Despite publishing and securing research grants being obligatory in research universities, the literature on the factors influencing academic productivity is relatively scarce. Thus, in this study, we aimed to determine the personal and behavioural-related factors that influence the culture of publishing and securing research grants among academicians with lower research-related performance. This cross-sectional study was conducted among 49 academic staff members of Universiti Kebangsaan Malaysia (UKM). A self-administered questionnaire consisting of personal, attitude and behavioural (barriers, perceived stress scale, work extrinsic and intrinsic motivation scale, psychological well-being scale, and basic needs satisfaction scale) questions were distributed during a workshop and online. Simple linear regression (SLR) analyses were performed for each variable, followed by multiple linear regression (MLR) to identify the associated factors of research output. After adjusting for covariates, having a doctoral degree (β=0.396, 95% CI=0.221-2.146, p<0.05) and integrated regulation (β=0.574, 95% CI=0.036-3.612, p<0.05) were found to be associated with research grant acquisition (R2=0.273). Moreover, increasing age (β=0.426, 95% CI=0.088-0.397, p<0.05), living alone (β=0.331, 95% CI=0.944-6.626, p<0.05), having a doctoral degree (β=0.248, 95% CI=0.174-6.747, p<0.05), environmental mastery (β=0.318, 95% CI=0.013-0.347, p<0.05), self-acceptance (β=0.284, 95% CI=0.010-0.242, p<0.05), satisfaction incompetence (β=0.273, 95% CI=0.001-0.200, p<0.05) and relatedness (β=0.280, 95% CI=0.001-0.116, p<0.05) were found to be the factors that influence the publications produced among participants (R2 =0.423). The findings of this study could be used by management to formulate effective strategies to increase the productivity of academics in their research-related performance.

Caesarean scar pregnancy (CSP) is a pregnancy where embryo is implanted in the myometrium of a previous caesarean scar and it is a rare type of ectopic pregnancy. Diagnosis and management of CSP is a challenge because caregivers lack awareness about the possibility of implantation in previous caesarean surgery scar. We present here six CSP cases. All patients presented with abdominal pain and/or bleeding per vaginum with history of previous caesarean section. On ultrasonography, caesarean scar pregnancy was diagnosed. We managed them endoscopically at an endoscopic surgery and training center during the year 2019 till the year 2022. The pre-operative and post-operative periods were uneventful and they were discharged on day 2 or 3 of surgery. Hystero-laparoscopic combined approach is a good option for managing CSP in expert hands. Although there are no clear guidelines for managing CSP, we suggest individualizing each patient's treatment plan, depending on their personal characteristics and available facilities at the managing center.

Introduction: The purpose of this study is to assess the outcomes of patients that underwent single-stage revision ACL reconstruction (ACLR) with peroneus longus tendon (PLT), augmented with lateral extra-articular tenodesis (LET) using the modified Lemaire technique. Materials and methods: All the 18 patients underwent arthroscopic single-stage revision ACLR using autologous PLT with an additional modified Limier LET procedure. Patients were thoroughly assessed pre- and post-operatively by the Lachman test, the pivot shift test, and the side-to-side difference by the Rolimeter. Functional evaluation was done with the help of the Lysholm score, the IKDC subjective score, Tegner score, VAS score, MARX activity rating scale and The American Orthopaedic Foot and Ankle Society (AOFAS) score. Post-operatively, patient satisfaction, return to sport, and physical activity were also recorded. SPSS ver. 22.0 software was used. Wilcoxon test, paired and unpaired t-tests were used to compare variables. Statistical significance was determined by a two-sided p-value <0.05. Results: Regarding subjective evaluations; post-operative residual laxity, and return to sport and physical activity, all of the patients demonstrated excellent results. Post-operatively, there was significant improvement in the anterior knee laxity. According to the Marx Activity Rating Scale, the extent of sports engagement was significantly increased at 18 months following surgery (p<0.001). According to the AOFAS score (p=0.38), there were no documented significant donor site morbidities. Conclusions: Single-stage revision ACLR using PLT with an additional modified Lemaire LET procedure results in a significant reduction in residual knee laxity with good clinical outcomes and a high return to play and physical activity

