MyMedR

Displaying publications 21 - 26 of 26 in total

Abstract:

Sort:

Splinting after Carpal Tunnel Release: Does it really Matter?

Shalimar A, Nor-Hazla MH, Arifaizad A, Jamari S

Malays Orthop J, 2015 Jul;9(2):41-46.
PMID: 28435609 MyJurnal DOI: 10.5704/MOJ.1507.011

Splinting of the wrist after carpal tunnel release (CTR) has been practised by many surgeons especially in North America. The main reason was to prevent possible adverse events of bowstringing of flexor tendons and the median nerve, pillar pain, entrapment of the median nerve in scar tissue and wound dehiscence. Studies on the effect of splinting after standard CTR have had dismal results. The duration of splinting in standard CTR has been either too long (for 2-4 weeks) or too short (48 hours only). The aim of our study was to compare the effects of post-operative splinting for a duration of one week with no splinting.
METHODS: All 30 of our patients underwent a standardized limited open CTR by a designated surgeon. Post operatively, they were randomized into a splinted (n=16) and a nonsplinted (n=14) group. The splint was kept for a week. Patients were reviewed at regular intervals of one week, two months and six months. At each follow up, these patients were clinically assessed for the following outcome measures: VAS (visual analogue score), 2PD (two-point discrimination), pinch grip, grip, Abductor Pollicis Brevis (APB)) power and completion of the Boston questionnaire.
RESULTS: All patients presented with significant improvement in the postoperative evaluation in the analyzed parameters within each group. However, there was no significant difference between the two groups for any of the outcome measurements at sequential and at final follow-up.
CONCLUSION: We conclude that wrist splinting in the immediate post-operative period has no advantage when compared with the unsplinted wrist after a limited open carpal tunnel release.

Matched MeSH terms: Median Nerve
Fulltext Adoption of the mobile health screening programme for farming communities: a study among pesticide-exposed farmers from north east of Peninsular Malaysia

Zariyantey Abdul Hamid, Zaliha Harun, Syarif Husin Lubis, Nihayah Mohamed, Ismarulyusda Ishak, Hidayatul Fathi Othman, et al.

Jurnal Sains Kesihatan Malaysia, 2014;12(2):63-70.
MyJurnal

Health awareness promotion among farming communities are important for a sustainable agriculture activities. A cross-sectional study was conducted to assess health status among farming communities in Cameron Highlands, Pahang (n = 61) and Bachok and Pasir Puteh, Kelantan (n = 143). Mobile Health Screening Programme composed of assessment of blood glucose, blood cholesterol, haemoglobin, blood pressure, pterygium, lung function and nerve conductive velocity was utilized. Our results indicate that the percentage of Cameron Highland’s farmers with hyperglycaemia, systolic hypertension, diastolic hypertension and anaemia were 8.2%, 14.8%, 11.5% and 8.2%, respectively. However, higher percentage of farmers in Bachok and Pasir Puteh, Kelantan with hyperglycaemia (32.8%), hypercholesterolaemia (83%), anaemia (24.2%) and systolic hypertension (41.9%) were observed. Pterygium was positive for 88.6% of farmers in Cameron Highlands and 94.4% in Bachok and Pasir Puteh. Lung function test shows that 61.7% and 11.4% of farmers in Cameron Highlands had restrictive and obstructive lung, respectively. In Bachok and Pasir Puteh, a total of 19.8%, 55.5% and 23.9% of farmers were found to have obstructive, restrictive and combined obstructive and restrictive lung, respectively. Current Perception Threshold (CPT) value which indicate nerve conductive velocity were significantly increased (p < 0.05) among Cameron Highland’s farmers for both median and peroneal nerve at all frequencies (5 Hz, 250 Hz and 2000 Hz). In Bachok and Pasir Puteh, the values of the CPT for median nerve was significantly increased (p < 0.05) for all frequencies (5, 250 and 2000 Hz). Meanwhile, a signifi cant increased (p < 0.05) was observed for the CPT values for peroneal nerve at the frequencies of 250 and 2000 Hz as compared to control groups. In conclusion, analysis revealed different health problem among the studied farming communities which could be influenced by the differences in farming practices. Thus, employed Mobile Health Screening Programme offers a monitoring approach that could highlight the need for suitable health services and awareness programmes for different farming communities.

