MATERIALS AND METHODS: A retrospective cross-sectional review of all adult haemophilia A (HA) or haemophilia B (HB) patients who received treatment in Hospital Pulau Pinang from January 2021 to December 2022 was conducted. Data was retrieved from patients' medical records.
RESULTS: A total of 75 haemophilia patients (64 HA and 11 HB) were included in this study with median age of 37 years (range 19 70). 42 of them had severe haemophilia (50% of HA, 91% of HB). All HB and 93.8% of severe HA patients were on prophylaxis. Six severe and one mild HA patients developed inhibitor with four of them currently on non-factor prophylaxis. 24 patients (32%) had prior hepatitis C infection and all of them have been successfully treated. The mean annual bleeding rate for severe haemophilia patients were 1.77 (SD ±3.6). Target joints were observed in 9.3% of patients with ankle joint (71.4%) being the most affected joint. More than one quarter (26.7%) of our patients have comorbidities with majority of them having hypertension (17/20), followed by diabetes mellitus (5/20) and ischemic heart disease (5/20).
CONCLUSION: Our study showed that a significant number of adult patients with haemophilia have comorbidities. Apart from optimising factor replacement therapy, future planning should include improvement in screening, risk modification and prevention of cardiovascular disease.
METHODS: The questionnaires for thirteen orthognathic-relevant FACE-Q scales, translated into Cantonese and validated, were administered to Hong Kong Chinese patients before and after orthognathic surgery in the short- and long-term, respectively. The assessed scales were categorized into four main domains: satisfaction with facial appearance, quality of life, patient's experience of care, and adverse effects.
RESULTS: Generally, highly significant (p
OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.
METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.
RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.
CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.
METHODS: Relations between skeletal movement, hyoid bone position and three-dimensional pharyngeal airway changes were retrospectively analyzed on pre- and post-surgical CBCTs in dento-skeletal class II patients who underwent orthognathic two-jaw surgery with segmentation.
RESULTS: While long-term significant reductions in length (P= 0.003), surface area (P= 0.042) and volume (P= 0.004) were found in the nasopharynx, the highly significant increases in oropharyngeal airway length, surface area, volume and the minimal cross-sectional area (P
METHODS: A retrospective analysis has been performed on patients with dento-skeletal class III deformity who had undergone orthognathic 2-jaw surgery with segmentations, presenting both pre- and post-surgical cone-beam computed tomographys. Three-dimensional skeletal movements, pharyngeal airway changes and hyoid bone position were measured and correlated.
RESULTS: The mean short term postsurgical review period for all included 47 patients was 5.8 ± 2.2 months. Thirteen patients among them provided a mean long term period of 26.4 ± 3.4 months. The mean postsurgical maxillary movement was 2.29 ± 2.49 mm in vertical, 2.02 ± 3.45 mm in horizontal direction, respectively, while the mandibular movement was 6.49 ± 4.58 mm in vertical, and -5.85 ± 6.13 mm in horizontal direction. In short-term, the vertical length of nasopharynx was found to be reduced (P = 0.005) but increased for the oropharynx (P 0.05) detected between patients with and without genioplasty advancement.
CONCLUSION: Two-jaw orthognathic surgery in dento-skeletal class III patients led to a statistically non-significant reduction of the post-surgical airway volume in both short- and long-term. Although the post-surgical oropharyneal minimum cross-sectional area was decreased significantly in the short term, this finding did not persist in the long term.
METHODS: Two sets of 3-dimensional facial photographs (1 male and 1 female) each comprised 7 images that showed different dentoskeletal relations (ie, Class I, bimaxillary protrusion, bimaxillary retrusion, maxillary protrusion, maxillary retrusion, mandibular protrusion, and mandibular retrusion). The sets of photographs were shown to 101 laypersons (age, 28.87 ± 6.22 years) and 60 patients seeking orthognathic treatment (age, 27.12 ± 6.07 years). They rated their esthetic perceptions of the photographs on the basis of a 100 mm visual analog scale (VAS) from 0 (very unattractive) to 100 (very attractive).
