Patient cancer care education aims to inform and empower patients by providing clear, relevant information about cancer, including its mechanisms, treatment options, and management strategies. This study evaluated the effectiveness and accuracy of existing patient cancer care education materials in Malaysia, specifically assessing patients’ understanding of treatment, side effects, and their management. Method: A descriptive, correlational study was conducted involving 20 cancer patients at Gleneagles Penang Medical Center, using the Patient Cancer Education Needs Assessment questionnaire. Data analysis was performed using SPSS version 21.0 and Microsoft Excel 2013. Result: Patient age, education level, occupation, and socioeconomic status were not significant factors influencing understanding. Findings highlight the need to improve existing educational materials to enhance patient comprehension and ensure materials are comprehensive, culturally appropriate, and innovative. Conclusion: Patient cancer care education materials should be comprehensive, interactive, and patient is friendly. Current materials require revision and enhancement to keep pace with technological developments, ensuring they are accessible, understandable, and effective in supporting patients’ knowledge of cancer treatment, side effects, management strategies, and psychosocial aspects.

The purpose of the current case is to describe a very rare coexistence of a replaced common hepatic artery (rCHA) and dorsal pancreatic agenesis with notable surgical implications. Preoperative computed tomography angiography, magnetic resonance imaging, and magnetic resonance cholangiopancreatography were performed in a 53-year-old female with cholangiocarcinoma. Imaging revealed an rCHA arising from the superior mesenteric artery (SMA) and coursing anterior to the pancreatic head, supplying the right and left hepatic arteries, right gastroepiploic artery, and both the superior and inferior pancreaticoduodenal arteries. The gastroduodenal artery was absent. Dorsal pancreatic agenesis was confirmed, with the absence of the pancreatic body and tail. This configuration places the rCHA at high intraoperative risk and eliminates a major coeliac–SMA collateral route. Detailed preoperative vascular mapping and tailored surgical strategies are essential to prevent catastrophic ischemia during pancreatic or hepatic surgery and to guide appropriative operative approach.

Cervical canal dimensions vary according to neck posture, and conventional magnetic resonance imaging (MRI) performed in a neutral position may underestimate the degree of cervical spinal cord compression. We report a patient with progressive cervical myelopathy in whom clinical deterioration was discordant with findings on static MRI. Dynamic MRI performed during cervical extension demonstrated significant multilevel spinal canal stenosis, which prompted timely surgical intervention. This case highlights the diagnostic value of dynamic MRI in situations of clinical-radiological mismatch and underscores its role in informing an appropriate surgical strategy.

Background: To assess the effectiveness of hyperbaric oxygen therapy (HBOT) as an adjunct to standard treatment in early-stage oral submucous fibrosis (OSMF), focusing on mouth opening, burning sensation, pain, and systemic inflammation. Methods: A randomized comparative study was conducted on early-stage OSMF patients divided into two groups. Group 1 received HBOT along with intralesional triamcinolone, hyaluronidase, and oral antioxidants. Group 2 received only the standard intralesional therapy with antioxidants. Clinical parameters—interincisal distance, burning sensation, and pain—were recorded at baseline, first, and second followup. Serum C-reactive protein (CRP) levels were measured pre- and post-treatment. Statistical analysis included unpaired t-tests and chisquare tests. Results: Both groups improved clinically, but Group 1 showed significantly greater reductions in burning sensation (p= 0.020), pain, and CRP levels (p= 0.033). Although intergroup differences in mouth opening were not statistically significant, Group 1 showed greater improvement over time. Fibrotic band distribution remained unchanged in both groups. No complications were reported with HBOT. Conclusion HBOT provides enhanced symptomatic relief and anti-inflammatory effects in early-stage OSMF when used alongside conventional therapy. While it may not reverse fibrosis, its safety and noninvasive nature support its role in multimodal OSMF management.

Objectives: To assess the efficacy of salmon calcitonin spray on postoperative pain, serum calcitonin levels, and bone healing after surgical removal of impacted mandibular third molar. Materials and Methods: This prospective study included 100 patients who required surgical removal of impacted mandibular third molars under local anesthesia. Group I included 50 patients who received intranasal serum calcitonin spray, and Group II included 50 patients who did not receive serum calcitonin spray. The postoperative pain was evaluated on the 1st, 3rd and 7th days. The serum osteocalcin levels were assessed at 1 month, and bone density was evaluated at the 3rd month postoperatively. Results: The severity of pain was less in Group I on days 3, and 7 postoperatively compared to Group II (P<0.05). The postoperative serum calcitonin level was higher in Group I compared to Group II (P<0.05), and the bone density was greater in Group I when compared to Group II evaluated at the 3rd month postoperatively (P<0.05). Conclusion The results of our study delineate that Group I patients had better efficacy in controlling pain and improved bone healing with calcitonin nasal spray when compared to Group II patients.

Objective: Biological processes are the sum of metabolic reactions that result in intermediate and end metabolite products. These processes are the reflection of genetic regulation and are profoundly impacted by environmental influence and changes, including those associated with attention-deficit/hyperactivity disorder (ADHD). This study aimed to assess the untargeted plasma metabolomic profile of children and adolescents with ADHD and to compare them with healthy controls and to study associations of dysregulated metabolic parameters with the clinical and socio-demographic parameters of ADHD. Methods: This study involved 42 registered cases of ADHD among children aged 6 to 16 years, diagnosed based on DSM-5 criteria. Each case was matched by age and gender with 24 healthy controls. The severity of ADHD was evaluated using the ADHD Rating Scale, while behavioral issues were assessed through the Child Behavior Checklist. The gas chromatography-mass spectrometry technique was employed to examine changes in plasma metabolite content. Results: We identified a total of 45 metabolites in the ADHD subtypes, which exhibited altered levels compared to the control group. The content of these metabolites and associated metabolic pathways showed significant differences between ADHD subjects and controls. Furthermore, we analyzed biomarkers derived from the compounds with the greatest fold changes in accumulation levels. Conclusion The identification and analysis of these metabolites and metabolic pathways represent a promising new approach for tracking disease progression in ADHD. The findings of this study indicate that metabolite-based biomarkers may hold considerable potential for effective disease management.

