Displaying publications 41 - 60 of 64 in total

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  1. Fulltext Two stage penile reconstruction with free prefabricated sensate radial forearm osteocutaneous flap
    Ramesh S, Serjius A, Wong TB, Jagjeet S, John R
    Med J Malaysia, 2008 Oct;63(4):343-5.
    PMID: 19385502 MyJurnal
    Penile reconstructive surgeries are performed mainly as radical treatment for conditions associated with congenital abnormalities of the urethra or penis, after penile trauma, penile cancer, short penis, corporal fibrosis and in cases of gender reassignment. We present here a method of penile reconstruction with a pre fabricated radial forearm free flap incorporating the segment of the radius for structural support.
    Matched MeSH terms: Forearm
  2. Role of high resolution ultrasound in ulnar nerve neuropathy
    Radhika S, Lee YL, Low SF, Fazalina MF, Sharifah Majedah IA, Suraya A, et al.
    Med J Malaysia, 2015 Jun;70(3):158-61.
    PMID: 26248778 MyJurnal
    AIM: This study was conducted to measure the cross sectional area (CSA) of the ulnar nerve (UN) in the cubital tunnel and to evaluate the role of high-resolution ultrasonography in the diagnosis of ulnar nerve neuropathy (UNN).

    MATERIALS AND METHODS: This was a cross sectional study with 64 arms from 32 patients (34 neuropathic, 30 nonneuropathic). Diagnosis was confirmed by nerve conduction study and electromyography. The ulnar nerves were evaluated with 15MHz small footprint linear array transducer. The ulnar nerve CSA was measured at three levels with arm extended: at medial epicondyle (ME), 5cm proximal and 5cm distal to ME. Results from the neuropathic and nonneuropathic arms were compared. Independent T-tests and Pearson correlation tests were used. P value of less than 0.05 was considered significant.

    RESULTS: Mean CSA values for the UN at levels 5cm proximal to ME, ME and 5cm distal to ME were 0.055, 0.109, 0.045 cm(2) respectively in the neuropathic group and 0.049, 0.075, 0.042 cm2 respectively in the non-neuropathic group. The CSA of the UN at the ME level was significantly larger in the neuropathic group, with p value of 0.005. However, there was no statistical difference between the groups at 5cm proximal and distal to the ME, with p values of 0.10 and 0.35 respectively.

    CONCLUSION: There is significant difference in CSA values of the UN at ME between the neuropathic and non-neuropathic groups with mean CSA value above the predetermined 0.10cm(2) cut-off point. High-resolution ultrasonography is therefore useful to diagnose and follow up cases of elbow UNN.

    Matched MeSH terms: Forearm
  3. Biaxial tension test of human skin in vivo
    Wan Abas WA
    Biomed Mater Eng, 1994;4(7):473-86.
    PMID: 7881331
    The response of human skin to biaxial stretch tests in vivo was investigated and compared to the response to uniaxial tension. The results obtained illustrate the nonlinear, anisotropic, and viscoelastic (time-dependent) properties of skin under biaxial stretch. Preconditioning in the load-extension response was found not to be prominent. The results also suggest that the response of skin to a biaxial stretch in vivo is qualitatively similar to that in vitro. Values of the terminal stiffness and limit strain of skin under a biaxial stretch are found.
    Matched MeSH terms: Forearm
  4. Fulltext Linkages between Chiropteran diversity and ecosystem services for sustainable fragmented forest conservation
    Fakhrul-Hatta SNN, Nelson BR, Shafie NJ, Zahidin MA, Abdullah MT
    Data Brief, 2018 Dec;21:2089-2094.
