Browse publications by year: 2014

Tropical wetlands: A missing link in the global carbon cycle?

Sjögersten S, Black CR, Evers S, Hoyos-Santillan J, Wright EL, Turner BL

Global Biogeochem Cycles, 2014 Dec;28(12):1371-1386.
PMID: 26074666

Tropical wetlands are not included in Earth system models, despite being an important source of methane (CH4) and contributing a large fraction of carbon dioxide (CO2) emissions from land use, land use change, and forestry in the tropics. This review identifies a remarkable lack of data on the carbon balance and gas fluxes from undisturbed tropical wetlands, which limits the ability of global change models to make accurate predictions about future climate. We show that the available data on in situ carbon gas fluxes in undisturbed forested tropical wetlands indicate marked spatial and temporal variability in CO2 and CH4 emissions, with exceptionally large fluxes in Southeast Asia and the Neotropics. By upscaling short-term measurements, we calculate that approximately 90 ± 77 Tg CH4 year(-1) and 4540 ± 1480 Tg CO2 year(-1) are released from tropical wetlands globally. CH4 fluxes are greater from mineral than organic soils, whereas CO2 fluxes do not differ between soil types. The high CO2 and CH4 emissions are mirrored by high rates of net primary productivity and litter decay. Net ecosystem productivity was estimated to be greater in peat-forming wetlands than on mineral soils, but the available data are insufficient to construct reliable carbon balances or estimate gas fluxes at regional scales. We conclude that there is an urgent need for systematic data on carbon dynamics in tropical wetlands to provide a robust understanding of how they differ from well-studied northern wetlands and allow incorporation of tropical wetlands into global climate change models.
Cytoprotective Effect of Tocotrienol-Rich Fraction and α-Tocopherol Vitamin E Isoforms Against Glutamate-Induced Cell Death in Neuronal Cells

Rati Selvaraju T, Khaza'ai H, Vidyadaran S, Sokhini Abd Mutalib M, Ramachandran V, Hamdan Y

Int J Vitam Nutr Res, 2014;84(3-4):140-51.
PMID: 26098478 DOI: 10.1024/0300-9831/a000201

Glutamate is the major mediator of excitatory signals in the mammalian central nervous system. Extreme amounts of glutamate in the extracellular spaces can lead to numerous neurodegenerative diseases. We aimed to clarify the potential of the following vitamin E isomers, tocotrienol-rich fraction (TRF) and α-tocopherol (α-TCP), as potent neuroprotective agents against glutamate-induced injury in neuronal SK-N-SH cells. Cells were treated before and after glutamate injury (pre- and post-treatment, respectively) with 100-300 ng/ml TRF/α-TCP. Exposure to 120 mM glutamate significantly reduced cell viability to 76% and 79% in the pre- and post-treatment studies, respectively; however, pre- and post-treatment with TRF/α-TCP attenuated the cytotoxic effect of glutamate. Compared to the positive control (glutamate-injured cells not treated with TRF/α-TCP), pre-treatment with 100, 200, and 300 ng/ml TRF significantly improved cell viability following glutamate injury to 95.2%, 95.0%, and 95.6%, respectively (p<0.05).The isomers not only conferred neuroprotection by enhancing mitochondrial activity and depleting free radical production, but also increased cell viability and recovery upon glutamate insult. Our results suggest that vitamin E has potent antioxidant potential for protecting against glutamate injury and recovering glutamate-injured neuronal cells. Our findings also indicate that both TRF and α-TCP could play key roles as anti-apoptotic agents with neuroprotective properties.

