Dietary fibre (DF) and fluid intakes have been reported elsewhere to reduce the risk of constipation. The association of these dietary components on Agachand’s Constipation Score (CS) was investigated in the present study. Methods: A total of 202 Malaysian participants comprising 50 adolescents (aged 12.4 ± 5.3 yrs), 50 adults (aged 46.3 ± 11.3 yrs), 52 women of childbearing age (aged 29.1 ± 9.3 yrs) and 50 elderly persons (aged 70.0 ± 7.4 yrs) were recruited by convenience sampling from five venues - two communities in Cheras, one community in Klang, the IMU campus, Bukit Jalil and a private secondary school in Klang. All participants were interviewed with a previously-evaluated food frequency questionnaire (FFQ) and an Agachand’s Constipation Score (CS) Questionnaire.Results: Mean daily DF intakes were low across all age groups with means ranging from 10.0 – 15.6g. The percentage of subjects with daily DF intakes below the “deficient” cut-off of 20g was alarmingly high; 80% in adolescents, 45% in adults, 85% in women of child-bearing age and 70% in the elderly. About onefifth or 20% of subjects in all age groups had CS values ≥15 which indicated a problem of constipation. Mean daily total fluid consumption (TFC) ranged from 2128 – 5490 ml in the four categories of subjects. Overall, both daily DF intakes and TFC were negatively associated with CS values. This inverse association was significant for DF vs CS scores in adolescents (r = -0.500, p = 0.001), adults (r = -0.351, p = 0.013), the elderly (r = -0.392, p = 0.005) and all subjects combined (r = -0.366, p=0.001). For TFC vs CS scores, the inverse association was only significant for the elderly (r = -0.312, p = 0.027) and all subjects combined (r = -0.245, p = 0.001). Conclusion: The results of this study support the role of dietary fibre intake and TFC in reducing the risk of constipation, as well as reinforcing previous data for low DF intakes among the Malaysian population.
Dietary Fiber

BACKGROUNDColorectal surgery was regarded as one of the high risk surgery for post-operative deep vein thrombosis (DVT) and pulmonary embolism. This study aimed at investigating the incidence of venous thromboembolism (VTE) after colorectal surgery for malignancy.

METHODSData were collected from the prospective database of colorectal malignancy from 2000 to 2008. A total of 1421 colorectal (open and laparoscopic) operations were performed for the colorectal malignancy without DVT prophylaxis.

RESULTSOnly seven patients (0.5%) developed symptomatic DVT and one of them had complication of pulmonary embolism without mortality. Open operation for colorectal malignancy was identified as possible risk factor of DVT, however, risk factors like operative time, low anterior resection, sex, age etc. were not identified.

CONCLUSIONRisk of venous thromboembolism after colorectal operation is low in Chinese of our locality and it might be safe to perform colorectal operation for malignancy without DVT prophylaxis.

Aged ; Aged, 80 and over ; Colorectal Neoplasms ; surgery ; Colorectal Surgery ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Pulmonary Embolism ; etiology ; Venous Thrombosis ; etiology

Metastasis from unknown primary is always a challenge because finding the true primary tumor significantly affects subsequent management. We present a case of malignant abdominal wall nodule initially diagnosed as metastasis from hepatocellular carcinoma through excisional biopsy and immunohistochemical (IHC) staining. Dual-tracer positron emission tomography/computed tomography (PET/CT) with 11 C-acetate and 18 F-FDG, however, showed metabolic findings in favor of metastasis from lung origin, which was finally confirmed by ensuing a lung biopsy with additional IHC stains. This case illustrates the complementary molecular role of PET to pathology, particularly when dual-tracer or multi-tracer PET is used in conjunction with pathology methods for cross referencing and confirmation.

BACKGROUNDSingle incision laparoscopic colectomy has been performed in recent years, and has been shown to be feasible and safe. This study was to assess the feasibility of single incision laparoscopic right hemicolectomy and to compare the differences in different approaches.

METHODSThis retrospective study included eighteen patients with carcinoma of caecum and ascending colon, undergoing single incision laparoscopic right hemicolectomy. This study also compared single incision laparoscopic right hemicolectomy using different approaches: (1) single incision multiport, (2) single access port and (3) glove port.

RESULTSThere was no statistical difference in surgical outcomes. Concerning the surgeon's satisfaction toward three methods, overcrowding and durability were similar but the single incision multiport was associated with the highest gas-leak and the "glove" port was associated with poor durability. However, the method of single incision multiport has the lowest average cost of the special trocar or port in each operation. The operative time and blood loss of the operations in this study were comparable to previous publications.

CONCLUSIONThere was no significant difference between different approaches of single incision laparoscopic right hemicolectomy for colonic cancer in right side colon.

Aged ; Cecal Neoplasms ; surgery ; Colectomy ; methods ; Colonic Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND: In Shenzhen, the Emergency Medical Service (EMS) system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS. METHODS: In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed. RESULTS: Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15–60 years are the principal users of EMS. There are no recognized 'paramedic' doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in post-trauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized. CONCLUSION: The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.