    PMID: 30533456 DOI: 10.1016/j.dib.2018.11.058
    This data article informs about Chiropteran diversity, new records, ecosystem services and possible pathogen carriers in fragmented forests (sub-divided by utility corridors, man-made structures, untouched and secondary plantations) within districts Setiu (Setiu Research Station), Hulu Terengganu (Saok and Lasir waterfalls) and Besut (Gunung Tebu Forest Reserve) of state Terengganu, Peninsular Malaysia. These bats were captured using harp traps and mist nets that were set 10 m apart across flyways, streams and less cluttered trees in the 50 m × 50 m transect zones (identified at each site). All animals were distinguished by morphology and gender before their release at the site of capture. The data comprise of five bat family groups Hipposideridae, Megadermatidae, Pteropodidae, Rhinolophidae and Vespertilionidae. It is interesting to note that untouched Saok Waterfalls is home to wide variety of bats listed (68.8%), followed by secondary forests of Gunung Tebu Forest Reserve (24.8%), untouched Lasir Waterfalls (4.8%) and lastly, Setiu Research Station as least favored (1.6%). Chiroptera like Cynopterus brachyotis (n = 23, 37.7%), Hipposideros bicolor (n = 6, 9.8%) and Scotophilus kuhli (n = 6, 9.8%) were most dominant in the checklist whereas Hipposideros armiger, Murina suilla and Scotophilus kuhlii are new data records in the fragmented forests of Terengganu. The data were interpret into Shannon, Simpson, Margalef, Menhinik and Evenness indices to individually or collectively distinguish chiropteran variety in Terengganu State whereas weight-forearm length (W/FA) informs about chiropteran Body Condition Index (-0.25 to 0.25). The function of bats were also identified to distinguish service providers (pollination and forests regeneration) and zoonotic pathogen carriers (in particular to Leptospira bacteria, Nipah virus and Sindbis virus).
    Matched MeSH terms: Forearm
  5. Fulltext Primary fixation of AO type-C fracture of the distal radius with volar locking plates. A cross-sectional study of patient rated outcomes at Hospital Tengku Ampuan Afzan
    Mohd Sallehuddin H, Zamzuri Z, Ariff MS, Mohd Shukrimi A, Mohamed Azril MA, Nazri MY
    International Medical Journal Malaysia, 2014;13(2):3-6.
    MyJurnal
    Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate.

    Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire.

    Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score.

    Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes.
    Matched MeSH terms: Forearm
  6. Fulltext Jellyfish Envenomation Resulting In Vascular Insufficiency And Neurogenic Injury of Upper Limb
    Choong C, Chan HZ, Faruk NA, Bea KC, Zulkiflee O
    Malays Orthop J, 2015 Nov;9(3):49-51.
    PMID: 28611910 MyJurnal DOI: 10.5704/MOJ.1511.007
    Following a week after a jellyfish sting, a young man presented with regional cyanosis and threat of distal gangrene secondary to vascular spasm in the forearm. The patient also suffered from transient paresis and numbness of the affected upper limb. Contrasted imaging revealed unopacified vessels in the distal forearm and worsening swelling warranted emergency surgical fasciotomy for impending compartment syndrome. This case highlights the occurrence of jellyfish envenomation and the need for early treatment.
    Matched MeSH terms: Forearm
  7. Fulltext Huge brachial plexus schwannoma, masking as a cystic neck mass
    Kho JPY, Prepageran N
    AME Case Rep, 2018;2:41.
    PMID: 30363802 DOI: 10.21037/acr.2018.08.01
    Schwannomas are solitary, benign tumors arising from the nerve sheaths. They are frequently reported in the thorax predominantly in the posterior mediastinum, but are rarely seen to arise from the brachial plexus. Schwannomas are well demarcated lesions with a slow insidious growth. Presented is a case of a large brachial plexus schwannoma, masking as a cystic lesion in the lateral neck. The patient presented with concerns of a cystic mass progressively increasing in size over a period of four years, initially symptomless, but later caused numbness and tingling sensation over his right forearm, tip of right thumb and index finger. Following histological confirmation via fine needle aspiration and magnetic resonance imaging, the patient underwent surgical excision where by the tumor was dissected from its attachment to the nerve sheath. The patient recovered well, and by the third day post operatively, his neurological symptoms resolved completely. Upon follow up in clinic 1-week post-surgery, the scar had healed well, and his numbness or tingling sensation remained in abeyance. This case illustrates that a schwannoma may present insidiously as a cystic lesion and its possible origin may arise from the brachial plexus.
    Matched MeSH terms: Forearm
  8. Variant Abductor Pollicis Longus Muscle: a Case Report
    Shipra P, Srijit D
    Acta Medica (Hradec Kralove), 2007;50(3):213-215.
