Displaying publications 1 - 20 of 135 in total

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  1. Roseni Abdul Aziz, Mat Rebi Abdul Rani, Jafri Mohd Rohani, Ademola James Adeyemi
    MyJurnal
    Studies have identified working postures as a major risk factors associated with Work-related musculoskeletal disorders (WMSD) in industries. This study investigated the prevalence of WMSD among assembly workers in Malaysia and how psychosocial factors such as personal values and workers relationship with family and superior are associated with discomfort and pain. A survey was conducted among 127 workers at assembly process in the manufacturing industry. The workers were aged 28.74±6.74 years and 64.6% of them were males. Analysis of Variance (ANOVA) was used to determine the effect of workplace factors on WMSD at different body regions. Spearman’s rank correlation was used to investigate association between psychosocial factors and occurrence of discomfort and pain. Only occupation and job activities revealed any significant different with WMSD in the major body regions while there was no significant difference in gender, age and work duration classifications. Shoulder painis the most prevalent in terms of frequency and intensity of occurrence. Psychosocial issues that have to do with person values, effect of job on family relationship and workers rapport with superiors are all found to be associated with the discomfort and pain among the occupational group. Employers and concerned government agencies need to take more proactive steps in tackling the problem as the occurrence of WMSD will have a significant effect on the overall wellbeing of the working population.
    Matched MeSH terms: Shoulder
  2. Madhwani KP, Nag PK
    Indian J Occup Environ Med, 2017 Jan-Apr;21(1):18-22.
    PMID: 29391743 DOI: 10.4103/ijoem.IJOEM_145_17
    Aims: The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics - a unique method for prevention of musculoskeletal discomfort (MSD) - in corporate offices that influences behavior modification.

    Background: With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study.

    Objective: To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible.

    Materials and Methods: An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions - baseline evaluation (n = 240) and a follow-up evaluation after 3 months (n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment.

    Statistical Analysis Used: Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test.

    Results: Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41-50% decline in ongoing symptoms.

    Conclusions: We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources.
    Matched MeSH terms: Shoulder Pain
  3. Tan GJS, Tan AGS, Peh WCG
    Med J Malaysia, 2008 Jun;63(2):164-5.
    PMID: 18942311
    A 74-year-old woman was incidentally found to have a left breast mass. The mass could not be adequately compressed to be visualized on mammography. Ultrasonography showed a heavily-calcified rounded mass in the left axillary tail of the left breast. Chest radiograph confirmed that the mass was a migrated humeral head. Remotely-displaced fracture-dislocations of the humeral head are very rare and to our knowledge, displacement into the breast, clinically mimicking a breast mass, has not been previously described.
    Matched MeSH terms: Shoulder Dislocation/complications*; Shoulder Fractures/complications*
  4. Ho W, Lin Seow L, Musawi A
    J Clin Transl Res, 2018 May 28;4(1):70-74.
    PMID: 30873496
    Background: The purpose of the present study was to investigate the effect of different viscosities of polyvinyl siloxane (PVS) impression materials on the accuracy of the stone die produced.

    Methods: A three-unit bridge master model was fabricated using cold-cure acrylic resin. Four combinations of different viscosities of PVS impression materials - regular body (monophase) alone, light body with regular body, light body with heavy body, and light body with putty - were used to make an impression of the master model. Ten impressions from each group were taken and Type IV gypsum stone was used to generate the dies. The dies were measured at the inter-abutment distance, occlusogingival length, and shoulder width with a measuring microscope and were compared with the master model using one-way analysis of variance and Tukey (honest significant difference) test.

    Results: Differences were found for inter-abutment distance between the master model and the light body with regular body and light body with putty dies (both P < 0.02). A difference was found for shoulder width between the master model and the regular body alone die (P = 0.01). No differences were found for occlusogingival distance (all P > 0.08).

    Conclusion: Results suggested inter-abutment distance was most accurate when using a PVS light body combination. Occlusogingival length was accurate using any of the studied PVS combinations, and shoulder width was more accurate when using the regular body PVS.

    Relevance for patients: These results should be considered when choosing the viscosity of the PVS to use for producing impressions of high accuracy and fabricating a well-fitting fixed prosthesis.

