Browse publications by year: 2013

Description of Goussia kuehae n. sp. (Apicomplexa: Eimeriidae) infecting the Asian seabass, Lates calcarifer (Bloch) (Perciformes: Latidae), cultured in Malaysian fish farms

Székely C, Borkhanuddin MH, Shaharom F, Embong MS, Molnár K

Syst Parasitol, 2013 Nov;86(3):293-9.
PMID: 24163029 DOI: 10.1007/s11230-013-9448-1

Culturing fishes in marine cages is a rapidly developing area of marine aquaculture. The Asian seabass Lates calcarifer (Bloch) is a fast growing good quality fish that is readily cultured in intensive systems in the South Asian region and in Malaysia in particular. Although several papers have been published to date on viral, bacterial, parasitic and fungal organisms causing diseases in the Asian seabass, the occurrence of a coccidian infection in this species has only recently been recorded. We collected sporulated and unsporulated oöcysts of a new species of Goussia Labbé, 1986, from the mucus covering the epithelium of the intestine of L. calcarifer. This paper provides a description of Goussia kuehae n. sp. Sporulated oöcysts of this species are ellipsoidal, 37-40 μm in length and 28-30 μm in width. The ellipsoidal sporocysts are relatively small, 15.2-17 × 5.7-8 μm, and located loosely in the oöcyst. There are residual bodies both in the oöcysts and the sporocysts. Goussia kuehae n. sp. differs from all known species of Goussia in the large size of the oöcysts and in having two types of oöcyst residuum.

MeSH terms: Animals; Coccidiosis/parasitology; Coccidiosis/veterinary*; Fish Diseases/parasitology*; Fisheries; Malaysia; Perciformes/parasitology*; Eimeriidae/classification*; Eimeriidae/cytology*
Fulltext Competitive interaction of Axonopus compressus and Asystasia gangetica under contrasting sunlight intensity

Samedani B, Juraimi AS, Anwar MP, Rafii MY, Sheikh Awadz SH, Anuar AR

ScientificWorldJournal, 2013;2013:308646.
PMID: 24163618 DOI: 10.1155/2013/308646

Axonopus compressus is one of the native soft grass species in oil palm in Malaysia which can be used as a cover crop. The competitive ability of A. compressus to overcome A. gangetica was studied using multiple-density, multiple-proportion replacements series under a glasshouse and full sunlight conditions in a poly bag for 10 weeks. A. compressus produced more dry weight and leaf area when competing against A. gangetica than in monoculture at both densities in the full sunlight and at high density in the shade. Moreover, the relative yield and relative crowding coefficients also indicated A. compressus is a stronger competitor than A. gangetica at both densities in the full sunlight and high density in the shade. It seemed that A. gangetica plants in the shade did not compete with each other and were more competitive against A. compressus as could influence A. compressus height in the shade. It is concluded that although suppression of A. gangetica by A. compressus occurred under full sunlight, irrespective of plant density, this ability reduced under shade as A. compressus density decreased. The result suggests that A. compressus in high density could be considered as a candidate for cover crops under oil palm canopy.

MeSH terms: Sunlight*; Acanthaceae/growth & development*; Acanthaceae/radiation effects
Fulltext Stabilizing effect of various polyols on the native and the denatured states of glucoamylase

Zaroog MS, Abdul Kadir H, Tayyab S

ScientificWorldJournal, 2013;2013:570859.
PMID: 24163624 DOI: 10.1155/2013/570859

Different spectral probes were employed to study the stabilizing effect of various polyols, such as, ethylene glycol (EG), glycerol (GLY), glucose (GLC) and trehalose (TRE) on the native (N), the acid-denatured (AD) and the thermal-denatured (TD) states of Aspergillus niger glucoamylase (GA). Polyols induced both secondary and tertiary structural changes in the AD state of enzyme as reflected from altered circular dichroism (CD), tryptophan (Trp), and 1-anilinonaphthalene-8-sulfonic acid (ANS) fluorescence characteristics. Thermodynamic analysis of the thermal denaturation curve of native GA suggested significant increase in enzyme stability in the presence of GLC, TRE, and GLY (in decreasing order) while EG destabilized it. Furthermore, CD and fluorescence characteristics of the TD state at 71°C in the presence of polyols showed greater effectiveness of both GLC and TRE in inducing native-like secondary and tertiary structures compared to GLY and EG.

