Sultan Ismail Specialist Hospital

Nerve injury often results in neuropathic pain, marked by spontaneous pain, hyperalgesia, and allodynia. Current treatments have moderate efficacy and have side effects, prompting interest in alternative approaches. Mesenchymal stem cell (MSC) therapy has shown promise in preclinical studies for reducing neuropathic pain and inflammation. However, the precise mechanisms underlying MSC-mediated pain reduction remain unclear. Investigating these mechanisms is crucial for optimizing MSC-based therapies for neuropathic pain. This article provides a brief overview of the MSC administration, animal models of neuropathic pain, and treatment regimens used in 25 preclinical studies, focusing on the potential mechanisms of action underlying the neuropathic pain-reducing effect of MSCs. Importantly, 23 out of the 25 studies demonstrated a reduction in neuropathic pain following MSC therapy, despite differences in MSC sources and treatment regimens. Neuropathic pain relief was associated with decreased inflammation, suggesting that MSCs may act through immune modulation. However, the resolution of inflammation does not always correlate with complete neuropathic pain relief, indicating the involvement of additional mechanisms.

Consistently high lactate levels and poor clearance on ECMO are important early signs of poor perfusion and useless care. For example, lactate levels over 8 mmol/L at 12 h, staying above 2.5 mmol/L at 24 h, or clearance rates below 22% are all strong signs that a patient will die in the hospital. Beyond metabolic markers, signs of specific organ failure are grave prognostic factors. Total bilirubin is a better way to check for liver problems than enzymes. A peak bilirubin level of more than 15 mg/dL means that the liver is not clearing the bilirubin properly and increases the risk of death by four times. Acute kidney injury requiring renal replacement therapy (CRRT) reflects severe multi-organ failure and is independently associated with mortality rates of 60-80%. Systemic coagulopathy also marks clinical decline, with an overt DIC score ≥5 or a precipitous ≥50% drop in platelets on the first day carrying an 8-9-fold increased risk of death. Furthermore, a profound inflammatory response, evidenced by high interleukin-6 and procalcitonin levels (≥0.5 μg/L), correlates with refractory shock and significantly worse outcomes compared to nonspecific markers like CRP. Ultimately, the persistence of these metabolic, hepatic, renal, and inflammatory abnormalities suggests irreversible organ damage and a poor prognosis.

Background and purpose: Diarrhea is a common side effect in cancer patients, especially during chemotherapy or antibiotic treatment. Managing this symptom is important for patient comfort, hydration, and nutritional status. Fibre, an important component of many oral nutritional supplements (ONS) formulations, has been shown to influence bowel function, including diarrhea. This case study examines the role of fibre proportion in ONS for managing diarrhea in two cancer patients undergoing treatment. Case presentation: Both patients initially experienced persistent diarrhea despite switching to fibre-based ONS. Upon transitioning to an ONS with an equal ratio of soluble to insoluble fibre, both patients showed improved stool consistency and bowel open frequencies with optimal energy and protein intake. Discussion: The proportion of soluble to insoluble fibre in ONS may play a crucial role in managing diarrhea among cancer patients. While achieving adequate total fibre intake is important, healthcare providers may need to consider not just the quantity but also the quality and proportion of fibre in nutritional interventions. Soluble fibre-enriched ONS may offer benefits for reducing diarrhea, while high insoluble fibre content could aggravate the condition. Conclusion: A careful consideration of the types and proportions of fibre may be necessary for optimal symptom management. A tailored approach that accounts for the patient’s specific needs is essential in optimizing nutritional care and improving quality of life.