    PMID: 28795947 DOI: 10.14712/18059694.2017.85
    Abductor pollicis longus (APL) muscle is known to exhibit different variations with respect to its attachments. Various studies have reported the splitting of the APL muscle. Comparative anatomical findings of split insertion of APL is commonly found in chimpanzees, gorillas and gibbons. In the present study, we describe an anomalous APL muscle, which originated from the posterior surface of the shaft of the radius and ulna and traversed a course deep to the extensor retinaculum. Interestingly, immediately after emerging form the deeper aspect of extensor retinaculum, the thin tendon of the APL muscle continued again as a muscular belly in relation to the dorsolateral part of the 1st metacarpal bone, to end as a tendon with its attachment to the base of the proximal phalanx. Such an unusual variation of APL with its attachment into proximal phalanx is a rare finding and may be of importance in altering the mechanics of the thumb during abduction. The clinical significance of such an anatomical variation of APL may be important during reconstructive surgeries involving thumb and also of academic interest.
    Matched MeSH terms: Forearm
  9. Fulltext Both-Bone Forearm Fractures in Children with Minimum Four Years of Growth Remaining: Can Cast Achieve a Good Outcome at Skeletal Maturity?
    Hadizie D, Munajat I
    Malays Orthop J, 2017 Nov;11(3):1-9.
    PMID: 29326760 MyJurnal DOI: 10.5704/MOJ.1711.009
    Introduction: Both-bone forearm fractures in children can be treated non-operatively with a cast. Most previous studies have shown favourable outcome; however, information on the functional outcome after skeletal maturity is still scanty. Therefore, this study was conducted to determine the functional outcome after skeletal maturity in fractures with at least four years of growth remaining. Materials and Methods: This retrospective study was conducted from March 2012 until March 2013. Age at the time of fracture was taken as until 10 years for females and until 12 years old for males with at least four years of growth remaining. Fractures occurring in the diaphysis were included in the study. Functional outcomes were assessed at or after skeletal maturity. Results: Forty-four children fulfilled the criteria. The ages of the youngest and the oldest at the time of fracture was five and 12 years old respectively. Follow-up of the male and female patients were 7.4 years and 5.5 years respectively. There was a significant difference between post-reduction angulation and angulation at skeletal maturity of the radius and ulna (p<0.001). Out of 44 patients, 39 had excellent and five had good functional outcomes. No patient had fair or poor functional outcome. There was no association between the functional outcome and the angulation of forearm bones after skeletal maturity. Age at the time of fracture had a significant association with the functional outcome. Conclusion: Non-operative treatment of both-bone diaphyseal forearm fractures in a cast has good to excellent functional outcomes in children who still have four years of growth remaining.
    Matched MeSH terms: Forearm
  10. Fulltext Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy
    Abdullah S, Ahmad AA, Lalonde D
    Plast Reconstr Surg Glob Open, 2020 Aug;8(8):e3023.
    PMID: 32983779 DOI: 10.1097/GOX.0000000000003023
    Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers.
    Matched MeSH terms: Forearm
  11. Endothelial nitric oxide synthase G894T gene polymorphism and response to skin reactive hyperemia
    Rasool AH, Ghazali DM, Abdullah H, Halim AS, Wong AR
    Microvasc Res, 2009 Sep;78(2):230-4.
    PMID: 19481100 DOI: 10.1016/j.mvr.2009.05.005
    Post occlusive skin reactive hyperemia (PORH) is a tool used to assess microcirculation. Endothelial nitric oxide synthase (eNOS) mediates nitric oxide (NO) production; polymorphism of the eNOS gene may affect response to the PORH process. This study aims to determine whether eNOS G894T gene polymorphism affects response to skin PORH. 230 normotensive male and females between 18 and 40 years participated in this cross-sectional study. 170 subjects were of the homozygous GG genotype, whereas 60 were of the GT genotype. Skin PORH was performed by occlusion of the upper arm at 200 mm Hg for 3 min. Skin perfusion and temperature were monitored before, during and after occlusion release using the laser Doppler fluximetry. There were no significant differences between genotypes in their baseline blood pressure, serum cholesterol, BMI and age. Maximum change in perfusion after occlusion release (PORHmax) for the GG and GT genotypes were not significantly different at 50.15+/-1.29 vs. 47.92+/-2.17 AU; ANCOVA, p=0.351. Peak perfusion (PORHpeak) were also not significantly different between the two genotypes (61.23+/-1.36 vs. 57.72+/-2.32 AU; p=0.169). Minimum baseline perfusion were however higher in the GG compared to the GT genotype (10.83+/-0.29 vs. 9.61+/-0.50, p=0.029). We conclude that microvascular reactivity, assessed by change in perfusion after temporary ischemia was not significantly different between the GG and GT genotypes of the eNOS G894T gene. eNOS 894T allele carriers however, have lower baseline perfusion compared to the homozygous G894 allele carrier.
