Browse publications by year: 2019

  1. Duong M, Islam S, Rangarajan S, Leong D, Kurmi O, Teo K, et al.
    Lancet Glob Health, 2019 05;7(5):e613-e623.
    PMID: 31000131 DOI: 10.1016/S2214-109X(19)30070-1
    BACKGROUND: The associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary across populations is unknown.

    METHODS: In this international, community-based cohort study, we prospectively enrolled adults aged 35-70 years who had no intention of moving residences for 4 years from rural and urban communities across 17 countries. A portable spirometer was used to assess FEV1. FEV1 values were standardised within countries for height, age, and sex, and expressed as a percentage of the country-specific predicted FEV1 value (FEV1%). FEV1% was categorised as no impairment (FEV1% ≥0 SD from country-specific mean), mild impairment (FEV1% <0 SD to -1 SD), moderate impairment (FEV1%

    MeSH terms: Adult; Age Factors; Aged; Cardiovascular Diseases/mortality*; Cardiovascular Diseases/epidemiology; Cardiovascular Diseases/physiopathology; Female; Forced Expiratory Volume*; Hospitalization/statistics & numerical data; Humans; Male; Middle Aged; Prospective Studies; Respiratory Tract Diseases/mortality*; Respiratory Tract Diseases/epidemiology; Respiratory Tract Diseases/physiopathology; Risk Factors; Sex Factors; Spirometry; Global Health/statistics & numerical data
  2. Chen XW, Shafei MN, Aziz ZA, Sidek NN, Musa KI
    J Neurol Sci, 2019 Jun 15;401:130-135.
    PMID: 31000206 DOI: 10.1016/j.jns.2019.04.015
    BACKGROUND: Stroke outcomes could be a quality indicator across the continuum of care and inform stroke management policymaking. However, this topic has rarely to date been studied directly.

    AIMS: We sought to investigate recent trends in stroke outcomes at hospital discharge among first-ever stroke patients.

    METHODS: This was an analysis of data from the Malaysia National Stroke Registry. Patients aged 18 years or older documented as having a first episode of stroke in the registry were recruited. Subsequently, the comparison of proportions for overall and sex-specific stroke outcomes between years (from 2009 to 2017) was conducted. The primary outcome was modified Rankin Scale score, which was assessed at hospital discharge, and each patient was categorized as follows: 1) functional independence, 2) functional dependence, or 3) death for analysis.

    RESULTS: This study included 9361 first-ever stroke patients. Approximately 36.2% (3369) were discharged in an independence state, 53.1% (4945) experienced functional dependence, and 10.8% (1006) patients died at the time of hospital discharge. The percentage of patients who were discharged independently increased from 23.3% in 2009 to 46.5% in 2017, while that of patients discharged in a disabled state fell from 56.0% in 2009 to 45.6% in 2017. The percentage of death at discharge was reduced from 20.7% in 2009 to 7.8% in 2017. These findings suggest that the proportions of stroke outcomes at hospital discharge have changed significantly over time (p 

    MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Disability Evaluation; Female; Disabled Persons/statistics & numerical data; Humans; Longitudinal Studies; Malaysia/epidemiology; Male; Middle Aged; Patient Discharge; Registries; Retrospective Studies; Sex Factors; Treatment Outcome; Stroke/mortality; Stroke/therapy*; Young Adult; Independent Living
  3. Nalliah S, Fong JSH, Yi Thor AY, Lim OH
    Indian J Urol, 2019;35(2):147-155.
    PMID: 31000921 DOI: 10.4103/iju.IJU_378_18
    INTRODUCTION: The aim of this systematic review is to compare chemotherapeutic agents commonly used in treating recurrent urinary infection in nonpregnant women by their efficacy, tolerability, adverse effects, and cost employing network meta-analysis.

