According to recently reported outcome studies, functional outcomes after arthroscopic rotator cuff repair are reasonable and comparable to open or mini-open techniques. We report the functional outcomes after arthroscopic rotator cuff repair of 10 consecutive patients. The average age was 53.9(range 46-59) years. There was a significant improvement of the function of the shoulder when the preoperative scores were compared with those at the time of at least six months follow-up (range of 6 months to 18 months). With the UCLA rating scale, the average total score increased from preoperative 9.8 (range, 6-15) to postoperative 32.6 (range,23-35). With the use of ASES shoulder index, the average total score improved from 14.6 range, 1.6-35) to 92.3 (range,66.6 to 100). We concluded that arthroscopic rotator cuff repair is a treatment method in selective patients with symptomatic rotator cuff pathology to alleviate shoulder pain and improve function.
This report describes an unusual case of multidrug resistant tuberculosis (MDR-TB), involving the right clavicle and multicentric aytpical spine involvement without any neurological deficit. The female patient presented with acute onset of right clavicular pain associated with a one-monthhistory of lower backache with constitutional symptoms. The clavicular lesion and MRI spine findings were highly suggestive of TB. Anti TB drugs (ATD) were started empirically as Sabah, Malaysia the patient’s home, is anendemic area for TB. Despite, 2 months of ATD administration, the patient did not respond well clinically and developed left sided chest wall abscesses arising from the left 3rd and 6th ribs. She was then treated for MDR-TB infection and has responded well to this treatment.
A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema. There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in other parts of the body were normal.
A 28-year-old man presented with a chief complaint of rashes all over his body. He had a history of a trip to Langkawi Island, a famous island resort off the west coast of Malaysia, over the Chinese New Year’s weekend. According to him, he had a lot of fun with a group of friends at the sunny beach and the beautiful sea. There were no untoward incidents and they were perfectly well when they returned home after a 2-day trip. On the evening of the second day after his return, he noticed rashes appearing over his body, notably on shoulders and trunk. These rashes were little painful in nature.
We report a rare case of undifferentiated (embryonal) sarcoma of the liver in a six-year-old girl who at presentation, had fever, right hypochondrium pain and hepatomegaly. The diagnosis was clinched by fine needle aspiration cytology and was subsequently reconfirmed by histopathological examination of the resected tumour. Pre-operative chemotherapy was given because primary resection was deemed not possible. The patient underwent a successful extensive hepatectomy followed by continuation chemotherapy
Introductions: Call center has been defined as a working environment in which uses telephone and computer for the purpose of marketing and manage communication with prospect clients or existing clients (Rocha, Glina, Morinho and Nakasato, 2005; Sprigg, Smith and Jackson, 2003).
Methodology: The study was conducted via observation of working condition and face to face interview with call center operators. Measurement of anthropometrics was also conducted.
Results: Ergonomics issues found at call center were inappropriate work condition and workstation which lead to awkward sitting posture (sitting with forward leaning posture, raised shoulder, feet not supported on floor). Besides that organizational policy which required high job demand and subsequently lead to prolonged sitting and static posture (very minimal posture changes). Combination all these factors lead to musculoskeletal symptoms and the operators reported of having neck, shoulder, upper back and lower back pain compared to other body parts.
Conclusion: The management should embark on organization wide ergonomics management program and should review the current policy and create safe and healthy working environment by providing suitable workstation for the operators in order to prevent musculoskeletal.
A 27-year-old man presented with a two-week history of central colicky abdominal pain associated with loose stools. Further history revealed that he had been exposed to contaminated waters. Stool investigation by direct wet stool smears revealed the presence of Entamoeba histolytica and Blastocystis hominis cysts. A diagnosis of amoebiasis secondary to E. histolytica and concurrent B. hominis infestation was made. We would like to emphasise the importance of clinical history including recent travel to endemic areas. Any suspicion of parasitic infection should prompt the clinician to investigate. Early diagnosis and management would prevent serious complications associated with E. Histolytica infection.
Introduction: Back pain associated with sense of pain and less comfort in back part of the body especially at the lower back area. Back pain is an occupational health problem with significant impact to productivity of workers.
Methodology: A cross sectional study was conducted to study the prevalence of back pain towards individual, physical and psychosocial factors associated among body shop’s operators at national Automotive Manufacturers.
