Late Complications of Allogenic Stem Cells Transplantation in Leukaemia

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can cure leukaemia. However, long term complications of post transplantation interfere with the patients’ full recovery. The objective of this review was to identify the various long term complications and to assess their individual prevalences. METHODS: Electronic databases including PubMed, Google Scholar and Cochrane were searched for years 2004-2017. The keywords used were leukaemia, allogenic stem cell transplantation, prevalence, side effects, long term, delayed, adverse effects, complications and outcome. RESULTS: A total of ten articles were included for analysis. There were 5 prospective studies, 3 retrospective studies and 2 cross sectional studies. A total of 40,069 patients, (20,189 males and 17,191 females) participated in these 10 studies. The gender of 2689 patients were not disclosed. Most common late complications and prevalence were chronic graft versus host disease (43% at 5 years post HSCT), secondary tumor (21% at 20 years post HSCT), hypothyroidism (11% at 15 years), bronchiolitis obliterans (9.7% at 122 days), cardiovascular disease (7.5% at 15 years) and avascular necrosis (5.4% at 10 years). The prevalence of azoospermia was 71.1% and depression, 18%. For the latter two conditions no time limit was available. Follow up duration ranged from 2 years till 30 years post HSCT. CONCLUSION: While allogenic stem cell transplantation is an effective cure for leukaemia, the procedure is associated with complications that can have their onset many years after the procedure.

Cyber Bullying - A New Social Menace

jective: Cyber bullying is a combination of the word cyber and bullying where cyber basically means the Internet or on-line. In this case, cyber bullying will focus on getting in action with bullying by using the Internet or modern technologies such as on-line chats, online media and short messaging texts through social media. The current review aims to compile and summarize the results of relevant publications related to “cyber bullying." The review also includes discussing on relevant variables related to cyber bullying. Methods: Information from relevant publications addresses the demographics, prevalence, differences between cyber bullying and traditional bullying, bullying motivation, avenues to overcome it, preventions, coping mechanisms in relation to “cyber bullying” were retrieved and summarized. Results: The prevalence of cyber bullying ranges from 30% - 55% and the contributing risk factors include positive association with perpetration, non-supportive school environment, and Internet risky behaviors. Both males and females have been equal weigh on being perpetrators and victims. The older groups with more technology exposures are more prone to be exposed to cyber bullying. With respect to individual components of bullying, repetition is less evident in cyber bullying and power imbalance is not measured by physicality but in terms of popularity and technical knowledge of the perpetrator. Conclusion: Due to the limited efforts centralized on the intervention, future researchers should focus on testing the efficacy of possible interventional programs and the effects of different roles in the intervention in ord

Retinal nerve fiber layer structure abnormalities in schizophrenia and its relationship to disease state: evidence from optical coherence tomography.

PURPOSE: We determined structural retinal nerve fiber layer (RNFL) changes in schizophrenia patients and established if the structural changes were related to the duration of the illness using spectral-domain optical coherence tomography (SD-OCT). METHODS: We recruited a total of 30 schizophrenic patients and 30 age-matched controls in the study. The schizophrenic patients were subdivided further to acute (n = 5), chronic (n = 13), and long-term chronic (n = 12) subgroups depending on their duration of illness. Using SD-OCT, the peripapillary RNFL thickness, macula thickness, and macula volume measurements of schizophrenic patients and the control subjects were measured and compared at each location. RESULTS: Schizophrenic patients showed a statistically significant reduction in overall peripapillary RNFL thickness (cases, 94.70 ± 9.88 µm; controls, 103.53 ± 6.53 µm; P < 0.001), macula thickness (cases, 269.26 ± 12.59 µm; controls, 284.83 ± 9.76 µm; P < 0.001), and macula volume (cases, 9.61 ± 0.45 mm(3); controls, 10.17 ± 0.35 µm; P < 0.001). Chronic and long-term chronic schizophrenic patients were found to have significant peripapillary RNFL thinning, macula thinning, and reduction of macula volume when compared to controls (P < 0.001). There also was a statistically significant reverse correlation (P < 0.05) of peripapillary RNFL thickness (r = -0.36), macula thickness (r = -0.38), and macula volume reduction (r = -0.36) with the duration of schizophrenic illness. CONCLUSIONS: These results indicate that RNFL and macula thickness, as well as macula volume measurements are reduced in schizophrenic patients. The degree of thinning and reduction was more significant in the chronic phase of the disease and correlated with the duration of illness. These findings demonstrate that SD-OCT can be a useful tool for the diagnosis and monitoring the progression of this disease.

Dissociative identity disorder: an attempt to understand the disorder in Malaysian context

Dissociation, including multiple personality disorder, has long been a controversial topic. Patients with suggestive symptoms are often misdiagnosed as malingering or even having schizophrenia. The former as a result of the overlooking of a clinician on the fact that suggestibility itself plays a key role in the emergence and perpetuation of this illness and the latter due to the lack of knowledge of the whole dissociative disorder spectrum, often resembling that of a psychotic disorder. Another contributing factor to the small number of patients with this diagnosis is due to the reluctance of a psychiatrist to do so because of his/her lack of experience and also fear of humiliation of being accused of seeking fame from diagnosing this somewhat glamorous phenomenon. In Malaysia, various culture bound syndromes often present with similar symptoms too. This article will attempt to understand this dissociation on the local context using case studies as a reference point.

Dissociative identity disorder: an attempt to understand the disorder in Malaysian context

Dissociation, including multiple personality disorder, has long been a controversial topic. Patients with suggestive symptoms are often misdiagnosed as malingering or even having schizophrenia. The former as a result of the overlooking of a clinician on the fact that suggestibility itself plays a key role in the emergence and perpetuation of this illness and the latter due to the lack of knowledge of the whole dissociative disorder spectrum, often resembling that of a psychotic disorder. Another contributing factor to the small number of patients with this diagnosis is due to the reluctance of a psychiatrist to do so because of his/her lack of experience and also fear of humiliation of being accused of seeking fame from diagnosing this somewhat glamorous phenomenon. In Malaysia, various culture bound syndromes often present with similar symptoms too. This article will attempt to understand this dissociation on the local context using case studies as a reference point.