MeSH terms: Circular Dichroism; Enzyme Stability/drug effects; Glucan 1,4-alpha-Glucosidase/chemistry*; Glycerol/pharmacology; Polymers/pharmacology*; Trehalose/pharmacology; Protein Folding/drug effects; Ethylene Glycol/pharmacology
Fulltext Assessing the ecological risk of polycyclic aromatic hydrocarbons in sediments at Langkawi Island, Malaysia

Nasher E, Heng LY, Zakaria Z, Surif S

ScientificWorldJournal, 2013;2013:858309.
PMID: 24163633 DOI: 10.1155/2013/858309

Tourism-related activities such as the heavy use of boats for transportation are a significant source of petroleum hydrocarbons that may harm the ecosystem of Langkawi Island. The contamination and toxicity levels of polycyclic aromatic hydrocarbon (PAH) in the sediments of Langkawi were evaluated using sediment quality guidelines (SQGs) and toxic equivalent factors. Ten samples were collected from jetties and fish farms around the island in December 2010. A gas chromatography/flame ionization detector (GC/FID) was used to analyse the 18 PAHs. The concentration of total PAHs was found to range from 869 ± 00 to 1637 ± 20 ng g⁻¹ with a mean concentration of 1167.00 ± 24 ng g⁻¹, lower than the SQG effects range-low (3442 ng g⁻¹). The results indicated that PAHs may not cause acute biological damage. Diagnostic ratios and principal component analysis suggested that the PAHs were likely to originate from pyrogenic and petrogenic sources. The toxic equivalent concentrations of the PAHs ranged from 76.3 to 177 ng TEQ/g d.w., which is lower compared to similar studies. The results of mean effects range-median quotient of the PAHs were lower than 0.1, which indicate an 11% probability of toxicity effect. Hence, the sampling sites were determined to be the low-priority sites.

MeSH terms: Environmental Monitoring/methods*; Malaysia; Polycyclic Hydrocarbons, Aromatic/analysis*; Geologic Sediments/analysis*
Fulltext The effects of water parameters on monthly seagrass percentage cover in Lawas, East Malaysia

Ahmad-Kamil EI, Ramli R, Jaaman SA, Bali J, Al-Obaidi JR

ScientificWorldJournal, 2013;2013:892746.
PMID: 24163635 DOI: 10.1155/2013/892746

Seagrass is a valuable marine ecosystem engineer. However, seagrass population is declining worldwide. The lack of seagrass research in Malaysia raises questions about the status of seagrasses in the country. The seagrasses in Lawas, which is part of the coral-mangrove-seagrass complex, have never been studied in detail. In this study, we examine whether monthly changes of seagrass population in Lawas occurred. Data on estimates of seagrass percentage cover and water physicochemical parameters (pH, turbidity, salinity, temperature, and dissolved oxygen) were measured at 84 sampling stations established within the study area from June 2009 to May 2010. Meteorological data such as total rainfall, air temperature, and Southern Oscillation Index were also investigated. Our results showed that (i) the monthly changes of seagrass percentage cover are significant, (ii) the changes correlated significantly with turbidity measurements, and (iii) weather changes affected the seagrass populations. Our study indicates seagrass percentage increased during the El-Nino period. These results suggest that natural disturbances such as weather changes affect seagrass populations. Evaluation of land usage and measurements of other water physicochemical parameters (such as heavy metal, pesticides, and nutrients) should be considered to assess the health of seagrass ecosystem at the study area.

MeSH terms: Environmental Monitoring/methods*; Malaysia; Seawater/analysis; Water/analysis*
Fulltext Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration

Abu Hassan H, Tohid H, Mohd Amin R, Long Bidin MB, Muthupalaniappen L, Omar K

BMC Fam Pract, 2013 Oct 29;14:164.
PMID: 24164794 DOI: 10.1186/1471-2296-14-164

BACKGROUND: Many Type 2 Diabetes Mellitus (T2DM) patients refuse insulin therapy even when they require this modality of treatment. However, some eventually accept insulin. This study aimed to explore the T2DM patients' reasons for accepting insulin therapy and their initial barriers to use insulin.
METHODS: This qualitative study interviewed twenty-one T2DM patients at a primary care clinic who had been on insulin for more than a year through three in-depth interviews and three focus group discussions. A semi structured interview protocol was used and the sessions were audio-recorded. Subsequently, thematic analysis was conducted to identify major themes.
RESULTS: The participants' acceptance of insulin was influenced by their concerns and beliefs about diabetes and insulin. Concerns about complications of poorly controlled diabetes and side effects of other treatment regime had resulted in insulin acceptance among the participants. They also had a strong belief in insulin benefits and effectiveness. These concerns and beliefs were the results of having good knowledge about the diabetes and insulin, experiential learning, as well as doctors' practical and emotional support that helped them to accept insulin therapy and become efficient in self-care management. These factors also allayed their negative concerns and beliefs towards diabetes and insulin, which were their barriers for insulin acceptance as it caused fear to use insulin. These negative concerns were related to injection (self-injection, needle phobia, injection pain), and insulin use (inconvenience, embarrassment, lifestyle restriction, negative social stigma, and poor self-efficacy), whereas the negative beliefs were 'insulin could cause organ damage', 'their diabetes was not serious enough', 'insulin is for life-long', and 'insulin is for more severe disease only'.
CONCLUSIONS: Exploring patients' concerns and beliefs about diabetes and insulin is crucial to assist physicians in delivering patient-centered care. By understanding this, physicians could address their concerns with aim to modify their patients' misconceptions towards insulin therapy. In addition, continuous educations as well as practical and emotional support from others were found to be valuable for insulin acceptance.
TRIAL REGISTRATION: Universiti Kebangsaan Malaysia FF-214-2009.

MeSH terms: Adult; Aged; Ambulatory Care Facilities; Attitude to Health*; Diabetes Mellitus, Type 2/drug therapy*; Diabetes Mellitus, Type 2/psychology; Female; Humans; Hypoglycemic Agents/therapeutic use*; Insulin/therapeutic use*; Malaysia; Male; Middle Aged; Patient Acceptance of Health Care*; Primary Health Care*; Self Care/psychology; Focus Groups; Self Efficacy; Qualitative Research; Social Stigma
Fulltext Complete life cycle of a pennellid Peniculus minuticaudae Shiino, 1956 (Copepoda: Siphonostomatoida) infecting cultured threadsail filefish, Stephanolepis cirrhifer

Ismail N, Ohtsuka S, Maran BA, Tasumi S, Zaleha K, Yamashita H

Parasite, 2013;20:42.
PMID: 24165196 DOI: 10.1051/parasite/2013041

The complete life cycle of a pennellid copepod Peniculus minuticaudae Shiino, 1956 is proposed based on the discovery of all post-embryonic stages together with the post-metamorphic adult females infecting the fins of threadsail filefish Stephanolepis cirrhifer (Monacanthidae) cultured in a fish farm at Ehime Prefecture, Japan. The hatching stage was the infective copepodid. The life cycle of P. minuticaudae consists of six stages separated by moults: the copepodid, four chalimi and adult. In this study, the adult males were observed frequently in precopulatory amplexus with various stages of females however, copulation occurs only between adults. Fertilized pre-metamorphic adult females carrying spermatophores may detach from the host and settle again before undergoing massive differential growth into the post-metamorphic adult female. Comparison of the life cycle of P. minuticaudae has been made with three known pennellids: Lernaeocera branchialis (Linnaeus, 1767), Cardiodectes medusaeus (Wilson, 1908) and Lernaeenicus sprattae (Sowerby, 1806). Among the compared species, P. minuticaudae is the first ectoparasitic pennellid to be discovered to complete its life cycle on a single host without any change in infection site preferences between infective copepodid and fertilized pre-metamorphic female.

MeSH terms: Animals; Ectoparasitic Infestations/parasitology; Ectoparasitic Infestations/veterinary*; Female; Fish Diseases/parasitology*; Life Cycle Stages*; Male; Microscopy, Electron, Scanning/veterinary; Sex Characteristics; Tetraodontiformes/parasitology*; Copepoda/growth & development*; Copepoda/ultrastructure
Fulltext Changes following nipple areolar complex reconstruction and tattooing resembling a recurrent Paget's disease of the breast

