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  1. PVA-chitosan composite hydrogel versus alginate beads as a potential mesenchymal stem cell carrier for the treatment of focal cartilage defects
    Dashtdar H, Murali MR, Abbas AA, Suhaeb AM, Selvaratnam L, Tay LX, et al.
    Knee Surg Sports Traumatol Arthrosc, 2015 May;23(5):1368-1377.
    PMID: 24146054 DOI: 10.1007/s00167-013-2723-5
    PURPOSE: To investigate whether mesenchymal stem cells (MSCs) seeded in novel polyvinyl alcohol (PVA)-chitosan composite hydrogel can provide comparable or even further improve cartilage repair outcomes as compared to previously established alginate-transplanted models.

    METHODS: Medial femoral condyle defect was created in both knees of twenty-four mature New Zealand white rabbits, and the animals were divided into four groups containing six animals each. After 3 weeks, the right knees were transplanted with PVA-chitosan-MSC, PVA-chitosan scaffold alone, alginate-MSC construct or alginate alone. The left knee was kept as untreated control. Animals were killed at the end of 6 months after transplantation, and the cartilage repair was assessed through Brittberg morphological score, histological grading by O'Driscoll score and quantitative glycosaminoglycan analysis.

    RESULTS: Morphological and histological analyses showed significant (p < 0.05) tissue repair when treated with PVA-chitosan-MSC or alginate MSC as compared to the scaffold only and untreated control. In addition, safranin O staining and the glycosaminoglycan (GAG) content were significantly higher (p < 0.05) in MSC treatment groups than in scaffold-only or untreated control group. No significant difference was observed between the PVA-chitosan-MSC- and alginate-MSC-treated groups.

    CONCLUSION: PVA-chitosan hydrogel seeded with mesenchymal stem cells provides comparable treatment outcomes to that of previously established alginate-MSC construct implantation. This study supports the potential use of PVA-chitosan hydrogel seeded with MSCs for clinical use in cartilage repair such as traumatic injuries.

    Matched MeSH terms: Cartilage, Articular/injuries*; Knee Injuries/pathology; Knee Injuries/surgery*
  2. Bilateral central vein stenosis in a dialysis patient with a pacemaker
    Yew KL, Anderson S, Farah R, Lim SH
    Asian Cardiovasc Thorac Ann, 2014 Oct;22(8):979-80.
    PMID: 24887840 DOI: 10.1177/0218492313491583
    Central vein stenosis is not uncommon in hemodialysis-dependent patients as a result of mechanical damage to the vessel walls from prior cannulation. It can cause ipsilateral upper limb swelling and pain, resulting in suboptimal hemodialysis. It is unfortunate for bilateral central vein stenosis to develop concomitantly, and rare in the setting of an in-situ pacemaker. This case illustrates the successful ligation of a nondependent left arteriovenous fistula and stenting of the right subclavian vein with functioning ipsilateral arteriovenous fistula, to overcome the problem of symptomatic bilateral upper limb swelling.
    Matched MeSH terms: Subclavian Vein/injuries*; Vascular System Injuries/diagnosis; Vascular System Injuries/etiology*; Vascular System Injuries/physiopathology; Vascular System Injuries/therapy
  3. Contrecoup injury in patients with traumatic temporal bone fracture
    Asha'Ari ZA, Ahmad R, Rahman J, Kamarudin N, Ishlah LW
    J Laryngol Otol, 2011 Aug;125(8):781-5.
    PMID: 21524330 DOI: 10.1017/S0022215111000545
    To study the prevalence and patterns of contrecoup injury in traumatic temporal bone fracture cases.
    Matched MeSH terms: Brain Injuries/diagnosis; Brain Injuries/etiology; Brain Injuries/epidemiology; Petrous Bone/injuries; Temporal Bone/injuries*
  4. Fulltext National Trauma Database (NTrD)--improving trauma care: first year report
    Sabariah FJ, Ramesh N, Mahathar AW
    Med J Malaysia, 2008 Sep;63 Suppl C:45-9.
