Browse publications by year: 2017

  1. Tan KK, Tan YC, Chang LY, Lee KW, Nor'e SS, Yee WY, et al.
    J Infect Dev Ctries, 2017 Jun 01;11(5):420-425.
    PMID: 30943180 DOI: 10.3855/jidc.7598
    INTRODUCTION: Currently available tests have limitations for the identification of Brucella species and strains, and their genetic lineage. The genome sequence of the rpoB gene encoding the β-subunit of DNA-dependent RNA polymerase was investigated for its use in genotyping Brucella melitensis.

    METHODOLOGY: Complete rpoB gene sequences of globally distributed Brucella melitensis strains were analyzed. Single nucleotides polymorphisms (SNPs) of the rpoB gene sequences were identified and used to type Brucella melitensis strains.

    RESULTS: Six DNA polymorphisms were identified, of which two (nucleotides 3201 and 558) were novel. Analysis of the geographical distribution of the strains revealed a spatial clustering pattern with rpoB type 1 representing European and American strains, rpoB type 2 representing European, African, and Asian strains, rpoB type 3 representing Mediterranean strains, and rpoB type 4 representing African (C3201T) and European (C3201T/T558A) strains.

    CONCLUSIONS: We report the discovery of two novel SNPs of rpoB gene that can serve as useful markers for epidemiology and geographical tracking of B. melitensis.

  2. Ab Malik N, M Yatim S, Lam OLT, Jin L, McGrath C
    JDR Clin Trans Res, 2017 Jul;2(3):312-319.
    PMID: 30938632 DOI: 10.1177/2380084417693784
    During a stroke, the mouth tends to become an unhealthy place and may give rise to various life-threatening conditions. To this end, there have been repeated calls to incorporate oral hygiene guidelines and practices for hospitalized stroke patients to prevent aspiration pneumonia and improve patients' oral health. The objective of the study was to determine health care providers' practices of oral health care among patients hospitalized after an occurrence of stroke and to determine health care providers' background and work environment effect on these practices. A cross-sectional study was conducted among stroke care providers in 13 public hospitals in Malaysia. The questionnaires distributed were self-administered, where nursing staff provided details of their oral health care practices for stroke patients. Information on the background of health care providers and work environment was also collected. Overall, a total of 780 responses from the registered nurses were obtained. Almost half of the respondents (48.1%) reported that they recommended toothbrushing twice or more per day to stroke patients. Two-thirds (64.7%) reported that they performed daily mouthwashing on their patient, while less than half (38.8%) reported daily oral hygiene assistance. Result of the analysis revealed that oral hygiene practices were significantly associated with having working wards ( P < 0.05), level of qualification ( P < 0.05), having oral health care guidelines ( P < 0.001), specific resources ( P < 0.05), and attending previous training in oral care ( P < 0.001). Provision of oral hygiene practices for hospitalized stroke patients is important. A lack of oral health care guidelines, support from dental professionals, specific resources, training, and assistance in daily oral care for patients is evident and detrimental to oral hygiene practices. The current findings have significant implications for new initiatives to support health care providers, particularly the registered nurses performing oral health care for hospitalized stroke patients. Knowledge Transfer Statement: This study may provide a basis of information for improving the delivery of oral health care to stroke patients. Enhancement in the training and improvement in the existing guidelines and resources is pivotal for the provision of better oral health care for the potential benefits to these patients, including their improved quality of life and disease prevention.
    MeSH terms: Cross-Sectional Studies; Health Personnel; Hospitals, Public; Humans; Malaysia; Mouth; Nursing Staff; Oral Health; Oral Hygiene; Pneumonia, Aspiration; Quality of Life; Surveys and Questionnaires; Toothbrushing; Stroke
  3. Yahui HC, Swaminathan N
    PMID: 30931041 DOI: 10.1016/j.hkpj.2016.12.002
    Background: Recently, there has been an increased need for all healthcare disciplines to provide interventions that are effective and evidence based. This has led to more implementation of evidence-based practice (EBP) in clinical settings. Following this, research regarding EBP gained attention to determine its uptake into the physiotherapy profession. Although there are numerous studies to determine the attitudes and barriers of physiotherapists towards EBP, most of them were done in developed nations. As for Malaysia, little research has been carried out, much less among physiotherapists.

    Purpose: The purpose of this study was to identify the knowledge, attitude, and barriers towards the implementation of EBP among physiotherapists in Malaysia.