Hanafiah M, Alhabshi SM, Mahin AH

BMJ Case Rep, 2013;2013.
PMID: 24165504 DOI: 10.1136/bcr-2013-201281
MeSH terms: Breast Neoplasms/diagnosis; Breast Neoplasms/surgery*; Diagnosis, Differential; Female; Follow-Up Studies; Foreign-Body Reaction/diagnosis; Foreign-Body Reaction/pathology*; Foreign-Body Reaction/therapy; Humans; Immunohistochemistry; Mammography/methods; Middle Aged; Neoplasm Recurrence, Local/diagnosis; Neoplasm Recurrence, Local/pathology*; Nipples/pathology; Nipples/surgery*; Paget's Disease, Mammary/diagnosis; Paget's Disease, Mammary/surgery*; Postoperative Complications/pathology; Postoperative Complications/ultrasonography; Tattooing/adverse effects*; Mammaplasty/adverse effects; Mammaplasty/methods; Risk Assessment; Ultrasonography, Doppler; Biopsy, Large-Core Needle/methods
Fulltext Developmental origins of the world's largest flowers, Rafflesiaceae

Nikolov LA, Endress PK, Sugumaran M, Sasirat S, Vessabutr S, Kramer EM, et al.

Proc Natl Acad Sci U S A, 2013 Nov 12;110(46):18578-83.
PMID: 24167265 DOI: 10.1073/pnas.1310356110

Rafflesiaceae, which produce the world's largest flowers, have captivated the attention of biologists for nearly two centuries. Despite their fame, however, the developmental nature of the floral organs in these giants has remained a mystery. Most members of the family have a large floral chamber defined by a diaphragm. The diaphragm encloses the reproductive organs where pollination by carrion flies occurs. In lieu of a functional genetic system to investigate floral development in these highly specialized holoparasites, we used comparative studies of structure, development, and gene-expression patterns to investigate the homology of their floral organs. Our results surprisingly demonstrate that the otherwise similar floral chambers in two Rafflesiaceae subclades, Rafflesia and Sapria, are constructed very differently. In Rafflesia, the diaphragm is derived from the petal whorl. In contrast, in Sapria it is derived from elaboration of a unique ring structure located between the perianth and the stamen whorl, which, although developed to varying degrees among the genera, appears to be a synapomorphy of the Rafflesiaceae. Thus, the characteristic features that define the floral chamber in these closely related genera are not homologous. These differences refute the prevailing hypothesis that similarities between Sapria and Rafflesia are ancestral in the family. Instead, our data indicate that Rafflesia-like and Sapria-like floral chambers represent two distinct derivations of this morphology. The developmental repatterning we identified in Rafflesia, in particular, may have provided architectural reinforcement, which permitted the explosive growth in floral diameter that has arisen secondarily within this subclade.

MeSH terms: Base Sequence; Cloning, Molecular; Malaysia; Molecular Sequence Data; Sequence Analysis, DNA; DNA Primers/genetics; DNA, Complementary/biosynthesis; Gene Expression Regulation, Developmental/physiology*; Angiosperms/growth & development*; Angiosperms/metabolism; Reverse Transcriptase Polymerase Chain Reaction; Gene Expression Profiling; Flowers/anatomy & histology*; Flowers/growth & development*; Flowers/metabolism
Fulltext Biological pretreatment of rubberwood with Ceriporiopsis subvermispora for enzymatic hydrolysis and bioethanol production

Nazarpour F, Abdullah DK, Abdullah N, Motedayen N, Zamiri R

Biomed Res Int, 2013;2013:268349.
PMID: 24167813 DOI: 10.1155/2013/268349

Rubberwood (Hevea brasiliensis), a potential raw material for bioethanol production due to its high cellulose content, was used as a novel feedstock for enzymatic hydrolysis and bioethanol production using biological pretreatment. To improve ethanol production, rubberwood was pretreated with white rot fungus Ceriporiopsis subvermispora to increase fermentation efficiency. The effects of particle size of rubberwood (1 mm, 0.5 mm, and 0.25 mm) and pretreatment time on the biological pretreatment were first determined by chemical analysis and X-ray diffraction and their best condition obtained with 1 mm particle size and 90 days pretreatment. Further morphological study on rubberwood with 1 mm particle size pretreated by fungus was performed by FT-IR spectra analysis and SEM observation and the result indicated the ability of this fungus for pretreatment. A study on enzymatic hydrolysis resulted in an increased sugar yield of 27.67% as compared with untreated rubberwood (2.88%). The maximum ethanol concentration and yield were 17.9 g/L and 53% yield, respectively, after 120 hours. The results obtained demonstrate that rubberwood pretreated by C. subvermispora can be used as an alternative material for the enzymatic hydrolysis and bioethanol production.