Matched MeSH terms: Median Nerve
Fulltext Demographics of Patients Undergoing Carpal Tunnel Release in an Urban Tertiary Hospital in Malaysia

Bahar-Moni AS, Abdullah S, Fauzi H, Chee-Yuen SY, Abdul-Razak FZ, Sapuan J

Malays Orthop J, 2019 Nov;13(3):53-59.
PMID: 31890111 DOI: 10.5704/MOJ.1911.009

Introduction: Carpal tunnel syndrome (CTS) is the most commonly encountered neuropathy. The entrapment of the median nerve at the wrist can be corrected with a carpal tunnel release (CTR) procedure. The objective of this retrospective study was to determine the demographic, medical, and surgical characteristics of the patients with CTS who presented for CTR surgery in a tertiary hospital in Malaysia. Materials and Methods: Malaysians patients with CTS who had undergone a CTR during the period from 1st June 2017 to 31st December 2017 were enrolled into the study. Each patient had a minimum follow-up of three months. The demographic data of age, gender, race and occupation, and the comorbid illnesses and associated risk factors were recorded. The prevalence and occurrence of CTS in the dominant or non-dominant hand and the effectiveness of surgical intervention were also noted. Data was collected, analysed and stored in Microsoft Excel and SPSS 25. Results: There was a total of 76 cases of CTR surgeries done in 62 patients in the study. Eighty percent of the patients were female, and most of the patients belonged to the age group of 41-60 years. Malays constituted 74.2% of the patients, and 34% were housewives. Hypertension, dyslipidaemia and diabetes mellitus were the three major comorbidities. Cervical spondylosis was seen in one-fourth of the patients. Bilateral hand involvement was present in 54.8% of patients. 59.7% of CTR surgery was done on the dominant hand alone, 17.7 % CTR on the non-dominant hand alone and 22.6% CTR on both hands. Numbness and pain (50%) were the predominant presenting symptoms. The most positive signs were the Durkan test (77.6%), followed by the Tinel sign at the carpal tunnel and the Phalen's test. At follow-up, three months or more, after the surgery, 75% of the patients showed a satisfactory improvement. Conclusion: Patients, who had undergone CTR, had a higher prevalence of pre-morbid conditions, and a quarter of them presented with associated cervical spondylosis. The most common presentation was a combination of numbness and pain. Many obtained satisfactory improvement post-surgery and thus open surgery could be considered a reliable treatment for CTS.

Matched MeSH terms: Median Nerve
Fulltext The Effects of Tocotrienol-Rich Vitamin E (Tocovid) on Diabetic Neuropathy: A Phase II Randomized Controlled Trial

Ng YT, Phang SCW, Tan GCJ, Ng EY, Botross Henien NP, M Palanisamy UD, et al.

Nutrients, 2020 May 23;12(5).
PMID: 32456230 DOI: 10.3390/nu12051522

Chronic hyperglycemia increases oxidative stress, activates inflammatory pathways and reduces nerve growth factor (NGF) among diabetic patients, which contribute to development of diabetic peripheral neuropathy (DPN). Tocotrienol-Rich Vitamin E (Tocovid) possesses potent antioxidant and anti-inflammatory properties which are postulated to target these pathogeneses in order to ameliorate DPN. This study aims to evaluate the effects of Tocovid on nerve conduction parameters and serum biomarkers among diabetic patients. This multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial was conducted on 80 eligible participants. The intervention group (n = 39) was randomly allocated to receive 200 mg of Tocovid twice a day, and the control group (n = 41) received placebo twice a day. At the end of eight weeks, the nerve conduction parameters, as assessed by nerve conduction study, as well as serum biomarkers (NGF, malondialdehyde, vascular cell adhesion molecule 1, tumor necrosis factor receptor 1 and thromboxane B2) were compared between the two groups. Compared to placebo, Tocovid significantly improves the nerve conduction velocities of all nerves (+1.25 m/s, interquartile range [IQR] 3.35, p < 0.001, median nerve; +1.60 m/s, IQR 1.80, p < 0.001, sural nerve; +0.75 m/s, IQR 2.25, p < 0.001, tibial nerve). Meanwhile, the levels of serum NGF were significantly higher in the Tocovid group as compared to placebo at eight weeks post-intervention. Participants receiving Tocovid illustrated highly significant improvement in terms of nerve conduction velocities for all nerves tested after eight weeks of supplementation. In addition, Tocovid supplementation elevated the levels of serum NGF, in which its increase is postulated to reflect enhanced neuronal functions. This novel finding suggests that Tocovid could be a disease-modifying agent targeting serum NGF to improve nerve conduction velocities.

Matched MeSH terms: Median Nerve
Nerve injuries in supracondylar fractures of the humerus in children: is nerve exploration indicated?

