Browse publications by year: 2017

  1. Hazwan Ab. Wahid, Khairul Nizam bin Siron, Ahmad Zakiran
    MyJurnal
    Displaced and unstable proximal humerus fractures are difficult to treat
    and they have high morbidity. The main goal is to achieve painless shoulder with full
    recovery of the shoulder joint motion. Impingement syndrome is one of the commonest
    postoperative complication. This study aim is to appreciate the functional outcomes of
    Philos-plate fixation for proximal humerus fractures and to establish association with
    high plate positioning with impingement syndrome of the shoulder after Philos-plate
    fixation. (Copied from article).
    MeSH terms: Bone Plates; Goals; Humerus; Postoperative Complications; Shoulder; Shoulder Fractures; Shoulder Joint; Rotator Cuff
  2. Samsudin S, Mohd Hashim S, Nawi A
    MyJurnal
    Introduction: Osteoporosis has frequently been regards as a disease of women only. However, men are also at risk of developing osteoporosis. We aimed to evaluate the knowledge of osteoporosis among men and its associated factors.
    Materials and method: A cross-sectional study of 245 male patients aged 50 and above was conducted in the primary care clinic, University Kebangsaan Malaysia Medical Centre. The research instrument used in this study was a validated self-administered questionnaire which consists of socio-demographic data and 16 items of knowledge of osteoporosis among men.
    Results: The mean score for knowledge was 7.78± 3.32 out of 16 points. Most of the subjects (83 percent) knew the definition of osteoporosis but were not aware that osteoporosis was a silent disease. Only a quarter of subjects (38 percent) recognized family history as a risk factors for osteoporosis. Despite 78 percent of subjects answer correctly regarding importance of calcium intake in their diet however only 7 percent
    of them knew the recommended dosage of daily calcium intake. Knowledge of osteoporosis was found to be significantly associated with education and total monthly household income.
    Conclusion: Findings indicate limited knowledge of osteoporosis among the subjects. Public education of osteoporosis among men is important to increase their knowledge. Meanwhile, primary care doctors should also emphasize and educate men regarding osteoporosis to enhance their knowledge of the disease.
    MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Female; Hospitals, University; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Male; Osteoporosis; Bone Density
  3. Tengku Kashfil
    MyJurnal
    Cast removal procedures can be a daunting experience for children giving
    rise to anxiety. The objective of this study is to measure the level of anxiety in children
    during cast removal at Hospital Tengku Ampuan Afzan. (Copied from article).
    MeSH terms: Anxiety; Anxiety Disorders; Child; Humans; Splints
  4. Nurhainis, O.S., Fuad, F.A.A.
    Trop Biomed, 2017;34(4):841-854.
    MyJurnal
    Lactate dehydrogenase from Plasmodium knowlesi (Pk-LDH) has been suggested
    as a potential therapeutic target for the development of drugs against malaria disease. This
    paper reported the screening of compounds which have potentials to be developed as drugs
    specific for malaria caused by P. knowlesi via in silico screening. Due to the unavailability
    of Pk-LDH crystal structure, a protein model was built based on the crystal structure of the
    closest similar protein, lactate dehydrogenase from Plasmodium falciparum (Pf-LDH) with
    91% sequence identity between the two enzymes. The model was developed using MODELLER
    program and verified in Structural Analysis and Verification Server. Primary and secondary
    structure features were determined and based on Globplot, two disordered regions were
    predicted at amino acid numbers 85-95 and 269-281. Meanwhile, results of PPCpred server
    predicted that Pk-LDH is crystallisable with predicted crystallisation propensity of 0.766.
    Verification of the model was performed with the ERRAT quality factor of 92.2% while Verify
    3D gave the percentage of 85.76%. Ligand-based drug design was performed using Ultra-Fast
    Shape Recognition with Atom Types (USFRAT) with scores for compounds most resemble
    oxamate ranged from 0.832-0.914. Meanwhile, the results from structure-based screening
    using Autodock4 and Cygwin gave minimum binding energies ranged from -3.59 to -0.07.
    Taken together, this study has successfully generated a verified model structure of Pk-LDH
    and yielded a list of compounds that have potentials to be developed as antimalarial drugs.