MeSH terms: Antioxidants; Cell Cycle/drug effects; Cell Survival/drug effects; Free Radicals/antagonists & inhibitors; Humans; Malondialdehyde/analysis; Microscopy, Electron, Scanning; Neuroblastoma; Neurons/drug effects*; Neurons/physiology; Neurons/ultrastructure; Cell Death/drug effects*; Apoptosis/drug effects; Neuroprotective Agents; Glutamic Acid/toxicity*; Neurodegenerative Diseases/prevention & control; alpha-Tocopherol/administration & dosage*; Tocotrienols/administration & dosage*; Cell Line, Tumor; Membrane Potential, Mitochondrial/drug effects
Fulltext The Malaysian Cataract Surgery Registry: Cataract Surgery Practice Pattern

Lee MY, Goh PP, Salowi MA, Adnan TH, Ismail M

Asia Pac J Ophthalmol (Phila), 2014;3(6):343-7.
PMID: 26107976 DOI: 10.1097/APO.0000000000000030

PURPOSE: To present the cataract surgery practice pattern among the ophthalmic surgeons in hospitals managed by the Ministry of Health (MOH) in Malaysia.
DESIGN: Secondary data analysis on Malaysian Cataract Surgery Registry (CSR).
METHODS: The Malaysian CSR collected data on cataract surgeries done at all the ophthalmology departments in MOH from year 2002 to 2004 (paper-based) and 2007 to 2011 (web-based). Data collected include type of admission, surgical techniques, type of anesthesia, and intraocular lens (IOL). Descriptive and inferential analysis was performed.
RESULTS: Of the 185,388 cataract surgeries done over 8 years, 171,482 (91.5%) were captured in CSR. There was a steep rise in phacoemulsification cataract surgery from 39.7% in 2002 to 78.0% in 2011 with a corresponding fall in extracapsular cataract extraction from 54.0% to 17.3% in the respective years. This explained the surge in the use of foldable IOL from 26.5% in 2002 to 88.3% in 2011. The proportion of cataract surgery with IOL implantation was 97.5% in 2012 and 98.2% in 2011. The proportion of day-care cataract surgery was low, with 39.3% in 2002 to 52.3% in 2011. Vitreoretinal surgery was the commonest type of combined surgery performed.
CONCLUSIONS: Although phacoemulsification was performed in two thirds of the patients who presented to MOH hospitals in Malaysia, extracapsular cataract extraction was still being performed because of a significant proportion of cataract that were brunescent and limited access to phacoemulsification machines and consumables. There is a need to increase day-care cataract surgery as it will eventually save cost.
Team-based learning in a medical centre in Malaysia: Perspectives of the faculty

Salam A, Mohamad N, Siraj HH, Kamarudin MA, Yaman MN, Bujang SM

Natl Med J India, 2014 Nov-Dec;27(6):350.
PMID: 26133346
MeSH terms: Academic Medical Centers*; Faculty; Humans; Learning*; Malaysia
WITHDRAWN: Rh genotypes among Malaysian blood donors

Musa RH, Hassan A, Ayob Y, Yusoff NM

Transfus Apher Sci, 2014 Dec 12.
PMID: 26144905 DOI: 10.1016/j.transci.2014.12.001

This article has been withdrawn at the request of the author and editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
Fulltext Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound

Liu H, Tan T, van Zelst J, Mann R, Karssemeijer N, Platel B

J Med Imaging (Bellingham), 2014 Jul;1(2):024501.
PMID: 26158036 DOI: 10.1117/1.JMI.1.2.024501

We investigated the benefits of incorporating texture features into an existing computer-aided diagnosis (CAD) system for classifying benign and malignant lesions in automated three-dimensional breast ultrasound images. The existing system takes into account 11 different features, describing different lesion properties; however, it does not include texture features. In this work, we expand the system by including texture features based on local binary patterns, gray level co-occurrence matrices, and Gabor filters computed from each lesion to be diagnosed. To deal with the resulting large number of features, we proposed a combination of feature-oriented classifiers combining each group of texture features into a single likelihood, resulting in three additional features used for the final classification. The classification was performed using support vector machine classifiers, and the evaluation was done with 10-fold cross validation on a dataset containing 424 lesions (239 benign and 185 malignant lesions). We compared the classification performance of the CAD system with and without texture features. The area under the receiver operating characteristic curve increased from 0.90 to 0.91 after adding texture features ([Formula: see text]).