    MATERIALS AND METHODS: We used three online databases, i.e., PubMed, ScienceDirect, and Cochrane Central Registry of Clinical Trials. Randomized controlled trials (RCTs) on the use of prophylactic chemotherapeutic agents used in treating nonpregnant women with recurrent urinary tract infections (RUTIs) published between 2002 and 2016 were selected. Only published papers in English were assessed for study quality, and meta-analyses were performed using fixed-effects model with NetMetaXL.

    RESULTS: Six RCTs fulfilled the criteria. When all three variables, i.e., efficacy, adverse effects and cost were considered, nitrofurantoin 50 mg once daily for 6 months appears to rank high for prophylaxis against RUTI. When efficacy was the only factor, fosfomycin had the highest superiority compared to D-mannose, nitrofurantoin, estriol, trimethoprim-sulfamethoxazole, and cranberry juice, respectively. However, fosfomycin was also ranked highest by adverse events. When cost alone is considered, nitrofurantoin appeared the most cost-effective agent while placed third for efficacy alone.

    CONCLUSION: Selecting appropriate chemotherapeutic agents for RUTI will need to factor in effectiveness, adverse effects, and cost. While it is difficult to select an ideal drug, evaluation using network analysis may guide choice of medication for best practice.

  4. Shivji Z, Jabeen A, Awan S, Khan S
    J Neurosci Rural Pract, 2019 4 20;10(2):178-184.
    PMID: 31001002 DOI: 10.4103/jnrp.jnrp_370_18
    Introduction: Most neurophysiology departments around the world establish their own normative data. However, ethnic differences are not taken into account. Our aim was to establish normal nerve conduction studies (NCS) data for routinely tested nerves in individuals of Pakistani (South Asian) origin and to compare with Western published data.

    Materials and Methods: One hundred healthy adults' nerves were assessed, using standardized techniques. Individuals were grouped into age groups. Gender differences were assessed.

    Results: Of the 100 volunteers, 49 were female and 51 were male. Their mean age was 39.8 years. Findings showed statistically significant prolongation of median distal motor latency (DML) and F-wave latency with age and reduction of median, ulnar, and sural sensory amplitudes as age increased. Gender differences showed consistent difference in the normal values for median, ulnar, and peroneal DMLs and respective F-wave latencies, which were significantly shorter in females. Sensory amplitudes of tested upper extremity nerves were significantly lower in males. Comparing with available data, our findings are similar to the Saudi population but significantly different from the American and multiethnic Malaysian populations. Pakistani individuals generally have significantly higher amplitudes and faster conduction velocities with similarities to South Asian studies.

    Conclusions: We recommend normative NCS parameters for commonly tested nerves for the Pakistani population, using standardized techniques to ensure highest quality testing and outcomes.