    Methods: A survey was conducted among the members of the Malaysian Physiotherapy Association and other practicing therapists in Malaysia. One hundred and two responses were collected throughout a span of 2 months.

    Results: Respondents agreed that EBP is necessary to practice and that it helps in decision making as well as improving patient care. Eighty-one percent of the respondents either agreed or strongly agreed that they had received formal training in EBP. However, 61% of the respondents reported that strong evidence is lacking to support their interventions. Thirty percent of the respondents reported reading <2 articles per month, with 57% stating that they read two to five articles in a typical month. This study also found time constraints, limited access to search engines, and lack of generalizability of research evidence as the top three barriers to implementing EBP.

    Conclusion: Physiotherapists in Malaysia had a positive attitude towards EBP and are inclined towards implementing evidence into their clinical practice. They are interested in attending courses to improve their knowledge and skills in EBP.

    MeSH terms: Attention; Attitude; Decision Making; Patient Care; Humans; Malaysia; Surveys and Questionnaires; Reading; Developed Countries; Physical Therapy Modalities; Evidence-Based Practice; Search Engine; Physical Therapists
  4. Thuraiya Mohd, Nur Hanim Ilias, Azran Mansor, Nor Azalina Yusnita Abd Rahman, Siti Fairuz Che Pin, Asma Senawi, et al.
    Jurnal Inovasi Malaysia, 2017;1(1):109-130.
    MyJurnal
    The teaching and learning process involves several activities and methods that are continuously implemented towards providing comprehensive and effective education. This teaching and learning process needs to be supported with effective teaching and learning facilities and equipment. Lack of facilities and teaching and learning equipment affects the quality of delivery as well as the teaching and learning process. The lack of teaching and learning’s facilities and equipment also affects the curriculum design and hence impact on the development of quality human capital with creativity and critical thinking. Therefore, this study focuses on the inefficiencies of the teaching and learning process due to the lack of teaching and learning equipment, i.e. the exhibition panel. The study also proposes creative and inventive product innovation namely “smart panel” to solve the problem. The findings from this empirical study have revealed some weaknesses in the teaching and learning process using existing exhibition panels. Significant disadvantages are long periods of presentation and consequently eliminating the concentration of students and lecturers. This situation has caused side effects to occur as they had to provide presentation slots in the evening and create a conducive environment in the studio. Thus, the “smart panel” product innovation has been developed in conjunction with existing desk and studio space to improve existing equipment taking into account the time factor, cost and current space. This “Smart Panel” is more efficient and easy to control. Applications on this system indicate he student’s presentation time can be abbreviated from one (1) hour (using standard panel) to half (1/2) hours (using “smart panel”). In addition, it can also save teaching and learning costs. Hence, it is hoped that this innovative product can be applied throughout UiTM and other organizations and thus contributes to the development of the country by producing a product as a result of innovation and inventions.
  5. Al-Haddad AY, Kutty MG, Abu Kasim NH, Che Ab Aziz ZA
    J Dent Sci, 2017 Dec;12(4):340-346.
    PMID: 30895073 DOI: 10.1016/j.jds.2017.03.008
    Background/purpose: Intraradicular moisture is not standardized and alters the sealing properties and adhesion of root sealers. The aim of this work was to evaluate the effect of different moisture on the constitution of bioceramic sealers.

    Materials and methods: The sealers were evaluated before mixing, and after setting using X-ray diffraction (XRD), Energy Dispersive Analysis (EDX) and Scanning Electron Microscope (SEM) techniques. Twenty four extracted teeth were prepared and assigned to four groups according to the moisture conditions: (1) dry: using ethanol as final irrigation, (2) normal: using paper points until the last one appeared dry, (3) moist: using a Luer adapter for 5 s followed by 1 paper point, and (4) wet: the canals remained totally flooded. The roots were filled with MTA Fillapex® and Endosequence® BC and kept in phosphate buffer solution at 37 °C for 10 days. Each root was sectioned transversally and longitudinally. The sealers harvested from longitudinal sections were analysed using XRD. Whilst the transverse sections were analysed using SEM/EDX.

    Results: The XRD analysis showed MTA Fillapex composed of Bismuth trioxide, calcium silicate and tricalcium aluminate. The intensity of peaks in the wet condition was reduced. Endosequence BC contained mainly calcium silicate, calcium silicate hydrate, zirconia and calcium hydroxide. The wet condition showed a small increase in hydrated calcium silicate. The EDX analysis showed changes in the elemental concentrations with different moisture conditions. The surface morphology differed with different moisture conditions.