    Matched MeSH terms: Forearm/blood supply
  12. Fulltext Palm oil thorn-induced squamous cell carcinoma with underlying burns scar
    Qi Qi C, Ajit Singh V
    BMJ Case Rep, 2012;2012.
    PMID: 22865804 DOI: 10.1136/bcr-2012-006401
    Marjolin's ulcers are malignancies that arise from previously traumatised, chronically inflamed or scarred skin. We present a case with childhood burns, who had repeated irritation of his forearm skin with palm oil thorns that eventually led to malignant change.
    Matched MeSH terms: Forearm Injuries/complications*
  13. Fulltext Longitudinal, lateral and transverse axes of forearm muscles influence the crosstalk in the mechanomyographic signals during isometric wrist postures
    Islam MA, Sundaraj K, Ahmad RB, Sundaraj S, Ahamed NU, Ali MA
    PLoS One, 2014;9(8):e104280.
    PMID: 25090008 DOI: 10.1371/journal.pone.0104280
    In mechanomyography (MMG), crosstalk refers to the contamination of the signal from the muscle of interest by the signal from another muscle or muscle group that is in close proximity.
    Matched MeSH terms: Forearm
  14. Successful treatment of very large congenital infantile fibrosarcoma
    Hamidah A, Reena M, Halim ARA, Ibrahim S, Eguchi M, Zarina AL, et al.
    Pediatr Int, 2011 Oct;53(5):768-770.
    PMID: 21955012 DOI: 10.1111/j.1442-200X.2011.03358.x
    Matched MeSH terms: Forearm
  15. Fulltext Contact dermatitis presenting as non-healing wound: case report
    Leelavathi M, Le Y, Tohid H, Hasliza A
    Asia Pac Fam Med, 2011 May 15;10(1):6.
    PMID: 21575147 DOI: 10.1186/1447-056X-10-6
    Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+) to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies.
    Matched MeSH terms: Forearm
  16. Reproducibility of laser Doppler fluximetry and the process of iontophoresis in assessing microvascular endothelial function using low current strength
    Al-Tahami BA, Yvonne-Tee GB, Halim AS, Ismail AA, Rasool AH
    Methods Find Exp Clin Pharmacol, 2010 Apr;32(3):181-5.
    PMID: 20448860 DOI: 10.1358/mf.2010.32.3.1423887
    Iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) combined with laser Doppler fluximetry (LDF) is a tool used to determine microvascular endothelial function. Our aim was to study the reproducibility of different parameters of this technique using iontophoresis with low current strength on the forearm skin of healthy subjects. Baseline skin perfusion was done before application of five current pulses with 1 min of current-free interval. Current strength of 0.007 mA, current density of 0.01 mA/cm(2) and charge density of 6 mC/cm(2) were used, along with 1% ACh and 1% SNP. The absolute maximum change in perfusion (max), percent change in perfusion (% change), peak change in perfusion (peak) and area under the curve during iontophoresis (AUC) at the anodal and cathodal leads were recorded. Measurements were performed in three sessions for 2 days. The coefficient of variation (CV) was calculated for each parameter. Among the parameters studied, maximum change in perfusion and peak flux were the most reproducible parameters.
    Matched MeSH terms: Forearm
  17. Fulltext Automatic top loader washing machine related injury. A report of four cases with serious injury
    Kwan MK, Saw A, Sara Ahmad T
    Med J Malaysia, 2005 Mar;60(1):112-4.
    PMID: 16250295 MyJurnal
    We are reporting four cases of serious washing machine related injury that presented within a period of 5 months. All patients were young children with the mean age of 9 year-old and three had their dominant hand injured. The washing machines involved were the automatic top loader type and all injuries occurred during the spinning phase. Serious automatic washing machine injury is not uncommon in Malaysia. We feel that there is a need to improve the safety features especially during the spinning phase. The operating instructions and safety precautions on the washing machine should be displayed in different languages that can be understood well. Parents should also aware of the potential risks of this seemingly benign household appliance.
