Displaying publications 61 - 70 of 70 in total

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  1. Lee WC, Chua T
    Malays Orthop J, 2021 Mar;15(1):138-140.
    PMID: 33880163 DOI: 10.5704/MOJ.2103.023
    Atypical femoral fractures (AFF) have low union rates. The use of teriparatide has been advocated for the post-operative healing of AFF, but the evidence is limited to case reports and some series due to its low incidence. We present a case series of four female patients to support the use of teriparatide after the surgical fixation of their AFF. Three of the patients had a complete AFF and one had an incomplete fracture. Their mean age was 70 (52 - 87) years, mean body mass index 24.6 (18.3 - 29.3), mean bone mineral density T-score of -2.3 (-4.8/-1.0), with a prior history of anti-resorptive therapy with bisphosphonates and denosumab. Teriparatide was started at an average of 8 (2-18) days post-fixation, with 20mcg daily for six months. Immediate full weight-bearing was permitted in three patients, while one was non-weight bearing for two months. The mean time to union was 12 (10 - 14) weeks. No side effects were observed over a mean follow-up of 58 (50 - 72) weeks. The use of teriparatide facilitated the quick union of AFF after surgical fixation. It appeared to be safe and promoted fracture healing in AFF.
    Matched MeSH terms: Bone Diseases
  2. Charlton MR, Alam A, Shukla A, Dashtseren B, Lesmana CRA, Duger D, et al.
    J Gastroenterol, 2020 Sep;55(9):811-823.
    PMID: 32666200 DOI: 10.1007/s00535-020-01698-4
    Asia has intermediate-to-high prevalence and high morbidity of hepatitis B virus (HBV) infection. The use of guideline-recommended nucleos(t)ide analogs with high barrier to resistance, such as entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), is one of the key interventions for curbing HBV infection and associated morbidity in Asia. However, there are some challenges to the use of ETV and TDF; while ETV is associated with high resistance in lamivudine (LAM)-exposed (especially LAM-refractory) patients; bone and renal safety issues are a major concern with TDF. Hence, a panel of twenty-eight expert hepatologists from Asia convened, reviewed the literature, and developed the current expert opinion-based review article for the use of TAF in the resource-constrained settings in Asia. This article provides a comprehensive review of two large, phase 3, double-blind, randomized controlled trials of TAF versus TDF in HBeAg-negative (study 0108) and HBeAg-positive (study 0110) chronic HBV patients (> 70% Asians). These studies revealed as follows: (1) non-inferiority for the proportion of patients who had HBV DNA bone and renal safety, with TAF vs. TDF up to 144 weeks. Considering the benefits of TAF, the expert panel proposed recommendations for optimizing the use of TAF in Asia, along with guidance on specific patient groups at risk of renal or bone disease suitable for TAF therapy. The guidance provided in this article may help clinicians optimize the use of TAF in Asia.
    Matched MeSH terms: Bone Diseases
  3. Chee, W.S.S., Chong, P.N., Chuah, K.A., Karupaiah, T ., Norlaila Mustafa, Seri Suniza, S., et al.
    Malays J Nutr, 2010;16(2):233-242.
    MyJurnal
    Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross
    link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high
    levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as
    Matched MeSH terms: Bone Diseases, Metabolic
  4. Malays J Nutr, 2000;6(1):-.
    MyJurnal
    This study aims to determine the relationship between calcium intake and lifestyle factors with bone health status among 56 postmenopausal women in the Evergreen Senior Citizens Club, Petaling Jaya. Purposive sampling technique was used for sample selection. Bone mineral density (BMD) of the femur proximal and lumbar L2-L4 was measured based on the Dual Energy X-ray Absorptionmetry (DEXA) technique at KVOTC Clinic, Subang Jaya. The interview sessions were conducted using a questionnaire followed by anthropometric measurements. The results revealed that the average age of the respondents was 64.0 years old. The average weight and height of the respondents were 53.68 kg and 1.55 meters, respectively. Overall, the average body mass index (BMI) of the respondents was quite satisfactory (22.4 kg/m²) with only 17.9% of them categorized as overweight (>25 kg/m²). The average total calcium intake was 807.31 mg and about 76.2% was contributed by food intake. About 83.9% of the respondents met the recommended calcium intake according to the Malaysian RDA. The average BMD of the lumbar, neck, wards and trochanter was 9.983 ± 0.178 g/cm², 0.745 ± 0.126 g/cm², 0.604 ± 0.150 g/cm² and 0.674 ± 0.127 g/cm², respectively. About 32.1% of the respondents were categorized as osteoporotic at the femoral wards, while 10.7% respectively was at the lumbar L2-L4 and femoral neck. Half of the respondents had osteopenia at the femoral neck (53.6%) and wards (50.0%) and at the lumbar L2-L4 (53.6%). Pearson correlation test showed significant negative correlations between age and BMD in the neck (r = -0.419, p
    Matched MeSH terms: Bone Diseases, Metabolic
  5. Jayusman PA, Mohamed IN, Shuid AN
    Int J Endocrinol Metab, 2018 Jul;16(3):e64038.
    PMID: 30197659 DOI: 10.5812/ijem.64038
    Background: Gonadotropin releasing hormone (GnRH) antagonists may cause chemical castration in males by suppressing the pituitary-gonadal axis, hence reducing testosterone level. There are limited data on the effects of degarelix, a newer series of potent and long acting GnRH antagonist on bone.