    MeSH terms: Adult; Female; Humans; Male; Neural Conduction; Neurophysiology; Pakistan; Peripheral Nerves; Reference Values; Saudi Arabia; Ulnar Nerve; United States; Volunteers
  5. Khoo CS, Tee TY, Tan HJ, Ali RA
    J Neurosci Rural Pract, 2019 4 20;10(2):324-326.
    PMID: 31001027 DOI: 10.4103/jnrp.jnrp_315_18
    We report a patient with end-stage renal disease on peritoneal dialysis, who developed encephalopathy after receiving a few doses of cefepime. He recovered clinically and electroencephalographically after having discontinued the culprit agent and undergone hemodialysis. This case highlights the importance of promptly recognizing this reversible encephalopathy, which can lead to the avoidance of unnecessary workup, reduce the length of hospital stay, and thereby improve the patients' outcome.
    MeSH terms: Brain Diseases; Cephalosporins; Renal Dialysis; Humans; Kidney Failure, Chronic; Length of Stay; Male; Peritoneal Dialysis
  6. Mohd Nor NH, Othman F, Mohd Tohit ER, Md Noor S, Razali R, Ahmad Hassali H, et al.
    PMID: 31001352 DOI: 10.1155/2019/3245836
    Coronary artery disease is the leading cause of mortality and morbidity worldwide. The pathogenesis is mainly due to atherosclerosis, plaque rupture, and platelet thrombus formation. The main risk factors for coronary artery disease include obesity, hypercholesterolemia, smoking, diabetes, and high blood pressure. As a part of disease management, treatment options using anticoagulant and antiplatelet drugs can be applied with addition to lipid-lowering medication. However, medicinal plants comprising antiatherothrombotic effects can be used as options to combat the disease rather than drug therapies with lesser adverse effects. Therefore, the haematological effect of Berberis vulgaris L., Teucrium polium L., and Orthosiphon stamineus Benth extracts was studied using in vitro model to prevent and to treat coronary atherothrombotic disease. The aqueous, methanol, and polysaccharide extracts of B. vulgaris, T. polium, and O. stamineus, respectively, were studied for their anticoagulant and antiplatelet effect on human whole blood. Extracts were subjected to the prothrombin time (PT) and activated partial thromboplastin time (APTT) test for anticoagulant activity. The antiplatelet activity was investigated using an electrical impedance method. B. vulgaris aqueous extract (BVAE), B. vulgaris polysaccharide extract (BVPE), T. polium aqueous extract (TPAE), and T. polium polysaccharide extract (TPPE) significantly prolonged the coagulation time in a concentration-dependent manner (p<0.05). The administration of BVAE demonstrated the most effective antiplatelet activity against platelet aggregation caused by arachidonic acid (AA) and collagen. These antiplatelet activities may correspond to the presence of higher total phenolic compound, which thus inhibit the platelet aggregation activity. In conclusion, these findings provide strong evidence on the antiatherothrombotic effect of BVAE and TPAE.
  7. Esa A, Connolly KD, Williams R, Archer CW
    Malays Orthop J, 2019 Mar;13(1):1-7.
    PMID: 31001376 DOI: 10.5704/MOJ.1903.012
    The role of extracellular vesicles (EV) in osteoarthritis has become the focus of much research. These vesicles were isolated from several cell types found in synovial joint including chondrocytes and synovium. As articular cartilage is an avascular tissue surrounded by synovial fluid, it is believed that EV might play a crucial role in the homeostasis of cartilage and also could hold key information in the pathogenesis of osteoarthritis. This is thought to be due to activation of pro-inflammatory factors leading to a catabolic state and degradation of cartilage. In addition, due to the nature of articular cartilage lacking neuronal innervation, knowledge of EV can contribute to identification of novel biomarkers in this debilitating condition. This can be either directly isolated from aspirate of synovial fluid or from peripheral blood. Finally, EVs are known to shuttle important signalling molecules which can be utilised as unique modality in transferring therapeutic compounds in a cell free manner.
    MeSH terms: Extracellular Vesicles; Cartilage, Articular; Homeostasis; Osteoarthritis; Synovial Fluid; Synovial Membrane; Biomarkers; Chondrocytes
  8. Daechavijit P, Siridonthanakasem J, Wongsupha P, Yuktanandana P, Honsawek S
    Malays Orthop J, 2019 Mar;13(1):8-13.
    PMID: 31001377 DOI: 10.5704/MOJ.1903.001