MeSH terms: Diagnosis, Computer-Assisted; Female; Probability; ROC Curve; Ultrasonography, Mammary; Imaging, Three-Dimensional; Support Vector Machine
Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

Sarin SK, Kedarisetty CK, Abbas Z, Amarapurkar D, Bihari C, Chan AC, et al.

Hepatol Int, 2014 Oct;8(4):453-71.
PMID: 26202751 DOI: 10.1007/s12072-014-9580-2

The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. Due to the rapid advancements in the knowledge and available information, a consortium of members from countries across Asia Pacific, "APASL ACLF Research Consortium (AARC)," was formed in 2012. A large cohort of retrospective and prospective data of ACLF patients was collated and followed up in this data base. The current ACLF definition was reassessed based on the new AARC data base. These initiatives were concluded on a 2-day meeting in February 2014 at New Delhi and led to the development of the final AARC consensus. Only those statements which were based on the evidence and were unanimously recommended were accepted. These statements were circulated again to all the experts and subsequently presented at the annual conference of the APASL at Brisbane, on March 14, 2014. The suggestions from the delegates were analyzed by the expert panel, and the modifications in the consensus were made. The final consensus and guidelines document was prepared. After detailed deliberations and data analysis, the original proposed definition was found to withstand the test of time and identify a homogenous group of patients presenting with liver failure. Based on the AARC data, liver failure grading, and its impact on the "Golden therapeutic Window," extra-hepatic organ failure and development of sepsis were analyzed. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals, and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information are presented here.

MeSH terms: Algorithms; Antiviral Agents; Asia; Blood Coagulation Disorders; Humans; India; Prospective Studies; Retrospective Studies; Cohort Studies; Liver Transplantation; Renal Replacement Therapy; Sepsis; Consensus; Hepatic Insufficiency; Acute-On-Chronic Liver Failure
Fulltext An Inexpensive Suturing Training Model

Kumaresan R, Karthikeyan P

J Maxillofac Oral Surg, 2014 Dec;13(4):609-11.
PMID: 26225037 DOI: 10.1007/s12663-013-0546-z

Demonstrations and training on live-subjects are not always the optimal means of introducing the students to minor oral surgery. Hence, the use of teaching models permit the students to handle the surgical instruments in a limited field under a semi-realistic circumstance and also helps in developing psychomotor skills in an non stressed situation. One among the competent exercise in oral surgery is suturing. Though there exist a variety of commercially available suturing training models, cost factor restrain their acquirement in few units.
Neuroethical issues in pharmacological cognitive enhancement

Mohamed AD

Wiley Interdiscip Rev Cogn Sci, 2014 Sep;5(5):533-549.
PMID: 26308743 DOI: 10.1002/wcs.1306

Neuroethics is an emerging field that in general deals with the ethics of neuroscience and the neuroscience of ethics. In particular, it is concerned with the ethical issues in the translation of neuroscience to clinical practice and in the public domain. Numerous ethical issues arise when healthy individuals use pharmacological substances known as pharmacological cognitive enhancers (PCEs) for non-medical purposes in order to boost higher-order cognitive processes such as memory, attention, and executive functions. However, information regarding their actual use, benefits, and harms to healthy individuals is currently lacking. Neuroethical issues that arise from their use include the unknown side effects that are associated with these drugs, concerns about the modification of authenticity and personhood, and as a result of inequality of access to these drugs, the lack of distributive justice and competitive fairness that they may cause in society. Healthy individuals might be coerced by social institutions that force them to take these drugs to function better. These drugs might enable or hinder healthy individuals to gain better moral and self-understanding and autonomy. However, how these drugs might achieve this still remains speculative and unknown. Hence, before concrete policy decisions are made, the cognitive effects of these drugs should be determined. The initiation of accurate surveys to determine the actual usage of these drugs by healthy individuals from different sections of the society is proposed. In addition, robust empirical research need to be conducted to delineate not only whether or not these drugs modify complex higher-order cognitive processes but also how they might alter important human virtues such as empathy, moral reasoning, creativity, and motivation in healthy individuals. WIREs Cogn Sci 2014, 5:533-549. doi: 10.1002/wcs.1306 For further resources related to this article, please visit the WIREs website.
CONFLICT OF INTEREST: The author has declared no conflicts of interest for this article.
Simulium (Simulium) lomkaoense, a New Species of Black Fly (Diptera: Simuliidae) From Thailand