    Conclusion: Tested sealers have different constitution that not affected by the degree of moisture. However, it changed their relative quantity.

  6. Peltzer K, Pengpid S
    Cent Asian J Glob Health, 2017;6(1):288.
    PMID: 30881756 DOI: 10.5195/cajgh.2017.288
    Introduction: There has been a global increase in illicit drug use among young people. The aim of this study was to estimate the prevalence of lifetime cannabis and amphetamine use, as well as to explore factors associated with substance use among adolescents in five Asian countries: Iraq, Kuwait, Malaysia, Mongolia, and Vietnam.
    Methods: 38,941 school children (mean age 15.4 years, SD=1.5) completed the cross-sectional Global School-Based Student Health Survey (GSHS). Topics covered in the questionnaire included cannabis and amphetamine use. Personal, parental, and environmental attributes were explored as predictors of cannabis and amphetamine use. Logistic regression was used to assess the contribution of potential predictors on lifetime cannabis and lifetime amphetamine use.
    Results: Overall, the prevalence of lifetime cannabis use was 0.9% and lifetime amphetamine use was 1.0% among research participants. Cannabis use was influenced by male gender (Kuwait, Mongolia), parental smoking habits (Kuwait, Iraq), and current cigarette smoking in all countries. Amphetamine use was associated with suicidal ideation (Kuwait, Malaysia, Vietnam), school truancy (Malaysia, Mongolia, Vietnam), being a victim of physical assault (Kuwait, Mongolia), bullying victimization (Iraq, Malaysia, Vietnam), as well as anxiety and current cigarette use in all countries.
    Conclusions: Our preliminary results show the importance of personal attributes such as mental distress and environmental stressors on lifetime cannabis and lifetime amphetamine use. Future prospective studies are needed to identify causal relationships among personal attributes, parental attributes, environmental stressors, and illicit substance use.
    Study name: Global School-Based Student Health Survey (GSHS)
    MeSH terms: Adolescent; Amphetamines; Anxiety; Asia; Cannabis; Child; Cross-Sectional Studies; Health Surveys; Humans; Iraq; Kuwait; Malaysia; Male; Marijuana Smoking; Mongolia; Prospective Studies; Surveys and Questionnaires; School Health Services; School Nursing; Street Drugs; Students; Vietnam; Prevalence; Logistic Models; Crime Victims; Substance-Related Disorders; Bullying; Suicidal Ideation
  7. Musawi A, Ariffin YT
    J Clin Transl Res, 2017 May 24;3(2):271-275.
    PMID: 30873478
    Background: The Condylar Path Angle (CPA) is an important measurement that is used to program articulators used in dental treatment. The purpose of the current study was to investigate the CPA in Malay subjects, to compare the measurements with average values, 25˚-35˚ Camper's (based on Caucasian studies), and to compare the right and left CPAs. Methods: Thirty subjects aged 21-23 years were recruited. A wash technique impression was made, casts were poured, and face-bow transfers were taken. The casts were mounted to their centric position on a semi-adjustable articulator. Protrusive guides were constructed to allow the mandible to be protruded for 5 mm, and then the angles were measured using the protrusive record method. Results: The right CPA was within the normal range for 43% (13/30) of participants and out of the normal range for 57% (17/30). The left CPA was within the normal range for 33% (10/30) of participants and out of the normal range for 67% (19/30). There was no statistically significant difference between the left and right CPAs (p = 0.72), but there was a strong linear relationship between left and right CPAs (p = 0.001). Conclusions: Results of the current study indicated Malay subjects had measurable variations in the CPA, suggesting this population has an ethnic variation in the CPA. Relevance for patients: To improve the quality of patient care, the CPA should be considered when constructing fixed/removable prostheses that use semi-adjustable articulators, and clinicians should not rely on the set average values that are pre-set on articulators.
  8. Win PP
    J Neonatal Surg, 2017 01 01;6(1):8.
    PMID: 28083494 DOI: 10.21699/jns.v6i1.443
    Gastroschisis is often found together with other extra intestinal conditions such as limb, spine, cardiac, central nervous system and genitourinary abnormalities. There are reports of its association with young maternal age. The cases presented here highlight the association of gastroschisis with limbs anomalies and young maternal age.