    Introduction: Anterior cruciate ligament (ACL) tear is the most common knee ligament injury, especially in athletes. The objective of this study was to investigate relative telomere length (RTL) in blood leukocytes of patients with ACL injury compared with that of controls. Materials and Methods: A total of 187 subjects were invited to participate in this study. Ninety-two patients with clinically diagnosed ACL rupture were enrolled. Ninety-five age and gender-matched healthy controls were also recruited. Blood leukocyte RTL were analysed using quantitative real-time polymerase chain reaction. Results: Patients with ACL rupture had significantly longer relative telomere length than healthy controls (P=0.002). The patients with ACL rupture were classified into two groups according to the sport history of patients which are contact sports and non-contact sports. RTL in patients with non-contact sports was significantly greater than those with contact sports (P=0.006). Moreover, RTL was inversely correlated with body mass index of patients with ACL injury (r=-0.34, P=0.001). Logistic regression analysis indicated that long RTL was associated with a higher risk of ACL rupture. Conclusion: The present study showed that subjects with ACL rupture had significantly greater telomere length compared with their age and gender-matched controls. This finding may result from the increases in physical activity and overexpression of telomerase which acts as a protective mechanism against ACL injury. RTL in blood leukocytes is associated with a risk of ACL rupture.
    MeSH terms: Humans; Knee Injuries; Leukocytes; Sports; Body Mass Index; Logistic Models; Anterior Cruciate Ligament; Telomere; Telomerase; Athletes; Real-Time Polymerase Chain Reaction; Anterior Cruciate Ligament Injuries
  9. Sia U, Tan BB, Teo YY, Wong CC
    Malays Orthop J, 2019 Mar;13(1):14-19.
    PMID: 31001378 DOI: 10.5704/MOJ.1903.002
    Introduction: Post-implantation rod deformation is anticipated in scoliosis surgery but the difference in rod deformation between titanium and cobalt chrome rod has not been elucidated. This study aims to compare the difference in rod deformation between two groups. Materials and Methods: Twenty-one adolescent idiopathic scoliosis (AIS) patients were recruited from a single center. The over-contoured concave rods were traced prior to insertion. Post-operative sagittal rod shape was determined from lateral radiographs. Rod deformation was determined using maximal rod deflection and angle of the tangents to rod end points. The differences between pre- and post-operative rod contour were analysed statistically. Rod deformation and thoracic kyphosis between two types of implants were analysed. Results: Both rods exhibited significant change of rod angle and deflection post-operatively. Curvature of the titanium rod and cobalt chrome rod decreased from 60.5° to 37°, and 51° to 28° respectively. Deflection of titanium rod and cobalt chrome rod reduced from 28mm to 23.5mm and 30mm to 17mm respectively. There was no significant difference between titanium and cobalt chrome groups with regard to rod angle (p=0.173) and deflection (p=0.654). Thoracic kyphosis was increased from 20° to 26° in titanium group but a reduction from 25° to 23° was noticed in cobalt chrome group, but these findings were not statistically significant. Conclusion: There was no statistical difference in rod deformation between the two groups. Thus, the use of titanium rod in correction of sagittal profile is not inferior in outcome compared with cobalt chrome but with lower cost.
    MeSH terms: Adolescent; Chromium Alloys; Cobalt; Humans; Kyphosis; Postoperative Period; Scoliosis; Titanium; Prostheses and Implants
  10. Agrawal S, Chabra T, Pandey S, Bhardwaj P
    Malays Orthop J, 2019 Mar;13(1):20-24.
    PMID: 31001379 DOI: 10.5704/MOJ.1903.003
    Introduction: Carpal collapse of wrist occurs in disorders like rheumatoid arthritis and Kienbock's disease. Three techniques have been described to measure carpal collapse. First, the carpal height ratio (CHR), measured by dividing carpal height by 3rd metacarpal length. Second, the revised carpal height ratio (RCH ratio), measured by dividing carpal height by length of capitate. Third, capitate radius distance (CR index), measured by shortest distance between distal edge of radius and the proximal edge of capitate. The index publications describe good reliability of all these but which method out of the three is best in terms of intra- and inter-observer variability is not known. The purpose of this study was to find out which method had the least inter- and intra-observer variability for determining carpal collapse. Materials and Methods: Fifty normal wrist postero-anterior radiographs were studied by three assessors who measured CHR, RCH ratio and CR index separately. The measurements were repeated after one month by all the three observers. The results were then statistically analysed. Results: The p-value was <0.001 in all the three assessors in CR index meaning that the intra-observer variability was least in CR index. For the inter-observer variability intra class coefficient of 0.9 indicated that the CR index has the least variability. Conclusion: CR index is the most reproducible method to measure carpal collapse. The method which provides accurate measurement of carpal collapse will allow better staging of carpal disorders.

