Browse publications by year: 2020

  1. Sath S
    Malays Orthop J, 2020 Nov;14(3):184-187.
    PMID: 33403084 DOI: 10.5704/MOJ.2011.031
    Complications in the form of esophageal injury, tracheal injury, injury to carotids, implant failure, loosening of screws, etc do occur after anterior cervical surgeries. Although intra-operative esophageal injuries are as such rare, there have been few reports of delayed esophageal perforation as well after anterior cervical surgeries. We report a very rare case of migration of missing screw from anterior cervical plate after anterior cervical corpectomy and plating, which had ultimately migrated down to colon and had to be removed via colonoscopy. Along with removal of migrated screw from colon, revision of failed anterior cervical surgery was done wherein plate and screws were removed with mesh cage left in-situ as it was snug-fit while pharyngeophageal perforation was explored and was found to be spontaneously healing, with addition of posterior Bohlman's interspinous wiring for added stability. Migration of screw from the anterior cervical plate into the colon although very rare, should be always kept in mind and its potentially serious complications. We also conclude that particular attention should be given to elderly people with poor bony quality who have high chances of implant failure, along with attention to proper cage size, screw position and proper locking of the screw to further lessen the chances of implant failure.
    MeSH terms: Aged; Attention; Bone Plates; Bone Screws; Colon; Colonoscopy; Esophageal Perforation; Fracture Fixation, Internal; Humans; Surgical Mesh
  2. Tagiling N, Mohd-Rohani MF, Wan-Sohaimi WF, Faisham WI, Nawi NM
    Malays Orthop J, 2020 Nov;14(3):188-193.
    PMID: 33403085 DOI: 10.5704/MOJ.2011.032
    Megaprosthesis is used to restore the form and function of massive skeletal defects, but it is accompanied by risks of failure, mainly due to perimegaprosthetic infection (PMI). In practice, the diagnosis of infected megaprosthesis among patients with a high index of clinical suspicion, elevated serological markers, and multiple negative or inconclusive imaging can be very challenging and poses a diagnostic conundrum to many orthopaedic surgeons. We present the case of a symptomatic 26-year-old female with large B-cell lymphoma who developed cellulitis with suspected complication of PMI 15 months post-implantation. The combination of advanced nuclear medicine imaging strategies, i.e., 99mTc-besilesomab/99mTc-sulfur colloid scintigraphy with hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) scanning helps to characterise and delineate both infections. Invasive procedures such as joint aspiration and biopsy were avoided, and the patient was successfully treated with antibiotics. Hence, we report a case where advanced imaging modalities were decisive in the investigation of PMI.
    MeSH terms: Adult; Anti-Bacterial Agents; Biopsy; Cellulitis; Colloids; Diagnostic Imaging; Female; Humans; Nuclear Medicine; Radionuclide Imaging; Sulfur; Lymphoma, B-Cell; Antibodies, Monoclonal, Murine-Derived; Single Photon Emission Computed Tomography Computed Tomography; Orthopedic Surgeons
  3. Xu S, Kang Y, Soeharno H, Yeo N
    Malays Orthop J, 2020 Nov;14(3):194-197.
    PMID: 33403086 DOI: 10.5704/MOJ.2011.033
    Marjolin's ulcer is a rare and often overlooked diagnosis which can be encountered by a variety of specialities. Majority of the literatures describe long latency period of 11 to 75 years. The authors present two unusual cases of rapid progression to Marjolin's ulcer in patients with previously negative biopsy 8- and 10-month prior. This highlights the importance for clinicians to have a high degree of suspicion when encountered with any non-healing wound, especially one who's symptomatology and morphological features have undergone an acute change. Even with previous negative biopsy, patients should still be followed-up closely and clinicians should not hesitate to perform re-biopsy if the suspicion arises.
    MeSH terms: Biopsy; Humans; Skin Ulcer; Ulcer; Dysuria
  4. Khaw YC, Wong JK, Sahran Y, Nor-Azman MZ, Faisham WI
    Malays Orthop J, 2020 Nov;14(3):198-201.
    PMID: 33403087 DOI: 10.5704/MOJ.2011.034
    Telangiectatic osteosarcoma is a rare variant of osteosarcoma and can be easily misdiagnosed as aneurysmal bone cyst. We report an atypical case of iliac telangiectatic osteosarcoma in a young healthy female, who presents with painful slow growing expansile lytic septate lesion in the left hemipelvis, which is initially treated as aneurysmal bone cyst. The diagnosis of aneurysmal bone cyst is made after histopathological examination of core needle biopsy. Her condition became unstable and massive bleeding is noted at the lesion site after sclerosant injection. She undergoes emergency hemipelvectomy and eventually the biopsy turns up to be telangiectatic osteosarcoma. Our case highlights that core needle biopsy is not useful in making diagnosis for iliac telangiectatic carcinoma. Hence, an open biopsy should be carried out in our case. This case also emphasises on careful evaluation for malignancy which is mandatory because bleeding from pelvis after an unsuitable treatment can be grave, to the extent that major amputation hemipelvectomy is an option. Even though telangiectatic osteosarcoma has the same prognosis and treatment with conventional osteosarcoma, the outcome of delayed treatment for telangiectatic osteosarcoma is not good due to the dilemma in establishing an early correct diagnosis.
    MeSH terms: Bone Neoplasms; Carcinoma; Diagnostic Errors; Female; Hemipelvectomy; Humans; Pelvis; Prognosis; Osteosarcoma; Sclerosing Solutions; Telangiectasis; Bone Cysts, Aneurysmal; Time-to-Treatment; Biopsy, Large-Core Needle
  5. Danial M, Arulappen AL, Ch'ng ASH, Looi I
    J Glob Health, 2020 Dec;10(2):0203105.
    PMID: 33403108 DOI: 10.7189/jogh.10.0203105
    MeSH terms: Humans; Malaysia/epidemiology; Cluster Analysis
  6. Alani AHHDA, Hassan BAR, Suhaimi AM, Mohammed AH
    Osong Public Health Res Perspect, 2020 Dec;11(6):373-379.
    PMID: 33403200 DOI: 10.24171/j.phrp.2020.11.6.05
    Objectives: This study aimed to assess medication use in pregnant women in Malaysia by measuring use, knowledge, awareness, and beliefs about medications.