    MeSH terms: Amino Acids; Antimalarials; Crystallization; L-Lactate Dehydrogenase; Ligands; Malaria; Models, Structural; Plasmodium falciparum; Drug Design; Plasmodium knowlesi
  5. Lau, K.W., Chen, C.D., Moh, H.H., Sofian-Azirun, M., Lee, H.L., Low, V.L.
    Trop Biomed, 2017;34(4):795-803.
    MyJurnal
    This study reports the distribution and abundance of Aedes by using ovitrap
    surveillance and aims to provide the most recent information on dengue vector distribution in
    Sarawak State, Malaysia. The ovitrap index (OI) of Aedes larvae was found highest in urban
    residential area (mean OI = 90.97%), followed by suburban (69.70%), rural (65.45%) and
    remote (52.63%) residential areas. The mean number of Aedes larvae per ovitrap was also
    found to be significantly highest in urban residential area (26.47 ± 1.62) compared to other
    type of residential areas (p 10%.
    MeSH terms: Aedes; Animals; Dengue; Disease Vectors; Larva; Malaysia; Mosquito Control; Mosquito Vectors
  6. Mohd-Zamri, N.H., Mat-Desa, N.W., Abu-Bakar, N.
    Trop Biomed, 2017;34(4):759-769.
    MyJurnal
    Artemisinin-based combination therapies (ACTs) serve as a first line of defence
    against malaria infection. The success of malaria treatment depends closely on the timing of
    action and the target of this drug. The early inhibitory effect of artemisinin associated with
    the integrity and pH of the digestive vacuole (DV) of the malaria parasite was investigated.
    Using the malaria SYBR Green I based-fluorescence assay, artemisinin showed activity against
    the chloroquine-sensitive strains of 3D7 and D10 higher than that against the chloroquineresistant
    strain of Dd2. A significant inhibition of parasite growth with marked changes in
    parasite morphology was seen following treatment with 0.2-60 times the IC50 value of
    artemisinin for a period of 4 hours was observed at mid ring, late trophozoite and late schizont
    stages. The drug had no obvious alterations in the distribution of a pH-sensitive probe,
    LysoSensor Blue labelling of the DV even at the highest concentration examined. Using a
    ratiometric pH probe, SNARF-1-dextran, the DV pH of treated trophozoites remained acidic,
    suggesting the loss of DV pH is probably not the mode of action of artemisinin that causes
    parasite killing.
    MeSH terms: Animals; Benzopyrans; Chloroquine; Dextrans; Fluorescence; Malaria; Naphthols; Organic Chemicals; Parasites; Rhodamines; Vacuoles; Inhibitory Concentration 50; Artemisinins; Schizonts; Trophozoites
  7. Vythilingam, I., Wan-Yusoff, W.S.
    Trop Biomed, 2017;34(4):746-758.
    MyJurnal
    Dengue is a major public health problem across more than 123 countries. Vector
    control has been the hallmark of the dengue control programme in many countries in Southeast
    Asia since there are no anti-dengue drugs available, and the most recent dengue vaccine is
    partly efficacious. House-to-house larval surveys, source reduction, larviciding, fogging, ULV
    which have been carried out since the inception of the dengue control programme in the
    1970s are no longer practicable and need to be augmented by more targeted but less ambitious
    outbreak responses that focus on a few tools that might justify expense of deployment.
    However, according to recent reports these tools have not really been evaluated for their
    effectiveness in dengue control. Novel techniques such the release of genetically modified
    mosquitoes (RIDL) and the use of the bacterium Wolbachia to control the populations of the
    Ae. aegypti are still under trial. In this review proactive methods to detect epidemics have
    been suggested. Tools based on adult mosquitoes is an important strategy for dengue vector
    surveillance and control. The outbreak response may be more efficient when timely vector
    control measures are implemented after the immediate detection of an infected mosquito.
    MeSH terms: Animals; Asia; Dengue; Disease Outbreaks; Disease Vectors; Larva; Culicidae; Public Health; Surveys and Questionnaires; Wolbachia; Dengue Vaccines; Epidemics
  8. Farah Haziqah, M.T., Nur Asyiqin, M.N., Mohd Khalid, M.K.N., Suresh, K., Rajamanikam, A., Chandrawathani, P., et al.
    Trop Biomed, 2017;34(3):741-745.