    Study site: Grande Hospital, Nepal
    MeSH terms: Arthritis, Rheumatoid; Carpal Bones; Humans; Osteonecrosis; Radius; Wrist; Wrist Joint; Reproducibility of Results; Observer Variation; Metacarpal Bones; Capitate Bone
  11. Yusof MN, Ahmad-Alwi AA
    Malays Orthop J, 2019 Mar;13(1):25-29.
    PMID: 31001380 DOI: 10.5704/MOJ.1903.004
    Introduction: Large wounds in the leg require combination of local flaps or free flap for wound coverage. Gastrocnemius musculocutaneous flap (GMCF) allows a large wound to be covered by a single local flap. However, the conventional GMCF is often associated with donor site morbidity where the exposed soleus raphe causes poor uptake of the skin graft. Islanding the skin on the muscles allows the donor site to be closed primarily, thus avoiding the donor site morbidity. Materials and Methods: Medical records of twelve patients who underwent islanded GMCF surgery from 2004 till 2018 were reviewed retrospectively. Results: The mean age was 31 years old. Eight cases were with open fracture of the tibia, two degloving injury exposing the patella, one open fracture of patella and necrotising soft tissue infection. The wound size ranged from 12cm2 to 120cm2. All flaps survived. Three patients required skin grafting at the donor site while in the rest the donor sites were able to be closed primarily. Four patients developed deep infection, one healed after vacuum dressing, one after bone transport and one after split thickness skin graft. One patient ended up with below knee amputation after developing chronic osteomyelitis of the tibia. Conclusion: Islanded gastrocnemius musculocutaneous flap is an effective simple alternative for coverage of large soft tissue defects from the knee to half of the leg distally with minimal donor site morbidity. Aggressive debridement of unhealthy tissue is necessary to prevent infection following wound coverage with this flap.
    MeSH terms: Adult; Amputation; Bandages; Debridement; Fractures, Open; Humans; Knee Joint; Medical Records; Osteomyelitis; Patella; Retrospective Studies; Skin; Tibia; Vacuum; Skin Transplantation; Soft Tissue Infections; Free Tissue Flaps; Myocutaneous Flap; Degloving Injuries
  12. Singh R, Singh H, Kanodia N
    Malays Orthop J, 2019 Mar;13(1):30-35.
    PMID: 31001381 DOI: 10.5704/MOJ.1903.005
    Introduction: Olecranon osteotomy is well described approach for complex intra-articular distal humeral fractures. In this study, we investigated the usefulness and complications of olecranon osteotomy approach for such fractures. We hypothesise that outcome is comparable in young adults and middle age group and also functional outcome is independent of fracture subtype following surgical fixation. Materials and Methods: Between December 2012 and September 2015, twenty-four adult patients (male: 15, female: 9) having mean age of 41.4 years with closed intra-articular fracture (AO-13C) were surgically managed using olecranon osteotomy approach and were followed-up for a mean of 28.5 months (range: 22-35 months). Functional outcome was measured using Mayo Elbow Performance Score (MEPS) and complications were observed. Statistical analysis was done using Student t-test and Kruskal Wallis test. Results: All fractures united by the end of three months. Mean elbow flexion achieved was 123°, mean extension lag was 9° and mean active arc of motion was 114°. Mean MEPS was 87 (excellent: 8, good: 14, fair: 1 and poor: 1). Post-operative transient ulnar nerve palsy was noted in two cases, heterotopic ossification (HO) was in one case, infection in two cases, implant prominence in five and elbow stiffness in three cases. Motion arc was higher in young adults and MEPS was comparable in both age group. Functional outcome was also dependent on fracture subtype. Conclusion: The olecranon osteotomy approach for distal humerus fractures had good functional outcome with fewer complications. Joint congruity and fixation could easily be assessed intraoperatively.
    MeSH terms: Carbon Isotopes; Child, Preschool; Elbow; Elbow Joint; Female; Fractures, Closed; Humans; Humeral Fractures; Humerus; Infant; Male; Middle Aged; Ossification, Heterotopic; Osteotomy; Ulnar Nerve; Ulnar Neuropathies; Young Adult; Olecranon Process; Intra-Articular Fractures