    Matched MeSH terms: Shoulder
  5. Ezrin Hani Sukadarin, Baba Md Deros, Jaharah A. Ghani, Ahmad Rasdan Ismail, Nur Syazwani Mohd Nawi, Norhidayah Abdull
    MyJurnal
    Validity test is important during the development of ergonomics measurement. Failure to conduct validity tests will result in the measurement method being developed to be incapable of providing reliable ergonomics measurements. The objective of this study is to conduct validity test on the simple method ergonomics measurement which was developed. The method named Simple Ergonomics Risks Assessment (SERA). Content validity test and criterion validity test were conducted. The content validity test consists of 6 ergonomics experts who actively provide inputs and positive feedbacks to improve the measurement method being developed. Meanwhile, the criterion validity test involves data collection of complaints on body parts among oil palm workers which were derived from Nordic Musculoskeletal Questionnaire (NMQ) and ergonomics risk assessment scores obtained from SERA. Both findings were tested with the Chi-square test to explore possible relations between the two findings. Results from the test conducted showed that there are significant relations in the scores of neck posture; hip, right and left shoulder, right and left wrists and the right hand associated with fresh fruit bunch (FFB) harvesting activities. In the loose fruits collection, the Chi-square test showed significant relations in the scores of neck posture, hip, right and left shoulders, right wrist, right arm and the left hand. However, there are body parts such as the legs which showed no significant relation. More tests should be conducted to further explore the validity of the method being developed. Findings from both validity tests show that SERA were verified by the experts and tested with validated method so that it is valid to be applied in the future.
    Matched MeSH terms: Shoulder
  6. Yuen GK, Clements JB, Ramalingam V, Sundar V
    Clin Ter, 2021 Mar 15;172(2):163-167.
    PMID: 33763681 DOI: 10.7417/CT.2021.2305
    Conclusion: The obtained results conclude piano players are highly prone to the risk of developing PRMSD in the upper body.

    Results: The findings showed piano players have a higher NDI, lower CVA, and RSP when compared with the non-piano players at a statistically significant level of p-value <0.05.

    Objective: Playing-related musculoskeletal disorders (PRMSD) are a common problem for the pianist. The poor upper body ergonomics influences the natural positioning of the neck and shoulders, which involves forward head posture (FHP) and rounded shoulder posture (RSP). This misaligned position could produce a sensation of pain over the upper body, which affects the piano player and computer users with similar ergonomic posture. Recently, photogrammetry methods are commonly applied in a clinical setting to assess posture. The goal of this research is to compare the upper body playing-related muscu-loskeletal disorders between the piano and the non-piano players by applying photogrammetry.

    Materials and Methods: This causal-comparative study includes 70 participants with 35 piano and 35 non-piano players. The participant's FHP was assessed using a digitized photo to record the Craniovertebral angle (CVA) with the support of Kinovea software. Besides, digital Vernier Calliper used to assess the scapular index on the RSP and Neck disability indices (NDI) used to measure neck pain and functional disability of the participants.

    Matched MeSH terms: Shoulder/physiopathology
  7. Lim E, Lim R, Suhaimi A, Chan BT, Wahab AKA
    J Back Musculoskelet Rehabil, 2018;31(6):1041-1047.
    PMID: 30149436 DOI: 10.3233/BMR-171042
    BACKGROUND: Low frequency sound wave stimulation therapy has become increasingly popular in the rehabilitation fields, due to its ease, less fatiguing and time efficient application.

    OBJECTIVE: This 12-week pilot study examines the efficacy of applying low frequency sound wave stimulation (between 16-160 Hz) through both hands and feet on relieving pain and improving functional ability in patients with chronic back pain.

    METHODS: Twenty-three participants with chronic shoulder (eleven participants) or low back pain (twelve participants) underwent a 12-week vibration therapy program of three sessions per week. A low frequency sound wave device comprising four piezoelectric vibration-type tactile tranducers enclosed in separate 5-cm diameter circular plates, which generate sinusoidal vibratory stimuli at a frequency of 16-160 Hz, was used in this study. Primary outcome measure was pain sensation measured using the Visual Analogue Scale (P-VAS). The secondary outcome measures were pain-related disability measured using the pain disability index (PDI) and quality of life measured using the SF-12.

    RESULTS: At week 12, significant reductions in pain sensation and pain-related disability were observed, with mean reductions of 3.5 points in P-VAS and 13.5 points in the PDI scores. Sixty-five percent of the participants had a reduction of at least 3 points on the P-VAS score, while 52% participants showed a decrease of at least 10 points in the PDI score. Significant improvement was observed in the SF-12 physical composite score but not the mental composite score.