Khademolhosseini M, Abd Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 Mar;22(2):123-6.
PMID: 23222035 DOI: 10.1097/BPB.0b013e32835b2e14

A retrospective study of nerve injuries with displaced supracondylar fractures of the humerus in children younger than 12 years of age, treated in Hospital Universiti Kebangsaan Malaysia. Our objectives were to determine the incidence of primary and iatrogenic nerve injuries in supracondylar humerus fractures Gartland types II and III and to determine the outcome of nerve recovery. A total of 272 patients with displaced supracondylar humerus fractures who required admission to Hospital Universiti Kebangsaan Malaysia from January 2000 to December 2007 were reviewed. There were 182 boys (67%) and 90 girls (33%). The mean age was 6.0 years, ranging from 1 to 12 years. Of 272 supracondylar fractures, 79 were type II and 193 were type III. Fifty-one (19%) patients had closed reduction, 160 (59%) had closed reduction and percutaneous crossed Kirschner (K) wires, and 61 (22%) had open reduction and crossed K-wires. Associated nerve injuries involving the median, radial, and ulnar nerves were observed in 48 (18%) patients. Nerve injuries were observed in nine (3%) patients upon admission. Thirty-nine (14%) patients developed nerve injuries following treatment. Of these 39 patients, 34 had ulnar, three had radial, and two had median nerve injuries. Nerve exploration was performed in five patients (in four patients following debridement of open fracture and in one because of unacceptable postoperative radiographs, and they subsequently underwent open reduction and exploration). Except for these five patients, the K-wires were not removed earlier nor were the nerves surgically explored in others. The nerve injuries resolved clinically on an average time of 3.5 months (range from 3 weeks to 8 months). Our study found complete resolution of all patients with nerve injuries confirmed by clinical assessment. On the basis of our study, we believe that there is no indication to remove the K-wires immediately or to explore the nerve surgically following a mini-open technique, which reduces the risk of penetrating a nerve during pinning.

Matched MeSH terms: Median Nerve/injuries
Fulltext Tocotrienol-Rich Vitamin E (Tocovid) Improved Nerve Conduction Velocity in Type 2 Diabetes Mellitus Patients in a Phase II Double-Blind, Randomized Controlled Clinical Trial

Chuar PF, Ng YT, Phang SCW, Koay YY, Ho JI, Ho LS, et al.

Nutrients, 2021 Oct 25;13(11).
PMID: 34836025 DOI: 10.3390/nu13113770

Diabetic peripheral neuropathy (DPN) is the most common microvascular complication of diabetes that affects approximately half of the diabetic population. Up to 53% of DPN patients experience neuropathic pain, which leads to a reduction in the quality of life and work productivity. Tocotrienols have been shown to possess antioxidant, anti-inflammatory, and neuroprotective properties in preclinical and clinical studies. This study aimed to investigate the effects of tocotrienol-rich vitamin E (Tocovid SuprabioTM) on nerve conduction parameters and serum biomarkers among patients with type 2 diabetes mellitus (T2DM). A total of 88 patients were randomized to receive 200 mg of Tocovid twice daily, or a matching placebo for 12 months. Fasting blood samples were collected for measurements of HbA1c, renal profile, lipid profile, and biomarkers. A nerve conduction study (NCS) was performed on all patients at baseline and subsequently at 2, 6, 12 months. Patients were reassessed after 6 months of washout. After 12 months of supplementation, patients in the Tocovid group exhibited highly significant improvements in conduction velocity (CV) of both median and sural sensory nerves as compared to those in the placebo group. The between-intervention-group differences (treatment effects) in CV were 1.60 m/s (95% CI: 0.70, 2.40) for the median nerve and 2.10 m/s (95% CI: 1.50, 2.90) for the sural nerve. A significant difference in peak velocity (PV) was also observed in the sural nerve (2.10 m/s; 95% CI: 1.00, 3.20) after 12 months. Significant improvements in CV were only observed up to 6 months in the tibial motor nerve, 1.30 m/s (95% CI: 0.60, 2.20). There were no significant changes in serum biomarkers, transforming growth factor beta-1 (TGFβ-1), or vascular endothelial growth factor A (VEGF-A). After 6 months of washout, there were no significant differences from baseline between groups in nerve conduction parameters of all three nerves. Tocovid at 400 mg/day significantly improve tibial motor nerve CV up to 6 months, but median and sural sensory nerve CV in up to 12 months of supplementation. All improvements diminished after 6 months of washout.

Matched MeSH terms: Median Nerve/drug effects