  13. Fahad S, Habib AA, Awais MB, Umer M, Rashid HU
    Malays Orthop J, 2019 Mar;13(1):36-41.
    PMID: 31001382 DOI: 10.5704/MOJ.1903.006
    Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes. Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. Patient records were reviewed for union of bone, bone and functional outcomes and complications. Results: The most common organism for infection was identified to be Staphylococcus Aureus. At the time of final follow-up all patients had achieved union except two, one of whom had to undergo amputation due to non-union and sepsis. Majority of the patients had an excellent score as per ASAMI grading system for bone and function results. The most common complication noted was pin track infections. Conclusion: In our experience, Ilizarov external fixator is better suited for infected non-union of tibia because it can provide a stable mechanical environment, bone transport, correct deformities, and enable weight bearing and hence we recommend its use for the same.
    MeSH terms: Amputation; Follow-Up Studies; Humans; Joints; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus; Tibia; External Fixators; Weight-Bearing; Sepsis
  14. Lee WC, Wee L
    Malays Orthop J, 2019 Mar;13(1):42-44.
    PMID: 31001383 DOI: 10.5704/MOJ.1903.008
    We present a unique case of tibial post fracture of a posterior-stabilised total knee arthroplasty (PS-TKA) using highly crosslinked polyethylene (HXLPE) in the unafflicted limb of a patient who had poliomyelitis. The tibial post is an upright structure perpendicular to the PE insert articular surface which articulates with the cam of the femoral component to prevent excessive posterior translation of the tibia. We explore the choice of PS polyethylene (PE) inserts in patients with neuromuscular disorders (NMD). A 74-year old gentleman presented with recurrent knee pain seven years after the index PS-TKA with HXLPE. The TKA was performed on the unafflicted left limb (contralateral to the weak side affected by poliomyelitis). The posterior drawer test was positive. During the single-stage revision surgery, the HXLPE tibial post was noted to be broken. The liner was replaced with a thicker non-HXLPE. The patient achieved an excellent outcome at one-year post-surgery. This is the first report of HXLPE tibial post fracture in the unaffected knee of a patient with NMD affecting the lower limb. The HXLPE's reduced resistance to fatigue crack propagation might not be suitable in PS-TKA where there might be focal stress points on the tibial post, which was amplified in this case as it was the limb that the patient most depended on. When managing end-stage osteoarthritis with TKA in the unafflicted knee of a patient with NMD causing lower limb weakness, the selection of polyethylene material in PS-TKA may need more consideration than previously thought.
    MeSH terms: Humans; Knee Joint; Osteoarthritis; Pain; Poliomyelitis; Reoperation; Tibia; Tibial Fractures; Arthroplasty, Replacement, Knee; Polyethylene; Lower Extremity
  15. Sahin K, Demirel M, Turgut N, Arzu U, Polat G
    Malays Orthop J, 2019 Mar;13(1):45-48.
    PMID: 31001384 DOI: 10.5704/MOJ.1903.009
    Aneurysmal bone cysts rather than local aggressive lesions of the bone which may arise in any part of the axial or appendicular skeleton. Although several theories are available in the literature, the pathogenesis is still conflicting. We report an exceptional case of an aneurysmal bone cyst in the distal femur of a female cerebral palsy patient who underwent bilateral distal femoral derotational osteotomy and plate-screw fixation operations when she was 11 years old. Twenty-four months after the operation, radiographs showed a cystic lesion in the distal portion of the right femur around the osteotomy site. The diagnosis of Aneurysmal Bone Cyst (ABC) was made and the lesion was treated by curettage with cement application. After 36 months of follow-up, there was no recurrence. This is the first case reported in literature which raises the possibility that an osteotomy could be a cause in the development of an aneurysmal bone cyst.
