Browse publications by year: 2020

  1. Anuar-Ramdhan IM, Remli R, Abdul-Rashid AH, Ibrahim S
    Malays Orthop J, 2020 Jul;14(2):126-129.
    PMID: 32983387 DOI: 10.5704/MOJ.2007.010
    Tardy ulnar nerve palsy is a known complication of cubitus valgus. The options for treating the ulnar neuropathy include anterior nerve transposition or neurolysis. We report on an 11-year-old boy who had a tardy ulnar nerve palsy due to cubitus valgus resulting from a non-union of a lateral condyle fracture of the humerus. Anterior transposition of the ulnar nerve was not done after the closing wedge osteotomy of the distal humerus. The close wedge osteotomy relieved the tension on the nerve and not transposing the ulnar nerve anteriorly prevented an iatrogenic nerve injury. The patient had no restriction with activities of daily living at the six years follow-up although neurological recovery was incomplete.
    MeSH terms: Activities of Daily Living; Child; Elbow Joint; Follow-Up Studies; Humans; Humerus; Iatrogenic Disease; Male; Osteotomy; Ulnar Nerve; Ulnar Neuropathies
  2. Abd-Rasid AF, Bajuri MY
    Malays Orthop J, 2020 Jul;14(2):130-133.
    PMID: 32983388 DOI: 10.5704/MOJ.2007.011
    Peroneal tendon tear is a relatively common cause of lateral ankle pain but often missed due to mixed presentation or low index of suspicion. Left untreated, peroneal injuries can lead to persistent ankle pain, instability and ultimately substantial functional disabilities. An isolated peroneus longus tear is rare with the lowest incidence rate compared to isolated peroneus brevis tear and mixed tear of both peroneal tendon. This is a case report of a 49-year-old lady with a chronic left ankle pain who ultimately underwent surgery for an isolated peroneus longus tear.
    MeSH terms: Ankle; Female; Humans; Middle Aged; Pain; Rupture; Tendons; Incidence; Muscle, Skeletal; Lacerations
  3. Teh KH, Ruben JK, Chan CK, Abbas AA
    Malays Orthop J, 2020 Jul;14(2):134-137.
    PMID: 32983389 DOI: 10.5704/MOJ.2007.022
    Avascular necrosis and non-union are two most dreaded complications of femoral neck fracture fixations. Hip replacement seems to be a simple solution for this complex problem. However, the long-term efficacy of prosthetic replacement in the young population with higher functional demand is still questionable. Femoral head preserving valgus subtrochanteric osteotomies in properly selected cases have strong support from literature. The conventional technique of valgus subtrochanteric osteotomy involves lateral based wedge resection. Alternatively, a simpler sliding oblique subtrochanteric osteotomy without any wedge removal can also be performed. We hereby describe a successful case of sliding subtrochanteric osteotomy with 135° dynamic hip screw (DHS) plate fixation in treating non-union neck of femur fracture in a young gentleman.
    MeSH terms: Bone Plates; Bone Screws; Femoral Fractures; Femoral Neck Fractures; Femur Head; Osteotomy; Arthroplasty, Replacement, Hip
  4. Tan SY, Leong WH, Ong LH, Mohd-Amin MZ
    Malays Orthop J, 2020 Jul;14(2):138-140.
    PMID: 32983390 DOI: 10.5704/MOJ.2007.023
    Lateral femoral wall perforation is a rare intra-operative complication in anterior cruciate ligament (ACL) reconstruction surgery. However, it can be challenging to manage if it occurs. We share our experience on lateral femoral wall perforation managed by a large fragment washer. A 25-year-old man with right ACL injury presented with knee instability despite physiotherapy. Anterior drawer test (ADT) and Lachman test were grade 3, glide on pivot shift was positive. During ACL reconstruction, the lateral femoral wall was perforated. Due to unavailability of the rescue endobutton and budget constraint, we passed the endobutton through a washer and allowed it to sit on the washer over the lateral femoral wall. ADT and Lachman test on post-operative 6, 12 and 24 weeks were grade 1, with a negative pivot shift test. Lysholm knee score improved from 69 pre-operatively to 98 post-operatively. Conventionally, lateral femoral wall perforation can be managed by rescue endobutton, or screw and washer post technique. As this complication is rare, the rescue endobutton may not be available at all times, and the cost of the implant is also another important factor to consider. A washer can be used as an alternative technique to manage lateral femoral wall perforation in ACL reconstruction as it is not only cost-effective but also provides stable fixation with good functional outcome.