    Methods: This was an observational, cross-sectional study involving a total of 447 pregnant women who attended the Obstetrics and Gynecology Clinic, Hospital Kuala Lumpur (HKL), Malaysia. A validated, self-administered questionnaire was used to collect participant data.

    Results: Most of pregnant women had taken medication during pregnancy and more than half of them (52.8%) showed a poor level of knowledge about the medication use during pregnancy. Eighty-three percent had a poor level of awareness and 56.5% had negative beliefs. Age and education level were significantly associated with the level of knowledge regarding medication use during pregnancy. Multiparous pregnant women, and pregnant women from rural areas were observed to have a higher level of awareness compared with those who lived in urban areas. Use of medication during pregnancy was determined to be significantly associated with education level, and race.

    Conclusion: Although there was prevalent use of medication among pregnant women, many had negative beliefs, and insufficient knowledge and awareness about the risks of taking medication during pregnancy. Several sociodemographic characteristics were significantly associated with the use (race and education level), level of knowledge (age and education level), awareness (parity and place of residence), and beliefs (race, education level, and occupation status) towards medication use during pregnancy.

    MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Educational Status; Employment; Female; Hospitals; Humans; Malaysia; Obstetrics; Occupations; Parity; Pregnancy; Surveys and Questionnaires; Pregnant Women
  7. Ahmad SN, Zaharim WN, Sulaiman S, Hasan Baseri DF, Mohd Rosli NA, Ang LS, et al.
    ACS Omega, 2020 Dec 29;5(51):33253-33261.
    PMID: 33403287 DOI: 10.1021/acsomega.0c04937
    Density functional theory computational investigation was performed to study the electronic structures, muon sites, and the associated hyperfine interactions in [Au25(SR)18]0 and [Au25(SeR)18]0 where R is phenylethane. The calculated electronic structures show inhomogeneous spin density distribution and are also affected by different ligands. The two most stable muon sites near Au atoms in the thiolated system are MAu11 and MAu6. When the thiolate ligands were replaced by selenolate ligands, the lowest energy positions of muons moved to MAu6 and MAu5. Muons prefer to stop inside the Au12 icosahedral shell, away from the central Au and the staple motifs region. Muonium states at phenyl ring and S/Se atoms in the ligand were found to be stable and the Fermi contact fields are much larger as compared to the field experienced by muons near Au atoms.
    MeSH terms: Electronics; Gold; Ligands; Mesons; Rotation
  8. Siti Mazlipah Ismail, Firdaus Hariri
    Ann Dent, 2020;27(1):66-68.
    MyJurnal
    There is a wide variation in the morphology of third maxillary molar which can be difficult to be identified radiographically. We present a case of a 26 year-old Yemeni female patient presented with difficult extraction of her left maxillary third molar. The extracted tooth showed a rare variation of root morphology, having four roots with three roots curving palatally at the apices. This report emphasized the potential complex morphological variation of maxillary third molar which may lead to the difficulty of a routine straight forward procedure thus needing careful extraction maneuvering to prevent any complications.
    MeSH terms: Adult; Female; Humans; Molar; Molar, Third; Tooth Extraction
  9. Mohd Tahir MKA, Ramanathan A, Foo GBT, Gopalan S, Zainal Abidin M, Abdul Rahman F
    Ann Dent, 2020;27(1):28-32.
    MyJurnal
    Pilomatrixoma is a relatively common benign tumour arising from the matrix and inner sheath of a normal hair follicle as well as hair cortex. It is usually presented as a superficial, solitary, firm mass which is asymptomatic and slowly growing. It accounts for about 0.2% of all routine skin specimens and may poses a diagnostic challenge as it may resemble other common benign lesions found in the head and neck region. We report a case of a 33-year old men presented to us with a pilomatrixoma of the right cheek, surgical management and histological findings.
    MeSH terms: Adult; Borneo; Cheek; Hair Diseases; Hospitals, General; Humans; Malaysia; Male; Skin Neoplasms; Pilomatrixoma
  10. Kabir S, Hossain AT, Shimmi SC, Jie CS
    BMJ Case Rep, 2020 Dec 28;13(12).
    PMID: 33372011 DOI: 10.1136/bcr-2020-236197