    CONCLUSIONS: The preliminary findings showed that passive application of low frequency sound wave stimulation therapy through both hands and feet was effective in alleviating pain and improving functional ability in patients with chronic back pain.

    Matched MeSH terms: Shoulder
  8. Choo C, Wong H, Nordin A
    Malays Orthop J, 2012 Nov;6(3):57-9.
    PMID: 25279061 MyJurnal DOI: 10.5704/MOJ.1207.008
    Shoulder girdle injuries after high energy traumatic impacts to the shoulder have been well documented. Based on the series of 1603 injuries of the shoulder girdle reported by Cave and colleagues, 85% of the dislocations were glenohumeral, 12% acromioclavicular and 3% sternoclavicular (1). Less frequently described are injuries involving both the sternoclavicular and acromioclavicular joints simultaneously in one extremity. The present report discusses a case of traumatic floating clavicle associated with ipsilateral forearm and wrist injury which was treated surgically.
    Matched MeSH terms: Shoulder; Shoulder Injuries
  9. Ariffin, M. H., Selvyn Lloyd, Rhani, S. A., Kamalnizat, Baharudin, A.
    Malays Orthop J, 2014;8(2):40-42.
    MyJurnal
    The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with post- radiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.
    Matched MeSH terms: Shoulder
  10. Ariffin M, Lloyd S, Rhani S, Kamalnizat, Baharudin A
    Malays Orthop J, 2014 Jul;8(2):40-2.
    PMID: 25279091 DOI: 10.5704/MOJ.1407.001
    The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.
    Matched MeSH terms: Shoulder
  11. Jagdish K, Paiman M, Nawfar A, Yusof M, Zulmi W, Azman W, et al.
    Malays Orthop J, 2014 Mar;8(1):14-20.
    PMID: 25279079 MyJurnal DOI: 10.5704/MOJ.1403.012
    A seven years retrospective study was performed in 45 consecutive vascular injuries in the extremities to investigate the pattern of injuries, managements and outcomes. Motor-vehicle accidents were the leading cause of injuries (80%), followed by industrial injuries (11.1%) and iatrogenic injuries (4.4%). Popliteal and brachial artery injuries were commonly involved (20%). Fifteen (33.3%) patients had fractures, dislocation or fracture dislocation around the knee joint and 6 (13.3%) patients had soft tissue injuries without fracture. Traumatic arterial transection accounted for 34 (75.6%) cases, followed by laceration in 7 (15.6%) and 9 (6.7%) contusions. Associated nerve injuries were seen in 8 (17.8 %) patients using intra-operative findings as the gold standard, both conventional angiogram (CA) and computerized tomography angiogram (CTA) had 100% specificity and 100% sensitivity in determining the site of arterial injuries. The mean ischemic time was 25.31 hours (4 - 278 hours). Thirty-three (73.3 %) patients were treated more than 6 hours after injury and 6 patients underwent revascularization after 24 hours; all had good collateral circulation without distal pulses or evidence of ischemic neurological deficit. The mean ischemic time in 39 patients who underwent revascularization within 24 hours was 13.2 hours. Delayed amputation was performed in 5 patients (11.1%). Of the 6 patients who underwent delayed revascularization, one patient had early amputation, one -had delayed amputation following infection and multiple flap procedures while the rest of the patients' limbs survived. Joint stiffness was noted in 10 patients (22.2%) involving the knee joint, elbow and shoulder in two patients each. Infection was also noted in 5 patients (11.1%) with two of them were due to infected implants. Other complications encountered included nonunion (2 patients, 4.4%), delayed union (1 patient, 2.2%),limb length discrepancy (1 patient, 2.2%), hematoma (1 patient, 2.2%) and leaking anastomosis in one patient (2.2%). Volkmann's ischemic contracture occurred in 3 (6.7%) patients. There was no complication noted in 8 (17.8%) patients Three patients (6.7%) died of whom two were not due to vascular causes. We conclude that early detection and revascularization of traumatic vascular injuries is important but delayed revascularization also produced acceptable results.
    Matched MeSH terms: Shoulder
  12. Yeap JS, Lee DJK, Fazir M, Borhan TAM, Kareem BA
    Med J Malaysia, 2004 Dec;59 Suppl F:19-23.
    PMID: 15941156 MyJurnal
    The case notes of 102 patients (117 shoulder dislocations) were reviewed retrospectively to improve the understanding of the epidemiology of this common injury. Eighty-one dislocations were primary and 36 dislocations were second or recurrent dislocations. The age distribution was characterized by a peak in male patients aged between 21-30 years. The mean age for males was 30.5 years and 47.7 years for females. The male:female ratio in first time dislocations was 5:2, while it was 5:1 in recurrent dislocations. Ninety-eight percent were anterior dislocations and 2% were posterior dislocations. Greater tuberosity fractures were found in 17 patients and almost half of these patients were aged between 41-50 years. The most common cause of first time dislocation was a direct blow or fall onto the shoulder, accounting for 42 patients (55%). The majority of these patients were aged 40 years and above. Next common cause was motor vehicle accident which occurred mostly in the younger age group. Dislocations due to sporting injuries accounted for only 5.3% of all first time dislocations. Nearly 97% were successfully reduced without a general anaesthesia. Seventy-seven percent of the patients had their shoulders immobilized after reduction, mostly with body strapping only. Fifteen patients (14.7%) were referred for physiotherapy for stiffness. Few operations were performed for recurrent dislocations but surgery does not appear to be well accepted as yet by our patients.
