TSH suppression combined with CBZ has little or no effect on remission and relapse rates in Graves' disease patients.

Varying duration and degree of exposure to malnutrition and iodine deficiency resulted in different mean levels of T4, TSH, IGF-I and IGFBP-3 in the three areas. The strong positive associations between IGF-I and IGFBP-3 levels and height SDS suggest that these biochemical measurements are indeed useful indicators of growth and nutritional status in children. The significant correlations between T4 and IGFBP-3 and IGF-1 suggests the importance of thyroid hormones in regulating the synthesis of these growth factors. The age-related increase of these growth factors even amongst malnourished, iodine deficient children implies that age-matched reference ranges are essential for proper evaluation of laboratory results.

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Malaysia always strives to provide high-performance education for its citizens by emphasising on the principle of equality that prioritises quality education for every child. However, the performance of Orang Asli (indigenous) children in science education is still lagging far behind as a result of their difficulty in understanding scientific concepts of science which they feel are foreign to their culture. Thus, a needs analysis study was conducted to identify the science topics that are the most difficult for primary school year five Semai Orang Asli children to understand and the elements of funds of knowledge (FOK) that can be applied in science teaching for these difficult topics. This needs analysis was conducted using survey research design with interview method. The study sample comprised three students and four teachers in an Orang Asli school in the district of Slim River, Perak. The needs analysis found that Electricity is the most difficult topic to be taught to and understood by the Orang Asli children. In addition, the findings also showed that the elements of FOK of the Orang Asli such as family values, hobbies, parents’ occupation, language, religion, tradition and school’s co-curricular activities can be applied in science teaching to bring the science concepts that are considered difficult into their lives. In conclusion, the FOK elements identified from the needs analysis are expected to be able to help educators and researchers design science teaching that is more equitable in upholding the principles of equity in education in Malaysia.

Introduction: Research suggests that neighborhood-level factors are associated with long-term health; however, there is a dearth of research evaluating this association among patients (pts) undergoing percutaneous coronary intervention (PCI), a population that is usually optimally treated with respect to long-term risk management. Hypothesis: We hypothesize that pts living in the most disadvantaged areas have a higher risk of post-discharge mortality after PCI compared with pts not living in the most disadvantaged areas. Methods: Using a clinical registry of pts with valid zip codes who underwent PCI between 1/2013 - 3/2018 at 47 Michigan hospitals linked to Medicare claims, we compared long-term outcomes between pts in the highest ADI decile (i.e. most disadvantaged) with the remainder. The Area Deprivation Index (ADI) is a zip-code-level composite measure of neighborhood disadvantage. Unadjusted mortality was depicted on a Kaplan-Meier plot. We used a Cox model to assess the association between the ADI and mortality after adjusting for pt factors. Results: Among 26,164 pts, 9.9% lived in the most disadvantaged zip codes and were more likely to be younger, of black race, have both Medicare and Medicaid insurance, and have more cardiovascular comorbidities. Unadjusted rates of mortality were higher among pts living in the most disadvantaged areas compared with the remainder (5-yr mortality: 64.5% vs 70.9%; Fig). After adjusting for pt factors, those living in the most disadvantaged areas had a significantly increased risk of long-term mortality (HR 1.16; 95% CI 1.08 - 1.25), a risk equivalent to an 8% reduction in one’s ejection fraction (HR for 8% EF reduction: 1.16; 95% CI 1.14 - 1.17). Conclusions: Medicare pts living in the most disadvantaged areas have a higher risk of post-PCI long-term mortality compared with the remainder. Policies targeting the deleterious health effects of neighborhood disadvantage and social risk are needed to improve survival after PCI.