    A 31-year-old woman, with a body mass index of 70.31 kg/m2, presented with progressive worsening of dyspnoea for 3 days. She had multiple comorbidities, including obesity hypoventilation syndrome. The patient developed type II respiratory failure with respiratory acidosis along with multiorgan failure. She was intubated and put on a mechanical ventilator and treated with intravenous diuretics, subcutaneous low-molecular-weight heparin and other supportive measures. Later, she was on noninvasive, continuous positive airway pressure ventilation overnight. She was prescribed a very-low-calorie diet along with physiotherapy and exercise. The patient underwent bariatric surgery 2 months after resolution of acute illness. Ten months after surgery, her body weight reduced from 180 kg to 121 kg, and her general condition improved. Successful management before and after surgical intervention depends on multidisciplinary teamwork, which includes the dietician, physiotherapist, endocrinologist, pulmonologist, nursing care and other supportive care.
    MeSH terms: Acidosis, Respiratory/complications; Adult; Diet, Reducing; Exercise Therapy; Female; Humans; Motivation; Multiple Organ Failure/complications; Obesity, Morbid/complications*; Obesity, Morbid/psychology; Obesity, Morbid/therapy*; Patient Care Team*; Obesity Hypoventilation Syndrome/therapy; Body Mass Index; Continuous Positive Airway Pressure; Bariatric Surgery
  11. Noman S, Shahar HK, Abdul Rahman H, Ismail S, Abdulwahid Al-Jaberi M, Azzani M
    PMID: 33396424 DOI: 10.3390/ijerph18010263
    There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.
    MeSH terms: Female; Humans; Health Knowledge, Attitudes, Practice*; Patient Education as Topic*; Early Detection of Cancer*
  12. Khalid AM, Hossain MS, Ismail N, Khalil NA, Balakrishnan V, Zulkifli M, et al.
    Polymers (Basel), 2020 Dec 30;13(1).
    PMID: 33396583 DOI: 10.3390/polym13010112
    In the present study, magnetic oil palm empty fruits bunch cellulose nanofiber (M-OPEFB-CNF) composite was isolated by sol-gel method using cellulose nanofiber (CNF) obtained from oil palm empty fruits bunch (OPEFB) and Fe3O4 as magnetite. Several analytical methods were utilized to characterize the mechanical, chemical, thermal, and morphological properties of the isolated CNF and M-OPEFB-CNF. Subsequently, the isolated M-OPEFB-CNF composite was utilized for the adsorption of Cr(VI) and Cu(II) from aqueous solution with varying parameters, such as pH, adsorbent doses, treatment time, and temperature. Results showed that the M-OPEFB-CNF as an effective bio-sorbent for the removal of Cu(II) and Cr(VI) from aqueous solution. The adsorption isotherm modeling revealed that the Freundlich equation better describes the adsorption of Cu(II) and Cr(VI) on M-OPEFB-CNF composite. The kinetics studies revealed the pseudo-second-order kinetics model was a better-described kinetics model for the removal of Cu(II) and Cr(VI) using M-OPEFB-CNF composite as bio-sorbent. The findings of the present study showed that the M-OPEFB-CNF composite has the potential to be utilized as a bio-sorbent for heavy metals removal.
    MeSH terms: Adsorption; Cellulose; Chromium; Fruit; Hydrogen-Ion Concentration; Kinetics; Temperature; Water; Metals, Heavy; Ferrosoferric Oxide; Physical Phenomena; Nanofibers; Magnetic Phenomena
  13. Williams R, Periasamy M
    Endocrinol Metab (Seoul), 2020 12;35(4):681-695.
    PMID: 33397033 DOI: 10.3803/EnM.2020.772
    Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity-the "skinny-fat" Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors-most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress-contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.
    MeSH terms: Adipose Tissue/metabolism; Asia; Diabetes Mellitus, Type 2/epidemiology; Diabetes Mellitus, Type 2/prevention & control; Diet; Humans; Life Style; Malaysia; Metabolic Syndrome X/epidemiology; Metabolic Syndrome X/prevention & control; Asian Continental Ancestry Group/genetics; Obesity, Abdominal/diagnosis; Obesity, Abdominal/genetics; Obesity, Abdominal/epidemiology*; Obesity, Abdominal/prevention & control; Gene-Environment Interaction*
  14. Shrestha AD, Vedsted P, Kallestrup P, Neupane D
    Eur J Cancer Care (Engl), 2020 Mar;29(2):e13207.
    PMID: 31820851 DOI: 10.1111/ecc.13207
    INTRODUCTION: Oral cancer is common cancer in many low- and middle-income countries (LMICs) with a low five-year survival rate. It is among the four most common types of cancer in South East Asia region. In South-Central Asia, lip and oral cavity cancer is the second most common cancer according to the specific cancer types.