    MeSH terms: Adult; Bone Screws; Cost-Benefit Analysis; Femur; Humans; Joint Instability; Male; Post and Core Technique; Anterior Cruciate Ligament; Physical Therapy Modalities; Anterior Cruciate Ligament Reconstruction; Lysholm Knee Score; Anterior Cruciate Ligament Injuries
  5. Thuraikumar K, Wan KL, Ong KL, Lim SW
    Malays Orthop J, 2020 Jul;14(2):141-144.
    PMID: 32983391 DOI: 10.5704/MOJ.2007.024
    Gouty arthritis commonly affects peripheral joints and is associated with hyperuricaemia. Spinal manifestations of gouty arthritis are not common, and majority of published articles worldwide were case reports. This is a case report of spinal gouty arthritis that presented with spinal vertebrae destruction and cauda equina syndrome. The magnetic resonance imaging (MRI) showed destruction of L5/S1end plates with cystic collection mimicking infective changes. The tissue histological examination confirmed presence of urate crystal needles that displayed negative double refraction on light microscopy. Spinal gouty arthritis is part of the differential diagnoses in gouty arthritis patients.
    MeSH terms: Birefringence; Bone Plates; Diagnosis, Differential; Histological Techniques; Humans; Magnetic Resonance Imaging; Microscopy; Needles; Spine; Uric Acid; Arthritis, Gouty; Hyperuricemia
  6. Chilmi MZ, Desnantyo AT, Widhiyanto L, Wirashada BC
    Malays Orthop J, 2020 Jul;14(2):145-148.
    PMID: 32983392 DOI: 10.5704/MOJ.2007.025
    In Indonesia, arthrodesis becomes a choice of treatment in the absence of ankle arthroplasty implants for young adults. Arthrodesis on ankle osteoarthritis (OA) often leads to functional impairment. Low tibiofibular osteotomy is an alternative and it has been known to be the preferable option for those in the productive-ages. A 22-year-old male with a previous history of a motorbike accident, operated eight years ago, came with persistent pain on the left ankle that has worsened over the years. Plain radiography with a tibial-ankle surface angle (TAS) of 74o (normally 88o-93o) indicated varus deformity. Osteotomy was performed on distal tibia above the syndesmotic joint, as well as on the middle third of fibula. Open wedge osteotomy of the tibia was corrected until the normal TAS angle was reached by fluoroscopy. Cortical allograft was used to fill the osteotomy gap. Instrumentation was performed using a clover leaf® plate with 6 screws insertion for fixation stability. All results were satisfactory. Twelve weeks post-operatively, the patient was performing activities normally. Four-month post-operative radiological evaluation showed fusion of graft and the angle of TAS of 89°. Post-operative functional assessment using the American Academy of Orthopaedic Surgeon (AAOS) Foot and Ankle Measurement (FAM) questionnaires showed significant improvement (pre 89, post 38).
    MeSH terms: Adult; Ankle; Ankle Joint; Arthrodesis; Arthroplasty; Fibula; Fluoroscopy; Humans; Indonesia; Male; Osteoarthritis; Osteotomy; Radiography; Talus; Tibia; United States; Off-Road Motor Vehicles; Medicago; Young Adult; Orthopedic Surgeons
  7. Liau LL, Looi QH, Chia WC, Subramaniam T, Ng MH, Law JX
    Cell Biosci, 2020;10:112.
    PMID: 32983406 DOI: 10.1186/s13578-020-00475-3
    Background: Spinal cord injury (SCI) is the damage to the spinal cord that can lead to temporary or permanent loss of function due to injury to the nerve. The SCI patients are often associated with poor quality of life.