Takaoka H, Srisuka W, Saeung A, Otsuka Y

J Med Entomol, 2014 Nov 01;51(6):1109-15.
PMID: 26309295 DOI: 10.1603/ME14039

Simulium (Simulium) lomkaoense sp. nov. is described from females, males, pupae, and larvae in Thailand. This new species is assigned to the Simulium malyschevi Dorogostaisky, Rubtsov & Vlasenko species-group of the subgenus Simulium, and appears to be closely related to Simulium baimaii Kuvangkadilok & Takaoka from Thailand in having a similar shape of the female and male genitalia, pupal gill with two inflated filaments, and simple wall-pocket-shaped cocoon. This new species is compared taxonomically with S. baimaii and other related species. It represents the third species of the S. malyschevi species-group known from Thailand.

MeSH terms: Animals; Female; Larva/anatomy & histology; Male; Pupa/anatomy & histology; Simuliidae/anatomy & histology*; Simuliidae/classification; Thailand; Biodiversity
Fulltext Effect of temperature-controlled fermentation on physico-chemical properties and lactic acid bacterial count of durian (Durio zibethinus Murr.) pulp

Wasnin RM, Karim MS, Ghazali HM

J Food Sci Technol, 2014 Nov;51(11):2977-89.
PMID: 26396291 DOI: 10.1007/s13197-012-0869-7

Effects of controlled-temperature fermentation on several physico-chemical properties, lactic acid bacteria (LAB) counts and aroma of durian pulp were examined by storing fresh durian pulp was mixed with 2 % (w/w) salt and stored at 15 °C, 27 °C and 40 °C for 10 days. Storage at 15 °C did not affect the properties of the pulp much. However, at 27 °C and 40 °C, pH and total soluble solids decreased up to 60 % and 52 %, respectively, with greater losses at 27 °C. Titratable acidity, which increased at 27 °C, was due to lactic and acetic acids formation. Loss of sucrose and increases in glucose were greater at 27 °C. LAB population increased up to Day 3 of storage, and then decreased slightly. Principal component analysis based on aroma examination using a zNose(TM) showed better retention of aroma profile at 27 °C. Overall, durian fermented at 27 °C was more acceptable than the one prepared at 40 °C, and it is ready to be consumed between Day 4 and 6.
Fulltext Optimization and physical properties of gelatin extracted from pangasius catfish (Pangasius sutchi) bone

Mahmoodani F, Ardekani VS, See SF, Yusop SM, Babji AS

J Food Sci Technol, 2014 Nov;51(11):3104-13.
PMID: 26396302 DOI: 10.1007/s13197-012-0816-7