    MeSH terms: Extremities; Intestinal Diseases; Maternal Age; Nervous System; Spine; Urogenital Abnormalities; Gastroschisis
  9. Pandey S, Singh K, Sharma V, Khan MT, Ghosh A, Santhosh D
    Malays J Med Sci, 2017 Mar;24(1):117-120.
    PMID: 28381935 DOI: 10.21315/mjms2017.24.1.13
    Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder characterised by various phenotypic features like hyperpigmented spots, neurofibromas, Lisch nodules, skeletal abnormalities and tendency to develop neoplasms. Only few cases of Non-Familial Spinal Neurofibromatosis-1 (Non-FSNF1) have been described in literature with tumors involving the spinal roots at every level being even rarer. We reported an interesting case of bilateral symmetrical cervical neurofibroma with multiple spinal neurofibromas appearing as mirror image on CT, associated with non familial NF-1 as a rare presentation in a 25-year-old adult male.
    MeSH terms: Adult; Humans; Male; Neurofibroma; Neurofibromatosis 1; Spinal Nerve Roots; Spinal Nerves; Tomography, X-Ray Computed; Neurofibromatoses; Nerve Sheath Neoplasms
  10. Goki-Kamei GK, Norimasa-Matsubara NM, Teruyasu-Tanaka TT, Koji-Natsu KN, Toshihiro-Sugioka TS
    Malays Orthop J, 2017 Mar;11(1):60-63.
    PMID: 28435577 DOI: 10.5704/MOJ.1703.004
    Intra-articular synovial haemangioma of the knee is a benign tumour. However, diagnostic delay leads to degenerative changes in the cartilage and osteoarthritis due to recurrent haemarthrosis. Therefore, treatment should be performed immediately. We report the case of a localized synovial haemangioma arising from the medial plica in a 38-year old female presenting with pain and restricted range of motion in the right knee joint. Initially, we diagnosed this case as a localized pigmented villonodular synovitis (LPVS) based on MRI and arthroscopic findings and performed only arthroscopic en bloc excision of the mass and synovectomy around the mass for diagnostic confirmation. Fortunately, there was no difference in the treatment approaches for LPVS and localized haemangioma and the synovial haemangioma had not recurred at the 3-month postoperative follow-up with MRI. The patient's clinical symptoms resolved and had not relapsed two years after surgery.
    Study site: Department of Orthopaedics, Miyoshi Central Hospital, Miyoshi, Japan
    MeSH terms: Adult; Cartilage; Female; Follow-Up Studies; Hemangioma; Hemarthrosis; Humans; Japan; Knee; Knee Joint; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Osteoarthritis; Pain; Synovitis, Pigmented Villonodular; Range of Motion, Articular; Delayed Diagnosis
  11. Kunnasegaran R, Chan YH
    Malays Orthop J, 2017 Mar;11(1):64-67.
    PMID: 28435578 DOI: 10.5704/MOJ.1703.007
    The treatment of fractures in osteopetrosis can be complicated and difficult. We describe the use of an industrial grade tungsten carbide drill bit in the treatment of one of these complex fractures. An industrial grade tungsten carbide drill bit was used to fashion a medullary canal in the surgical treatment of a left peri-implant fracture of the neck of femur in a patient with osteopetrosis. The patient was successfully treated with a hemiarthroplasty with good functional outcomes. A tungsten carbide drill bit serves as an effective and safe option in the treatment of osteopetrotic femoral neck fractures.
    MeSH terms: Femoral Neck Fractures; Femur; Humans; Osteopetrosis; Tungsten Compounds; Periprosthetic Fractures; Hemiarthroplasty
  12. Sharma A, Dosajh R, Bedi GS, Gupta K, Jain A
    Malays Orthop J, 2017 Mar;11(1):71-73.
    PMID: 28435580 DOI: 10.5704/MOJ.1703.010
    Dislocation of multiple metatarsophalangeal joint is an uncommon injury. The mechanism of injury is a high energy force distal to proximal with foot in hyperextension at the metatarsophalangeal (MTP) joint. The acute hyperextension of the toe at the moment of injury causes avulsion of the plantar part of the capsule from the junction of head and neck of the metatarsal. If the collateral ligaments remain intact, they maintain the locked fibrocartilaginous plate over the dorsum of the head of the metatarsal, making closed reduction impossible. We report a case of simultaneous 1st and 2nd MTP joint open dislocation. In the present case, we chose the plantar approach utilizing the already present plantar wound. At 18 months post-operative follow-up, there was no instance of redislocations or signs of avascular necrosis of head of metatarsal.