    PMID: 19227673
    The first Malaysian National Trauma Database was launched in May 2006 with five tertiary referral centres to determine the fundamental data on major trauma, subsequently to evaluate the major trauma management and to come up with guidelines for improved trauma care. A prospective study, using standardized and validated questionnaires, was carried out from May 2006 till April 2007 for all cases admitted and referred to the participating hospitals. During the one year period, 123,916 trauma patients were registered, of which 933 (0.75%) were classified as major trauma. Patients with blunt injury made up for 83.9% of cases and RTA accounted for 72.6% of injuries with 64.9% involving motorcyclist and pillion rider. 42.8% had severe head injury with an admission Glasgow Coma Scale (GCS) of 3-8 and the Revised Trauma Score (RTS) of 5-6 were recorded in 28.8% of patients. The distribution of Injury Severity Score (ISS) showed that 42.9% of cases were in the range of 16-24. Only 1.9% and 6.3% of the patients were reviewed by the Emergency Physician and Surgeon respectively. Patients with admission systolic blood pressure of less than 90 mmHg had a death rate of 54.6%. Patients with severe head injury (GCS < 9), 45.1% died while 79% patients with moderate head injury survived. There were more survivors within the higher RTS range compared to the lower RTS. Patients with direct admission accounted for 52.3% of survivors and there were 61.7% survivors for referred cases. In conclusion, NTrD first report has successfully demonstrated its significance in giving essential data on major trauma in Malaysia, however further expansion of the study may reflect more comprehensive trauma database in this country.
    Matched MeSH terms: Brain Injuries/mortality; Brain Injuries/epidemiology*; Brain Injuries/surgery; Brain Injuries/therapy; Wounds and Injuries/epidemiology*
  5. Medium-term (5-year) comparison of the functional outcomes of combined anterior cruciate ligament and posterolateral corner reconstruction compared with isolated anterior cruciate ligament reconstruction
    Cartwright-Terry M, Yates J, Tan CK, Pengas IP, Banks JV, McNicholas MJ
    Arthroscopy, 2014 Jul;30(7):811-7.
    PMID: 24794571 DOI: 10.1016/j.arthro.2014.02.039
    To present a 5-year comparison of the functional outcomes of combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction with those of isolated ACL reconstruction.
    Matched MeSH terms: Athletic Injuries/surgery; Knee Injuries/surgery*; Posterior Cruciate Ligament/injuries*
  6. Articular cartilage regeneration with autologous peripheral blood progenitor cells and hyaluronic acid after arthroscopic subchondral drilling: a report of 5 cases with histology
    Saw KY, Anz A, Merican S, Tay YG, Ragavanaidu K, Jee CS, et al.
    Arthroscopy, 2011 Apr;27(4):493-506.
    PMID: 21334844 DOI: 10.1016/j.arthro.2010.11.054
    PURPOSE: The purpose of this study was to evaluate the quality of articular cartilage regeneration after arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous peripheral blood progenitor cells (PBPCs) in combination with hyaluronic acid (HA).
    METHODS: Five patients underwent second-look arthroscopy with chondral core biopsy. These 5 patients are part of a larger pilot study in which 180 patients with International Cartilage Repair Society grade III and IV lesions of the knee joint underwent arthroscopic subchondral drilling followed by postoperative intra-articular injections. Continuous passive motion was used on the operated knee 2 hours per day for 4 weeks. Partial weight bearing was observed for the first 6 to 8 weeks. Autologous PBPCs were harvested 1 week after surgery. One week after surgery, 8 mL of the harvested PBPCs in combination with 2 mL of HA was injected intra-articularly into the operated knee. The remaining PBPCs were divided into vials and cryopreserved. A total of 5 weekly intra-articular injections were given.
    RESULTS: Second-look arthroscopy confirmed articular cartilage regeneration, and histologic sections showed features of hyaline cartilage. Apart from the minimal discomfort of PBPC harvesting and localized pain associated with the intra-articular injections, there were no other notable adverse reactions.
    CONCLUSIONS: Articular hyaline cartilage regeneration is possible with arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous PBPCs in combination with HA.
    LEVEL OF EVIDENCE: Level IV, therapeutic case series.
    Matched MeSH terms: Cartilage, Articular/injuries; Knee Injuries/pathology; Knee Injuries/rehabilitation; Knee Injuries/surgery
  7. Cladosporium cladosporioides keratomycosis: a case report
    Chew FLM, Subrayan V, Chong PP, Goh MC, Ng KP
    Jpn. J. Ophthalmol., 2009 Nov;53(6):657-659.
