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Background: Axillary dissection is one of the important components of modified radical mastectomy (MRM). The present study was conducted to compare surgical outcomes by using monopolar electrocautery and ultrasonic dissector for axillary dissection in MRM. Methods: A parallel randomised controlled single blinded study was conducted with a sample size of 70 patients who were randomised into two groups. One group underwent MRM using ultrasonic dissector (Group A) and the other one using electrocautery (Group B). Intra- and post-operative outcomes were compared. Results: Group A had an average operating time of 30.86 min, which was statistically less than that of Group B. The mean mop count and the daily drain output in Group A were less as compared to Group B and the differences were statistically significant. Drain was removed early in Group A as compared to Group B. However, post-operative pain scores and seroma formation were not statistically significant among the two groups. Conclusion: Ultrasonic dissector group had significantly lesser intra-operative bleeding, operating time and post-operative drain output when compared to electrocautery group. However, the two groups had no significant difference in post-operative pain scores and seroma formation. [ABSTRACT FROM AUTHOR]

Background: The prevalence of colorectal cancer (CRC) among young individuals is rising worldwide, especially in Malaysia. Investigations are currently employed to distinguish the features of young-onset CRC (YOCRC) from adult-onset CRC (AOCRC). This study aimed to compare the characteristics of patients with YOCRC and AOCRC diagnosed at Hospital Universiti Sains Malaysia (HUSM). Methods: This was a retrospective study of CRC cases from January 2013 to December 2021. The details of YOCRC (< 50 years old) and AOCRC (≥ 50 years old) patients were retrieved from the laboratory system and medical records. The Pearson's chi-square test, Fisher's exact test and multiple logistic regression were used to compare the AOCRC and YOCRC cases. Statistical significance was defined at a P-value of ≤ 0.05. Results: The AOCRC (254/319, 79.6%) was more prevalent than YOCRC (65/319, 20.4%), with a predominance of males (53.9%) and Malay sub-population (90.2%). AOCRC and YOCRC shared similarities in left-sided location, high occurrence of adenocarcinoma with moderately differentiated histology and advanced stage of diagnosis. More patients with YOCRC (23.1%) had a family history of cancer than patients with AOCRC. YOCRC also differed from AOCRC by having more specific histological subtypes, such as mucinous adenocarcinoma (15.4%) and signet ring carcinoma (6.2%). In addition, patients with YOCRC commonly presented with a low density of tumour-infiltrating lymphocytes (TILs) (60%). Multiple logistic regression showed a family history of CRC (adjusted odds ratio [AOR] = 3.75, P = 0.003) and histological type (AOR = 15.21, P < 0.001) are more likely to cause YOCRC than diabetes (AOR = 0.06, P < 0.001) and hypertension (AOR = 0.14, P < 0.001) comorbidities, which are associated with AOCRC. Conclusion: Our descriptive study presented the epidemiological and histopathological characteristics of AOCRC and YOCRC in HUSM, providing current information on distinguishing features between the groups. [ABSTRACT FROM AUTHOR]

Background: Regular consumption of sweetened beverages has been associated with dental caries, which is mediated through salivary pH. The salivary pH changes among individuals with low caries experience after consumption of two local sweetened drinks is compared. Methods: In this block randomised controlled parallel group, an open-label pilot study of 49 participants aged 21-25 were selected. The participants were randomised into three groups: mineral water, chocolate drink and sirap bandung. One day prior to the test, scaling was done and the participants did not eat or drink anything on the test day till the saliva sample collection was done. Salivary pH was measured at baseline and after the consumption of the drinks with a glass electrode digital pH meter at five-minute interval for half an hour. The statistical significance was assessed at the level of 5%. Results: After consumption of chocolate drink and sirap bandung, the salivary pH dropped from a baseline of 7.09 for chocolate drink and 7.13 for sirap bandung to 6.69 for chocolate and 6.86 for sirap bandung. This difference was statistically significant (P < 0.001). Conclusion: Sweetened milk based local drinks can increase the caries susceptibility. In the community, information about limiting the intake of sweetened drinks should be reinforced. [ABSTRACT FROM AUTHOR]