    MyJurnal
    There are few reports on Blastocystis spp. infections in invertebrate hosts namely,
    cockroaches. Due to their close proximity to humans especially to their dwellings prompted
    this study as these organisms could possibly play a role in human transmission. A total of 151
    cockroaches consisted predominantly of nymph and adult stages were captured from several
    types of dwellings in the state of Perak and Selangor, Malaysia. Approximately half (40.4%) of
    the cockroach intestinal contents screened were positive and were found associated to two
    main factors, host-stage and types of dwellings. The granular and vacuolated forms were the
    most common cell form found in the in vitro cultures and were morphologically similar to B.
    hominis. However, the surface coat observed was thick with an electron lucent area observed
    in the central vacuole. The isolates grew in room temperature but optimal growth was
    observed at a 24ºC similar to the reptilian Blastocystis with a high number of cells were
    recovered. Using the DNA barcoding method, two isolates were identified as ST3 (allele 56),
    one isolate was consider as the new subtype with close relation to allele 114.
    MeSH terms: Alleles; Animals; Biological Phenomena; Cockroaches; Electrons; Gastrointestinal Contents; Humans; Invertebrates; Malaysia; Nymph; Research Design; Temperature; Vacuoles; Blastocystis Infections; Blastocystis; DNA Barcoding, Taxonomic
  9. Ng, Y.L., Hamdan, N.E.S., Tuen, A.A., Mohd-Azlan, J., Chong, Y.L.
    Trop Biomed, 2017;34(3):723-731.
    MyJurnal
    Little is known regarding infestation of ectoparasites in synanthropic rodents in
    Sarawak, Malaysia. A total of 44 rodents from three species (Rattus rattus, Rattus tiomanicus
    and Sundamys muelleri) were trapped from four residential areas in western Sarawak,
    Malaysia, for ectoparasites screening. A total of 117 ectoparasites from three hard tick
    species (Ixodes granulatus, Haemaphysalis sp. 1, Haemaphysalis sp. 2), three mesostigmatid
    mite species (Laelaps echidninus, Laelaps sedlaceki, and Laelaps nuttalli), one trombiculid
    mite (chigger species), and one louse species (Hoplopleura sp.), were recovered from 32
    infected rodents (72.73% infestation). Infestations by multiple ectoparasite species on the
    same rodent individuals were recorded in R. rattus and R. tiomanicus (28.1%, n=9) in this
    study, while Sundamys muelleri was only infested with L. echidninus. One R. rattus individual
    was co-infected with ticks, louse, and mesostigmatid mite. L. echidninus was the generalist
    ectoparasite species that infected all three rodent species in three of the residential areas
    studied. Ectoparasite species diversity was significantly different among four residential
    areas based on Shannon index and diversity t-test (p-value
    MeSH terms: Animals; Anoplura; Malaysia; Mite Infestations; Parasitic Diseases; Trombiculidae; HIV Infections; Ixodes; Ixodidae; Murinae; Rats; Coinfection
  10. Nur Aida, H., Abu Hassan, A., Suhaila, A.H., Rajasaygar, S., Nur Hafiza, M., Anita, T., et al.
    Trop Biomed, 2017;34(3):691-707.
    MyJurnal
    Autoregressive integrated moving average (ARIMA) was applied to make realtime
    predictions on the Aedes egg populations in three selected dengue hotspots of
    Penang, Malaysia. The weekly ovitrap collection was carried out to determine the
    abundance of Aedes eggs in field population in some selected areas. The ARIMA models
    were able to estimate actual egg abundance using two criteria. The first criteria is
    determine the reliability of statistics and the second is to measure the accuracy of
    forecasting ability of the model equation. The parsimonious model with a lowest order
    of AR or MA and RMSE value of the forecast for each data set was considered the best.
    ARIMA (1,0,0), ARIMA (2,0,0) and ARIMA (0,1,1) models were judged to be the best fit
    for the suburban, urban squatter and urban area data sets respectively. The models were
    able to forecast the number of eggs within a range of one to eleven weeks. The developed
    models were able to estimate the egg abundance adequately to permit their use in Aedes
    control programme in Penang Island. Thus, it can be a useful tool for health officials to
    improve the management of mosquito control and alert the public to reduce the possibility
    of dengue outbreaks.