    PMID: 20020251 DOI: 10.1007/s10384-009-0722-3
    Matched MeSH terms: Eye Injuries/diagnosis; Eye Injuries/drug therapy; Eye Injuries/microbiology*; Corneal Injuries*
  8. Fulltext Unintentional injuries and psychosocial correlates among in-school adolescents in Malaysia
    Peltzer K, Pengpid S
    Int J Environ Res Public Health, 2015 Nov;12(11):14936-47.
    PMID: 26610542 DOI: 10.3390/ijerph121114936
    The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS) included 21,699 students (predominantly ≤13 to ≥17 years) that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were "fall" (9.9%) and motor vehicle accident or being hit by a motor vehicle (5.4%), and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2%) and a broken bone or dislocated joint (4.2%). In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status), substance use (tobacco and cannabis use), frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied), psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children.
    Study name: Global School-Based Student Health Survey (GSHS)
    Matched MeSH terms: Wounds and Injuries/epidemiology*; Wounds and Injuries/psychology
  9. Zinc: indications in brain disorders
    Prakash A, Bharti K, Majeed AB
    Fundam Clin Pharmacol, 2015 Apr;29(2):131-49.
    PMID: 25659970 DOI: 10.1111/fcp.12110
    Zinc is the authoritative metal which is present in our body, and reactive zinc metal is crucial for neuronal signaling and is largely distributed within presynaptic vesicles. Zinc also plays an important role in synaptic function. At cellular level, zinc is a modulator of synaptic activity and neuronal plasticity in both development and adulthood. Different importers and transporters are involved in zinc homeostasis. ZnT-3 is a main transporter involved in zinc homeostasis in the brain. It has been found that alterations in brain zinc status have been implicated in a wide range of neurological disorders including impaired brain development and many neurodegenerative disorders such as Alzheimer's disease, and mood disorders including depression, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and prion disease. Furthermore, zinc has also been implicated in neuronal damage associated with traumatic brain injury, stroke, and seizure. Understanding the mechanisms that control brain zinc homeostasis is thus critical to the development of preventive and treatment strategies for these and other neurological disorders.
    Matched MeSH terms: Brain Injuries/diagnosis; Brain Injuries/metabolism
  10. Who decides? A qualitative study on the decisional roles of patients, their caregivers and doctors on the method of bladder drainage after spinal cord injury
    Engkasan JP, Ng CJ, Low WY
    Spinal Cord, 2015 Feb;53(2):130-4.
    PMID: 25403504 DOI: 10.1038/sc.2014.199
    STUDY DESIGN: Qualitative study using individual in-depth interviews.

    OBJECTIVE: To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI).

    SETTING: Five public hospitals in Malaysia.

    METHODS: Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals.

    RESULTS: Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers.

    CONCLUSIONS: A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.
    Matched MeSH terms: Spinal Cord Injuries/psychology*; Spinal Cord Injuries/rehabilitation*
  11. Fulltext The effect of motorcycle helmet type, components and fixation status on facial injury in Klang Valley, Malaysia: a case control study
    Ramli R, Oxley J, Hillard P, Mohd Sadullah AF, McClure R
    BMC Emerg Med, 2014;14:17.
    PMID: 25086638 DOI: 10.1186/1471-227X-14-17
    The effectiveness of helmets in reducing the risk of severe head injury in motorcyclists who were involved in a crash is well established. There is limited evidence however, regarding the extent to which helmets protect riders from facial injuries. The objective of this study was to determine the effect of helmet type, components and fixation status on the risk of facial injuries among Malaysian motorcyclists.
    Matched MeSH terms: Facial Injuries/etiology*; Facial Injuries/prevention & control
  12. Elective proximal lower limb amputation in spinal cord injury patients with chronic pressure ulcers: improve quality of life, function, and shorten hospital stay. Case report
    Yusmido YA, Hisamud-Din N, Mazlan M
    Eur J Phys Rehabil Med, 2014 Oct;50(5):557-60.
    PMID: 24694951
    Pressure ulcers are common among patients with spinal cord injury and can be very challenging to treat. The treatment involves multidisciplinary approach and ranges from simple pressure relieve and wound dressings to a more radical treatment like proximal lower limb amputations, especially in chronic cases with potential detrimental effects to physical and mental health.