In the present study, to establish the optimum gelatin extraction conditions from pangasius catfish (Pangasius sutchi) bone, Response Surface Methodology (RSM) with a 4-factor, 5-level Central Composite Design (CCD) was conducted. The model equation was proposed with regard to the effects of HCl concentration (%, X1), treatment time (h, X2), extraction temperature (°C, X3) and extraction time (h, X4) as independent variables on the hydroxyproline recovery (%, Y) as dependent variable. X 1 = 2.74 %, X 2 = 21.15 h, X 3 = 74.73 °C and X 4 = 5.26 h were found to be the optimum conditions to obtain the highest hydroxyproline recovery (68.75 %). The properties of optimized catfish bone gelatin were characterized by amino acid analysis, SDS-PAGE, gel strength, TPA and viscosity in comparison to bovine skin gelatin. The result of SDS-PAGE revealed that pangasius catfish bone gelatin consisted of at least 2 different polypeptides (α1 and α2 chains) and their cross-linked chains. Moreover, the pangasius catfish bone gelatin was found to contain 17.37 (g/100 g) imino acids (proline and hydroxyproline). Pangasius catfish bone gelatin also indicated physical properties comparable with that of bovine and higher than those from cold water fish gelatin. Based on the results of the present study, there is a potential for exploitation of pangasius catfish bone for gelatin production. Furthermore, RSM provided the best method for optimizing the gelatin extraction parameters.

MeSH terms: Amino Acids; Animals; Catfishes; Cattle; Electrophoresis, Polyacrylamide Gel; Gelatin; Hydroxyproline; Imino Acids; Peptides; Proline; Temperature; Viscosity; Water
Fulltext Design and develop a nondestructive infrared spectroscopy instrument for assessment of mango (Mangifera indica) quality

Izneid BA, Fadhel MI, Al-Kharazi T, Ali M, Miloud S

J Food Sci Technol, 2014 Nov;51(11):3244-52.
PMID: 26396317 DOI: 10.1007/s13197-012-0880-z

A portable infrared spectroscopy system has been designed and developed for assessment of quality of mango fruit. This paper describes the design and development of a fruit quality grading device using reflectance mode optical sensor. The experiment was conducted to obtain the best results from the system and the device was correlated according to the measured output. In the experiment, several samples of mango fruits have been monitored for six days to study the relation how fruit quality increases with time as fruit ripens. Between the unripe mango fruit and the ripest one, a range of 3.5 V to 4.2 V was measured by the developed system. The rate of quality increase was calculated as an average of 6.7 mV per day. These results were used to correlate the final hardware and software development of the device. The results demonstrate that, portable near infrared spectroscopy is feasible for evaluating mango quality non-destructively.

MeSH terms: Algorithms; Fruit; Monitoring, Physiologic; Software; Spectrophotometry, Infrared; Spectroscopy, Near-Infrared; Mangifera
Fulltext Cinnamon bark deodorised aqueous extract as potential natural antioxidant in meat emulsion system: a comparative study with synthetic and natural food antioxidants

Chan KW, Khong NM, Iqbal S, Ch'ng SE, Younas U, Babji AS

J Food Sci Technol, 2014 Nov;51(11):3269-76.
PMID: 26396320 DOI: 10.1007/s13197-012-0818-5

Cinnamon deodorised aqueous extract (CinDAE) was prepared and evaluated for its total phenolic (315.3 ± 35.4 mg GAE/g) and flavonoid (99.3 ± 9.6 mg RE/g) contents. Stabilizing efficiency of CinDAE, for chicken meatballs, was measured against oxidative deterioration as function of storage time under chilled conditions. For this purpose, oxidative stability [2-thiobarbituric acid reactive substances (TBARS); peroxide value (PV)], colour and sensory acceptability were measured in the control meatballs (C), and those stabilized with 200 ppm of: CinDAE (T1), ascorbic acid (T2), BHA/BHT (50/50; w/w) (T3). In comparison to "C", induction period (IP) and redness (a* value) of the stabilized samples (T1, T2 and T3) were increased, while PV and TBARS were decreased throughout storage (8 ± 1 °C) significantly (p

MeSH terms: Animals; Antioxidants; Ascorbic Acid; Butylated Hydroxyanisole; Butylated Hydroxytoluene; Chickens; Cinnamomum zeylanicum; Color; Diet; Flavonoids; Meat Products; Oxidation-Reduction; Peroxides; Phenols; Thiobarbituric Acid Reactive Substances; Oxidative Stress
Fulltext Pneumatization of Mastoid Air Cells, Temporal Bone, Ethmoid and Sphenoid Sinuses. Any Correlation?