The integration of wearable technology into inclusive education presents a promising avenue for empowering individuals with disabilities, particularly the deaf community. Despite advancements in smart textiles, few innovations have specifically addressed the intersection of fashion technology education and safety for deaf users. To bridge this gap, this study evaluates the effectiveness of a CDIO (Conceive-Design-Implement-Operate) based smart safety jacket developed for deaf individuals in educational and community settings. The primary objective was to assess the improvement in safety functionality, the accuracy and usability of biometric monitoring components, and the differences in user satisfaction between student and community groups. This quantitative study employed a quasi-experimental design, involving a pre-test and two post-tests, to collect data from two user groups: fashion technology students and community members with hearing impairments. Three key constructs, safety, health monitoring, and usability, were evaluated using structured questionnaires. Inferential statistics, including two-way ANOVA and independent t-tests, were used to evaluate the effectiveness of the intervention. Results revealed significant improvements in safety and health scores over time (p < .01), affirming the functional impact of the CDIO-based intervention. Usability scores showed a notable difference between groups (p = .006), with students reporting slightly higher satisfaction, suggesting that age-related or technological familiarity effects may be at play. The discussion reflects how CDIO’s iterative, user-centred design enhances assistive garment functionality while promoting inclusivity and autonomy. The findings demonstrate that incorporating CDIO principles into smart garment development not only improves safety and health monitoring but also fosters user engagement and educational integration. This research contributes new insights into the convergence of wearable technology, inclusive design, and fashion education for special populations.

Myiasis is the term referring to an infestation of dipterous larvae in the living body tissue, where they feed on the tissue and cause infection. It is typically found in individuals living in unhygienic conditions, with foul-smelling odor emanating from neglected wounds or body discharge, which attract flies to lay their eggs in the affected area. Myiasis can cause life-threatening complications if maggots invade vital organs, resulting in sepsis, hemorrhage, and organ dysfunction. The mainstay of treatment includes mechanical removal of the maggots, wound debridement, daily wound dressing, and administration of antibiotics for concurrent bacterial infections. Recently, we encountered a patient who presented with bleeding and foul-smelling discharge from a tracheostomy wound, which was found to be infested with maggots.

In this study, optimization of a rectangular dielectric resonator antenna is proposed to analyze the influence of various feeding methodologies on the impedance bandwidth, gain, and radiation pattern. All the feeding techniques can be used for 5G-NR bands, specifically, N257, N258, and N260 for millimeter-wave applications. They used Rogers 5880 as a substrate with a permittivity of 2.2 and a cladding of copper 0.035mm on both sides. In contrast, DRA has a permittivity of 10 and is excited in the fundamental mode. The suggested antennas reveal commendable bandwidth with ML, MSA, and probe feeding configurations whereas SIW offers extensive bandwidth ranging from 25.8 to 30.7(17.34%) accompanied by a peak gain of 7.46 dBi.

ABSTRACTBackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) impacts patients' concentration, ability to work, and overall quality of life. Current treatment options include topical and oral medications, and surgery. Recent evidence supports the efficacy of biologics in improving symptoms and quality of life. This study addresses the lack of consensus in the ASEAN region, providing guidance for otolaryngologists on appropriate CRSwNP management.MethodsA modified Delphi panel was conducted to gather expert opinion and establish consensus on the use of biologics and management of CRSwNP among otolaryngologists in the ASEAN region. Statements were developed based on a literature review and inputs from a Steering Committee of eight experts from Malaysia, Singapore, and Thailand. A three‐stage process was utilized for consensus generation: two online surveys for voting by at least 12 panelists from seven ASEAN countries, followed by moderated online Consensus Meetings with the Steering Committee.ResultsConsensus was achieved on 61/69 statements (88%). In Rounds 1 and 2, 37/67 statements (55%) and 13/28 statements (46%) achieved consensus, respectively. During the moderated Consensus Meetings, consensus was achieved on 12/16 statements (75%). Key aspects addressed include symptoms, comorbidities, diagnosis, and treatment pathways, with a focus on biologics. Eligibility criteria and considerations for biologic use were also defined.ConclusionsInsights from this Delphi consensus provide guidance on biologic use for managing CRSwNP in the ASEAN region. Future efforts, such as developing a regional guideline, continued medical education, and further research are essential for appropriate biologic use.