    Matched MeSH terms: Spinal Cord Injuries/complications*; Spinal Cord Injuries/rehabilitation
  13. Fulltext Watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) juice modulates oxidative damage induced by low dose X-ray in mice
    Mohammad MK, Mohamed MI, Zakaria AM, Abdul Razak HR, Saad WM
    Biomed Res Int, 2014;2014:512834.
    PMID: 24877107 DOI: 10.1155/2014/512834
    Watermelon is a natural product that contains high level of antioxidants and may prevent oxidative damage in tissues due to free radical generation following an exposure to ionizing radiation. The present study aimed to investigate the radioprotective effects of watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) juice against oxidative damage induced by low dose X-ray exposure in mice. Twelve adult male ICR mice were randomly divided into two groups consisting of radiation (Rx) and supplementation (Tx) groups. Rx received filtered tap water, while Tx was supplemented with 50% (v/v) watermelon juice for 28 days ad libitum prior to total body irradiation by 100 μGy X-ray on day 29. Brain, lung, and liver tissues were assessed for the levels of malondialdehyde (MDA), apurinic/apyrimidinic (AP) sites, glutathione (GSH), and superoxide dismutase (SOD) inhibition activities. Results showed significant reduction of MDA levels and AP sites formation of Tx compared to Rx (P < 0.05). Mice supplemented with 50% watermelon juice restore the intracellular antioxidant activities by significantly increased SOD inhibition activities and GSH levels compared to Rx. These findings may postulate that supplementation of 50% watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) juice could modulate oxidative damage induced by low dose X-ray exposure.
    Matched MeSH terms: Radiation Injuries, Experimental/drug therapy*; Radiation Injuries, Experimental/metabolism*
  14. Fulltext Comparing the morbidity of external laryngeal nerve injury in thyroid surgery with and without identifying the nerve using intraoperative neuromonitoring
    Khaled AO, Irfan M, Baharudin A, Shahid H
    Med J Malaysia, 2012 Jun;67(3):289-92.
    PMID: 23082419 MyJurnal
    To describe and determine the possibility of surgical trauma to the external branch of the superior laryngeal nerve and to assess the role of intraoperative neuromonitoring in thyroid surgery.
    Matched MeSH terms: Laryngeal Nerve Injuries/complications*; Laryngeal Nerve Injuries/prevention & control
  15. Analysis of airway epithelial regeneration and repair following endobronchial brush biopsy in sheep
    Yahaya B, Baker A, Tennant P, Smith SH, Shaw DJ, McLachlan G, et al.
    Exp. Lung Res., 2011 Nov;37(9):519-35.
    PMID: 21895444 DOI: 10.3109/01902148.2011.605513
    Understanding the fundamental processes involved in repairing the airway wall following injury is fundamental to understanding the way in which these processes are perturbed during disease pathology. Indeed complex diseases such as asthma and chronic obstructive pulmonary disease (COPD) have at their core evidence of airway wall remodeling processes that play a crucial functional role in these diseases. The authors sought to understand the dynamic cellular events that occur during bronchial airway epithelial repair in sheep. The injury was induced by endobronchial brush biopsy (BBr), a process that causes epithelial débridement and induces a consequential repair process. In addition, the current experimental protocol allowed for the time-dependent changes in airway wall morphology to be studied both within and between animals. The initial débridement was followed by evidence of dedifferentiation in the intact epithelium at the wound margins, followed by proliferation of cells both within the epithelium and in the deeper wall structures, notably in association with the submucosal glands and smooth muscle bundles. Seven days after injury, although the airway wall was thickened at the site of damage, the epithelial layer was intact, with evidence of redifferentiation. These studies, in demonstrating broad agreement with previous studies in small animals, indicate the wider relevance of this system as a comparative model and should provide a solid basis upon which to further characterize the critical cellular and molecular interactions that underlie both effective restitution and pathological repair.
    Matched MeSH terms: Bronchi/injuries; Respiratory Mucosa/injuries
  16. Benefit of triple-strap abdominal binder on voluntary cough in patients with spinal cord injury
    Julia PE, Sa'ari MY, Hasnan N
    Spinal Cord, 2011 Nov;49(11):1138-42.