    MeSH terms: Follow-Up Studies; Foot; Metatarsal Bones; Metatarsophalangeal Joint; Toes; Collateral Ligaments
  13. Sharma A, Jindal S, Narula MS, Garg S, Sethi A
    Malays Orthop J, 2017 Mar;11(1):74-76.
    PMID: 28435581 DOI: 10.5704/MOJ.1703.011
    The incidence of bilateral gleno-humeral joint dislocation is rare, is almost always posterior and is usually caused by sports injuries, epileptic seizures, electrical shock, or electroconvulsive therapy. Bilateral fracture-dislocation is even rarer, with a few cases reported in the literature. We report an unusual case with dislocation of the both glenohumeral joints in opposite direction after a seizure episode, with fracture of greater tuberosity on one side and of the lesser tuberosity on the contralateral side. Although there have been a few reports of bilateral asymmetric fracture dislocations of the shoulder in the past, an injury pattern resembling our case has, to the best of our knowledge, not been described in the literature so far. This report includes a detailed discussion regarding the mechanism of injury in a case of asymmetrical dislocation following a seizure episode. At final follow-up, the patient had healed fractures, painless near normal range of motion with no redislocations.
    MeSH terms: Athletic Injuries; Electroconvulsive Therapy; Epilepsy; Follow-Up Studies; Humans; Humerus; Seizures; Shoulder; Shoulder Joint; Incidence; Range of Motion, Articular; Fracture Dislocation
  14. Pande K, Aung TT, Leong JF, Bickle I
    Malays Orthop J, 2017 Mar;11(1):77-78.
    PMID: 28435582 DOI: 10.5704/MOJ.1703.012
    Transient osteoporosis of the hip (TOH) is a benign, selflimiting condition characterised by acute onset groin pain in adults. Early diagnosis is important to differentiate it from progressive conditions such as osteonecrosis. We report on a middle-aged male who presented with right groin pain without any prior trauma. The diagnosis of transient osteoporosis of hip was confirmed by Magnetic Resonance Imaging (MRI) and he was successfully treated with a course of Alendronate sodium, anti-inflammatory analgesics and a period of non-weight bearing ambulation.
    MeSH terms: Adult; Anti-Inflammatory Agents, Non-Steroidal; Brunei; Groin; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Osteonecrosis; Osteoporosis; Walking; Alendronate; Early Diagnosis; Acute Pain
  15. Nurul-Laila S, Chai KS, Liza-Sharmini AT, Shatriah I
    Case Rep Ophthalmol Med, 2017;2017:1087821.
    PMID: 28546880 DOI: 10.1155/2017/1087821
    Kingella kingae had rarely been reported as a causative organism for corneal ulcer and had not been described before in vernal keratoconjunctivitis (VKC). Generally regarded as commensals of respiratory tract particularly in young children, it had however been isolated from the corneal ulcer scraping of both adult and children. We report a case of bacterial ulcer with isolation of Kingella kingae from the corneal scraping in a young child with underlying VKC.
  16. Bhatt S, Mishra B, Tandon A, Manchanda S, Parthsarathy G
    Malays J Med Sci, 2017 May;24(3):96-100.
    PMID: 28814938 DOI: 10.21315/mjms2017.24.3.12
    Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge. Therefore, an unknown cause (SMAS) of upper gastrointestinal obstruction in a patient of abdominal tuberculosis is being presented for the first time through this case report. An imaging diagnosis of SMAS was made on contrast enhanced CT abdomen which also confirmed the clinical suspicion of abdominal tuberculosis in the patient. The patient was managed conservatively and recovered without requiring any surgical intervention for the obstructive symptoms.
    MeSH terms: Abdomen; Aorta, Abdominal; Duodenum; Humans; Superior Mesenteric Artery Syndrome; Tomography, X-Ray Computed; Tuberculosis; Weight Loss; Mesenteric Artery, Superior; Upper Gastrointestinal Tract; Intra-Abdominal Fat
  17. Iqbal S, Raiz I, Faiz I
    Malays J Med Sci, 2017 Mar;24(2):106-115.
    PMID: 28894411 DOI: 10.21315/mjms2017.24.2.14