Introduction: Symptomatic chronic subdural hematomas (CSDH) remain one of the most frequent diagnoses in current neurosurgical practice. Burr-hole craniostomy with irrigation and placement of close-system drainage is the current recommended surgery for symptomatic CSDH. The aim of this study is to perform a direct comparison between two surgical techniques in the treatment of symptomatic CSDH, which have been proven in previous studies to be efficient. Our main objective was to compare the efficacy of placement of a subperiosteal drain (SPD) and a subdural drain (SDD) following single burr-hole craniostomy and irrigation, and to demonstrate any significant differences in terms of overall surgical complications, functional outcome at three months and mortality rate. Materials and Methods: The study was carried out in two local neurosurgical centres. The SPD group was performed in Hospital Umum Sarawak (HUS) and the SDD group was performed in Hospital Sultanah Aminah Johor Bahru (HSAJB), from 1 January 2012 till 30 January 2014 with a total of 30 patients in both treatment groups. Results: Overall, there were no statistically significant difference in terms of patient general characteristics, pre-operative and post-operative symptoms, Markwalder grades, postoperative hematoma volume and recurrence, mortality and functional outcome at discharge and at three month follow-up between both groups. Albeit not achieving statistical significance, we observed a lower rate of surgical complication especially for post-operative intracranial hematoma with placement of the SPD system. Conclusions: Our study concludes that both treatment methods proved to be highly effective in the treatment of CSDH. However, with a lower overall surgical complication rate, treatment with single burr-hole craniostomy, irrigation and placement of the SPD system can be considered a treatment of choice for the management of symptomatic CSDH. [ABSTRACT FROM AUTHOR]

Introduction: Health-related quality of life (HRQoL) issues are importantly emphasised in holistic medicine, particularly for chronic conditions like epilepsy. Being a multifactorial construct, HRQoL could be maximised if its contributors are correctly identified. This study was embarked to compare HRQoL profile among epilepsy patients with different duration of diagnosis, duration of anti-epileptic medication and the frequency of seizure. Methodology: This prospective, cross-sectional study was conducted in 3 government hospitals in Selangor. Eligible adult out-patients (>18 years) capable of reading and/or writing in Malay/English were identified and invited to participate. Upon written consents, participants completed the 30-item modified Quality of Life In Epilepsy Inventory (QOLIE-30) which evaluates Seizure Worry, Overall QoL, Emotional Well-Being, Energy/Fatigue, Cognitive Functioning, Medication Effects and Social Functioning. Scores were compared using non-parametric Kruskall-Wallis test in SPSS 14. Results: A total of 29 patients participated (mean age = 28 years; range= 18-64 years). Majority were male (n=17), unmarried (n=23), Malay (n=12), unemployed (n=7) and live with their spouse/ family (n=25). Most patients had been diagnosed for 1-5 years (n=7) or >15 years (n=7). Many were on medications for 6-12 months (n=11) and had experienced ≥ 1 attack in the past 4 weeks (n=19). Highest HRQoL score was reported for Overall QoL (median= 67.5) while Seizure Worry (median =42.3) was scored lowest. Those diagnosed between 5-10 years, were taking medications for < 1 month and experienced no attack consistently reported more favourable scores in most subscales (no significant difference). Conclusions: Findings indicate that the HRQoL level of this sample was generally above average although patients' worry about seizure attack seemed unsettled and this requires careful attention from healthcare professionals. Despite the absence of any statistical significance (due to small sample size), it could be concluded that longer duration of diagnosis, shorter period of medication and minimal attack could contribute to better HRQoL. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies showed that elevation of C-reactive protein and endothelial dysfunction is associated with Chronic Periodontitis (CP). Studies have proved that periodontal disease can induce atherosclerosis and it has strong relationship with arterial stiffness as determined by pulse wave velocity (PWV). The aim is to compare aortic stiffness as carotid-femoral PWV between subjects with localised and generalised severe CP. Methodology: Five subjects with localised severe CP and 12 subjects with generalised severe CP were recruited in a cross sectional study. Subjects were excluded if they had systemic diseases other than CP. Periodontal examination was done and carotid femoral PWV was measured using the Complior(r) machine in both groups. Diagnosis of localised and generalised severe CP was made based on clinical attachment loss and radiographic bone loss. Data was analyzed using SPSS. Results: Carotid femoral PWV was higher among subjects with generalised severe CP as compared to those with localised severe CP although the difference did not reach significant level. Median (interquartile range) PWV was 7.5 (1.50) and 7.0 (1.03) m/sec respectively in subjects with generalized and localized CP (p = 0.224). There was no correlation of PWV with plaque index and bleeding point index. Conclusion: Among subjects with CP, aorta is stiffer in generalised than in localised CP. This difference however did not reach significant level probably due to inadequate sample size. Further studies with larger sample size are required to reveal the statistical significance. [ABSTRACT FROM AUTHOR]