    PMID: 21577218 DOI: 10.1038/sc.2011.53
    STUDY DESIGN: A cross-sectional experimental study.
    OBJECTIVE: The purpose of this study is to examine the benefit of elastic abdominal binders on voluntary cough in persons with spinal cord injury.
    SETTING: Spinal rehabilitation unit in a teaching hospital.
    METHODS: We measured voluntary cough peak expiratory flow rate (in 21 subjects with spinal cord injury, (18 tetraplegia, 3 paraplegia) under three conditions: without abdominal binder as the baseline, with single-strap abdominal binder and triple-strap abdominal binder.
    RESULTS: The results showed that the mean cough peak expiratory flow rate in all subjects without abdominal binder was 277.1 l per min. There was a significant increase in flow rate with the use of abdominal binders: 325.7 l per min with single-strap abdominal binder and 345.2 l per min with triple-strap abdominal binder (P<0.05, paired t-test). The mean cough peak expiratory flow rate in tetraplegic subjects using triple-strap abdominal binders was significantly higher compared with those using single-strap abdomina
    l binders (322.1 l per min and 299.4 l per min, respectively).
    CONCLUSION: Abdominal binders can be used as an effective method to improve cough ability in spinal cord injured patients, with triple-strap abdominal binder achieving greater cough peak expiratory flows.

    Comment in: Frisbie JH. Question of stamina for the diaphragm. Spinal Cord. 2012 Jun;50(6):480. doi: 10.1038/sc.2011.164. Epub 2012 Jan 17. PubMed PMID: 22249332.
    Matched MeSH terms: Spinal Cord Injuries/physiopathology*; Spinal Cord Injuries/rehabilitation*
  17. Fatal lightning strikes in Malaysia
    Murty OP, Kian CK, Ari Husin MH, Nanta Kumar RK, Mohammed Yusuf WY
    Am J Forensic Med Pathol, 2009 Sep;30(3):246-51.
    PMID: 19704405 DOI: 10.1097/PAF.0b013e31819d20a4
    Lightning strike is a natural phenomenon with potentially devastating effects and represents one of the important causes of deaths from environmental phenomena. Almost every organ system may be affected as lightning current passes through the human body taking the shortest pathways between the contact points. A 10 years retrospective study (1996-2005) was conducted at University Hospital Kuala Lumpur (20 cases) also including cases during last 3 years from Hospital Tengku Ampuan Rahimah, Klang (7 cases) from the autopsy reports at Forensic Pathology Units of these 2 hospitals. Both these hospitals are attached to University of Malaya. There were 27 fatal cases of lightning strike with male preponderance(92.59%) and male to female ratio of 12.5:1. Majority of victims of lightning strike were from the age group between 30 and 39 years old. Most of the victims were foreign workers. Indonesians workers contributed to 59.26% of overall cases. Majority of them were construction workers who attributed i.e.11 of 27 cases (40.74%). Most of the victims were brought in dead (37.04%). In majority of the cases the lightning incidence occurred in the evenings, with the frequency of 15 of 27 cases (62.5%). The month of December represented with the highest number of cases (5 cases of 23 cases); 2004 had the highest incidence of lightning strike which was 5 (19.23%). Lightning strike incidence occurred when victims had taken shelter (25.9%) under trees or shades. Lightning strike in open areas occurred in 10 of 27 cases (37.0%). Head and neck were the most commonly affected sites with the incidence of 77.78% and 74% respectively in all the victims. Only 29.63% of the cases presented with ear bleeding.
    Matched MeSH terms: Lightning Injuries/mortality*; Lightning Injuries/pathology*
  18. Fulltext Botulinum toxin type A for rehabilitation after a spinal cord injury: a case report
    Naicker AS, Roohi SA, Chan JL
    J Orthop Surg (Hong Kong), 2009 Apr;17(1):96-9.