RESULTS: The dentoskeletal Class I facial profile was ranked as the most attractive profile. Female orthognathic judges selected the retrusive maxilla while male orthognathic judges and male and female laypersons ranked the mandibular protrusion profile as the least attractive profile for both females and males. A bimaxillary protrusive female profile was viewed as more attractive by the orthognathic male (P = 0.006) and female (P = 0.006) judges, compared with female layperson judges. After adjustment for age, no statistically significant interaction between sex and judges (P >0.10) for all VAS scores were detected. For the female bimaxillary protrusive profile, orthognathic patient judges assigned a mean VAS score of 9.174 points higher than layperson judges (95% confidence interval, 3.11-15.24; P = 0.003).
CONCLUSION: Dentoskeletal Class I facial profile was generally considered the most attractive profile in both sexes; male and female orthognathic patients preferred a bimaxillary protrusive female profile. A concave facial profile was perceived as least attractive in both sexes.
OBJECTIVE: To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.
METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.
RESULTS: Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.
CONCLUSION: Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.
STUDY REGISTRATION: PROSPERO (registration number: CRD42016046484).
METHODS: The questionnaire was distributed physically and digitally to non-OGS users aged above 60, living in the Klang Valley, Malaysia, using a non-probability sampling approach. A total of 302 data were analysed using PLS structural equation modelling.
RESULTS: The findings indicate that perceived ease of use, functional ability, life-course events, and digital literacy are associated with the elderly's perception of OGS's usefulness, while life-course events, digital literacy, technology anxiety, and facilitating conditions are associated with the perceived ease of use.
CONCLUSION: This study contributes to the OGS literature by addressing ageing complexities with OGS adoption among the elderly population, thereby offering insights for marketers and the government to tailor services and provide relevant support.
OBJECTIVE: This research aims to determine factors influencing students' behavioural intention to use Rain Classroom.
METHODS: In this cross-sectional and correlational investigation, 1138 medical students from five medical universities in Guangxi Province, China, made up the sample. This study added self-efficacy (SE), motivation (MO), stress (ST), and anxiety (AN) to the UTAUT framework. This study modified the framework by excluding actual usage variables and focusing only on intention determinants. SPSS-26 and AMOS-26 were used to analyze the data. The structural equation modelling technique was chosen to confirm the hypotheses.
RESULTS: Except for facilitating conditions (FC), all proposed factors, including performance expectancy (PE), effort expectancy (EE), social influence (SI), self-efficacy (SE), motivation (MO), anxiety (AN), and stress (ST), had a significant effect on students' behavioural intentions to use Rain Classroom.
CONCLUSIONS: The research revealed that the proposed model, which was based on the UTAUT, is excellent at identifying the variables that influence students' behavioural intentions in the Rain Classroom. Higher education institutions can plan and implement productive classrooms.
METHODS: Randomized controlled trials and cohort studies with a minimum 2-year follow-up assessing survival and complication rates of resin composite laminate veneers on permanent dentition from 1998 to May 2022. Literature searches were conducted in MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Trials electronic databases. References cited in the related reviews and included full-text articles were also hand-searched to further identify potentially relevant studies.
RESULTS: A total of 827 articles were identified. Twenty-two studies were considered for full-text review after the title and abstract screening stage. After exclusion, 7 studies (3 randomized controlled trials and 4 cohort studies) were included in the systematic review. Three published scales were adopted for the quality and risk of bias assessment. At the survival rate threshold, the overall heterogeneity (I2) for randomized controlled trials was 50.5% (P = .108). The overall pooled survival rate of the randomized controlled trials was 88% (95% CI: 81%-94%), with the mean follow-up time ranging from 24 to 97 months. Surface roughness, color mismatch, and marginal discoloration were the most reported complications.
CONCLUSION: Resin composite laminate veneers demonstrated moderately high survival rates for the entire sample and the direct laminate veneer group demonstrated higher survival rates than the indirect approach. Most of the complications were regarded as clinically acceptable with or without reintervention.