Result: A total of 32 operators were involved in this study. Nordic Musculoskeletal questionnaire has been used in this study and body position assessment was done by using Ovako Working Posture Analyzing System (OWAS) method. Study showed the prevalence of back pain among operators throughout their work and in the last 12 months was 93.8% and 87.5% respectively. There are significant association (p0.05) between prevalence of back pain with another individual, physical and psychosocial factor.
Conclusion: This study shows that back pain prevalence were influenced by types of activity and body posture during working at assembling division among workers. Attention should be given to ergonomics factors to prevent back pain incident among automotive industry assembly workers.
Introduction : Nursing is an occupation associated with high risk of developing back pain due to their nature of work practices. The aim of this study was to determine the prevalence of back pain among nurses working in government health clinics and hospitals in Port Dickson and the factors associated with it.
Methods : A cross sectional study was conducted involving 126 nurses working in government health clinics and district hospital in Port Dickson. They were universally sampled. A selfadministered questionnaire, assessing personal and socio-demographic characteristics, back pain, work factors and psychosocial factors.
Results :The prevalence of back pain among nurses was 79.4% and factors that showed significant association were workplace (p=0.026) and carried heavy load (p=0.043).
Conclusion : Where one work and nature of work one does has been shown in this study to be important issues to be considered in helping to manage back pain related to work. It is also recommended that staff need to be encouraged to do exercise to strengthen the back muscles, increase spinal flexibility and blood circulation to the spine as well as need to be reminded regarding ergonomic adjustment at work.
Right iliac fossa pain can often be misdiagnosed as something sinister or benevolent despite assistance with state of the art imaging techniques. This is particularly more challenging in the female gender whereby the error of managing a right iliac fossa pain may approach forty percent. A 66-year-old lady, ten years post-menopause, presented with a week history of progressively worsening right iliac fossa pain. Malignancy was suspected with a palpable abdominal mass. Computed tomography was suggestive of an abscess collection, but a needle aspirate produced brown faecal material suggestive of a diverticulitis. An exploratory appendisectomy revealed a non malignant appendicular abscess. In conclusion, when clinical and imaging assessments are inconclusive, an exploratory laparotomy for a surgical excision is warranted primarily if malignancy is suspected.
Gastro-peritoneal fistula is a rare but serious complication of laparoscopic sleeve gastrectomy with significant morbidity and mortality. We present the case of a 42-year-old man who underwent laparoscopic sleeve gastrectomy for morbid obesity and presented later with a history of chronic epigastric pain and severe reflux. Upper gastrointestinal series showed the presence of a communicating fistula between the stomach and the left hemi-diaphragm and peri-splenic area.
The purpose of this study is to assess the effectiveness of C02 laser in relieving symptoms associated with Oral lichen planus (aLP) and lichenoid lesions (aLL) and the event of healing. Six patients were selected for this study with 13 sites treated. Each lesion was ablated with C02 laser and the wound allowed to heal undisturbed. Prior to treatment, 4 patients had both unprovoked and provoked pain and 2 patients rated for provoked pain only. After laser ablation, five out of six patients treated recorded no pain / 0 pain score. One month post-laser, the treated area was almost the same colour as the surrounding normal mucosa and soft in texture in all but one patient in which there was some fibrosis and residual plaque-like patch. Weconclude that the use of C02 laser in the treatment of aLP and aLL shows positive results in relieving symptoms associated with these lesions.
Spinal epidural angiolipomas are rare benign tumors. The tumors contain both vascular and mature adipose components. Typically, they present with a progressive clinical course. Acute presentation is rare. We present a case of a fifteen-year-old girl who presented with a sudden onset of backpain followed by paraparesis with bladder and bowel incontinence. Neurological examination showed sensory loss below T10 with Grade 2 motor power. Spinal MRI showed long segment extradural lesion at T6-T9 level. Multiple laminectomy and excision of the tumor containing areas of hemorrhage was performed. Histopathology report revealed angiolipoma.
Vaginal agenesis is a rare event occurring at a frequency of 1 case per 4000-10 000 female lives born. The most common etiology of vaginal agenesis is congenital absence of the uterus and vagina called mullerian agenesis (Mayer-Rokitansky-Hauser Syndrome). Although most patients with mullerian agenesis have small rudimentary 2 ‘mullerian bulbs’ without any endometrial activity, 7-8% of these cases possibly have a functioning uterus 3. In vaginal agenesis, genetic females are thought to have persistence of mullerian inhibiting factor MIF, resulting in failure of the vagina and uterus to develop 4. The ovaries, given their separate embryonic source, are normal in structure and function. This condition usually goes undetected until these patients reach puberty, when they start to experience cyclic pelvic pain due to the accumulation of menstrual blood.