    PMID: 19398803 DOI: 10.1177/230949900901700121
    A 56-year-old man became quadriplegic, bed bound, and carer-dependent secondary to cervical osteomyelitis. Three years later, he presented with generalised spasticity, crouched posture, and a large sacral pressure sore. The severe spasticity in his hips and knees prevented ischial sitting. Injections of botulinum toxin type A to both hamstrings and gastrosoleuii controlled the flexor spasticity of his lower limbs and facilitated rehabilitation and wound healing through proper positioning, wound care, stretching, and weight-bearing exercises. A few weeks later, the patient could better position himself in bed (prone lying) and on his wheelchair (ischial sitting). His spasm-related pain lessened and his mobility and activities of daily living improved. The sacral pressure sore healed completely a few months later. The patient could sleep better, feed with set-up and adaptive aids, groom, dress, and transfer himself with minimal assistance. The effects of botulinum toxin extended beyond just spasticity reduction. His upper extremity function, mobility, and social well-being were all improved through better positioning.
    Matched MeSH terms: Spinal Cord Injuries/complications*; Spinal Cord Injuries/therapy*
  19. Fulltext The rate of glove perforations in orthopaedic procedures: single versus double gloving. A prospective study
    Chan KY, Singh VA, Oun BH, To BH
    Med J Malaysia, 2006 Dec;61 Suppl B:3-7.
    PMID: 17605178
    Glove perforation during surgery has always been a matter of concern as it increases the infection rate and the risk of transmission of blood borne diseases. To determine the common causes, the site and the awareness of glove perforations in orthopaedic surgery, a prospective study was conducted to assess the rate of glove perforation during 130 consecutive orthopaedic operations. All gloves worn by the surgical team were assessed after the surgery using the water-loading test. A total of 1452 gloves were tested, and the rate of perforation was 3.58%. Most of these perforations (61.5%) were unnoticed. The main surgeons had the most perforations (76.9%), followed by first assistants (13.5%) and second assistants (9.6%). Most perforations occurred at the non-dominant hand. The commonest site of perforation was the index finger followed by the thumb. Shearing force with instruments accounted for 45% of the noticed perforations. Majority of these occurred during nailing procedures (33%) and internal fixation without the use of wires (19%). Our rate of glove perforation is similar to other series. Most of them went unnoticed and were mainly due to shearing injuries rather than perforation by sharps. Therefore, there is an increased risk of contamination and break in asepsis during surgery.
    Matched MeSH terms: Needlestick Injuries/etiology*; Needlestick Injuries/epidemiology
  20. Fulltext Spinal injuries in a level-one trauma centre: a demographic study
    Roohi SA, Naicker AS, Shukur MH, Mohammad AR
    Med J Malaysia, 2006 Feb;61 Suppl A:30-5.
    PMID: 17042226
    The incidence of spinal injuries in Malaysia is on the rise following similar trend of rapid development and increasing number of building constructions sites, and motor vehicles. This epidemiological study was aimed at compiling local data with a view to identifying target areas for preventive measures as well as improvement strategies in the management of these potentially devastating injuries. Seventy eight patients admitted with spine trauma in 1998 in a level-one trauma centre were retrospectively reviewed. All records were traced from the admission and discharge books of the orthopaedic wards, accident and emergency wards, operative registration book, spinal rehabilitation ward and orthopaedic registration data of the Department of Orthopaedics, Hospital Kuala Lumpur. Details on pre-treatment neurological and radiological level of injury and post-treatment outcomes were recorded according to the American Spinal Injury Association (ASIA) impairment scale. Most patients (61.5%) were in the productive ages of less than 34 years with a 4:1 male to female ratio. Majority were due to motor vehicle accidents (57.7%) and fall from a height (28.3%). The thoraco-lumbar junction was the most common site of injury followed by the lower cervical region with 62.5% of which associated with neurological deficit. Neurological deficits: 11 ASIA-A, 1 ASIA-B, 6 ASIA-C, and 3 ASIA-D were detected in 21 (27%) patients with fall from height (50%) particularly landing on the feet (50%) and recreational sports (100%) were the risk factors. Less than 10% of patients were treated surgically and this explains an average 39.4 days of hospitalization (5 times longer in patients treated non-operatively). On discharge, four patients with incomplete neurology recovered to ASIA-E status and the remaining improved to ASIA-C and -D in one and five patients respectively. Only one patient with complete neurology improved to ASIA-B status following surgical treatment. The demographic profiles of our patients were comparable to other series in the literature but still inadequate to provide enough epidemiological data. A multicenter study to provide a larger pool of patients is needed.
    Matched MeSH terms: Spinal Injuries/epidemiology*; Spinal Injuries/physiopathology
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