MeSH terms: Ethanol/metabolism*; beta-Glucosidase/metabolism; Biotechnology/methods*; Cellulase/metabolism*; Crystallization; Hydrolysis; Particle Size; Time Factors; Wood/microbiology*; Wood/ultrastructure; Spectroscopy, Fourier Transform Infrared; Hevea/microbiology*; Hevea/ultrastructure; Coriolaceae/physiology*; Biofuels/microbiology*
Fulltext Leptin increases blood pressure and markers of endothelial activation during pregnancy in rats

Ibrahim HS, Omar E, Froemming GR, Singh HJ

Biomed Res Int, 2013;2013:298401.
PMID: 24167814 DOI: 10.1155/2013/298401

Raised leptin levels have been reported in the placentae and serum of women with elevated blood pressure and proteinuria during pregnancy. The role of leptin in this however remains unknown. This study investigates the effect of leptin administration on systolic blood pressure (SBP) and proteinuria and serum markers of endothelial activation during pregnancy in Sprague Dawley rats. From day 1 of pregnancy, 24 rats were randomised into those given either saline (group 1) or leptin at 60 or 120 μ g/kg/body weight/day (groups 2 and 3 resp.). SBP was measured every 5 days and 24-h urinary protein was measured at days 0 and 20 of pregnancy. Animals were euthanised on day 20 of pregnancy, and serum was collected for estimation of E-selectin and ICAM-1. Compared to group 1, SBP during the latter part of the pregnancy was significantly higher in the leptin-treated group (P < 0.01). Urinary protein excretion, serum E-selectin, and ICAM-1 were significantly higher in leptin-treated rats (P < 0.05). It seems that leptin administration to normotensive Sprague Dawley rats during pregnancy significantly increases SBP, urinary protein excretion, and markers of endothelial activation. However, further studies are required to examine the underlying mechanism responsible for this and its relevance to preeclampsia in humans.

MeSH terms: Animals; Blood Pressure/drug effects*; Body Weight/drug effects; Drinking Behavior/drug effects; Female; Pregnancy; Proteinuria/blood; Proteinuria/physiopathology; Systole/drug effects; Biomarkers/metabolism*; Rats, Sprague-Dawley; Intercellular Adhesion Molecule-1/blood; E-Selectin/blood; Leptin/pharmacology*; Endothelial Cells/drug effects; Endothelial Cells/metabolism*; Rats
Fulltext Assessing the threat of chikungunya virus emergence in Australia

Viennet E, Knope K, Faddy HM, Williams CR, Harley D

Commun Dis Intell Q Rep, 2013 Jun;37(2):E136-43.
PMID: 24168087

Chikungunya virus (CHIKV) is a major threat to Australia given the distribution of competent vectors, and the large number of travellers returning from endemic regions. We describe current knowledge of CHIKV importations into Australia, and quantify reported viraemic cases, with the aim of facilitating the formulation of public health policy and ensuring maintenance of blood safety.

MeSH terms: Australia/epidemiology; Chikungunya virus/isolation & purification*; Disease Outbreaks*; Humans; India; Indonesia; Malaysia; Risk; Travel; Viremia; Disease Notification; Public Health Surveillance; Chikungunya Fever/epidemiology*; Chikungunya Fever/virology
Fulltext Anti-quorum sensing activity of the traditional Chinese herb, Phyllanthus amarus

Priya K, Yin WF, Chan KG

Sensors (Basel), 2013;13(11):14558-69.
PMID: 24169540 DOI: 10.3390/s131114558

The discovery of quorum sensing in Proteobacteria and its function in regulating virulence determinants makes it an attractive alternative towards attenuation of bacterial pathogens. In this study, crude extracts of Phyllanthus amarus Schumach. & Thonn, a traditional Chinese herb, were screened for their anti-quorum sensing properties through a series of bioassays. Only the methanolic extract of P. amarus exhibited anti-quorum sensing activity, whereby it interrupted the ability of Chromobacterium violaceum CVO26 to response towards exogenously supplied N-hexanoylhomoserine lactone and the extract reduced bioluminescence in E. coli [pSB401] and E. coli [pSB1075]. In addition to this, methanolic extract of P. amarus significantly inhibited selected quorum sensing-regulated virulence determinants of Pseudomonas aeruginosa PA01. Increasing concentrations of the methanolic extracts of P. amarus reduced swarming motility, pyocyanin production and P. aeruginosa PA01 lecA::lux expression. Our data suggest that P. amarus could be useful for attenuating pathogens and hence, more local traditional herbs should be screened for its anti-quorum sensing properties as their active compounds may serve as promising anti-pathogenic drugs.

