Objective: The objective was to determine the survival rates and prognostic factors of survival in HIV-infected adults treated with ART in Malaysia.
Materials and Methods: This retrospective cohort study considered all HIV-positive adult patients registered in Sungai Buloh Hospital, a major referral center in Malaysia, between January 1, 2007 and December 31, 2016. Then, patients were selected through a systematic sampling method. Demographic, clinical, and treatment data were extracted from electronic medical records. Person-years at risk and incidence of mortality rate per 100 person-years were calculated. The Kaplan-Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.
Results: A total of 339 patients were included. The estimated overall survival rates were 93.8%, 90.4%, 84.9%, and 72.8% at 1, 3, 5, and 10 years, respectively, from ART initiation. The results of multiple Cox proportional hazard regression indicated that anemic patients were at a 3.76 times higher risk of mortality (95% confidence interval [CI]: 1.97-7.18; P < 0.001). The hazard risk was 2.09 times higher for HIV patients co-infected with tuberculosis (95% CI: 1.10, 3.96; P = 0.024).
Conclusion: The overall survival rates among HIV-infected adults in this study are higher than that from low-income countries but lower than that from high-income countries. Low baseline hemoglobin levels of <11 g/dL and tuberculosis co-infection were strong prognostic factors for survival.
Materials and Methods: A total of 3701 patients visited the clinics during the study period. Through the use of radiographs, 161 patients were initially selected who had endodontically treated teeth. However, after applying the inclusion criteria, the total number of eligible cases was reduced to 155. Patients were divided into three groups according to age (children 1-12 years, adults 13-65 years and geriatrics >65 years).
Results: On average, each patient had 2.28 ± 1.88 root canal-treated teeth and 24.02 ± 5.03 teeth without root canal treatment. The average number of endodontically treated teeth increased with an increase in age. The adult group showed the highest number of root-filled teeth 314 (93.4%). Of the 336 endodontically treated teeth, only 75 (22.3%) teeth exhibited periapical radiolucency. First molars (28.43-36.36%) and second premolars (20.1-27.27%) were the most frequently root-filled teeth in both jaws, followed by the first maxillary premolars (11.76%). Periapical lesions showed an almost similar pattern with the highest number of radiolucencies found in the first molars in both jaws (29.3-33.3%) followed by the second premolars in the mandible (30.6%) and first premolars in both jaws (20.8-25%).
Conclusion: The first molars and second premolars were the most frequently root-filled teeth in both jaws, followed by maxillary first premolars. Periapical lesions showed an almost similar pattern among teeth with a higher number of radiolucencies found in the first molars in both jaws, followed by the second premolars in the mandible and the first premolars in both jaws.
OBJECTIVE: To determine the predictors of repeat CS among women from Malaysia with one previous lower segment CS (LSCS) who underwent trial of labor (TOLAC).
MATERIALS AND METHODS: This retrospective cohort study included women with one previous LSCS who followed up and delivered their current pregnancy at Hospital Universiti Sains Malaysia (USM), Kelantan, Malaysia, between January 01, 2016, and December 31, 2017. Women with singleton pregnancies were included while those who had a history of classical CS, current pregnancy with preterm birth, non-cephalic pregnancy, lethal fetal anomalies, uterine rupture, and severe preeclampsia or planned for elective CS were excluded. Logistic regressions were performed.
RESULTS: The study included 388 women who underwent TOLAC and successfully gave childbirth through vaginal birth after cesarean (VBAC) (n = 194) or emergency LSCS (n = 194). Factors significantly associated with repeat CS were no history of vaginal delivery (adjusted odds ratio (aOR): 2.71; 95% confidence interval (CI): 1.60, 4.60; P < 0.001), estimated fetal weight ≥3500 grams (aOR: 4.78; 95% CI: 2.45-9.34; P < 0.001), and presence of meconium-stained liquor (aOR: 2.40; 95% CI: 1.33-4.35; P = 0.004).
CONCLUSION: The above-mentioned predictors of a repeat CS among women from Malaysia with one previous LSCS who underwent TOLAC can be useful for clinicians in making an informed decision.