    MeSH terms: Aedes; Animals; Dengue; Disease Outbreaks; Forecasting; Malaysia; Mosquito Control; Transients and Migrants; Reproducibility of Results; Moclobemide; Islands
  11. Nurkunasegran, M., Kho, K.L., Koh, F.X., Tan, P.E., Nizam, Q.N., Ong, B.L., et al.
    Trop Biomed, 2017;34(3):675-680.
    MyJurnal
    Coxiella burnetii, the causative agent of Q fever, is an intracellular bacterium of
    medical and veterinary importance. The reservoirs of C. burnetii are extensive which include
    mammals and arthropods, particularly ticks. As the organism is difficult to culture, this study
    was aimed to detect C. burnetii DNA in animal (mainly blood and vaginal samples of cattle,
    goats and sheep) and tick samples obtained from farm animals, wild rodents and vegetation.
    Two polymerase chain reaction (PCR) assays targeting IS1111 transposon-like gene (TransPCR)
    and com1 gene (OMP-PCR) were used for C. burnetii detection. Sequence determination
    of the amplified fragments and a real-time PCR assay were used to confirm PCR findings. C.
    burnetii DNA was detected from 9.1% of cattle blood and 4.2% vaginal samples, respectively.
    A small percentage (5.8%) of ticks (including Amblyomma, Dermacentor, Rhipicephalus and
    Haemaphysalis spp.) haboring C. burnetii were identified in this study. This study provides
    molecular evidence on the presence of C. burnetii in cattle and ticks. The possible zoonotic
    transmission of C. burnetii is yet to be investigated.
    MeSH terms: Animals; Animals, Domestic; Arthropods; Cattle; Dermacentor; DNA; Female; Goats; Mammals; Q Fever; Rodentia; Sheep; Coxiella burnetii; Sequence Analysis; Ixodidae; Rhipicephalus; Real-Time Polymerase Chain Reaction
  12. Mohd Hasan, L.I., Kho, K.L., Koh, F.X., Tay, S.T., Hassan Nizam, Q.N.
    Trop Biomed, 2017;34(3):668-674.
    MyJurnal
    Hemotrophic mycoplasma (hemoplasmas) is a cell wall-less bacterium causing
    infectious anemia in animals. As data on hemoplasmas infecting cattle in Malaysia is scarce,
    specific polymerase chain reaction assays were used for detection of hemoplasmas from
    blood samples of cattle and ticks in this study. Hemoplasma DNA was detected in 69 (69.0%)
    of 100 cattle blood samples obtained from different breeds. A total of 50.0% of the cattle in
    this study were infected with only Mycoplasma wenyonii, while 2.0% were infected with
    only Candidatus Mycoplasma haemobos and 17% were infected with both species. Based on
    sequence analysis of the partial or nearly full length sequences of hemoplasma 16S rRNA
    gene, the presence of M. wenyonii and Candidatus M. haemobos was confirmed. Hemoplasmapositive
    cattle of less than three years appeared to have higher infection rate compared to
    other age groups. M. wenyonii was identified for the first time in approximately 30% of cattle
    ticks (Rhipicephalus microplus and Haemaphysalis sp.) in this study. This study presents the
    first molecular evidence of hemoplasmas in Malaysian cattle and ticks.
    MeSH terms: Anemia; Animals; Breeding; Cattle; Cell Wall; DNA; Malaysia; Mycoplasma; RNA, Ribosomal, 16S; Polymerase Chain Reaction; Sequence Analysis; Rhipicephalus
  13. Wong CF, Rahman RNZRA, Basri M, Salleh AB
    Iran J Biotechnol, 2017;15(3):194-200.