    Matched MeSH terms: Forearm Injuries
  18. Fulltext Palmaris longus tendon absence in pre-clinical medical students of Universiti Malaysia Sabah
    Navin Ravi, Elvira Effie Juis, Michelle Maria Vincent, Rasyidah Shokri, Vinooshana R. Kannan, Izzudin Madin, et al.
    Borneo Journal of Medical Sciences, 2019;14(1):73-79.
    MyJurnal
    Palmaris longus (PL) tendon is regularly used in reconstructive surgeries as a donor tendon because it is observed as an accessory muscle and has little practical use to the human hands. It is only found in mammals. For example, the orangutan has PL but it is absent variable in the higher class of apes such as gorillas and chimpanzees. The absence of PL in humans appears to be hereditary, but the genetic transmission is unclear. The main objective of this study is to determine the prevalence of PL tendon absence in pre-clinical medical students of UMS and to compare the lack between gender and ethnic groups. By using standard Schaffer’s test, we examined the presence or absence of PL tendon among the first and second-year medical students of UMS. Four additional tests, Thompson’s test, Mishra’s test I, and II, Pushpakumar’s tests were used to determine whether PL present or not. A total of 134 volunteers were examined, and 91.8% were right-handed, and 8.2% were left-handed. The overall absence (bilateral and unilateral) of PL tendon was 23.9%, whereas unilateral absent was 17.9%, and bilateral absent was 6.0%. The high prevalence of absence of PL tendon among females 25.5% compared to males 20.0%. Chinese and Indian have a higher incidence of PL tendon absence followed by Kadazandusun and Malay. In this study, there were different figures for each ethnic group. The prevalence of absence of PL varies depending on the populations.
    Matched MeSH terms: Forearm
  19. Fulltext Development of folliculitis in a patient with recalcitrant pustular psoriasis following acitretin treatment: A case report
    Nur Ashikin Ahmad, Tarita Taib, Meera Kuppusamy
    Journal of Clinical and Health Sciences, 2017;2:48-51.
    Oral retinoids are among the drugs of choice for pustular psoriasis. Therapy with retinoids, including acitretin, is potent teratogens with other common side effects such as mucocutaneous involvement. Mucocutaneous side effects including dry lips (cheilitis), skin peeling, hair loss (alopecia), dry skin, or rhinitis are dose-related, with cheilitis occurring in more than 75% of patients receiving the highest doses of acitretin (75 mg/day). We report on a 37-year-old woman who developed folliculitis with acitretin which is a rare cutaneous side effect. She presented with eruptions pruritic papules with follicular pattern on anterior thigh and forearms after almost 1 year of treatment with acitretin (50mg OD) for pustular psoriasis. The skin lesion was treated successfully with skin dressing and antibiotic treatment and skin biopsy is suggestive of folliculitis. Several treatments for pustular psoriasis including topical steroids, methotrexate and oral prednisolone were ineffective or not tolerated. Treatment with acitretin which are 50mg OD provided partial resolution of skin lesions. The case is hereby reported because of its rarity and folliculitis must be considered in the differential diagnosis of a popular eruption, especially in patients with high dose acitretin.
    Matched MeSH terms: Forearm
  20. Fulltext Pulled/nursemaid's elbow
    Mohd Miswan MF, Othman MS, Muhamad Effendi F, Ibrahim MI, Rozali KN
    Malays Fam Physician, 2017;12(1):26-28.
    PMID: 28503271
    Nursemaid's elbow is a radial head subluxation caused by axial traction on the extended arm while the forearm is pronated, allowing for slippage of the radial head. A 2-year-old boy presented with pain, swelling and reduced range of movement of the right elbow for 4 days. The mother noted that the child was moving the right upper limb less often and there was tenderness over the right elbow. X-ray of the right elbow showed subluxation of the elbow joint with no obvious fracture. A trial of conservative management was decided upon and the patient was placed on a right elbow backslab with the right forearm in a supine position. On follow-up, there was no swelling, tenderness or neurological deficit noted. A repeate x-ray revealed normal findings.
    Matched MeSH terms: Forearm
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