    Results: This review discusses the current status of mesenchymal stem cell (MSC) therapy for SCI, criteria to considering for the application of MSC therapy and novel biological therapies that can be applied together with MSCs to enhance its efficacy. Bone marrow-derived MSCs (BMSCs), umbilical cord-derived MSCs (UC-MSCs) and adipose tissue-derived MSCs (ADSCs) have been trialed for the treatment of SCI. Application of MSCs may minimize secondary injury to the spinal cord and protect the neural elements that survived the initial mechanical insult by suppressing the inflammation. Additionally, MSCs have been shown to differentiate into neuron-like cells and stimulate neural stem cell proliferation to rebuild the damaged nerve tissue.

    Conclusion: These characteristics are crucial for the restoration of spinal cord function upon SCI as damaged cord has limited regenerative capacity and it is also something that cannot be achieved by pharmacological and physiotherapy interventions. New biological therapies including stem cell secretome therapy, immunotherapy and scaffolds can be combined with MSC therapy to enhance its therapeutic effects.

    MeSH terms: Adipose Tissue; Biological Therapy; Bone Marrow; Humans; Immunotherapy; Inflammation; Nerve Tissue; Neurons; Quality of Life; Spinal Cord Injuries; Umbilical Cord; Physical Therapy Modalities; Cell Proliferation; Neural Stem Cells
  8. Abdullah S, Ahmad AA, Lalonde D
    Plast Reconstr Surg Glob Open, 2020 Aug;8(8):e3023.
    PMID: 32983779 DOI: 10.1097/GOX.0000000000003023
    Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers.
    MeSH terms: Anesthesia, Local; Anesthetics; Elbow; Epinephrine; Fingers; Forearm; Humans; Lidocaine; Radial Nerve; Tendon Transfer; Thumb; Wakefulness; Wrist; Wrist Joint; Sodium Bicarbonate; Radial Neuropathy
  9. Hamedanchi A, Momtaz YA, Khankeh HR, Zanjari N
    J Family Med Prim Care, 2020 Jun;9(6):2837-2842.
    PMID: 32984135 DOI: 10.4103/jfmpc.jfmpc_264_20
    BACKGROUND: Statistics show that the age of the Iranian population is advancing, and the marriage age is increasing as well. Clearly, an increase in the number of never-married older adults is expected. The aim of this descriptive, analytical study was to determine the growth trend of never-married older population and its association with education level in Iran.

    METHODS: Based on the raw data collected from the Statistical Center of Iran, we studied the population of never-married older adults in the past 25 years and evaluated the growth pattern in different parts of Iran, using ArcGIS software. We also examined the association of singlehood in late life with education in men and women residing in rural and urban areas, using the Chi-square test in SPSS version 22.

    RESULTS: A sharp increase was observed in the population of never-married older adults, particularly women, in the past 10 years. Women with formal education from urban and rural areas were more likely to be never married in late life (χ2 = 10455.35, P < 0.001 and χ2 = 271.31, P < 0.001, respectively). Older men with formal education from urban areas were more likely to be never married (χ2 = 35.44, P < 0.001), while men with formal education from rural areas were less likely to be never married (χ2 = 179.13, P < 0.001).

    CONCLUSION: The rate of increase in the population of never-married older women was much higher than the overall growth of older population. Women with formal education, particularly those with university and pre-university degrees, were more likely to be single in late life. It is strongly suggested to determine the causes and process of singlehood in old age in future research, including qualitative studies.

  10. Bamatraf AA, AlAmodi AA, Ali MA, Chan CM, Mazlan M, Shareef MA
    J Family Med Prim Care, 2020 Jun;9(6):2990-2994.
    PMID: 32984161 DOI: 10.4103/jfmpc.jfmpc_247_20
    Purpose: This study aims to investigate the level of strain and various influencing factors among informal care providers of traumatic brain injury (TBI) patients.