    Matched MeSH terms: Shoulder Dislocation/etiology; Shoulder Dislocation/epidemiology*
  13. Hazmy CHW, Parwathi A
    Med J Malaysia, 2005 Jul;60 Suppl C:17-21.
    PMID: 16381277
    This retrospective study was conducted in a state hospital set-up and aimed at identifying the magnitude of shoulder dislocations and their demographic data, characteristics of the injury, mechanism and predisposing factors, and the instituted treatment. Patients with radiographic evidence of shoulder dislocation admitted to the hospital from January 1999 to December 2002 were included. Data were recorded from the case notes. There were 105 shoulder dislocations with male predomination in 77% cases and age ranged between 11 and 90 years (average 30.9 years). The right shoulder was affected in 68% of the cases. The contributing events were fall in 37% of cases, road traffic accident 23%, sports 17% and pathological conditions 13%. Anterior dislocation occurred in 96.2% of the cases. Posterior and inferior dislocations encountered in two patients for each type. Twelve dislocations were associated fracture of the greater tuberosity, two each with humeral neck fracture and cerebral injuries. First time dislocation occurred in 73.6% of the cases. The recurrences ranged between 2 to 6 times (average 3.4 times). Closed manipulative reduction and strapping was the definitive treatment in 92.4% of the cases and the remaining needed surgical reconstruction. Four patients had open reduction and internal fixation of the associated fractures while another four had arthroscopic Bankart's repair. In conclusion, shoulder dislocation represents the most common shoulder problems. It afflicted young adults of reproductive age (21-40 years) and participation in sports was a risk factor in men. Women over 40 years and fall were at risk to develop shoulder dislocation.
    Matched MeSH terms: Shoulder Dislocation/etiology; Shoulder Dislocation/epidemiology*; Shoulder Dislocation/therapy
  14. Ali Md Nadzalan
    MyJurnal
    This study was conducted to investigate i) while the shoulder was in 180° of flexion and the elbow extended, which of the forearm position (supination, pronation and neutral) can generate the greatest handgrip strength, ii) is there any correlation of the handgrip strength between the dominant hand (right hand) and non-dominant hand (left hand) in each forearm position, and iii) will the dominant hand possessed 10% higher handgrip strength than the non-dominant hand. 100 right handed sedentary active students age 22.20 years old (± 1.03), height 172.83 cm (± 6.37), body mass 68.87 (± 11.52) and grip position 3.77 (± 0.77) were recruited in this study. The result indicated that for both the dominant and non-dominant hand, when the shoulder is in 180˚ flexion of the body with the elbow extended, the greatest grip strength was obtained when the forearm was in neutral position followed by pronation and supination position. Post Hoc analysis showed that for both dominant hand and non-dominant hand, pronation and supination forearm position produced greater strength score compared to supination forearm position (p0.05). In all forearm position, participants were shown to produced significantly greater strength in their dominant hand and all the scores were more than 10% greater compared to when using non-dominant hand. Positive relationships were also found for the strength score between dominant hand and non-dominant hand. As the conclusion, different shoulder, elbow and forearm position can affect handgrip strength.
    Matched MeSH terms: Shoulder
  15. Omar N, Abidin FZ, Das S, Abd Ghafar N, Haji Suhaimi F, Abd Latiff A, et al.
    Morphologie, 2010 May;94(305):36-9.
    PMID: 20359930 DOI: 10.1016/j.morpho.2010.03.001
    The latissimus dorsi is a muscle of the back which forms the posterior fold of the axilla and its tendon twists to insert into the floor of the intertubercular sulcus of the humerus. Occasionally, the muscle has a muscular slip which crosses the axilla to insert into the pectoralis major. This muscular slip is often termed as "axillary arch." In the present study, we report bilateral axillary arch detected in a 45-year-old male cadaver. The average vertical length of the axillary arch measured 7 cm. The average maximum width of the uppermost, middle and lower part of the arch measured 2, 3.5 and 3.2 cm, respectively. The presence of the axillary arch is an uncommon finding in humans, considering the fact that it is solely found in the animals who prefer to hang on the trees. A histological study of the axillary arch was also performed and it showed skeletal muscle fibres which was uniformly arranged. The presence of the axillary arch may assist in the adduction of the shoulder. It may also compress the axillary vessels and nerves thereby causing resultant symptoms. Prior anatomical knowledge of the presence of axillary arch may be helpful for surgeons performing radical dissection of the axillary lymph nodes and ligation of axillary vessels, clinicians diagnosing abduction syndromes and interventional radiologists interpreting axillary mass in day to day clinical practice.
    Matched MeSH terms: Shoulder/anatomy & histology
  16. Kwan MK, Chiu CK, Goh SH, Ng SJ, Tan PH, Chian XH, et al.
    Clin Spine Surg, 2019 Jul;32(6):256-262.
    PMID: 30640749 DOI: 10.1097/BSD.0000000000000769
    STUDY DESIGN: Retrospective study.

