INTRODUCTION: Oral cancer is a major public health concern in India. Both conventional and altered fractionation radiotherapy schedules have been used in curative treatment of oral cancer. This study aimed to retrospectively evaluate the clinical profile and treatment outcomes of patients with carcinoma buccal mucosa who underwent treatment with definitive hypofractionated accelerated radiotherapy. METHODS: A total of 517 patients treated from January 2011 to December 2016 were eligible for the analysis. All patients were treated with definitive hypofractionated accelerated radiotherapy schedule of 5,250 cGy in 15 fractions over 3 weeks. Survival estimates were generated using the Kaplan-Meier method. RESULTS: At a median follow-up of 77.4 months, 473 (91.5%) patients attained complete remission with radiation therapy. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 69% and 80.5%, respectively. The 5-year OS for stage I, II, III and IVa tumours was 80.3%, 84.4%, 81.4% and 73.7%, respectively, and the DFS was 75.7%, 73.2%, 69.6% and 60.2%, respectively. Age >50 years was found to be a significant factor affecting DFS ( P = 0.026) and OS ( P = 0.048) in multivariate analysis. Fifty-three (10.3%) patients developed osteoradionecrosis of the mandible. CONCLUSION Excellent outcome could be achieved in less-aggressive, low-volume carcinoma of the buccal mucosa with radical accelerated hypofractionated radiotherapy. A radiotherapy schedule over a 3-week period is useful in high-volume centres.
Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; Mouth Neoplasms/mortality* ; Mouth Mucosa/radiation effects* ; Treatment Outcome ; Aged ; Adult ; Radiation Dose Hypofractionation ; Disease-Free Survival ; India ; Kaplan-Meier Estimate ; Dose Fractionation, Radiation ; Aged, 80 and over

Background: Thalassaemia is a public health burden in Malaysia and its prevention faces many challenges. In this study, we aimed to assess the effectiveness of a web-based educational module in improving knowledge and attitudes about thalassaemia prevention amongst Malaysian young adults. Methods: We designed an interactive web-based educational module in the Malay language wherein videos were combined with text and pictorial visual cues. Malaysians aged 18-40 years old who underwent the module had their knowledge and attitudes assessed at baseline, post-intervention and at 6-month follow-up using a selfadministered validated questionnaire. Results: Sixty-five participants: 47 Malays (72.3%), 15 Chinese (23.1%), three Indians (4.6%) underwent the module. Questionnaires were completed at baseline (n=65), postintervention (n=65) and at 6-month follow-up (n=60). Out of a total knowledge score of 21, significant changes were recorded across three time-points- median scores were 12 at pre-intervention, 19 at post-intervention and 16 at 6-month follow-up (p<0.001). Post-hoc testing comparing preintervention and 6-month follow-up scores showed significant retention of knowledge (p<0.001). Compared to baseline, attitudes at 6-month follow-up showed an increased acceptance for “marriage avoidance between carriers” (pre-intervention 20%, 6-month follow-up 48.3%, p<0.001) and “prenatal diagnosis” (pre-intervention 73.8%, 6-month follow-up 86.2%, p=0.008). Acceptance for selective termination however, remained low without significant change (pre-intervention 6.2%, 6-month follow-up 16.7%, p=0.109). Conclusion: A web-based educational module appears effective in improving knowledge and attitudes towards thalassaemia prevention and its incorporation in thalassaemia prevention programs is potentially useful in Malaysia and countries with a high internet penetration rate.

Introduction: Often considered a legitimate strategy to enhance health and performance, the consumption of nutritional supplements (NS) has become a common practice which frequently results in unintentional doping among athletes. Despite a probable association between NS and doping, there are limited studies on this topic in developing countries such as Malaysia. Thus, this study aimed to identify the prevalence of NS usage among national elite athletes and assess their knowledge and attitude regarding its use and doping. Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among national elite athletes (n=50) recruited via convenience sampling. The athletes completed a self-administered questionnaire documenting their demographic characteristics, training information, NS consumption, knowledge and attitude related to supplement-doping. The total knowledge and attitude scores were compared according to demography, training information, and NS consumption. Results: The prevalence of NS use among the athletes was 72%. NS usage was significantly associated with training duration (p=0.029), source of nutrition information (p=0.047) and self-exploration on supplements (p=0.045). Supplement-doping knowledge was significantly higher among athletes with tertiary level education (p=0.027), NS users (p=0.044), those obtaining information from nutritionists (p=0.048) and those who had attended nutrition workshops (p<0.001). The attitude score was significantly higher among males (p=0.021), professional athletes (p=0.041), athletes with lower training hours (p=0.010), those obtaining information from nutritionists (p=0.035) and those who had attended nutrition workshops (p=0.005). Conclusion: A demographic- and training-specific education on NS should be provided by qualified nutritionists to reduce the risk of doping amongst athletes.

Introduction: This study aimed to (i) determine rapid weight loss (RWL) practices among Malaysian elite combat sports athletes and (ii) examine the relationship between the characteristics of athletes, self-reported history of weight loss, perceived influence on weight loss and RWL practices. Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among elite combat sports athletes (n=40) recruited via a convenience sampling method. The athletes completed a self-administered validated Rapid Weight Loss Questionnaire. Each response was provided a score and the total RWL score corresponded to the aggressiveness of weight management methods. Partial correlations were used to assess the relationships between total RWL score and independent variables. Results: The prevalence of RWL among the athletes was high (92.5%). Training with rubber or plastic suits (62.2%) and meal-skipping (27.0%) were the most common RWL techniques practised by the respondents. Aggressive weight-cutting as depicted by a higher total RWL score that correlated with most weight ever lost, duration taken to lose weight, influence of training colleagues and coaches, BMI, current weight and post-competition weight regain (all p<0.05). In contrast, negative correlations were seen between total RWL score, and the age at which the athletes began competing (p<0.001), duration of competition (p<0.001), age at first participation (p<0.05), duration of participation (p<0.05) and influence of nutritionists on weight loss (p<0.05). Conclusion: A high prevalence of aggressive weight loss among elite combat sports athletes and its association with perceived influence of sports professionals, colleagues and actual weight-related characteristics are of great concern.