Hindi K, Alazzawi S, Raman R, Prepageran N, Rahmat K

Indian J Otolaryngol Head Neck Surg, 2014 Dec;66(4):429-36.
PMID: 26396957 DOI: 10.1007/s12070-014-0745-z

The aim of this study is to assess the pneumatization of the paranasal sinuses (PNS) and other parts of temporal bone such as mastoid air cells and to investigate if there was any association between the aeration of these structures among the three major ethnic groups in Malaysia (Malay, Chinese, Indian) as this would be representative of Asia. A retrospective review of 150 computed tomography (CT) scans of PNS and temporal bones was done and analysed. The pneumatization of each area was obtained and compared using statistical analysis. Patients with a history of previous medical or surgical problems in the intended areas were excluded from the study. The pneumatization of the mastoid air cells and other temporal bone parts were noted to be symmetrical in more than 75 %. There was a positive correlation between the pneumatization of mastoid air cells and that of the sphenoid sinus. The prevalence of Agger nasi, Haller's and Onodi cells was observed to be significantly higher in the Chinese group. Preoperative assessment of the temporal bone and PNS with CT scan may be helpful in the evaluation of their anatomical landmark and decrease the possibility of surgical complications related to 3D structures.

MeSH terms: Asia; Ethnic Groups; Humans; Malaysia; Mastoid; Nose; Paranasal Sinuses; Retrospective Studies; Sphenoid Sinus; Temporal Bone; Tomography, X-Ray Computed; Prevalence
Fulltext Outcome of Surgical Treatment for Displaced Acetabular Fractures

Anizar-Faizi A, Hisam A, Sudhagar KP, Moganadass M, Suresh C

Malays Orthop J, 2014 Nov;8(3):1-6.
PMID: 26401227 MyJurnal DOI: 10.5704/MOJ.1411.001

The aim of this study was to assess the outcome of surgical treatment in displaced acetabular fractures in our local facilities. Previous studies reveal good outcome via open reduction method with achievement of congruent joint. We note that studies in this respect have not been conducted in our region. We retrospectively analyzed thirty patients with acetabular fractures who underwent open reduction and internal fixation. The data collection was performed over a 4-year period, from 2008 to 2011. The results showed 20 out of 30 patients (66.7%) had excellent/good results (Harris Hip Score equal or more than 80). Post operative complications were deep infection (6.7%), iatrogenic sciatic nerve injury (10.0%), avascular necrosis (16.7%), heterotopic ossificans (3.3%), degenerative changes in hip joint (43.3%) and loss of reduction (3.3%). In conclusion, surgical treatment of displaced acetabular fractures produces good functional outcome despite the complications.

MeSH terms: Fracture Fixation, Internal; Hip Fractures; Hip Joint; Humans; Iatrogenic Disease; Retrospective Studies; Sciatic Nerve; Open Fracture Reduction
Fulltext Knowledge and practice of diabetic foot care in an inpatient setting at a tertiary medical center

Muhammad-Lutfi AR, Zaraihah MR, Anuar-Ramdhan IM

Malays Orthop J, 2014 Nov;8(3):22-6.
PMID: 26401231 MyJurnal DOI: 10.5704/MOJ.1411.005

Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients' knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 'yes' or 'no' questions on foot care knowledge and practice. Score of 1 was given for each 'yes' answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.
Study site: Hospital Sultanah Nur Zahirah, Kuala Terengganu,Terengganu, Malaysia

MeSH terms: Adult; Cross-Sectional Studies; Hospitals, General; Inpatients; Health Knowledge, Attitudes, Practice*; Malaysia; Diabetic Foot*
Fulltext Improved Accuracy and Safety of Intracorporeal Transpedicular Bone Grafting - using Contrast Impregnated Bone: A Case Report

