Displaying publications 61 - 80 of 1479 in total

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  1. Fulltext Cauda Equina Syndrome: A Review of 15 Patients Who Underwent Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD) Under Local Anaesthesia
    Krishnan A, Kohli R, Degulmadi D, Mayi S, Ranjan R, Dave B
    Malays Orthop J, 2020 Jul;14(2):101-110.
    PMID: 32983384 DOI: 10.5704/MOJ.2007.019
    Introduction: To analyse the results of Cauda Equina Syndrome (CES) operated by Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD).

    Material and Methods: The study is a retrospective series of 15 patients operated by PTELD. Bladder dysfunction was classified as incomplete CES (CESI) and complete CES retention (CESR). Bladder / motor recovery rate and its timing, Oswestry Disability Index (ODI), Visual Analogue Score (VAS), patient satisfaction index, and sexual dysfunction were used to measure the outcome objectively. Additionally, in CESR patients, post-void residual (PVR) urine was measured by sonography. Complications and technical problems were noted.

    Results: There were ten patients of CESI and five patients of CESR. The average follow-up was 20.33(12.05) months. Bladder symptoms recovery was 100%, and motor recovery was 80%. VAS for back pain recovered to 0.53(0.52) from 8(2.39). VAS for leg pain recovered to 0.13(0.35) from 9.20(1.32). ODI improved to 6.07(2.85) from 77.52(13.20). The time to the recovery of bladder function was 1.47(1.55) days. All CESR patient's abnormal PVR urine was normalised at five weeks post-operative. No complications were reported. However, five technical executional problems occurred.

    Conclusion: PTELD can be considered for CES treatment due to its substantial and quick recovery advantages. However, more evidence support is needed to make it a practice recommendation.

    Matched MeSH terms: Follow-Up Studies
  2. Fulltext In Situ Fixation of Symptomatic Fibrous Non-union Hoffa Fracture: A Case Report
    Soni A, Kansay R, Gupta S, Malhotra A
    Malays Orthop J, 2019 Mar;13(1):57-59.
    PMID: 31001387 DOI: 10.5704/MOJ.1903.014
    Femoral condyle fracture in coronal plane, also known as Hoffa fracture, is a rare fracture. Non-union of Hoffa fracture is even rarer. We present a case of fibrous nonunion of a Hoffa fracture in which the fractured fragment, though not freely movable, led to painful walking. Since the fragment was un-displaced and non-movable we fixed the fractured fragment in situ. Patient regained full range of motion of the knee and was asymptomatic on follow-up.
    Matched MeSH terms: Follow-Up Studies
  3. Fulltext Comparison of diametric and volumetric changes in Stanford type B aortic dissection patients in assessing aortic remodeling post-stent graft treatment
    Wan Ab Naim WN, Sun Z, Liew YM, Chan BT, Jansen S, Lei J, et al.
    Quant Imaging Med Surg, 2021 May;11(5):1723-1736.
    PMID: 33936960 DOI: 10.21037/qims-20-814
    Background: The study aims to analyze the correlation between the maximal diameter (both axial and orthogonal) and volume changes in the true (TL) and false lumens (FL) after stent-grafting for Stanford type B aortic dissection.

    Method: Computed tomography angiography was performed on 13 type B aortic dissection patients before and after procedure, and at 6 and 12 months follow-up. The lumens were divided into three regions: the stented area (Region 1), distal to the stent graft to the celiac artery (Region 2), and between the celiac artery and the iliac bifurcation (Region 3). Changes in aortic morphology were quantified by the increase or decrease of diametric and volumetric percentages from baseline measurements.

    Results: At Region 1, the TL diameter and volume increased (pre-treatment: volume =51.4±41.9 mL, maximal axial diameter =22.4±6.8 mm, maximal orthogonal diameter =21.6±7.2 mm; follow-up: volume =130.7±69.2 mL, maximal axial diameter =40.1±8.1 mm, maximal orthogonal diameter =31.9+2.6 mm, P<0.05 for all comparisons), while FL decreased (pre-treatment: volume =129.6±150.5 mL; maximal axial diameter =43.0±15.8 mm; maximal orthogonal diameter =28.3±12.6 mm; follow-up: volume =66.6±95.0 mL, maximal axial diameter =24.5±19.9 mm, maximal orthogonal diameter =16.9±13.7, P<0.05 for all comparisons). Due to the uniformity in size throughout the vessel, high concordance was observed between diametric and volumetric measurements in the stented region with 93% and 92% between maximal axial diameter and volume for the true/false lumens, and 90% and 92% between maximal orthogonal diameter and volume for the true/false lumens. Large discrepancies were observed between the different measurement methods at regions distal to the stent graft, with up to 46% differences between maximal orthogonal diameter and volume.

    Conclusions: Volume measurement was shown to be a much more sensitive indicator in identifying lumen expansion/shrinkage at the distal stented region.