    Bilateral hydroureteronephrosis involves the dilatation of the renal pelvis, calyces and ureter; it develops secondary to urinary tract obstruction and leads to a build-up of back pressure in the urinary tract, and it may lead to impairment of renal function and ultimately culminate in renal failure. Although clinically silent in most cases, it can be diagnosed as an incidental finding during evaluation of an unrelated cause. In a minority of patients, it presents with signs and symptoms. Renal calculus is the most common cause, but there are multiple non-calculus aetiologies, and they depend on age and sex. Pelviureteric junction obstruction, benign prostatic hypertrophy, urethral stricture, neurogenic bladder, retroperitoneal mass and bladder outlet obstruction are some of the frequent causes of hydroureteronephrosis in adults. The incidence of non-calculus hydronephrosis is more common in males than in females. Ultrasonography is the most important baseline investigation in the evaluation of patients with hydronephrosis. Here, we report a rarely seen case of bilateral hydroureteronephrosis associated with a hypertrophied, trabeculated bladder in an adult male cadaver, suspected to be due to a primary bladder neck obstruction, and analyse its various other causes, clinical presentations and outcomes.
    MeSH terms: Adult; Urinary Bladder Neck Obstruction; Urinary Bladder, Neurogenic; Cadaver; Dilatation; Female; Humans; Hydronephrosis; Kidney Calculi; Kidney Calices; Kidney Pelvis; Male; Prostatic Hyperplasia; Ultrasonography; Ureter; Ureteral Obstruction; Urethral Stricture; Incidence; Incidental Findings; Renal Insufficiency
  18. Thakur A, Basu PP
    Malays J Med Sci, 2017 Aug;24(4):102-105.
    PMID: 28951695 DOI: 10.21315/mjms2017.24.4.12
    Acute pancreatitis is considered to be an extremely rare extrahepatic manifestation of acute viral hepatitis E. The incidence is reported to be around 5%-6% in the available case series. It has usually been reported in non-fulminant cases of acute viral hepatitis E in the second or third week of illness, with a favourable outcome. Here, we report the case of a young male subject with acute viral hepatitis E presenting as acute pancreatitis at its onset and exhibiting a prolonged recovery phase. To the authors' knowledge, such a presentation of acute viral hepatitis E as acute pancreatitis at its inception has been only sparsely reported in the available literature.
    MeSH terms: Acute Disease; Male; Pancreatitis; Publications; Incidence; Hepatitis E
  19. Ralot TK, Singh R, Bafna C, Rajesh S, Singh S
    Malays J Med Sci, 2017 Aug;24(4):106-110.
    PMID: 28951696 DOI: 10.21315/mjms2017.24.4.13
    A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.
    MeSH terms: Female; Humans; Hypesthesia; Middle Aged; Multiple Sclerosis; Myelitis; Neck; Recurrence; Brown-Sequard Syndrome; Lower Extremity
  20. Behera G, Poduval M, Patro DK, Sahoo S
    Malays Orthop J, 2017 Jul;11(2):68-71.
    PMID: 29021883 DOI: 10.5704/MOJ.1707.009
    Brodie's abscess is a variety of subacute osteomyelitis with a long duration of presentation and intermittent pain. It usually involves the metaphyseal region of long bones of the lower limbs. Brodie's abscess of pelvic bone is very rare. Involvement of posterior ilium with gluteal syndrome is extremely unusual and can be easily missed or misdiagnosed. We present a 9-year old boy who reported to us with intermittent low back pain of three months duration without any other constitutional symptoms. Clinically, there was mild tenderness over the posterior ilium. Computed tomography showed a lytic lesion in the posterior ilium with a breach in the outer cortex. MRI and bone scan were suggestive of inflammatory pathology. Keeping infective, tubercular and benign bone tumors as differential diagnoses, open biopsy and curettage were done. Staphylococcus aureus was cultured and histopathology was suggestive of osteomyelitis. The patient received appropriate antibiotics for six weeks. He was asymptomatic till 18 months of follow up without any recurrence. We present this case because of its rarity and unusual presentation as gluteal syndrome and low back pain, and its resemblance to other pelvic and sacroiliac joint pathologies which are often missed or misdiagnosed in paediatric patients.

    Study done in India
    MeSH terms: Abscess; Anti-Bacterial Agents; Biopsy; Bone Neoplasms; Child; Curettage; Diagnosis, Differential; Follow-Up Studies; Humans; Ilium; Magnetic Resonance Imaging; Male; Osteomyelitis; Pelvic Bones; Pelvis; Sacroiliac Joint; Staphylococcus aureus; Tomography, X-Ray Computed; Low Back Pain; Lower Extremity
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