symptom onset and hospital admission, symptom duration and length of hospitalization. Discussion: Knowing which factors predict the duration of COVID-19 symptoms can help in planning management strategies, such as the duration of isolation, predict the length of hospitalization and treatment, and provide more accurate counselling to patients regarding their illness.

Signet ring cell lymphoma of the small bowel: a case report

Gastrointestinal lymphoma of the bowel is uncommon compared to adenocarcinoma. Signet ring cell lymphoma [SRCL] is a rare variant of non-Hodgkin's lymphoma that is characterized by clear cytoplasm with displaced nuclei to the periphery giving a signet ring appearance. Small bowel involvement has not been previously reported. We report the rare case of a 78-year-old female who presented with short history of fever, loss of appetite, nausea, vomiting, mild weight loss with abdominal discomfort and was later diagnosed to have SRCL of the ileum

Breast cancer in Brunei Darussalam - Incidence and the role of evaluation of molecular markers

Introduction: Molecular markers determined by immunohistochemistry are routinely used for predicting and prognosticating cancers including breast cancer. Molecular markers for breast cancer such as oestrogen and progesterone receptors, Her2, p53, pS2, Bcl2, EGFR, Ki67, CD34 and Cathepsin D have been used in Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital. This study assessed the ethnic variations in breast cancer incidence as well as the relationships between expression of these markers with tumour stage and grade and patient survival in Brunei Darussalam . Materials and Methods: Records of breast cancer patients between 2001 and 2009 were retrieved and abstracted from the Cancer Registry maintained by the Department of Pathology at the RIPAS Hospital. These were reviewed and analysed using appropriate statistical methods. Results: Overall, the mean age at diagnosis was 49.2 years. The incidence rate of breast cancer among Chinese (56.4 per 100,000 per year) was significantly higher than Malays (27.8) and the other ethnic groups (12.3). The expression of oestrogen and progesterone receptors and pS2 was significantly greater in the more differentiated tumours while that of Ki67 and p53 in tumours and CD34 in blood vessels within the tumour was significantly greater in the less differentiated tumours. Positivity for oestrogen receptor was significantly associated with the absence of metastases in regional lymph nodes. Expression of oestrogen and progesterone receptors in tumour cells was significantly associated with enhanced patient survival, while the detection of CD34 in blood vessels within tumours was associated with poorer survival. Survival trends seen for other markers were not statistically significant. Conclusions: The different incidence of breast cancer among the different ethnic groups merits more detailed investigation of the responsible genetic, social and environmental factors. Oestrogen and progesterone receptors and CD34 are confirmed as useful markers for prognosis among our population with breast cancer. Expression of p53, Ki67 and pS2 may also be useful. These markers will be helpful in determining treatment options and for patient education.