MeSH terms: Methanol; Anti-Bacterial Agents/pharmacology*; Biological Assay; Chromobacterium/drug effects; Drugs, Chinese Herbal/pharmacology*; Pseudomonas aeruginosa/drug effects; Pyocyanine/analysis; Pyocyanine/metabolism; Adhesins, Bacterial/analysis; Adhesins, Bacterial/metabolism; Phyllanthus/chemistry*; Cell Proliferation/drug effects; Quorum Sensing/drug effects*
A case of chronic subdural hematoma following lumbar drainage for the management of iatrogenic cerebrospinal fluid rhinorrhea: pitfalls and lessons

Tan VE, Liew D

Ear Nose Throat J, 2013 Oct-Nov;92(10-11):513-5.
PMID: 24170465

Chronic subdural hematoma as a complication of lumbar drain placement for the management of iatrogenic cerebrospinal fluid (CSF) leak has not been previously documented in the literature. We describe such a case in a 69-year-old man who presented with right nasal obstruction secondary to an inverted papilloma involving the paranasal sinuses. The patient underwent endoscopic sinus surgery, which included a medial maxillectomy. Surgery was complicated by a small CSF leak, which was repaired intraoperatively. Five days later, the patient experienced CSF rhinorrhea, and a lumbar drain was inserted. He developed overdrainage symptoms but was well when he was discharged. However, 22 days later he returned with right hemiparesis. Computed tomography of the brain showed a left frontoparietal subdural hematoma with a mass effect. The neurosurgical team performed an emergency drainage procedure, and the patient experienced a complete neurologic recovery. We discuss the pitfalls of lumbar drainage, the possible pathophysiology of overdrainage, and the lessons learned from this case.

MeSH terms: Aged; Cerebrospinal Fluid Rhinorrhea/etiology; Cerebrospinal Fluid Rhinorrhea/therapy; Drainage/adverse effects*; Endoscopy/adverse effects; Humans; Lumbosacral Region; Male; Paranasal Sinus Neoplasms/surgery*; Papilloma, Inverted/surgery*; Hematoma, Subdural, Chronic/etiology*
Fulltext Synthesis and antioxidant activities of novel 5-chlorocurcumin, complemented by semiempirical calculations

Al-Amiery AA, Kadhum AA, Obayes HR, Mohamad AB

Bioinorg Chem Appl, 2013;2013:354982.
PMID: 24170994 DOI: 10.1155/2013/354982

The novel curcumin derivative (1E,4Z,6E)-5-chloro-1,7-bis(4-hydroxy-3-methoxyphenyl)hepta-1,4,6-trien-3-one (5-chlorocurcumin) was prepared from natural curcumin. The newly synthesised compound was characterised by spectral studies (IR, 1H NMR, and 13C NMR). The free radical scavenging activity of 5-chlorocurcumin has been determined by measuring interaction with the stable free radical DPPH, and 5-chlorocurcumin has shown encouraging antioxidant activities. Theory calculations of the synthesised 5-chlorocurcumin were performed using molecular structures with optimised geometries. Molecular orbital calculations provided a detailed description of the orbitals, including spatial characteristics, nodal patterns, and the contributions of individual atoms.
Fulltext Reconstruction of the Second Metatarsal with Non-vascularised Fibular Graft following En-bloc Resection for Giant Cell Tumour: A Case Report

Rengsen P, Tiong K, Teo Y, Goh T, Sivapathasundram N

Malays Orthop J, 2013 Nov;7(3):15-7.
PMID: 25674301 DOI: 10.5704/MOJ.1311.001

Giant cell tumour in the metatarsal of a skeletally immature person is uncommon. Adequate surgical resection in this region can be difficult to achieve as there is little space between the rays of the foot. Furthermore, there is the challenge of restoring the metatarsophalangeal articulation after resection of the tumor. We describe a technique using non-vascularised fibular graft for reconstructing the 2nd metatarsal after en-bloc resection for giant cell tumour in a 14 year old adolescent female.

