Detailed anatomical volumetric study of deep nuclei of brain and other structures between parkinson's disease patients who had deep brain stimulation (DBS) and control group

Background: In my country, Deep Brain stimulation surgery (DBS) was pioneered by Neuroscience team Hospital Universiti Sains Malaysia (HUSM) nearly a decade ago. The treatment was mainly directed to advanced Idiopathic Parkinson’s Disease (PD) patients. Objectives: It is known that volume reduction occurs with age, we searched to define the degree of volume discrepancy in PD patients and attempted to correlate the anatomical volumetric changes to motor symptoms and cognitive function. Methods: The research aimed to establish a baseline Magnetic resonance imaging (MRI) based volumetric analysis of the seven brain structures (Head of caudate nucleus, Putamen, Thalamus, Globus pallidus, Hippocampal head, Amygdala & Subthalamic nucleus) of selected pre-DBS advanced PD patients in comparison to matched healthy controls. Results: Significant atrophy and volume discrepancy were observed in PD surgical group, though thalamus and amygdala were not affected. Positive correlation of globus pallidus volume to higher mental function in the absence of cognitive or behavioural problem. Conclusions: These findings might imply that structural alteration could be the early changes prior to clinical manifestation and PD involves multiple alternative pathway other than nigrostriatal circuit

A review of clinical and surgical outcomes of endoscopic endonasal skull base surgery in a Tertiary Center in Sarawak

Background: Endoscopic endonasal approach (EEA) for skull base tumor has been extensively developed in recent years. Objectives: To review the demographic data, indications, clinical presentations and surgical outcomes of endoscopic endonasal skull base surgeries performed. Methods: A retrospective analysis on all patients who had undergone endoscopic endonasal skull base surgery at the Skull Base Unit (ENT & Neurosurgery) from December 2013 to December 2015. Results: A total 34 cases were operated on during the study period. Female patients account for 44% of patients while 56% were male patients, with ages ranging from 8 to 77 years, with the mean age of 51.88 years. Majority of the cases were pituitary tumors (41%), followed by sinonasal tumors (15%), meningioma (12%), clival tumor (8%), cerebrospinal fluid (CSF) leak repair (8%) and frontal mucocoele (6%). Transsellar approach was the commonest approach (41%) followed by the transclival, transplanum, transfrontal approaches. In about 80% of cases, CSF leak was encountered intraoperatively and was successfully repaired endoscopically with the Hadad-Bassagasteguy flap and with the insertion of a lumbar drain. Only one case (3%) of CSF leak was noted postoperatively which was then successful repaired endoscopically with a nasoseptal flap. Systemic complications and intracranial infections were seen in 3 cases (8%) and were managed accordingly. No cases of epitaxis requiring surgical intervention were noted post operatively

An empirical study on buyer's key factors of consideration for capital equipment purchases in Singapore.

In this research, the key factors of consideration and frustration encountered by the buyers and perceived by the supplier of wafer fabrication capital equipment in Singapore were surveyed and discussed. The survey showed that both suppliers and buyers agreed on the relative importance of key categories of consideration.Master of Business Administration (Management of Technology

Switching behaviour of retail banking customers in Singapore

87 p.The present study sought to establish the extent to which Singaporeans have switched banks in the past and the reasons which caused switching to take place. The study also attempted to distinguish switchers from non-switchers using demographic and psychographic variables.ACCOUNTANC

Tourism marketspace on the Internet.

According to WTTC, Travel & Tourism is the world's largest industry and generator of quality jobs. In Singapore, its many economic spin-offs on related industries have probably made it the most important sector of Singapore's economy. Singapore now faces growing competition from its regional neighbours. Coupled with its inherent lack of natural resources, Singapore must critically enhance its attractiveness as a tourist destination and create new room for the growth of the local tourism industry if it wants to remain in business.Master of Business Administration (Accountancy

A cross-sectional study of gender differences in lifestyle behavior and usage of medications among community-dwelling Asians towards achieving their LDL-Cholesterol treatment goals

Background: Men differ from women in their cardiovascular mortality and morbidity globally, possibly due to their varying dietary and lifestyle behavior and usage of medications in dyslipidemia control. Objectives: The study aimed to compare the gender differences among community-dwelling Asians in their dietary habits, physical activity, their perception and use of lipid-lowering medications towards achieving their LDL-Cholesterol goals. Methods: A cross-sectional study was conducted, which included patients with physician-diagnosed dyslipidemia, aged 31–80 years in two public primary care clinics in Singapore. They were administered a questionnaire survey on their diet, exercise and lipid-lowering medication. Their latest laboratory fasting lipid tests, retrieved from their electronic health records, defined their treatment goals based on adapted Framingham risk scores. Results: Amongst 1093 patients, 61.9% were female. Fewer men (65.9%) achieved LDL-C treatment goals compared with women (75.2%). Comparing with their counterpart, more women were willing to change their diet (75.8% vs. 46.2%) and exercise (78.4% vs. 70.9%) to achieve their LDL treatment goals. However, men who were treated with lipid medication were more likely to reach LDL-C treatment goals. Conclusion: Fewer Asian men in Singapore attained their LDL-C treatment goals than women, which appeared to be associated with greater reluctance to embark on dietary and lifestyle changes. Gender-specific interventions should be considered to address these differences

Implications of corporate email on company liability.

This paper presents legal issues that companies may face with regards to their corporate e-mail accounts. A standard e-mail policy is drafted with the aim of helping companies to guard against any legal actions taken against them

Ultrasound-Guided Scalp Blocks for an Awake Craniotomy: A Case Report

Ultrasound-guided scalp blocks may revolutionize regional anesthesia for neurosurgery. In this report, we demonstrate that ultrasound-guided scalp blocks can be used effectively for a craniotomy. A 48-year-old patient with a brain tumor at the motor cortex was scheduled for an awake craniotomy. Ultrasound-guided scalp blocks targeting the bilateral supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater auricular, lesser occipital, greater occipital, and third occipital nerves were performed. A total of 29mL of levobupivacaine 0.3% was used. No additional local anesthetic agent was given for skull pinning, skin incision, or the craniotomy. Postoperatively, the patient remained pain-free, and she was discharged without complications. (A&A Practice. 2022;16:e01618.

Strategic alliance : in search of success

This is a discussion on the strong emergence of strategic alliances in the global market, followed by an assessment of the reasons behind it so that firms can realise why strategic alliance is of importance to them if they want to succeed in an increasingly competitive global market.BUSINES