    Objectives: The current study aimed at determining the effects of degarelix on bone turnover, bone densitometry, and bone mechanical strength in male rats.

    Methods: Eighteen male Sprague-Dawley rats were randomly divided into sham (SHAM), orchidectomized (ORX), and degarelix-induced (DGX) groups. Chemical castration was performed by subcutaneous degarelix injection (2 mg/kg) at the scapular region. The rats were scanned for baseline bone mineral area (BMA), bone mineral content (BMC), and bone mineral density (BMD) using dual-energy x-ray absorptiometry (DXA). Following six weeks of experimental period, BMA, BMC, and BMD were measured again with DXA and blood was collected for testosterone and bone biomarkers (osteocalcin and C-terminal of type I collagen crosslink (CTX-1)) measurements. The rats were euthanized and femora were dissected for bone biomechanical strength analysis.

    Results: Bilateral orchidectomy and degarelix administration significantly lowered serum testosterone level, decreased whole body BMC, femoral BMA, femoral BMC, and femoral BMD (P < 0.05) compared with the SHAM group. However, no significant changes were observed in bone biochemical markers and bone mechanical strength in all experimental groups.

    Conclusions: In conclusion, degarelix administration had comparable effects on bone as bilateral orchidectomy. Administration of degarelix provides an alternative method of inducing testosterone deficient-osteopenia in male rats without need for removing the testes.

