Background: Colorectal cancer (CRC) is the most common gastrointestinal cancer and the incidence is increasing. CRC is more common with increasing age, but a proportion occurs in young adults, termed young CRC. This study assessed the incidence and the demographic of young CRC in Brunei Darussalam. Materials and Methods: All histologically proven CRC between 1986 and 2014 registered with the Department of Pathology cancer registry were reviewed and data extracted for analyses. Young CRC was defined as cancer in patients aged less than 45 years. The various population groups were categorized into locals (Malays, Chinese and Indigenous) and expatriates. Results: Over the study period, there were 1,126 histologically proven CRC (mean age 59.1 ± 14.7 years, Male 58.0%, Locals 91.8% and 8.2% expatriates). Young CRC accounted for 15.1% with the proportion declining over the years, from 29% (1986-1990) to 13.2% (2011-2014). The proportion of young CRC was highest among the indigenous (30.8%), followed by the expatriates (29.3%), Malays (14.3%) and lowest among the Chinese (10.8%). The mean age of young CRC was 35.9 ± 6.2; lowest among the indigenous (33.5 ± 6.7), expatriate (34.9 ± 6.0) groupd and the Malays (35.6 ± 6.5) compared to the Chinese (38.6 ± 4.6), a similar trend being observed in the non-young CRC groups. There were no difference between the genders and tumor locations (rectum or colon) between the young and the non-young CRC cases. Female young CRC was significantly younger than male (p<0.05) without any significant variation between the various population groups (p>0.05). Conclusions: Our study showed that the young CRC accounted for 15.1% of all CRC with declining trend observed over recent years. Young CRC was more common among indigenous, expatriates and Malays and least common among the Chinese. There were no differences in the gender and tumor locations.

respiratory, cutaneous/ limb and urinary tract (41.7%, 26.4% and 20.8% respectively). Positivity of blood cultures were 43.1%. A total of 66 subjects (91.7%) were mechanically ventilated (median duration 5 days), while 59 (81.9%) required inotropic support (median duration 3 days). Modalities for RRT were haemodialysis (HD) in 84.7% of cohort (n ¼ 61), peritoneal dialysis (PD) in 4.2% of cohort (n ¼ 3), or a combined modality of HD and PD in 11.1% of cohort (n ¼ 8). Median HD catheter days and PD catheter days were 4 days (IQR 3 days) and 2 days (IQR 3 days) respectively. Percentages of subjects receiving 1, 2, 3 and > 4 sessions of HD were 44.1%, 26.5%, 8.8% and 20.6% respectively. Median length of hospitalisation was 14 days (IQR 16 days) with in-hospital mortality of 54.2% (n¼ 39). Causes of death attributed directly to index infection, nosocomial infection and noninfectious causes were 74.4%, 10.3% and 15.4% respectively. Among survivors, 11 (34.4%) were functionally dependent at discharge. Predictors of mortality were use of mechanical ventilation, inotrope use, younger patients, and cutaneous/ limb infection. Comorbidities, CKD status, CCI, positivity of blood culture and SOFA score did not predict mortality. Conclusion: Mortality and morbidity remain high for patients with SA-AKI requiring RRT, primarily driven by the index infection.

Chronic kidney disease is the progressive loss of kidney function over months or years. The significant increase in new cases of chronic kidney disease is in line with the increasing number of patients undergoing hemodialysis as kidney replacement therapy in an effort to survive. Comorbid cardiovascular disease is a major risk factor for morbidity and mortality with chronic kidney disease. The study was conducted to determine the survival of hemodialysis patients in the group with comorbid cardiovascular disease and the group without comorbid cardiovascular disease. This study used a retrospective cohort design. The location of this study was conducted at Persahabatan Central Public Hospital, DKI Jakarta, and used secondary data from the hospital information system data from 2015 to 2019. The variables significantly related to the survival of patients undergoing hemodialysis with comorbid cardiovascular disease were age, complications of anemia, diabetes mellitus, and hypertension. The age variable has a p-value of 0.029 with an HR of 1.54 (95% CI OR 1.043-2.262). The anemia variable has a p-value of 0.013 with an HR of 1.60 (95% CI 1.117-2.515). The diabetes mellitus variable has a p-value of 0.000 with HR2.71 (95% CI 1.780-4.11). The hypertension variable has a p-value of 0.004 with HR1.79 (95% CI 1.208-2.646). In conclusion, patients undergoing hemodialysis with comorbid cardiovascular disease have a risk of death of 0.76 times compared to patients undergoing hemodialysis with the comorbid non-cardiovascular disease. This study's internal validity was not good due to selection bias and non-differential misclassification information bias. Thus, the results of this study cannot be generalized.