No abstract available.
Cardiac Resynchronization Therapy* ; Echocardiography*

With the advent of modern surgical techniques, paediatric cataract has become much more manageable. Intraocular lens (IOL) implantation is the standard of care for patients over the age of 2 years. The use of IOL in young infants is still controversial. In addition, there are still unresolved issues, such as the minimum age at which IOL can be safely implanted, IOL power selection and IOL power calculation. The current trends in the management of the above challenges are discussed. Although numerous reports on the prevention and management of posterior capsule opacification have been published, there are ongoing intensive debates and research. Long-term postoperative complications like glaucoma and rhegmatogenous retinal detachment are problems that cannot be overemphasised and these issues are also reviewed.
Cataract ; congenital ; Cataract Extraction ; adverse effects ; methods ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Lens Implantation, Intraocular ; adverse effects ; methods ; Lenses, Intraocular ; Postoperative Complications ; prevention & control ; Refraction, Ocular

OBJECTIVETo determine if there are any differences in the number of exclusions from paternity of men using an anonymous parentage testing service compared with that of men using an in-person parentage testing service provided by the same company in Hong Kong SAR of China.

METHODSComparable numbers of consecutive anonymous and in-person parentage tests conducted by the same company were analyzed.

RESULTSMen using an anonymous parentage testing service were excluded from paternity at a significantly greater rate (P < 0.001), compared with men using an in-person parentage test service.

CONCLUSIONSThe results obtained from anonymous parentage testing indicate that the number of families containing children of doubtful parentage is much greater than expected previously. As illegitimate children are known to suffer greater degrees of abuse and neglect, this finding poses serious social questions regarding the welfare of families, which the relevant authorities should acknowledge and address.

Child ; China ; DNA Fingerprinting ; methods ; Gene Frequency ; Hong Kong ; Humans ; Male ; Paternity ; Polymerase Chain Reaction ; Tandem Repeat Sequences

Purpose: The aim of this study was to investigate the feasibility and preliminary efficacy of a modified mindfulness-based stress reduction (MBSR) program and mindfulness-based cognitive therapy (MBCT) program for reducing the stress, depressive symptoms, and subjective burden of family caregivers of people with dementia (PWD). Methods: A prospective, parallel-group, randomized controlled trial design was adopted. Fifty-seven participants were recruited from the community and randomized into either the modified MBSR group (n = 27) or modified MBCT group (n = 26), receiving seven face-to-face intervention sessions for more than 16 weeks. Various psychological outcomes were measured at baseline (T0), immediately after intervention (T1), and at the 3-month follow-up (T2). Results: Both interventions were found to be feasible in view of the high attendance (more than 70.0%) and low attrition (3.8%) rates. The mixed analysis of variance (ANOVA) results showed positive within-group effects on perceived stress (p = .030, Cohen's d = 0.54), depressive symptoms (p = .002, Cohen's d = 0.77), and subjective caregiver burden (p < .001, Cohen's d = 1.12) in both interventions across the time points, whereas the modified MBCT had a larger effect on stress reduction, compared with the modified MBSR (p = .019). Conclusion Both the modified MBSR and MBCT are acceptable to family caregivers of PWD. Their preliminary effects were improvements in stress, depressive symptoms, and subjective burden. The modified MBCT may be more suitable for caregivers of PWD than the MBSR. A future clinical trial is needed to confirm their effectiveness in improving the psychological well-being of caregivers of PWD.

Purpose: The aim of this study was to investigate the feasibility and preliminary efficacy of a modified mindfulness-based stress reduction (MBSR) program and mindfulness-based cognitive therapy (MBCT) program for reducing the stress, depressive symptoms, and subjective burden of family caregivers of people with dementia (PWD). Methods: A prospective, parallel-group, randomized controlled trial design was adopted. Fifty-seven participants were recruited from the community and randomized into either the modified MBSR group (n = 27) or modified MBCT group (n = 26), receiving seven face-to-face intervention sessions for more than 16 weeks. Various psychological outcomes were measured at baseline (T0), immediately after intervention (T1), and at the 3-month follow-up (T2). Results: Both interventions were found to be feasible in view of the high attendance (more than 70.0%) and low attrition (3.8%) rates. The mixed analysis of variance (ANOVA) results showed positive within-group effects on perceived stress (p = .030, Cohen's d = 0.54), depressive symptoms (p = .002, Cohen's d = 0.77), and subjective caregiver burden (p < .001, Cohen's d = 1.12) in both interventions across the time points, whereas the modified MBCT had a larger effect on stress reduction, compared with the modified MBSR (p = .019). Conclusion Both the modified MBSR and MBCT are acceptable to family caregivers of PWD. Their preliminary effects were improvements in stress, depressive symptoms, and subjective burden. The modified MBCT may be more suitable for caregivers of PWD than the MBSR. A future clinical trial is needed to confirm their effectiveness in improving the psychological well-being of caregivers of PWD.