    METHODS: This scoping review intended to investigate published studies on the current prevalence and incidence of oral cancer in LMICs. The review was conducted applying the search words "Oral Cancer" and "Mouth neoplasm" as the Medical Subject Heading (MeSH) major topic and "Epidemiology" and ("prevalence" OR "incidence") as the MeSH subheading; the search was supplemented by cross-references. Included studies met the following criteria: original studies, reporting of prevalence or incidence rates, population-based studies, studies in English language and studies involving humans.

    RESULTS: The sample sizes ranged from 486 to 101,761 with 213,572 persons included. Buccal mucosa is one of the most common sites of oral cancer, associated with the widespread exposure to chewing tobacco. The incidence is likely to rise in the region where gutkha, pan masala, pan-tobacco and various other forms of chewing tobacco are popular.

    CONCLUSION: This review contributes to useful information on prevalence and incidence estimates of oral cancer in LMICs.

    MeSH terms: Alcohol Drinking/epidemiology; Areca; Myanmar/epidemiology; Cambodia/epidemiology; Developing Countries*; Gingival Neoplasms/epidemiology; Humans; India/epidemiology; Lip Neoplasms/epidemiology; Malaysia/epidemiology; Mouth Mucosa; Mouth Neoplasms/epidemiology*; Palatal Neoplasms/epidemiology; Risk Factors; Smoking/epidemiology; Sri Lanka/epidemiology; Tobacco, Smokeless*; Tongue Neoplasms/epidemiology; Incidence; Prevalence; Tobacco Use/epidemiology*
  15. Pan JW, Zabidi MMA, Ng PS, Meng MY, Hasan SN, Sandey B, et al.
    Nat Commun, 2020 Dec 22;11(1):6433.
    PMID: 33353943 DOI: 10.1038/s41467-020-20173-5
    Molecular profiling of breast cancer has enabled the development of more robust molecular prognostic signatures and therapeutic options for breast cancer patients. However, non-Caucasian populations remain understudied. Here, we present the mutational, transcriptional, and copy number profiles of 560 Malaysian breast tumours and a comparative analysis of breast cancers arising in Asian and Caucasian women. Compared to breast tumours in Caucasian women, we show an increased prevalence of HER2-enriched molecular subtypes and higher prevalence of TP53 somatic mutations in ER+ Asian breast tumours. We also observe elevated immune scores in Asian breast tumours, suggesting potential clinical response to immune checkpoint inhibitors. Whilst HER2-subtype and enriched immune score are associated with improved survival, presence of TP53 somatic mutations is associated with poorer survival in ER+ tumours. Taken together, these population differences unveil opportunities to improve the understanding of this disease and lay the foundation for precision medicine in different populations.
    MeSH terms: Breast Neoplasms/genetics*; Breast Neoplasms/immunology; Breast Neoplasms/pathology; Female; Genetics, Population*; Humans; Mutation/genetics; Receptors, Estrogen/metabolism; Genome, Human; Survival Analysis; Tumor Suppressor Protein p53/genetics; Receptor, ErbB-2/genetics; Receptor, ErbB-2/metabolism; European Continental Ancestry Group/genetics; Asian Continental Ancestry Group/genetics*; Tumor Microenvironment/immunology
  16. Chitamparam S, Lim TH, Tai E, Ibrahim M
    Turk J Ophthalmol, 2020 12 29;50(6):332-338.
    PMID: 33389932 DOI: 10.4274/tjo.galenos.2020.57609
    Objectives: To identify the clinical profile, etiology, and outcome of culture-positive mycotic keratitis in a tertiary referral centre in the Northeastern part of Malaysia.