Introduction: This study aimed to study the usefulness of CTX II levels to identify normal population with patients of knee osteoarthritis, and its utility in identifying the severity of disease in primary knee osteoarthritis (KOA). Materials and methods: This research recruited 80 cases of KOA and 80 healthy adults (160 subjects). Patients with primary knee osteoarthritis were graded according to the KL grading system, and serum CTX II (sCTX II) value were analysed. The age, gender, and BMI of the subjects were recorded. Results: The sCTX-II value in cases (719.87 ± 256.1pg/ml) was more than in controls (419.26 ± 208.18pg/ml, p<0.001). The sCTX-II value in case group was significantly higher in males (812.67 ± 289.24) than in females (680.11 ± 236.59, p=0.03). In the control group, males (426.13 ± 221.06) and females (398.66 ± 166.92) had similar values (p=0.60). sCTX II level was higher with higher age, but this difference is significant in the case group only (p=0.003). Multivariate analysis revealed that the sCTX II level was only dependent on the severity of the disease. Analysis of the ROC curve reveals a cut-off value of sCTX II as 557.5pg/ml among cases and controls, 407.5pg/ml between KL grade 0-I, as 528.5pg/ml between KL grade I-II, as 681.1pg/ml between KL grade II-III, and as 866.4pg/ml between KL grade III-IV. Conclusion: sCTX II values are dependent only on the severity of the disease. sCTX II level estimation is an excellent diagnostic tool for identifying the normal population with knee osteoarthritis patients and has a clinical significance in identifying KOA cases of KL grade I and II.

Background: s/Aims: Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT. Methods: This study included all patients who underwent curative resection for GBC from 2007 to 2017. Analyses were conducted of clinicopathological characteristics, surgical details, and postoperative therapeutic records. The benefits of adjuvant chemotherapy (CT) or chemoradiotherapy (CTRT) were evaluated against surgery alone using SPSS version 20 for statistical analysis. Results: The median age of patients (n = 142) was 50 years. The median overall survival (OS) was 93, 34, and 30 months with CT, CTRT, and surgery alone respectively (p = 0.612). Multivariate analysis indicated that only disease stage and microscopically involved margins significantly impacted OS and disease-free survival (DFS). CT showed increased effectiveness across all prognostic subsets, except for stage 4 and margin-positive resections. Following propensity score matching, median DFS and OS were higher in the CT group than in the CTRT group, although the differences were not statistically significant (p > 0.05). Conclusions Radically resected GBC patients appear to benefit more from adjuvant CT, while CTRT should be reserved for cases with high-risk features.

Background: There are diverse treatment modalities available for managing pediatric dentate mandibular fractures, ranging from various closed reduction techniques to open reduction methods. This systematic review and meta-analysis aim to evaluate the most appropriate and preferred management method for pediatric dentate mandibular fractures, focusing on outcomes such as wound infection and malocclusion. Methods: A systematic search was performed using the PubMed Central and Scopus databases from January 1980 to December 2022, following PRISMA guidelines. The inclusion criteria comprised case reports with more than 10 cases, clinical trials, and prospective and retrospective clinical studies addressing the management of displaced dentate-segment mandibular fractures in patients up to 15 years old using open and/or closed reduction techniques. Results: Six retrospective studies were included in the systematic review and meta-analysis. The primary outcomes assessed were wound infection and malocclusion. The pooled estimate for wound infection significantly favored the maxillomandibular fixation (MMF) group (p= 0.0007). In contrast, although the pooled estimate for malocclusion favored surgical treatment, the difference was not statistically significant (p= 0.86). Conclusion The risk of wound infection is significantly lower with MMF in pediatric mandibular fractures, while open reduction and internal fixation (ORIF) using miniplates is associated with a relatively lower risk of malocclusion, although this difference is not statistically significant. The authors conclude that, based on reduced wound infection rates, MMF should be the preferred management approach, whereas ORIF should be reserved for severely displaced and comminuted fractures. Future randomized controlled trials with larger sample sizes are needed to validate and strengthen these findings.

Background: Chitosan, a cationic polysaccharide, exerts hemostatic activity by promoting platelet adhesion and aggregation. This clinical study aimed to evaluate the effectiveness of chitosan-based dental dressing in achieving early local hemostasis, in comparison to gauze packs, after dental extractions in patients with deranged coagulation profiles. Methods: This study included 102 patients (204 extraction sites), of whom 86 were on anticoagulant therapy,15 had liver cirrhosis, and one with thrombocytopenic purpura required two or more tooth extractions. These sites were randomly divided into test and control sites. Patients with deranged coagulation profiles, including an international normalized ratio of 1.5–4, altered prothrombin time, activated partial thromboplastin time, and decreased platelet counts, were selected. Hemostasis was assessed at 10, 30, and 60 minutes post-extraction. Patients were evaluated on days 1, 3, and 7 for dry sockets and other adverse effects. Results: Hemostasis was achieved in 83.1% of test sites within 10 minutes, compared to only 18.8% of control sites. By 30 minutes, an additional 16.8% of test sites had achieved hemostasis versus an additional 16.7% of control sites. By 60 minutes, a further 5.9% of test sites had achieved hemostasis, compared to 63.7% of control sites. The mean postoperative hemostasis times were 15.10± 12.88 minutes for test sites and 45.20± 20.62 minutes for control sites. Dry socket incidence was slightly higher in test sites, but this tendency was not statistically significant (p>0.05). Conclusion The study suggests that chitosan-based dental dressing facilitates early local hemostasis after tooth extraction in anticoagulated patients or patients with bleeding disorders.