Objective
To examine the results of the Malaysian Advanced Prostate Cancer Consensus Conference (MyAPCCC) 2018, held for assessing the generalizability of consensus reached at the Advanced Prostate ...Cancer Consensus Conference (APCCC 2017) to Malaysia, a middle‐income country.
Methods
Six key sections were chosen: (1) high‐risk localized and locally advanced prostate cancer, (2) oligometastatic prostate cancer, (3) castration‐naïve prostate cancer, (4) castrate resistant prostate cancer, (5) use of osteoclast‐targeted therapy and (6) global access to prostate cancer drugs. There were 101 consensus questions, consisting of 91 questions from APCCC 2017 and 10 new questions from MyAPCCC 2018, selected and modified by the steering committee; of which, 23 questions were assessed in both ideal world and real‐world settings. A panel of 22 experts, comprising of 11 urologists and 11 oncologists, voted on 101 predefined questions anonymously. Final voting results were compared with the APCCC 2017 outcomes.
Results
Most voting results from the MyAPCCC 2018 were consistent with the APCCC 2017 outcomes. No consensus was achieved for controversial topics with little level I evidence, such as management of oligometastatic disease. No consensus was reached on using high‐cost drugs in castration‐naïve or castration‐resistant metastatic prostate cancer in real‐world settings. All panellists recommended using generic drugs when available.
Conclusions
The MyAPCCC 2018 voting results reflect the management of advanced prostate cancer in a middle‐income country in a real‐world setting. These results may serve as a guide for local clinical practices and highlight the financial challenges in modern healthcare.
Introduction
Uveitis is one of the common causes of visual impairment in Malaysia. It remains a challenging entity to diagnose and manage due to variation in its clinical presentation. This study ...aims to observe the demographic and clinical pattern of cases from the participating ophthalmology units in Malaysia.
Methods
This study involved prospective and multicentered data collection for patients newly diagnosed with uveitis from 1
st
January 2018 to 31
st
December 2018. Variables collected and analyzed included age, gender, ethnicity, nationality, state of origin, laterality, granulomatous or non-granulomatous uveitis, and etiology of uveitis.
Results
A total of 1199 newly diagnosed uveitis patients were analyzed within the study period. There was a significant association between the anatomical location of uveitis with age at presentation. The percentage of patients with anterior uveitis was higher in the ‘40 to 60’ years and ‘above 60’ years age groups at 52.1% (
n
= 210) and 61.3% (
n
= 114) respectively. In contrast the percentage of patients with posterior and panuveitis was higher in the 1 to 20 and 20 to 40 years age groups at 51.4% (
n
= 54) and 48.7% (
n
= 246) respectively.
Sixty three percent of the patients presented with unilateral uveitis (
n
= 760,
p
< 0.001) vs bilateral. Non-granulomatous uveitis comprised 84.5% of all patients (
n
= 1013,
p
< 0.001) compared to granulomatous uveitis. Non-infectious etiology contributed to 65.7% of all patients (
n
= 788,
p
< 0.001) with the majority being unclassifiable uveitis (
n
= 686, 57.2%,). Specific inflammatory entities contributed to only 8.5% (
n
= 102) of the non-infectious causes with Vogt-Koyanagi-Harada (VKH) syndrome being the most common (
n
= 25, 2.1%,). Infectious uveitis comprised 34.3% (
n
= 411) with tubercular (TB) uveitis (
n
= 105, 8.8%) and viral uveitis (
n
= 107, 8.9%) contributing the most followed by ocular Toxoplasmosis (
n
= 93,7.8%).
Conclusion
This study has highlighted the demographic data and common causes of uveitis in Malaysia.
Summary While electrocardiogram (ECG) changes are common during viral dengue infection, atrial fibrillation (AF) is a very rare manifestation. It has previously been highlighted that cardiac ...complications during dengue infection are invariably transient and will spontaneously resolve following recovery from the illness. We present the case of a young patient with IgM- and IgG-positive dengue hemorrhagic fever complicated by AF. ECG revealed a structurally normal heart. The patient remained in AF despite resolution of the illness. Reversion to normal sinus rhythm was achieved after loading of oral amiodarone.
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