Background: s/Aims: Postoperative pancreatic fistulas (POPF) remain a major cause of morbidity and mortality following pancreatoduodenectomy (PD). Pancreatogastrostomy (PG) and pancreatojejunostomy (PJ) are the two most commonly used reconstruction techniques, yet evidence favoring one over the other is inconclusive. This study evaluates postoperative outcomes following open PD at a single institution that transitioned from PG to PJ as the preferred reconstruction method. Methods: This retrospective comparative study included patients who underwent PD between April 2005 and August 2022. Of 757 patients identified, 522 met the inclusion criteria. Propensity score matching (PSM) was performed to adjust for clinically relevant covariates. Primary endpoints were clinically relevant (CR) POPF (grade B/C) and Clavien–Dindo (CD) grade ≥ 3 POPFs. Secondary outcomes included post-pancreatectomy hemorrhage (PPH), delayed gastric emptying (DGE), systemic complications, length of hospital stay, and mortality. Results: Overall, CR-POPF and CD grade ≥ 3 POPFs occurred in 21.3% and 8.0% of patients, respectively. Thirty-day and in-hospital mortality rates were 3.1% and 4.2%. After PSM, 368 patients (184 PG and 184 PJ) were analyzed. Grade B POPFs were more frequent following PJ than PG (24.5% vs. 15.8%, p < 0.001). Although CR-POPF and CD grade ≥ 3 POPFs were numerically higher in the PJ group, differences were not statistically significant. In contrast, DGE, PPH, and in-hospital mortality were significantly higher following PG (37.0% vs. 25.0%, p = 0.025; 16.3% vs. 8.7%, p = 0.025; and 7.6% vs. 2.7%, p = 0.049, respectively). Conclusions PG was associated with a lower incidence of grade B POPFs but higher rates of DGE, PPH, and in-hospital mortality.

ntroduction: Chinese Herbal Medicine (CHM) is becoming increasingly popular among cancer patients worldwide. While health-related quality of life (HRQoL) in relation to cancer outcomes has attracted global attention, there are few studies on CHM use and HRQoL among cancer patients in Malaysia. This study attempted to determine the association between use of CHM, including the types, reasons, and beliefs, and HRQoL among Malaysian cancer patients. Methods: cross-sectional study was conducted among 120 cancer patients (60 male and 60 female) recruited from government oncology clinics in Johor state. A purposive non-probability sampling was applied to recruit respondents. Results: Use of CHM was reported by about half of the patients (49.2%). Common types of CHM used included Chinese herbal extracts (27.5%), Sabah snake grass (12.2%), and ginger (11.5%). The median score for overall belief in CHM significantly differed between CHM users (71.7%) and non-users (65.0%) (p<0.001). The HRQoL was generally reported as ‘good’ with high scores for overall functioning scales and low scores for symptom scales. However, no significant difference in HRQoL between CHM users and non-users was noted. ‘Social Functioning’ scores between both groups showed a significant difference (p < 0.001) with respect to sex, with females scoring higher than males. No significant association was noted between CHM use and socio-demographic characteristics except for sex. Conclusion: There is a high prevalence of self-prescription of CHM among the cancer patients studied. Nonetheless use of CHM did not show any significant difference in terms of quality of life among CHM users.

Introduction: Appropriate oral health knowledge is essential to enable parents to be responsible for the oral health care of their children especially those with special needs. This study aimed to determine the oral health knowledge, attitude and practice (KAP) of parents and cariogenic food intake of their non-syndromic cleft lip with or without cleft palate children (NSCLP) compared to non-cleft children. Methods: A comparative cross-sectional study was conducted on randomly selected parents with children aged 1 to 6 years at Hospital Universiti Sains Malaysia and Kota Bharu Dental Clinic. A face-to-face interview using a validated questionnaire on oral health KAP and cariogenic food intake of their children was done. Data were analysed by using IBM SPSS version 22.0. Results: Sixty-four Malay parents with NSCLP (n=33) and non-cleft (n=31) children were recruited. The mean (SD) percentage score of oral health knowledge of parents in both groups (NSCLP and non-cleft) was fair, 59.5%(11.85) and 62.0%(15.00), P=0.4722; oral health attitude was good, 78.0% (9.30) and 80.2% (15.40), P=0.504; but oral health practice was poor 33.8% (5.94) and 36.1 (8.44), P=0.220. The cariogenic food frequency score was significantly higher in noncleft children; 40.2(10.32) compared to NSCLP children, 34.8(9.46), P=0.032. Conclusion: Parents of both groups had fair knowledge and good attitude but poor oral health practice. Cariogenic foods were consumed more by the non-cleft children. Oral health awareness among the parents needs to be strengthened towards good oral health attitude and practice and non-cariogenic food choices for the betterment of oral health status of their children.

The Health Promotion Board (HPB) has developed the Clinical Practice Guidelines (CPG) on Falls Prevention among Older Adults Living in the Community to provide health professionals in Singapore with recommendations for evidence-based assessments and interventions for falls prevention. This article reproduces the introduction and executive summary of the key recommendations from the HPB-MOH CPG on Falls Prevention among Older Adults Living in the Community for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov. sg/cpg-falls-prevention. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Accidental Falls ; prevention & control ; Aged ; Environment ; Evidence-Based Medicine ; Geriatrics ; standards ; Health Promotion ; methods ; Housing ; Humans ; Incidence ; Middle Aged ; Practice Guidelines as Topic ; Risk Assessment ; methods ; Singapore ; Social Class