Chiu CK, Chan C, Kwan MK

Malays Orthop J, 2014 Nov;8(3):27-9.
PMID: 26401232 MyJurnal DOI: 10.5704/MOJ.1411.006

A method of transpedicular bone grafting using contrast impregnated bone to improve the visualization of bone graft on the image intensifier is reported. A - 36-year old man who had sustained traumatic burst fracture of T12 vertebra, with Load-Sharing Classification (LSC) score of 8, was treated with posterior short segment fusion from T11 to L1 with transpedicular bone graft of T12 vertebra. We were able to correct the kyphotic end plate angle (EPA) from 19º to 1.4º. Anterior bone graft augmentation was achieved with contrast enhaced transpedicular bone grafts. At six months follow up, CT scan showed good bony integration of the anterior column with EPA of 4.5º and two years later, radiographs showed EPA of 7.6 º.

MeSH terms: Adult; Bone Plates; Follow-Up Studies; Humans; Kyphosis; Male; Radiographic Image Enhancement; Thoracic Vertebrae; Tomography, X-Ray Computed; Bone Transplantation
Fulltext Minimally Invasive Plate Osteosynthesis with Conventional Compression Plate for Diaphyseal Tibia Fracture

Anuar-Ramdhan IM, Azahari IM, Med Orth M

Malays Orthop J, 2014 Nov;8(3):33-6.
PMID: 26401234 MyJurnal DOI: 10.5704/MOJ.1411.008

The diaphyseal tibia fracture is best treated with intramedullary nail but in some cases where the nail is not applicable, plate fixation will be the next option of fixation. The extensile anterior approach is normally used for conventional compression plate fixation in tibia shaft fractures. The extensive surgical dissection may devitalizes the bony fragments and interfere with the fracture union as well as soft tissue healing. Minimally Invasive Plate Osteosynthesis (MIPO) provides good preservation of blood supply and fracture hematoma at the fracture site thus promotes biological bone healing. The use of indirect reduction techniques and small skin incisions to introduce the plate is technically demanding and requires fluoroscopy exposures throughout the surgery, being some of its drawbacks. We recommend MIPO for conventional compression plate fixation in tibial shaft fractures in view of the reduced surgical trauma to the surrounding soft tissue and good functional outcome.

MeSH terms: Bone Plates; Fluoroscopy; Fracture Fixation, Internal; Hematoma; Tibia; Tibial Fractures
Fulltext "'Doc' do I need an anterior cruciate ligament reconstruction? What happens if I do not reconstruct the cruciate ligament?"

Dhillon KS

Malays Orthop J, 2014 Nov;8(3):42-7.
PMID: 26401236 DOI: 10.5704/MOJ.1411.010

We are all aware that there has been a dramatic increase in the number of anterior cruciate ligament (ACL) reconstructions that are carried out here in Malaysia as well as around the world. The numbers of ACL injuries have undoubtedly increased over the years with greater participation of young adults in sporting activities. However it is not certain whether the increase in the numbers of reconstructions can be accounted for by the increasing numbers of ACL injuries. Without doubt commercial interests as well the influence of the biomedical companies have a role to play. In the past the rationale for surgical treatment of an ACL tear was that the ACL is vital for knee function and that in the long term ACL deficiency will lead to more injuries of the meniscus and more degeneration of the joint. This belief was prevalent because the natural history of an ACL deficient knee and the ultimate outcome of reconstruction of the ACL were both not known. However in recent years a substantial amount of research has been published, which has elucidated the natural history of ACL deficient knees as well as the long term outcome of reconstruction of the ACL.

MeSH terms: Humans; Joint Instability; Knee Joint; Malaysia; Anterior Cruciate Ligament; Young Adult; Anterior Cruciate Ligament Reconstruction; Anterior Cruciate Ligament Injuries; Meniscus

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