A 15-year–old Malay male with congenital insensitivity to pain presented with recurrent septic arthritis of the left knee complicated by osteomylitis. Repeated arthrotomy and wound debridement was done, however, the condition was not resolved. Amputation was suggested as the best method of treatment to eradicate the infection.
Leaves of Thottea dependens have been used as folk medicine in Malaysia for the treatment of
several conditions involving pain and inflammation with accompanying pyrexia. However, there is no scientific
evidence for its effectiveness to treat fever. Hence, the purpose of this study was to evaluate the anti-pyretic
activity of methanol (MeOH) and aqueous (Aq) extracts of T. dependens leaves in albino mice (ICR strain).
Neck abscess is still common in developing countries. Often the presentation is late especially when the pain becomes intolerable or the airway is compromised. Intramuscular abscess in the neck is very rarely encountered. We report a case of an abscess of the right sternocleidomastoid. The culture grew Proteus mirabilis. The outline of management is discussed.
Arthroscopic sub acromial debridement surgery with acromioplasty is one of the shoulder surgeries performed to treat chronic shoulder pain. This surgical procedure is usually indicated in sub acromial impingement syndrome of shoulder, degenerative rotator cuff tears, severe functional limitation of shoulder joint and often surgery was performed in cases where all the conservative management had failed in the treatment of chronic shoulder pain. Even though the patient would be referred for early rehabilitation, post operative management of this surgical condition is highly challenging. Movement of the shoulder joint is often related with scapulo-thoracic joint, acromio-clavicular joint and sternoclavicular joint and the shoulder movements are governed by various different muscular forces from these joints. Failure to understand this biomechanical complexity of shoulder joint during post operative rehabilitation results in failure of the surgical outcome and might cause severe functional limitation with recurrent shoulder pain. Often in clinical practice, greater emphasis is given to achieve and regain movements in shoulder joint at the expense of the joint stability. However, inadequate scapular stability might further predispose the shoulder joint to excessive loading and results in repetitive injuries leading to chronic shoulder pain. This might affect the surgical and clinical outcome of the acromioplasty and result in surgical failure. Hence, surgeons and clinicians need to understand the biomechanical contributions in the post operative rehabilitation of the shoulder joint. The present case report emphasises the biomechanical model of post operative rehabilitation of a patient who had arthroscopic sub acromial debridement with acromioplasty.
Purpose - An outbreak of food poisoning had occurred in Health Institute A on 1st June 2010 which involved twenty four staffs. Six of them were hospitalized and eighteen received outpatient treatment. A case control study was done to describe the epidemiological characteristics of the outbreak and to determine the source of infection.
Design/methodology/approach - Food samples, rectal swab from cases, environmental and hand swab from the food handlers were also taken and sent for microbiological analysis.
Finding- The outbreak was explosive, and the prominent clinical features were abdominal pain (62.2%), fever (51.4%), and diarrhea (56.8%). The onset time was between 9-24 hours and the median incubation period was at 15 hours. The possible source of the outbreak was durian gravy (OR= 14.00,95%CI: 2.72-92.55, p<0.001, food attack rate: 100%) and rotijala (OR= 6.69, 95%CI: LB5-24.23, p<0.001, food attack rate: 95%), The microbiological investigation revealed that various microorganisms including Salmonella spp, The food was supplied by the same food supplier from Caterer B since 2006 and the assessment of the kitchen showed that the cleanliness rate was only 54,3% with positive results of Coliform in all utensils and areas investigated in the kitchen.
Conclusion- In conclusion, the most probable causative organism based on signs and symptoms, epidemiological analysis and microbiological results was Salmonella spp. from contaminated food seryed during the ceremony. Education on food safety and food hygiene especially personal hygiene and hand washing should be emphasized continuously for prevention of future outbreak,
The simultaneous presence of polycystic ovary syndrome with pelvic endometriosis presents compounded gynecological effects on women with subfertility and pelvic pain as the common symptoms. We describe one such case. The molecular basis for etiology is discussed and the need for individualized treatment is suggested.