    Matched MeSH terms: Follow-Up Studies
  4. Fulltext WHO 2009 guidelines for anti-retroviral therapy: its implication for primary care physician
    Koh KC
    Malays Fam Physician, 2010;5(2):77-82.
    PMID: 25606192 MyJurnal
    Careful drug history should be elicited from HIV infected patient on ART by the attending primary care physician in order to avoid potential adverse effects from drug-drug interactions. In conclusion, primary care physicians have a significant role in early diagnosis of HIV infected people, ensuring wider access to early ART, ensuring the welfare of health care workers attending to possible HIV positive patients and safe long term follow up of HIV positive patients needing medications for non-HIV related ailments.
    Matched MeSH terms: Follow-Up Studies
  5. Fulltext Conservative Treatment in Patients With Type 2 Odontoid Fracture - Functional Outcome Following Halovest Immobilization
    Zairul, A., Vicknesh, A., Zulkefli, A., Ramanathan, R.
    Malays Orthop J, 2010;4(2):13-16.
    MyJurnal
    Objective: to assess the severity of neck pain and functional status (neck motion and return to pre-injury daily activity) in patients with type 2 odontoid fracture following conservative treatment by halo vest immobilization. Methodology: A retrospective cohort study of 21 patients with type 2 odontoid fracture treated conservatively with halo ves immobilization from January 2007 and followed-up til December 2009. Fracture union and complications related to treatment were documented. At the final follow up visit (1 year post injury), the patient’s neck pain, neck range o motion and return to pre-injury daily activities were assessed. Result: Twenty-one patients were included in the study. Fracture union was documented in 17 patients (81%) only 4 suffered from nonunion. Despite the good union rate only 8 patients (38.1%) achieved a good neck range o motion and returned to pre injury daily activity. Neck pain was minimal in all patients. Conclusion: Type 2 odontoid fractures treated with halo vest results in good union and minimal residual neck pain; however, it causes neck stiffness.
    Matched MeSH terms: Follow-Up Studies
  6. Fulltext Bipolar Hemiarthroplasty in Elderly Patients Presenting WithDisplaced Intracapsular Femoral Neck Fractures ..
    Krishnan, H., Yoon, T.R., Park, K.S.
    Malays Orthop J, 2010;4(1):26-31.
    MyJurnal
    This retrospective study was undertaken to analyze perioperative parameters, functional outcomes and complications of cemented versus uncemented bipolar hemiarthroplasty in elderly patients presenting with displaced intracapsular femoral neck fracture. The authors reviewed 17 patients that underwent cemented bipolar hemiarthroplasty and 21 patients that underwent uncemented bipolar hemiarthroplasty. The mean follow-up duration in the cemented and uncemented group was 29.9 and 30.5 months respectively. Intraoperative and postoperative blood loss was higher in the cemented group. On the last follow-up the mean HHS was 74.7 in the cemented group and 84.2 in the uncemented group. No statistically significant difference was evident in the pain score. In summary, bipolar hemiarthroplasty was found to be a good option for displaced intracapsular femoral neck fractures, and overall outcome was marginally better in the uncemented group in terms of postoperative of blood loss and functional outcome at last follow up.
    Matched MeSH terms: Follow-Up Studies
  7. Fulltext Expectant management of missed miscarriage
    Andi Anggeriana Andi Asri, Noor Azmi Mat Adenan, Ali Jafarzadeh Esfehani, Norhafizah Mohtaruddin, Ma, Saung Oo, Latiffah A. Latiff
    Malaysian Journal of Medicine and Health Sciences, 2015;11(1):69-76.
    MyJurnal
    Early pregnancy losses occur in 10-20% of all pregnancies. Surgical evacuation has always been the mainstay of management of miscarriages. The main aim of this study was to understand the success rate of expectant management of miscarriage with regards to gestational sac size and period of gestation. The secondary outcome was to measure the satisfaction level and the rate of pregnancy after 6 month of expectant management. Patients diagnosed with missed miscarriages were requested to choose between expectant or surgical management. Those decided for expectant management on “wait and watch” approach were assessed weekly up to 5 completed weeks until complete miscarriage was achieved spontaneously. Surgical evacuation was performed if medically indicated or requested by the patients at any time or at the end of fifth week if complete miscarriage was not achieved. Out of 212 cases, 75 (35.4%) opted for expectant management. Complete miscarriage was achieved in 85.3% of subjects by the end of fifth weeks respectively. Mean of Gestational sac size and period of gestation was not found to influence the success rate of complete spontaneous miscarriage in the expectant management. No morbidity was recorded during the five weeks of the study period. Mean satisfaction score was 9.7±8.3. Pregnancy occurred in 47% of patients within 6 months follow up. The Receiver operation characteristic (ROC) curve analysis suggested the end of second week as the cut off for surgical intervention. This study revealed that expectant management of missed miscarriage is a reliable management of missed miscarriage within the first two weeks.
    Matched MeSH terms: Follow-Up Studies