    OBJECTIVE: This study looked into whether crossbar can reliably measure Upper Instrumend Vertebra (UIV) tilt angle intraoperatively and accurately predict the UIV tilt angle postoperatively and at final follow-up.

    SUMMARY OF BACKGROUND DATA: Postoperative shoulder imbalance is a common cause of poor cosmetic appearance leading to patient dissatisfaction. There were no reports describing the technique or method in measuring the UIV tilt angle intraoperatively. Therefore, this study was designed to look into the reliability and accuracy of the usage of intraoperative crossbar in measuring the UIV tilt angle intraoperatively.

    METHODS: Lenke 1 and 2 Adolescent Idiopathic Scoliosis patients who underwent instrumented Posterior Spinal Fusion using pedicle screw constructs with minimum follow-up of 24 months were recruited for this study. After surgical correction, intraoperative UIV tilt angle was measured using a crossbar. Immediate postoperative and final follow up UIV tilt angle was measured on the standing anteroposterior radiographs.

    RESULTS: A total of 100 patients were included into this study. The reliability of the intraoperative crossbar to measure the optimal UIV tilt angle intraoperatively was determined by repeated measurements by assessors and measurement by different assessors. We found that the intra observer and inter observer reliability was very good with intraclass correlation coefficient values of >0.9. The accuracy of the intraoperative crossbar to measure the optimal UIV tilt angle intraoperatively was determined by comparing this measurement with the postoperative UIV tilt angle. We found that there was no significant difference (P>0.05) between intraoperative, immediate postoperative, and follow-up UIV tilt angle.

    CONCLUSIONS: The crossbar can be used to measure the intraoperative UIV tilt angle consistently and was able to predict the postoperative UIV tilt angle. It was a cheap, simple, reliable, and accurate instrument to measure the intraoperative UIV tilt angle.