    Methods: A cross-sectional study was conducted in a single center in Malaysia via recruiting care providers of patients with TBI. The modified caregiver strain index (MCSI) questionnaires were utilized to ascertain the level of strain. The demographic data of informal care providers were also obtained. Independent sample t-test, analysis of variance (ANOVA), and a linear regression model were processed for data analysis.

    Results: A total of 140 informal care providers were included in the study. More than half of informal care providers claimed to have strain (54.3%). Factors associated with increased strain include receiving tertiary education, being of Chinese background, and employed experience higher strain level. Informal care providers with characteristics such as being single, retired and provided care for 5 years experienced a lower level of strain.

    Conclusion: Guidance on integrating the TBI knowledge into practice, assessing the care provider's level of strain regularly and providing supportive measures may aid in supporting informal care providers at risk.

    MeSH terms: Analysis of Variance; Cross-Sectional Studies; Demography; Patient Care; Humans; Malaysia; Surveys and Questionnaires; Retirement; Linear Models; Caregivers; Brain Injuries, Traumatic
  11. Lee SWH, Teh PL
    Front Public Health, 2020;8:376.
    PMID: 32984232 DOI: 10.3389/fpubh.2020.00376
    Background: Healthcare professionals who have a positive attitude and who are more empathetic toward older adults are in a better position to deliver quality healthcare. This study examines the impact of using an aging simulation suit on undergraduate pharmacy students' empathy levels.
    Methods: One hundred and twenty first-year students enrolled in the Bachelor of Pharmacy course were randomized to either a medication review polypharmacy workshop (control) or an immersive aging simulation suit and medication review polypharmacy workshop (intervention). Intervention participants donned the aging suit and performed a series of tasks, including walking up a flight of stairs and filling up a form to simulate the physical limitations experienced by an older adult. The workshop was delivered at week 10 of semester. Both groups also completed a medication review polypharmacy workshop at week 12 of semester. The primary outcome was a measurement of change on the Jefferson Empathy Scale-Healthcare Professional Questionnaire among both groups at week 12 of semester. Secondary outcomes include the longitudinal impact of intervention after 3 months of the workshop and perceptions on learning.
    Results: The use of a simulation suit did not increase participants' self-rated empathy compared to control. However, the suit enhanced the ability of participants to understand the physical limitations and visual issues associated with aging. Participants also felt that it enhanced their health advocacy, as it taught them the importance of listening, patience and respect for older adults.
    Conclusion: The use of an immersive aging suit can be a useful adjunctive tool to help enhance students' understanding of the physical limitations and visual limitations of aging. Further research is needed to understand how these limitations affect other healthcare students. Trial Registration: ClinicalTrials.gov identifier: NCT04133727.
    Study site: Monash University Malaysia
    MeSH terms: Aged; Aging*; Emotions; Empathy*; Humans; Malaysia; Research Design; Walking
  12. Ismail A, Ahmad SA, Che Soh A, Hassan MK, Harith HH
    Data Brief, 2020 Oct;32:106268.
    PMID: 32984464 DOI: 10.1016/j.dib.2020.106268
    A fully labelled image dataset serves as a valuable tool for reproducible research inquiries and data processing in various computational areas, such as machine learning, computer vision, artificial intelligence and deep learning. Today's research on ageing is intended to increase awareness on research results and their applications to assist public and private sectors in selecting the right equipments for the elderlies. Many researches related to development of support devices and care equipment had been done to improve the elderly's quality of life. Indoor object detection and classification for autonomous systems require large annotated indoor images for training and testing of smart computer vision applications. This dataset entitled MYNursingHome is an image dataset for commonly used objects surrounding the elderlies in their home cares. Researchers may use this data to build up a recognition aid for the elderlies. This dataset was collected from several nursing homes in Malaysia comprises 37,500 digital images from 25 different indoor object categories including basket bin, bed, bench, cabinet and others.