    Matched MeSH terms: Bone Diseases, Metabolic
  6. Hermizi Hapidin, Hawa Mahmood, Sakinah Harith
    Sains Malaysiana, 2013;42:1191-1200.
    Menopause is the most prevalent cause of accelerated bone loss in women. Biochemical markers of bone resorption can be used clinically to predict future bone loss. This study aimed to determine the level of bone resorption markers in healthy pre and postmenopausal Malay women and determine their association with the risk. A total of 150 healthy women were recruited for this study (51 pre and 99 postmenopausal subjects). Data on socioeconomic, lifestyle habit and clinical were gained by personal interview. Fasting serum was collected to measure both C-telopeptide (CTx) and N-telopeptide (NTx) of type 1 collagen. Both markers were highly correlated with each other (r=0.568, p<0.001). Both intra- and inter-assay coefficient of variations (CV) of NTx were higher than those of CTx (8% and 12% vs 6% and 5%). The mean CTx values of pre and postmenopausal subjects were comparable with the expected values (0.2833 (0.1769) ng/mL and 0.4323 (1.851) ng/mL compared with 0.287 and 0.438 ng/mL, respectively). The NTx value for premenopausal subjects were higher than the expected values (15.2 (8.10) compared to 12.6 (3.20) nM BCE). The median was 19.929 nM BCE. The mean CTx and NTx levels of postmenopausal subjects were significantly lower than premenopausal subjects (p<0.05). The risk factors for bone resorption in this population were duration of menopause, marital status, body mass index (BMI), physical activity and education level. In conclusion, postmenopausal women showed a higher bone resorption, indicating higher bone loss. Increasing education and physical activity intervention might be effective to ensure better health in Malaysian older population.
    Matched MeSH terms: Bone Diseases, Metabolic
  7. Malik MMA, Othman F, Hussan F, Shuid AN, Saad QM
    Vet World, 2019 Dec;12(12):2052-2060.
    PMID: 32095059 DOI: 10.14202/vetworld.2019.2052-2060
    Background and Aim: Both virgin coconut oil (VCO) and tocotrienol-rich fraction (TRF) are rich in antioxidants and may protect the bone against bone loss induced by ovariectomy and high-fat diet. The study aimed to determine the protective effects of combined therapy of VCO and TRF on osteoporosis in ovariectomized (OVX) rat fed with high-fat diet.

    Materials and Methods: Thirty-six female Sprague-Dawley rats were divided into six groups: Sham-operated (SHAM), OVX control, OVX and given Premarin at 64.5 µg/kg (OVX+E2), OVX and given VCO at 4.29 ml/kg (OVX+V), OVX and given TRF at 30 mg/kg (OVX+T), and OVX and given a combination of VCO at 4.29 ml/kg and TRF at 30 mg/kg (OVX+VT). Following 24 weeks of treatments, blood and femora samples were taken for analyses.

    Results: There were no significant differences in serum osteocalcin levels between the groups (p>0.05), while serum C-terminal telopeptide of Type I collagen levels of the OVX+VT group were significantly lower than the other groups (p<0.05). The dynamic bone histomorphometry analysis of the femur showed that the double-labeled surface/bone surface (dLS/BS), mineral apposition rate, and bone formation rate/BS of the OVX+E2, OVX+T, and OVX+VT groups were significantly higher than the rest of the groups (p<0.05).

    Conclusion: A combination of VCO and TRF has the potential as a therapeutic agent to restore bone loss induced by ovariectomy and high-fat diet.