    MeSH terms: Bone Plates; Bone Screws; Cerebral Palsy; Curettage; Female; Femur; Follow-Up Studies; Humans; Neoplasm Recurrence, Local; Osteotomy; Bone Cysts, Aneurysmal
  16. Mejabi JO, Sergeenko OM, Ryabykh SO
    Malays Orthop J, 2019 Mar;13(1):49-53.
    PMID: 31001385 DOI: 10.5704/MOJ.1903.010
    Severe rigid neuromuscular scoliosis is a major challenge to the spine surgeon due to the possibilities of neurological sequelae from acute correction of the deformity. Halo gravity traction has been considered as a way of reducing the deformity before correction to prevent neurological complications. Three female patients with severe neuromuscular scoliosis aged seven to 13 years with main coronal Cobb angle of 95°-128° and Kyphotic Cobb of 47°-118° having ≤35% flexibility on traction, had between 18 to 23 days of 16 hour/day of halo gravity traction and night time supine traction with 4kg weight for 7-8 hours. They had 28.9% and 18.5% of main coronal and kyphotic Cobb angle correction post-traction respectively. All had posterior instrumentation and post-operatively, they had correction of main coronal Cobb angle of 29°-58° and kyphotic Cobb angle of 30°-77° with no neurological complication. Halo gravity traction is therefore a viable option for reducing post-operative neurological complication in rigid severe scoliosis.
    MeSH terms: Adolescent; Child; Female; Humans; Kyphosis; Postoperative Period; Scoliosis; Spine; Traction; Surgeons
  17. Soni A, Kansay R, Gupta S, Malhotra A
    Malays Orthop J, 2019 Mar;13(1):57-59.
    PMID: 31001387 DOI: 10.5704/MOJ.1903.014
    Femoral condyle fracture in coronal plane, also known as Hoffa fracture, is a rare fracture. Non-union of Hoffa fracture is even rarer. We present a case of fibrous nonunion of a Hoffa fracture in which the fractured fragment, though not freely movable, led to painful walking. Since the fragment was un-displaced and non-movable we fixed the fractured fragment in situ. Patient regained full range of motion of the knee and was asymptomatic on follow-up.
    MeSH terms: Follow-Up Studies; Humans; Knee Injuries; Knee Joint; Pseudarthrosis; Range of Motion, Articular; Walking
  18. Awang-Kechik NH, Ahmad R, Doustjalali SR, Sabet NS, Abd-Rahman AN
    J Clin Exp Dent, 2019 Mar;11(3):e269-e274.
    PMID: 31001398 DOI: 10.4317/jced.55546
    Background: The biological responses involved during retention phase have been studied for many years but little is known about the effect of saliva proteome during retention phase of post-orthodontic treatment. This study aims to identify the protein profiles during retention phase in relation to biological processes involved by Liquid Chromatography Mass Spectrometry (LC-MS) approach.

    Material and Methods: A total of 5 ml of unstimulated saliva was collected from each subject (10 non-orthodontic patients and 15 post-orthodontic patients with 6-months retention phase). Samples were then subjected to LC-MS analysis. The expressed proteins were identified and compared between groups. Incisor irregularity for both maxilla and mandible were determined with Little's Irregularity Index at 6-months retention phase.

    Results: 146 proteins and 135 proteins were expressed in control and 6-months retention phase group respectively. 15 proteins were identified to be co-expressed between groups. Immune system process was only detected in 6-months retention phase group. Detected protein in immune system process was identified as Tyrosine-protein kinase Tec. Statistical significant of incisor irregularity was only found in mandible at 6-months retention phase.

    Conclusions: Our study suggests that immune system process protein which is Tyrosine-protein kinase Tec could be used as biomarker for prediction of stability during retention phase of post-orthodontic treatment. Key words:Orthodontics, proteomics, retention, LC-MS, saliva.

    MeSH terms: Biological Phenomena; Chromatography, Liquid; Humans; Incisor; Mandible; Maxilla; Orthodontics; Protein-Tyrosine Kinases; Saliva; Tyrosine; Biomarkers; Proteome; Proteomics; Tandem Mass Spectrometry; Immune System Phenomena
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