MeSH terms: Adolescent; Female; Fibula; Foot; Giant Cell Tumors; Humans; Metatarsal Bones; Metatarsophalangeal Joint
Fulltext Shoulder impingement, an uncommon complication of distal clavicle fracture treated arthroscopically: a case report

Wang C, Bea K, Zulkiflee O

Malays Orthop J, 2013 Nov;7(3):18-20.
PMID: 25674302 MyJurnal DOI: 10.5704/MOJ.1311.002

Clavicle fracture is commonly treated conservatively. However uncommon complication can arise causing impingement. We report a patient who sustained distal clavicle fracture and was treated conservatively. However he developed persistent shoulder pain that affected his daily life. Shoulder impingement was diagnosed and arthroscopic subacromioclavicular decompression was done. Following early physiotherapy the early recovery was good with full range of motion of the shoulder.
KEY WORDS: Clavicle fracture, shoulder impingement, arthroscopic subacromioclavicular decompression.
Fulltext Symptoms indicating imminent breakage of a femoral interlocking nail: a case report

Pan K, Chan W

Malays Orthop J, 2013 Nov;7(3):21-3.
PMID: 25674303 MyJurnal DOI: 10.5704/MOJ.1311.003

Fractures of the femoral shaft treated with interlocking nails will ultimately result in breakage of the nail if the bone does not unite. Further management requires removal of the broken nail which may be a difficult process for the distal segment. If we can identify the symptoms just before the nail breaks, an exchange nailing becomes much easier. We present a patient with fibromatosis who underwent repeated surgery as well as radiotherapy at the age of 16. Six years later, she had a pathological fracture of the upper third of the femur for which an interlocking nail was inserted. The femur did not unite and the nail subsequently broke. Over a period of 12 years, three nails broke and had to be replaced. Two to 3 months before each breakage, the patient experienced the same set of symptoms for each episode. Knowing that her fracture was not going to heal will now alert us to do an exchange nailing before the nail broke again. It is well known that where there is evidence of non-union, pre-emptive treatment is necessary before implant failure.
KEY WORDS: Femur nonunion, interlocking nail, symptoms before breakage of nail.

MeSH terms: Female; Femur; Fibroma; Fracture Fixation, Intramedullary; Fractures, Spontaneous; Humans; Nails; Diaphyses
Fulltext Subtalar coalition: a case report

Chua C, Yeap E, Yazid M

Malays Orthop J, 2013 Nov;7(3):27-9.
PMID: 25674305 MyJurnal DOI: 10.5704/MOJ.1311.011

Subtalar coalition is an uncommon condition that usually manifests in early adolescence(1). Frequently, this condition is missed. Delayed diagnosis may result in osteoarthritis requiring triple arthrodesis. Here, we report two patients with subtalar coalition. The first patient is a 12 year old boy who presented with right ankle pain for one year and was treated with excision of the coalition and bone wax insertion at the excision site. We followed up the patient for two years and the result was excellent with full range of movement of his right ankle and subtalar joint attained within two months. He returned to athletic activity by six months and was discharged with no complications after two years. The second patient is a 15 year old girl who presented with bilateral ankle pain and swelling for three years and was treated with excision of the coalition and subtalar interpositional arthroplasty bilaterally. She defaulted follow up after seven months as she was very satisfied with the result. We wish to highlight this condition which may be misdiagnosed as flexible flat foot or ankle sprain.

MeSH terms: Adolescent; Case Reports; Malaysia; Male; Subtalar Joint*
Fulltext Acromioclavicular Reconstruction using Autogenous Semitendinosus Tendon Graft and the Importance of Postoperative Rehabilitation: A Case Report

Ho JP, Ahmad Faizal A, Sivapathasundaram N

Malays Orthop J, 2013 Nov;7(3):30-2.
PMID: 25674306 MyJurnal DOI: 10.5704/MOJ.1311.012

We present a case of chronic acromioclavicular joint dislocation (Rockwood type 5) in which the choice of acromioclavicular reconstruction using autogenous semitendinosus tendon graft was made due to its superiority in anatomical reconstruction of the coracoclavicular ligaments, and the impact of postoperative rehabilitation on the recovery of this patient. We also discuss the rationale behind this.

MeSH terms: Acromioclavicular Joint; Humans; Ligaments, Articular; Shoulder Dislocation; Autografts; Hamstring Tendons

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