    Matched MeSH terms: Shoulder
  17. Tamadon A, Pons DJ, Clucas D, Sued K
    Materials (Basel), 2019 Oct 01;12(19).
    PMID: 31581446 DOI: 10.3390/ma12193215
    One of the difficulties with bobbin friction stir welding (BFSW) has been the visualisation of microstructure, particularly grain boundaries, and this is especially problematic for materials with fine grain structure, such as AA6082-T6 aluminium as here. Welds of this material were examined using optical microscopy (OM) and electron backscatter diffraction (EBSD). Results show that the grain structures that form depend on a complex set of factors. The motion of the pin and shoulder features transports material around the weld, which induces shear. The shear deformation around the pin is non-uniform with a thermal and strain gradient across the weld, and hence the dynamic recrystallisation (DRX) processes are also variable, giving a range of observed polycrystalline and grain boundary structures. Partial DRX was observed at both hourglass boundaries, and full DRX at mid-stirring zone. The grain boundary mapping showed the formation of low-angle grain boundaries (LAGBs) at regions of high shear as a consequence of thermomechanical nature of the process.
    Matched MeSH terms: Shoulder
  18. Grismer LL, Wood PL, Anuar S, Riyanto A, Ahmad N, Muin MA, et al.
    Zootaxa, 2014;3880:1-147.
    PMID: 25544645 DOI: 10.11646/zootaxa.3880.1.1
    A well-supported and well-resolved phylogeny based on a concatenated data set from one mitochondrial and two nuclear genes, six morphological characters, and nine color pattern characters for 44 of the 50 species of the Southeast Asian Rock Geckos (genus Cnemaspis Strauch, 1887) is consistent with the previous taxonomy of Cnemaspis based solely on morphology and color pattern. Cnemaspis is partitioned into four major clades that collectively contain six species groups. The monophyly of all clades and species groups is strongly supported and they are parapatrically distributed across well-established, biogeographical regions ranging from southern Vietnam westward through southern Indochina, southward through the Thai-Malay Peninsula, then eastward to Borneo. Eight new species (Cnemaspis omari sp. nov. from the Thai-Malaysian border; C. temiah sp. nov. from Cameron Highlands, Pahang, Malaysia; C. stongensis sp. nov. from Gunung Stong, Kelantan, Malaysia; C. hangus sp. nov. from Bukit Hangus, Pahang, Malaysia; C. sundagekko sp. nov. from Pulau Siantan, Indonesia; C. peninsularis sp. nov. from southern Peninsular Malaysia and Singapore, and C. mumpuniae sp. nov. and C. sundainsula sp. nov. from Pulau Natuna Besar, Indonesia) are described based on morphology and color pattern and all but C. sundagekko sp. nov. are included in the phylogenetic analyses. Cnemaspis kendallii is polyphyletic and a composite of six species. An updated taxonomy consistent with the phylogeny is proposed for all 50 species and is based on 25 morphological and 53 color pattern characters scored across 594 specimens. Cladogenetic events and biogeographical relationships within Cnemaspis were likely influenced by this group's low vagility and the cyclical patterns of geographical and environmental changes in Sundaland over the last 25 million years and especially within the last 2.5 million years. The phylogeny indicates that nocturnality, diurnality, substrate preferences, and the presence of ocelli in the shoulder regions have evolved independently multiple times. 
    Matched MeSH terms: Shoulder
  19. Choy, Yew Sing, Sinniah, D.
    MyJurnal
    Reported is the first case of syringomyelia and syringobulbia associated with Arnold Chiari I malformation in a Malaysian child. The initial complaint was that of unilateral anhidrosis of the face. The chief presenting features were dissociated sensory loss, asymmetrical weakness of the left upper limb associated with subluxation of left shoulder and signs of upper motor neurone lesion in the left lower limb. One unusual feature was the presence of vesiculation followed by ulceration of the pinnae of both ears. Magnetic resonance imaging (MRI) of the posterior fossa and cervical and thoracic cord facilitated the diagnosis and was the most useful diagnostic procedure in this child.
    Matched MeSH terms: Shoulder
  20. Dhillon KS
    Malays Orthop J, 2019 Nov;13(3):1-7.
    PMID: 31890103 DOI: 10.5704/MOJ.1911.001
    Subacromial impingement syndrome (SAIS) is a commonly diagnosed disorder of the shoulder. Though this disorder has been known for a long time, it remains a poorly understood entity. Over the years several hypotheses have been put forward to describe the pathogenesis of SAIS but no clear explanation has been found. Two mechanisms, the extrinsic and intrinsic mechanism, have been described for the impingement syndrome. The intrinsic mechanism theories which deny the existence of impingement are gaining popularity in recent years. The various shoulder tests used to diagnose SAIS have low specificity with an average of about 50%. Meta-analysis shows that neither the Neer sign nor the Hawkins sign has diagnostic utility for impingement syndrome. Several randomised controlled trials have shown that the outcome of treatment of SAIS by surgery is no better than conservative treatment. Physiotherapy alone can provide good outcome which is comparable to that achieved with surgery without the costs and complications associated with surgery. Since decompression with surgery does not provide any additional benefits as compared to conservative treatment for patients with SAIS, the impingement theory has become antiquated and surgical treatment should have no role in the treatment of such patients. There are calls by some practitioners to abandon the term impingement syndrome and rename it as anterolateral shoulder pain syndrome. It appears that SAIS is a medical myth. There are others who called SAIS as a clinical illusion.
    Matched MeSH terms: Shoulder; Shoulder Impingement Syndrome; Shoulder Pain
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