Background: Transcranial random noise stimulation (tRNS) is a non-invasive brain stimulation technique that modulates cortical excitability through stochastic resonance. While promising, its safety and efficacy in psychiatric disorders remain underexplored. Objective: To systematically evaluate the efficacy and safety of tRNS in various psychiatric disorders. Methods: A systematic review was conducted per PRISMA guidelines and registered on PROSPERO (CRD420251040192).Databases searched included CENTRAL-Cochrane Central Register of Controlled Trials, PubMed, Scopus, and Web of Science. Studies were included from their inception to 30th April, 2025. Studies involving tRNS in psychiatric populations, regardless of study design, were included. The risk of bias was assessed using JBI tools. Results: 22 studies were included (642 individuals), spanning ADHD, depression, schizophrenia, dyslexia, and other conditions. Most studies used 20-minute tRNS sessions over 1−4 weeks. ADHD and dyslexia showed consistent improvements in overall executive function and reading & phonological skills, respectively. Schizophrenia studies demonstrated significant reductions in negative symptoms and auditory hallucinations. Effects in depression were mixed, with some studies reporting substantial symptom relief, while others found no significant benefit. Across disorders, tRNS was generally well-tolerated with only mild, transient adverse effects. Conclusion tRNS appears to be a safe, well-tolerated, and potentially effective intervention for specific psychiatric symptoms, especially in ADHD, dyslexia, and schizophrenia. However, inconsistent protocols and mixed outcomes in mood disorders highlight the need for standardized protocols and further research.

Purpose: When managing femoral neck fractures, National Institute for Health and Care Excellence guidelines (2023) recommend total hip arthroplasty (THA) for patients who are expected to independently perform activities of daily living (ADLs) beyond two years. These attempt to clarify the indication for THA versus hemiarthroplasty (HA). Frailty assessment tools, such as the Rockwood Frailty Scale (RFS), may provide surgeons a more objective means to assess patient function. The aim of this study is to ascertain whether frailty assessments are predictive of mortality associated with THA thus helping determine arthroplasty suitability. Materials and Methods: Single-center data was collected retrospectively between 2014 and 2020. Three hundred thirty-three cases were eligible for review. For the RFS, Johns Hopkins Frailty Assessment (JHFA) and Nottingham Hip Fracture Score (NHFS), frailty scores were generated and 2-year mortality was calculated for ‘frail’ and ‘non-frail’ patient cohorts. Results: Overall 2-year mortality was 8.4%. Mortality within two postoperative years was 0.8% for RFS <4 compared to 12.7% for scores ≥4. This highlights an approximate 17-times greater mortality risk between these groups (odds ratio [OR] 17.27, 95% confidence interval [CI] 2.32-128.82, P=0.005). For the JHFA, the 2-year mortality rate for ‘frail’ patients was over 6-times greater than those ‘not frail’ (OR 6.91, 95% CI 3.04-15.72, P<0.0001). Positive findings were noted by the NHFS (P=0.054). Conclusion This study demonstrates that following THA for femoral neck fractures, preoperative frailty scores are predictive of 2-year postoperative mortality. Frailty assessments could objectively guide surgical decision making with respect to offering THA versus HA.

Objective To explore the clinical efficacy and safety of endoscopic endonasal dorsum sellae and posterior clinoid process resection combined with pituitary hemi-transposition in the treatment of pan-sellar area lesions. Methods Clinical data from 57 patients with pan sellar diseases who underwent endoscopic transnasal resection of the posterior clinoid process combined with lateral pituitary displacement surgery in the neurosurgery department of Zhongshan Hospital, Fudan University from January 2019 to January 2025 were collected, and their clinical surgical characteristics and prognosis were analyed. Results A total of 57 patients with pan-sellar area lesions were included in this study, comprising 27 craniopharyngiomas, 7 giant suprasellar pituitary adenomas, 7 chordomas, 6 chondrosarcomas, 5 diaphragma sellae/dorsum sellae meningiomas, and 5 rare lesions. All procedures were completed successfully, and gross total or near-total resection was achieved in all patients. No new neurovascular complications occurred intraoperatively. The follow-up duration ranged from 3 to 24 months. New postoperative anterior pituitary insufficiency occurred in 3 patients (5.3%), and new posterior pituitary insufficiency requiring long-term hormone replacement therapy occurred in 4 patients (7.0%). No additional pituitary dysfunction was observed in the remaining patients. Cerebrospinal fluid rhinorrhea occurred in 1 patient (1.8%) and was successfully repaired. Intracranial infection occurred in 3 patients (5.3%) and resolved after medical treatment. Conclusion Endoscopic resection of the posterior clinoid process combined with lateral displacement of the pituitary gland can effectively expand the surgical space, while repositioning the pituitary gland can reduce the extent of skull base defects. In addition, the risk of pituitary dysfunction caused by lateral displacement of the pituitary gland is relatively low.