PURPOSE: Patients with secondary hyperparathyroidism are at high risk for developing postoperative hypocalcemia. However, there are limited data regarding predictors of postoperative hypocalcemia in renal failure patient with secondary hyperparathyroidism. This study aimed to determine the clinical presentations of renal hyperparathyroidism and the predictors of early postoperative hypocalcemia after total parathyroidectomy. METHODS: Data of patients with renal hyperparathyroidism who underwent total parathyroidectomy between January 2007 to December 2014 were reviewed retrospectively. Patients were divided into 2 cohort groups according to their serum calcium levels within 24 hours of parathyroidectomy: the hypocalcemia group (calcium levels of 2 mmol/L or less), and the normocalcemia group (calcium levels more than 2 mmol/L). With the use of multivariable logistic regression analyses, the predictors of early postoperative hypocalcemia after total parathyroidectomy in patients with renal hyperparathyroidism were investigated. RESULTS: Among 68 patients, 56 patients (82.4%) were symptomatic preoperatively. Fifty patients (73.5%) presented with bone pain and 14 patients (20.6%) had muscle weakness. Early postoperative hypocalcemia occurred in 25 patients (36.8%). Preoperative alkaline phosphatase level was the predictor of early postoperative hypocalcemia (adjusted odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P = 0.002). CONCLUSION Results from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels.

Breast cancer (BC) is one of the most common cancer incidents among women and is estimated at around 24.2% worldwide and 32.1% in Malaysia. Accessibility to current breast promotion is limited to those who seek the information, suggesting consideration of an alternative approach using a mobile app. This study aimed to identify existing breast awareness mobile apps based on the Health Belief Model (HBM) components with a descriptive observation review. Fifty-two apps fulfilled the inclusion and exclusion criteria and were reviewed. Eligible apps (N=52) which are standalone (n=41) and non-standalone (n=11). The categories of the eligible apps are health & fitness (n=31), lifestyle (n=6), medical (n=11), entertainment (n=2), book & reference (n=1), education (n=3). The apps focused on perceived susceptibility (n=33/52, 63.5%), perceived severity (n=30/52, 57.7%), perceived threat (n=48/52, 92.3%), perceived benefit (n=46/52, 88.5%), perceived barriers (n=23/52, 44.2%), self-efficacy (n=25/52, 48.1%) and cues to action (n=27/52, 51.9%). Most of the apps focused on perceived threat and benefit but lacking on a perceived barrier. This review could provide information to develop appropriately tailored content supported by health theories to promote breast cancer awareness.