    PMID: 29845069 DOI: 10.15171/ijb.1524
    Background:Pseudomonas protein expression in E. coli is known to be a setback due to significant genetic variation and absence of several genetic elements in E. coli for regulation and activation of Pseudomonas proteins. Modifications in promoter/repressor system and shuttle plasmid maintenance have made the expression of stable and active Pseudomonas protein possible in both Pseudomonas sp. and E. coli. Objectives: Construction of shuttle expression vectors for regulation and overexpression of Pseudomonas proteins in Pseudomonas sp. and E. coli. Materials and Methods:Pseudomonas-Escherichia shuttle expression vectors, pCon2(3), pCon2(3)-Kan and pCon2(3)-Zeo as well as E. coli expression vectors of pCon4 and pCon5 were constructed from pUCP19-, pSS213-, pSTBlue-1- and pPICZαA-based vectors. Protein overexpression was measured using elastase strain K as passenger enzyme in elastinolytic activity assay. Results: The integration of two series of IPTG inducible expression cassettes in pCon2(3), pCon2(3)-Kan and pCon2(3)-Zeo, each carrying an E. coli lac-operon based promoter, Plac, and a tightly regulated T7(A1/O4/O3) promoter/repressor system was performed to facilitate overexpression study of the organic solvent-tolerant elastase strain K. These constructs have demonstrated an elastinolytic fold of as high as 1464.4 % in comparison to other published constructs. pCon4 and pCon5, on the other hand, are series of pCon2(3)-derived vectors harboring expression cassettes controlled by PT7(A1/O4/O3) promoter, which conferred tight regulation and repression of basal expression due to existence of respective double operator sites, O3 and O4, and lacIq. Conclusions: The constructs offered remarkable assistance for overexpression of heterogeneous genes in Pseudomonas sp. and E. coli for downstream applications such as in industries and structural biology study.
    MeSH terms: Biology; Escherichia coli; Genetic Vectors; Isopropyl Thiogalactoside; Lac Operon; Maintenance; Pancreatic Elastase; Plasmids; Promoter Regions, Genetic; Pseudomonas; Solvents; Genetic Variation
  14. Mohammed Aliyu Modibbo, Mohammed Arif Shahidah, Isah Funtua Abdulkadir, Umar Wali
    MyJurnal
    This paper has evaluated the spatial growth of Bauchi Metropolis from 1976 to 2015
    through the application of Remote Sensing and GIS techniques. Various satellite
    imageries of the metropolis (Landsat MSS of 1976, TM of 1986, 1996 and ETM+ of 2006
    and 2015) were integrated; processed and classified using ERDAS imagine 9.1. The
    results showed an increase in area from 11.68km2
    in 1976 to 12.51km2
    in 1986 to
    32.44km2 in 1996, to 49.66km2
    in 2006 and finally to 89.23km2 in 2015. It is
    recommended that government should provide the required capacities for the use of
    Remote Sensing and GIS in planning for the growth of the town.
    MeSH terms: Biological Phenomena; Environment; Government; Imagination; Imagery (Psychotherapy); Geographic Information Systems; Remote Sensing Technology
  15. Norhafiza Mohamed, Wan Hasrulnizzam Wan Mahmood, Muhamad Zaki Yusup, Mohd Razali Muhamad
    MyJurnal
    This paper aims to explore the level of manufacturing performance, environmental
    actions and customer activities in implementing green supply chain initiatives. Besides,
    the relationship between environmental actions and customer activities towards
    manufacturing performance also been investigated. For this purposes, the data was
    collected using questionnaire-based survey among Malaysian manufacturing firms.
    Using the descriptive and correlation test, the data was analyzed. From the results, it
    is showing that the manufacturing performance through the implementation of green
    supply chain management has a positive relationship to environmental action and
    customer activities.
    MeSH terms: Commerce; Environment; Surveys and Questionnaires
  16. Erni Suryani Suharto, Nurul I'zzah Othman, Mohd Agos Salim Nasir
    MyJurnal
    In this paper, we demonstrate a modified scheme for solving the nonlinear KleinGordon
    equation of PDE hyperbolic types. The Klein-Gordon equation is a relativistic
    wave equation version of the Schrodinger equation, which is widely used in quantum
    mechanics. Additionally, the nonstandard finite difference scheme has been used
    extensively to solve differential equations and we have constructed a modified scheme
    based on the nonstandard finite difference scheme associated with harmonic mean
    averaging for solving the nonlinear inhomogeneous Klein-Gordon equation where the
    denominator is replaced by an unusual function. The numerical results obtained have
    been compared and showed to have a good agreement with results attained using the
    standard finite difference (CTCS) procedure, which provided that the proposed scheme
    is reliable. Numerical experiments are tested to validate the accuracy level of the
    scheme with the analytical results.