    Matched MeSH terms: Bone Diseases, Metabolic
  8. Lim CY, Mat-Hassan S, Awang M, Md-Ariff MF, Hau-Abdullah MA
    Malays Orthop J, 2019 Nov;13(3):21-27.
    PMID: 31890106 DOI: 10.5704/MOJ.1911.004
    Introduction: Proximal femur resection and endoprosthetic reconstruction is the preferred treatment for extensive bony destruction and pathological fractures. Due to the relatively high cost of endoprosthesis, we adopted the modified unipolar hemiarthroplasty (MUH) for reconstruction when the mode of treatment was for palliation. Materials and Methods: This is a retrospective case study of six patients, who had bone and multi-organs metastases with extensive proximal femur involvement with pathologic fractures who underwent resection and MUH reconstruction during the period 2013 to 2017. All patients were classified as Group B / C based on Scandinavian Sarcoma Group survival scoring, with estimated survival of maximum six months. The basic MUH construct consisted of Austin-Moore prosthesis which was secured to a Küntscher nail using cerclage wire and cemented into the femoral canal. Subsequently, the whole length of the prosthesis which remained outside the canal was coated with cement. Results: The mean age was 61.8 years. The mean survival was 3.9 months, post-operation. There was no implant failure during patients' life span; however, a third of the patients developed infection. Wheel chair ambulation was started immediately post-operation for all patients, and two patients progressed to walking frame ambulation. The total cost of each construct was below US$490 in comparison to long-stem hemiarthroplasty (roughly US$ 1700). Conclusion: Our aim was to alleviate pain, facilitate rehabilitation, ease nursing care and improve quality of life for metastatic bone disease patients until end of life. MUH for the treatment of pathological fracture in proximal femoral metastases is a feasible palliative surgical modality in resource-limited settings.
    Matched MeSH terms: Bone Diseases
  9. Shuid AN, Mohamed N, Mohamed IN, Othman F, Suhaimi F, Mohd Ramli ES, et al.
    PMID: 22973403 DOI: 10.1155/2012/696230
    Nigella sativa seeds (NS) has been used traditionally for various illnesses. The most abundant and active component of NS is thymoquinone (TQ). Animal studies have shown that NS and TQ may be used for the treatment of diabetes-induced osteoporosis and for the promotion of fracture healing. The mechanism involved is unclear, but it was postulated that the antioxidative, and anti-inflammatory activities may play some roles in the treatment of osteoporosis as this bone disease has been linked to oxidative stress and inflammation. This paper highlights studies on the antiosteoporotic effects of NS and TQ, the mechanisms behind these effects and their safety profiles. NS and TQ were shown to inhibit inflammatory cytokines such as interleukin-1 and 6 and the transcription factor, nuclear factor κB. NS and TQ were found to be safe at the current dosage for supplementation in human with precautions in children and pregnant women. Both NS and TQ have shown potential as antiosteoporotic agent but more animal and clinical studies are required to further assess their antiosteoporotic efficacies.
    Matched MeSH terms: Bone Diseases
  10. Kanwar JR, Samarasinghe RM, Kumar K, Arya R, Sharma S, Zhou SF, et al.
    Drug Des Devel Ther, 2015;9:2927-40.
    PMID: 26089642 DOI: 10.2147/DDDT.S77369
    INTRODUCTION: Inflammatory mediators are key players in the pathogenesis of osteoarthritis (OA) and bone destruction. Conventional drugs suppress symptomatic activity and have no therapeutic influence on disease. Cissus quadrangularis and Withania somnifera are widely used for the treatment of bone fractures and wounds; however, the cellular and molecular mechanisms regulated by these herbals are still unclear.

    METHODS: We established an in vitro OA culture model by exposing human chondrocytes to proinflammatory cytokine and interleukin (IL)-1β for 36 hours prior to treatment with the herbals: C. quadrangularis, W. somnifera, and the combination of the two herbals. Cell viability, toxicity, and gene expression of OA modifying agents were examined. In addition, expression of survivin, which is crucial for cell growth, was analyzed. In vivo work on osteotomized rats studied the bone and cartilage regenerative effects of C. quadrangularis, W. somnifera, and the combination therapy.

    RESULTS: Exposure of chondrocytes to IL-1β induced significant toxicity and cell death. However, herbal treatment alleviated IL-1β induced cell toxicity and upregulated cell growth and proliferation. C. quadrangularis inhibited gene expression of cytokines and matrix metalloproteinases, known to aggravate cartilage and bone destruction, and augmented expression of survivin by inhibiting p38 MAPK. Interestingly, osteotomized rats treated with C. quadrangularis drastically enhanced alkaline phosphatase and cartilage tissue formation as compared to untreated, W. somnifera only, or the combination of both herbals.

    CONCLUSION: Our findings demonstrate for the first time the signaling mechanisms regulated by C. quadrangularis and W. somnifera in OA and osteogenesis. We suggest that the chondroprotective effects and regenerative ability of these herbals are via the upregulation of survivin that exerts inhibitory effects on the p38 MAPK signaling pathway. These findings thus validate C. quadrangularis as a potential therapeutic for rheumatic disorders.

    Matched MeSH terms: Bone Diseases/prevention & control*
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