    MeSH terms: Machine Learning; Aging; Artificial Intelligence; Computers; Home Care Services; Humans; Malaysia; Nursing Homes; Quality of Life; Software; Private Sector
  13. Silvarajoo S, Osman UM, Kamarudin KH, Razali MH, Yusoff HM, Bhat IUH, et al.
    Data Brief, 2020 Oct;32:106299.
    PMID: 32984485 DOI: 10.1016/j.dib.2020.106299
    One-pot synthetic method was adopted to prepare three isomers 4-(ortho-fluorophenyl)thiosemi- carbazide), 4-(meta-fluorophenyl)thiosemicarbazide and 4-(para-fluorophenyl)thiosemicarbazide. The products were obtained in ethanolic solution from a reaction between ortho, meta and para derivatives of fluorophenyl isothiocyanate and hydrazine hydrate. This work presents the theoretical Molecular Electrostatic Potential (MEP) and Highest Occupied Molecular Orbital-Lowest Unoccupied Molecular Orbital (HOMO-LUMO) computational data through Gaussview 5.0.9 and Gaussian09 software. Experimental Cole-cole plot for conductivity determination was also illustrated. The present data is important to manipulate the properties of compounds according to the position of a fluorine atom.
    MeSH terms: Electric Conductivity; Fluorine; Hydrazines; Semicarbazides; Software; Isothiocyanates; Static Electricity
  14. Al-Nema M, Gaurav A, Lee VS
    Heliyon, 2020 Sep;6(9):e04856.
    PMID: 32984588 DOI: 10.1016/j.heliyon.2020.e04856
    Inhibition of phosphodiesterase 4 (PDE4) is a promising therapeutic approach for the treatment of inflammatory pulmonary disorders, i.e. asthma and chronic obstructive pulmonary disease. However, the treatment with non-selective PDE4 inhibitors is associated with side effects such as nausea and vomiting. Among the subtypes of PDE4 inhibited by these inhibitors, PDE4B is expressed in immune, inflammatory and airway smooth muscle cells, whereas, PDE4D is expressed in the area postrema and nucleus of the solitary tract. Thus, PDE4D inhibition is responsible for the emetic response. In this regard, a selective PDE4B inhibitor is expected to be a potential drug candidate for the treatment of inflammatory pulmonary disorders. Therefore, a shared feature pharmacophore model was developed and used as a query for the virtual screening of Maybridge and SPECS databases. A number of filters were applied to ensure only compounds with drug-like properties were selected. Accordingly, nine compounds have been identified as final hits, where HTS04529 showed the highest affinity and selectivity for PDE4B over PDE4D in molecular docking. The docked complexes of HTS04529 with PDE4B and PDE4D were subjected to molecular dynamics simulations for 100ns to assess their binding stability. The results showed that HTS04529 was bound tightly to PDE4B and formed a more stable complex with it than with PDE4D.
    MeSH terms: Asthma; Emetics; Nausea; Vomiting; Solitary Nucleus; Pulmonary Disease, Chronic Obstructive; Area Postrema; Myocytes, Smooth Muscle; Cyclic Nucleotide Phosphodiesterases, Type 4; Molecular Dynamics Simulation; Phosphodiesterase 4 Inhibitors; Molecular Docking Simulation
  15. Zaulkiflee ND, Ahmad AL, Sugumaran J, Lah NFC
    ACS Omega, 2020 Sep 22;5(37):23892-23897.
    PMID: 32984709 DOI: 10.1021/acsomega.0c03142
    The purpose of this study is to explore the emulsion liquid membrane stability for acetaminophen (ACTP) removal from aqueous solution. In this work, the membrane phase was prepared by dissolving trioctylamine (TOA) with kerosene and Span80. The stability of the emulsion in terms of emulsion size, membrane breakage, and its efficiency in removing ACTP was considered for the optimization of parameters. Investigation on the stability of emulsion was carried out by manipulating the concentration of stripping agent, agitation speed, extraction time, and treat ratio. The best condition to produce a very stable emulsion was achieved at 0.1 M of stripping agent concentration, with 300 rpm of agitation speed for 3 min of extraction time with a treat ratio of 3:1. Eighty-five percent of ACTP successfully stripped into the emulsion with minimum membrane breakage of 0.17% through this experiment.
    MeSH terms: Acetaminophen; Amines; Emulsions; Kerosene; Membranes; Water
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