    MeSH terms: Numerical Analysis, Computer-Assisted; Nonlinear Dynamics; Electromagnetic Phenomena
  17. Umar Suleiman Dauda, Nik Noordini Nik Abdl Malik, Mazlina Esa, Mohd Fairus Mohd Yusoff, Mohamed Rijal Hamid
    MyJurnal
    Parameter estimation of complex exponential signals corrupted by additive white
    Gaussian noise (AWGN) is crucial in the study of distributed beamforming in a practical
    scenario. Near zero (0) phase offset are expected at the receiver end which rely on the
    smoothing and correction of the frequency and phase estimates. Neither
    computational complexity nor the processing latency has an effect on the expected
    zero phase offset but the estimation accuracy does. Thus, the maximum likelihood
    estimator (MLE) using Fast Fourier Transform (FFT) approach is being considered for
    cases with none and post processing in locating of the maximum peaks. Details on how
    the phase estimates are arrived at is not always covered in literatures but explained in
    the article. Numerical results obtained showed that global maximum peaks are arrived
    at by employing a fine search with higher values of FFT.
    MeSH terms: Fourier Analysis; Normal Distribution; Likelihood Functions
  18. Ilanur Muhaini Mohd Noor, Muhamad Kamal Mohammed Amin
    MyJurnal
    This paper aim is to design an education kit for wastewater system that can maintain
    the standard parameters of neutralized wastewater by maintaining the suitable pH
    (Potential Hydronium) level and temperature of the wastewater from industry by using
    fuzzy controller. This study is capable to control the unwanted bacteria by automatic
    regulatory and monitoring the temperature, pH and water level. Fuzzy logic method is
    use to control and monitor pH level as well as the temperature during clarifying process
    because pH control process is a complex physical-chemistry process of strong
    individuality of time-varying and non-linearity properties. Pumps used in the prototype
    need to be controlled precisely to enable either acid or base to be pumped into mix
    tank of the wastewater treatment. The control and monitoring system, which has been
    designed through LabVIEW front panel will ease end user in inspection of the
    parameters involve in wastewater treatment. The entire system output could be
    observed remotely in Data Dashboard application in smartphone or tablet. The GUI
    was designed and interfaced with the prototype constructed to carry out the process
    of controlling and monitoring the required parameters. Few tests were conducted
    repetitively to analyse the performance of the system parameters. It was found that
    the controlled set point fixed within the range of pH 7.6-8.4, temperature 25-29.44
    Celsius and water level of 20cm in this research that was effectively achieved in the
    entire test conducted. In addition, the wastewater system accuracy and performance
    is 96.72% and 90.22% respectively.
    MeSH terms: Smartphone; Bacteria; Hydrogen-Ion Concentration; Individuality; Maintenance; Paper; Research; Tablets; Temperature; Water; Fuzzy Logic; Waste Water
  19. Nurfadly Z., Suhartono T.P., Umar Z., Herman H.
    MyJurnal
    Background: The apoptosis of microvascular endothelial cells causes plasma leakage in dengue haemorrhagic fever patients. The soluble Fas ligand is a protein with molecular weight of 40 kDa that acts as a mediator of apoptosis. This study aimed to prove whether soluble Fas ligand can be used as a potential marker to predict the severity of dengue infection by comparing the soluble Fas ligand levels in dengue fever (DF) and dengue haemorrhagic fever (DHF) patients early in the course of illness. Method: This was a prospective study. It included 42 dengue patients (22 DF patients and 20 DHF patients) and 20 healthy people as a control group. The soluble Fas ligand was measured by the enzyme-linked immunosorbent assay (ELISA). Result: Soluble Fas ligand was increased significantly (P < 0.001) in DHF patients (median = 130.19, IQR = 36.26) compared to DF patients (median = 104.73, IQR = 53.94) and the control group (median = 87.16, IQR = 24.91). Conclusion: Soluble Fas ligand can be used as a potential marker to predict the severity of dengue infection in the early course of the illness. However, a larger sample size and further objective studies are needed to confirm these findings. © Penerbit Universiti Sains Malaysia, 2017.
  20. Ardilla Hanim Abdul Razak, Ahmad Hafiz Zulkifly, Ramli Musa, Mohd Shukrimi Awang, Goh, Kian Liang
    MyJurnal
    Total knee arthroplasty represents a major advance in the treatment of
    degenerative joint disease. It provides excellent restoration of joint function and pain
    relief. The primary indication for total knee arthroplasty is to relieve pain caused by
    severe arthritis, with or without significant deformity. This study is to assess
    psychological impact pre and post arthroplasty. (Copied from article).
    MeSH terms: Osteoarthritis; Pain; Arthroplasty, Replacement, Knee
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