CRITICAL APPRAISAL OF CLINICAL PRACTICE GUIDELINES FOR OTITIS MEDIA IN ASIAN AND WESTERN COUNTRIES WITH CONSIDERATION OF UPDATES: A NARRATIVE REVIEW Introduction: Acute otitis media is a common disease in children under the age of 5 years due to their primitive ear anatomy. One of its consequences is otitis media with effusion (OME), which is a condition wherein serous secretion accumulates in the middle ear due to Eustachian tube dysfunction. OME results in conductive hearing loss, impacting children’s learning and development. This review aimed to identify discrepancies in clinical practice guidelines (CPGs) for managing OME in children across Asian and Western countries, focusing on updates to these guidelines. Methods: A comparative review involving critical appraisal using the Appraisal of Guidelines for Research and Evaluation II tool was conducted. CPGs for managing ear effusion in children in Western and Asian countries published in the PubMed, Cochrane Library, Scopus and Science Direct databases were reviewed. Four CPGs from Western countries (Scotland, England, the United States of America and France) and three CPGs from Asian countries (Japan, Korea and Malaysia) were selected. Results: There was a mild discrepancy regarding conducting surgery after 3 months, particularly myringotomy and adenoidectomy with or without grommets, between the Scottish CPG and other CPGs. Conclusion: Asian CPGs for the management of OME share many similarities with Western CPGs. However, Asian CPGs tend to be stronger in most domains and levels of evidence. Japanese and American CPGs are up to date as of 2022 and 2016, respectively, while other CPGs are outdated for about 10 years.

Introduction: Lymphoma is a diverse group of malignant proliferations that arise as discrete tissue masses. The 5th edition of the World Health Organization classification of Tumours of Haematopoietic and Lymphoid Tissues was released on 22nd June 2022. The WHO-HAEM5 classification of Mature T and NK neoplasms is further subclassified into various categories which are detailed in this review. Methods: A search was conducted using bibliographic databases, various repositories, and the Clinical Research Centre website retrieving journal articles, conference proceedings, book Chapters, guidelines, and thesis. The search terms used were Malaysia AND lymphoma. Results: The search earmarked a total of 561 papers. There were nine case series retrieved from 1967 to 2022. The site, age distribution, prognostic markers, and the various subclassification of NK/T cell lymphomas were studied. The gastrointestinal tract was the commonest site for extranodal lymphomas. Prognostic markers associated were EBV, C-MYC protein and staining for CD2, CD3, CD20, CD56, and CD57 antigens. For anaplastic large cell lymphoma (ALCL), CD30 (Ki-1) and ALK antigens were noted as important. The use of 18F-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PETCT) has emerged as an important investigation. Various chemotherapeutic regimens, surgical interventions where necessary and autologous peripheral blood stem cell transplantation when indicated are the mainstay of treatment. Conclusion Research on NK/T cell lymphoma, including ALCL, has been ongoing in recent years. This review adds on to the existing literature on lymphoma in Malaysia that can lead to further research, into the diagnosis and treatment of lymphoma in Malaysia and around the world.
Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Malaysia