Introduction: Medial open wedge high tibial osteotomy (MOWHTO) is one of the modalities to treat unicompartmental knee osteoarthritis (KO). Many studies have shown good outcomes of MOWHTO, but there are no published series of Malaysian patients. The aim of this study is to determine the outcome of MOWHTO in primary medial compartment KO in a university teaching hospital in Malaysia. Materials and methods: This is a retrospective study of patients who underwent MOWHTO in our Joint Reconstruction Unit between 2017 and 2022 with a minimum of 12 months follow-up. Results: Data from a total of 15 knees were reviewed. The mean age of patients was 41.8 years, and the mean BMI was 31.7. The mean Kellgren-Lawrence (KL) osteoarthritis grade was 2.87 (±0.52). The mean hip knee angle (HKA) preoperatively was 12.26° varus and post-operatively was 3.33° valgus. Mean correction of HKA was 13.59°. The results revealed an improvement in all patients, as observed from the significant mean difference between pre-operative (38.53) and post-operative (77.60) Knee Injury and Osteoarthritis Outcome (KOOS) (p-value<0.001) scores. Patients who were above 50 years old showed a significantly better improvement in KOOS score compared to those below 50 (p-value <0.05). There was no significant difference observed between BMI and KOOS score improvement (Fstat=0.580, p-value >0.05). Conclusion: MOWHTO is a good treatment option in medial compartment primary KO with varus deformity among Malaysian population. A larger sample size with a longer follow-up period is needed to draw a definitive conclusion

Postoperative chylothorax is a serious complication after oesophagectomy. Real-time identification of the thoracic duct (TD) could prevent injury or facilitate prompt management when it occurs. Intraoperative TD lymphography with indocyanine green (ICG) is a novel technique that may help prevent chyle leaks following thoracic surgery. A systematic search of PubMed, Embase, MEDLINE, Scopus, and the Cochrane Library for studies published until July 2024 evaluating ICG for TD identification during oesophagectomy was performed. Studies were included in the review if they assessed intraoperative TD identification with ICG to prevent chyle leakage in patients undergoing oesophagectomy. Nine of 265 screened papers were included in the present review, with 3 reporting comparative techniques of TD identification between patients. Only 1 study had a control group without ICG administration. TD was identified in 281 of the 303 patients who received ICG.Chyle leak incidence was 0.66% in the ICG group. The mean observation time of TD after ICG administration was 162 minutes. Most of the included patients received neoadjuvant treatment before surgery. Different application routes of ICG have been reported, with the most prominent one being through the inguinal region under ultrasound guidance. Real-time TD identification with ICG might be a valuable tool for avoiding injury or managing it intraoperatively. To our knowledge, this is the first systematic review on this complex topic. However, as no randomized controlled trials have been published, sufficient evidence is needed to determine whether the aforementioned method can sufficiently reduce the chyle leak rate.

Functional dyspepsia (FD) is a chronic gastrointestinal disorder without a readily identifiable organic cause, resulting in bothersome upper abdominal symptoms. It is a highly prevalent disorder of which the pathophysiology remains mostly elusive, despite intensive research efforts. However, recent studies have found alterations in the microenvironment of the duodenum in patients with FD. In this review we summarize the duodenal microenvironment in homeostatic conditions and the alterations found in patients with FD, highlighting the similarities and discrepancies between different studies. The most consistent findings, being an impaired duodenal barrier and duodenal immune activation, are reviewed. We discuss the potential triggers for these observed alterations, including psychological comorbidities, luminal alterations and food related triggers. In summary, this review presents the evidence of molecular and cellular changes in patients with FD, with an impaired duodenal barrier and activated mucosal eosinophils and mast cells, challenging the notion that FD is purely functional, and offering different targets for potential future treatments.

Objective: Using semiquantitative risk scoring, this study estimated the probability of ASF transmission in 23 selected provinces. Methods: The factors influencing ASF spread were identified; 10 through a literature review and the positivity for ASF virus (ASFv) of meat samples from an ongoing surveillance study.Secondary data from each sampled province were collected, and the provinces were scored across these factors and classified into one of three risk categories. Results: Six out of 23 provinces were categorized as high-risk due to the high number of ASFv-positive meat samples, backyard pigs, and ASF occurrences. Conversely, four provinces were classified as low-risk due to consistently low scores across all indicators. The difference in the meat contamination level between low- and high-risk provinces emphasizes the importance of including this factor in the ASF spread assessment. Conclusions and Relevance: Risk estimation of ASF transmission must consider meat sample contamination. Active surveillance at local borders can monitor contamination and prevent ASFv sources from entering areas. This approach allows the government to allocate resources and prioritize higher-risk areas.

Functional dyspepsia (FD) is a chronic gastrointestinal disorder without a readily identifiable organic cause, resulting in bothersome upper abdominal symptoms. It is a highly prevalent disorder of which the pathophysiology remains mostly elusive, despite intensive research efforts. However, recent studies have found alterations in the microenvironment of the duodenum in patients with FD. In this review we summarize the duodenal microenvironment in homeostatic conditions and the alterations found in patients with FD, highlighting the similarities and discrepancies between different studies. The most consistent findings, being an impaired duodenal barrier and duodenal immune activation, are reviewed. We discuss the potential triggers for these observed alterations, including psychological comorbidities, luminal alterations and food related triggers. In summary, this review presents the evidence of molecular and cellular changes in patients with FD, with an impaired duodenal barrier and activated mucosal eosinophils and mast cells, challenging the notion that FD is purely functional, and offering different targets for potential future treatments.

Objective: Using semiquantitative risk scoring, this study estimated the probability of ASF transmission in 23 selected provinces. Methods: The factors influencing ASF spread were identified; 10 through a literature review and the positivity for ASF virus (ASFv) of meat samples from an ongoing surveillance study.Secondary data from each sampled province were collected, and the provinces were scored across these factors and classified into one of three risk categories. Results: Six out of 23 provinces were categorized as high-risk due to the high number of ASFv-positive meat samples, backyard pigs, and ASF occurrences. Conversely, four provinces were classified as low-risk due to consistently low scores across all indicators. The difference in the meat contamination level between low- and high-risk provinces emphasizes the importance of including this factor in the ASF spread assessment. Conclusions and Relevance: Risk estimation of ASF transmission must consider meat sample contamination. Active surveillance at local borders can monitor contamination and prevent ASFv sources from entering areas. This approach allows the government to allocate resources and prioritize higher-risk areas.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Background/Aims: Alcohol represents a leading burden of disease worldwide, including alcohol use disorder (AUD) and alcohol-related liver disease (ALD). We aim to assess the global burden of AUD, ALD, and alcohol-attributable primary liver cancer between 2000–2021. Methods: We registered the global and regional trends of AUD, ALD, and alcohol-related liver cancer using data from the Global Burden of Disease 2021 Study, the largest and most up-to-date global epidemiology database. We estimated the annual percent change (APC) and its 95% confidence interval (CI) to assess changes in age-standardized rates over time. Results: In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer. Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence. While the age-standardized prevalence rate for liver cancer from alcohol increased (APC 0.59%; 95% confidence interval [CI] 0.52 to 0.67%) over these years, it decreased for ALD (APC –0.71%; 95% CI –0.75 to –0.67%) and AUD (APC –0.90%; 95% CI –0.94 to –0.86%). There was significant variation by region, socioeconomic development level, and sex. During the last years (2019–2021), the prevalence, incidence, and death of ALD increased to a greater extent in females. Conclusions Given the high burden of AUD, ALD, and alcohol-attributable primary liver cancer, urgent measures are needed to prevent them at both global and national levels.