Osteoporosis dikenali sebagai penyakit senyap kerana tidak mempunyai tanda-tanda awal. Ini disebabkan oleh kepadatan tulang yang berkurangan secara perlahanlahan seiring dengan peningkatan usia. Insiden penyakit ini semakin meningkat setiap tahun di seluruh dunia. Mengukur ketumpatan mineral tulang (BMD) menggunakan densitometry tulang konvensional (DXA) adalah praktikal dalam diagnosis osteoporosis tetapi kosnya adalah tinggi dan tidak dapat dilaksanakan dalam masyarakat. Untuk mengukur ketumpatan tulang, “quantitative ultrasound” (QUS) adalah teknik yang agak moden untuk diagnosis osteoporosis. Ianya agak mudah, konsisten, lebih murah dan kaedah yang selamat berbanding dengan teknik densitometry yang lain. Kedua-dua parameter QUS yang diukur pada masa kini adalah ultrasound jalur pengecilan (BUA) dan kelajuan bunyi (SOS). QUS juga dapat menjangka risiko patah. Ianya kini digunakan untuk memantau tindakbalas kepada rawatan anti-osteoporosis. Kajian in-vitro menunjukkan bahawa indeks QUS berhubungkait dengan BMD, bentuk tulang mikro dan parameter mekanikal. Oleh yang demikian, QUS berupaya untuk menjadi teknik baru untuk penilaian tulang.
Micro computed tomography (micro-CT) imaging is a useful tool to monitor fracture
healing in osteoporosis model. It creates a 3-D image of the fracture callus which can
be analysed to assess bone parameters quantitatively. In this study, micro-CT was
used to assess the fracture healing of orchidectomised rats, an androgen-deficient
osteoporosis model. The effects of Eurycoma longifolia, a medicinal plant with proandrogenic
effects, on fracture healing were assessed. The rats were grouped into
orchidectomised-control (ORX), sham-operated (SHAM), orchidectomised and
injected with testosterone intramuscularly once weekly (TEN) and orchidectomised
and daily oral gavage of Eurycoma longifolia (EL). Treatment duration was six
weeks following bone fracture. Fracture was induced in the right tibia of all the
rats. A total of 100 axial slices above and below fracture line were scanned with
a micro-CT. The micro-CT analysis was able to detect significant difference in the
fracture healing rate of ORX and TEN groups. The bridging cortices and fraction
of mineralized tissue of the bridging cortices of the callous of ORX group was
significantly lower than TEN group. No significant micro-CT changes were seen
in the fracture healing of the EL group. The effect of EL on fracture healing was not
demonstrable in orchidectomised rat model.
Patient’s belief towards pain management may affect pain management outcomes and quality of life. The main aim of the present study was to determine the impact of a pre-operative pain education package towards pain belief among patients undergoing orthopaedic surgery in a tertiary hospital. A one-group pre-test post-test design study was conducted on orthopaedic surgery patients. Thirty respondents were recruited and pre-operative pain education was administered individually before surgery. Pre-operative and post-operative pain belief, management scores and side effects were measured using the Barrier Questionnaire (BQ-13). The results reported significant differences between pre-test scores (Mean = 41.87, Standard Deviation = 11.467) and post-test scores (Mean=34.80, Standard Deviation=13.026) of pain belief (t = 2.84, p = 0.004). There were also significant differences between pre-test scores (Mean = 37.10, Standard Deviation = 10.610) and post-test scores (Mean=30.80, Standard Deviation = 11.424) of pain management (t = 3.856, p = 0.0005). Respondent’s gender (t = -2.403, p = 0.023) and ethnicity (F = 5.038, p=0.014) reported significant differences with p value < 0.05, respectively. However, there were no significant differences between educational level, ethnicity, prior surgical history with pain belief (p> 0.05). There was positive impact of the pain education package towards pain belief and painmanagement among respondents who underwent orthopaedics surgery in a tertiary hospital. Reinforcement of pain educational program is pivotal in order to achieve optimal post-operative pain management.
Keywords: pain, education, orthopaedics, patient, surgery