    Materials and Methods: A retrospective review of all patients with culture-positive mycotic keratitis in Hospital Universiti Sains Malaysia over a 3-year period, from January 2015 to December 2017.

    Results: This study included 27 eyes of 27 patients treated for mycotic keratitis based on a positive fungal culture. The most common predisposing factor was ocular trauma, in 22 patients (81.5%). Eleven patients (40.7%) had a presenting visual acuity worse than 6/60, due to central ulcer involvement. Approximately half of these (6 patients) experienced visual improvement post-treatment. Fusarium spp. was the most common fungus isolated (37%), followed by non-sporulating fungi and Curvularia spp. Three patients (7.4%) had corneal microperforations, which healed after gluing and bandage contact lens application. One patient (3.7%) required tectonic penetrating keratoplasty and 1 patient (3.7%) underwent evisceration. The final visual acuity was 6/18 or better in approximately half (14 patients) of our cohort and worse than 3/60 in approximately 20% (5 patients).

    Conclusion: Mycotic keratitis occurred mainly in males and secondary to ocular trauma. The most common organism isolated was Fusarium spp. Although treatment may improve vision, the visual outcome is guarded.

    MeSH terms: Adult; Aged; Cornea/microbiology; Cornea/surgery*; Female; Follow-Up Studies; Fungi/isolation & purification; Humans; Keratitis/diagnosis; Keratitis/microbiology; Keratitis/epidemiology*; Malaysia/epidemiology; Male; Middle Aged; Retrospective Studies; Visual Acuity*; Eye Infections, Fungal/diagnosis; Eye Infections, Fungal/microbiology; Eye Infections, Fungal/epidemiology*; Incidence; Young Adult; Tertiary Care Centers/statistics & numerical data*
  17. Ab Kahar MEPI, Muhammed J, Hitam WHW, Husin A
    Turk J Ophthalmol, 2020 12 29;50(6):371-376.
    PMID: 33389938 DOI: 10.4274/tjo.galenos.2020.83873
    Bartonella henselae is a recognized cause of neuroretinitis in cat scratch disease. Meanwhile, polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome with Castleman disease (evidence of lymph node hyperplasia), is a chronic debilitating condition that predisposes to various superimposed infections. B. henselae neuroretinitis implicated in POEMS syndrome has not been reported previously. A 34-year-old asymptomatic man was referred for an eye assessment. Examination showed visual acuity of 6/18 in the right eye and 6/24 in the left eye. On fundus examination, both eyes exhibited typical features of neuroretinitis (optic disc swelling and incomplete macular star). There was otherwise no vitritis or chorioretinitis. Serology for B. henselae revealed high immunoglobulin M (IgM) titer (1:96) indicative of acute disease, and positive immunoglobulin G (IgG) (1:156). He was treated with oral azithromycin for 6 weeks and a short course of oral prednisolone. Subsequently, the visual acuity in both eyes improved with resolution of macular star. However, both optic discs remained swollen.
    MeSH terms: Adult; Antibodies, Bacterial/analysis*; Bartonella Infections/diagnosis*; Bartonella Infections/microbiology; Fluorescein Angiography; Fundus Oculi; Humans; Male; Retinitis/complications; Retinitis/diagnosis*; Retinitis/microbiology; Visual Acuity*; Eye Infections, Bacterial/complications; Eye Infections, Bacterial/diagnosis*; Eye Infections, Bacterial/microbiology; POEMS Syndrome/complications*; POEMS Syndrome/diagnosis; Bartonella henselae/immunology*
External Links