  8. Fulltext Bilateral idiopathic optic perineuritis in a young Malay woman: A case report
    Ayesha Mohd Zain, Umi Kalthum Md Noh, Mushawiahti Mustapha, Norshamsiah Md. Din, Bastion, Mae Lynn Catherine
    Neurology Asia, 2015;20(4):407-409.
    MyJurnal
    A 28-year-old Malay woman presented with severe loss of vision in both eyes associated with periocular pain on eye movement. She was completely blind at presentation and examination showed optic discs
    swelling. Optic nerve imaging showed ‘doughnut sign’, characteristic of optic perineuritis. Steroid was
    given over six months. Visual function improved gradually and was maintained at one year follow-up.
    This case highlights the importance of differentiation between optic neuritis and optic perineuritis as
    visual recovery depends on prolonged management with corticosteroid in optic perineuritis.
    Matched MeSH terms: Follow-Up Studies
  9. Fulltext Plunging epidermoid cyst of the floor of the mouth mimicking a ranula
    Anusha Balasubramanian, Irfan Mohamad, Purushotman Ramasamy, Avatar Singh Mohan Singh, Lina Ling Chooi, Ferdinand Jesudian Kovilpillai
    Malaysian Journal of Medicine and Health Sciences, 2016;12(1):67-69.
    MyJurnal
    Plunging epidermoid cyst of the floor of mouth is indeed an uncommon entity. A 34-year old Malay
    gentleman had presented to our centre with a floor of mouth lesion that extended into the submental
    region. Clinical findings and imaging studies pointed towards the impression of a plunging ranula.
    Histopathological examination of a completely excised mass via intraoral approach, confirmed the
    diagnosis of an epidermoid cyst. He was well on follow up with no subsequent recurrence. We discuss
    the nature of epidermoid cyst and its surgical management.
    Matched MeSH terms: Follow-Up Studies
  10. Fulltext Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
    Goh, K.L., Zamzuri, Z., Mohd Ariff, S., Mohamed Azril, M.A.
    International Medical Journal Malaysia, 2016;15(1):31-34.
    MyJurnal
    Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness.
    Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication.
    Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration.
    Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.
    KEYWORDS: Intertrochanteric fracture, dynamic hip screw, tip-apex distance, screw cut-out
    Matched MeSH terms: Follow-Up Studies
  11. Fulltext Juvenile Breast Hypertrophy: A Successful Breast Reduction of 14.9% Body Weight without Recurrence in a 5-Year Follow-Up
    Hisham A, Abd Latib M, Basiron N
    Case Rep Surg, 2017;2017:3491012.
    PMID: 28255494 DOI: 10.1155/2017/3491012
    Juvenile hypertrophy of the breast (JHB) is a rare and relentless disease affecting women in the peripubertal period. We present a 13-year-old girl with massive bilateral JHB, successfully treated with a breast reduction and free nipple graft technique. A total of 7300 grams of breast tissue had been removed, accounting for 14.9% of the patient's total body weight. Prophylactic hormonal therapy was not commenced. During the 5-year follow-up period, there was no recurrence and the patient remains satisfied with the aesthetic outcome. A recent meta-analysis study indicates that subcutaneous mastectomy is associated with reduced risk of recurrence, but it is more deforming and the aesthetic result is inferior to a reduction mammaplasty. In patients treated with the latter technique, some evidence exists suggesting that the use of a free nipple graft is associated with a less frequent risk of recurrence than a pedicle technique. This present case is unique as it demonstrates the clinical course of this patient at a considerably longer follow-up period than most reported studies. We adhered to the limited available evidence and highlight the long-term reliability of breast reduction with free nipple grafting as the first line surgical option in JHB, eliminating the need for repeated surgeries.
    Matched MeSH terms: Follow-Up Studies
  12. Fulltext Treatment of Developmental Dysplasia of the Hip: Short and Mid-term Outcome
    Malays Orthop J, 2011;5(1):17-20.
    MyJurnal
    Objective: To review the presentation and outcome of developmental dysplasia of the hip (DDH) cases in the last 6 years. Methodology:We retrospectively reviewed the presentation as well as short and mid-term outcome of 17children (18 hips) with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness,closed or open reduction depending on age at presentation and the individual needs of each patient. Results:Theaverage age at presentation was 31.1 months, and the male to female ratio was 1:4.6. Six patients (35%) presented early(less than 6 months old) while 7 patients (41%) presented between 6 -24 months. In these 2 groups splinting or closed reduction under anaesthesia was initially utilized for treatment depending on age, and open reduction was use dafter failure of closed reduction and for those presented late.Average age at the time of closed reduction was 11 months,and 6 years for those underwent open reduction. The average period of follow up for all patients was 29.4 months. The final outcome was successful in 12 hips (66%) in 11 patients.Ten of these presented at less than 2 years old, in the other 6 hips in which there was failure, 50% presented after 3 years of age. Conclusion:Late presentation of DDH is still common in Malaysia, which necessitates more complex management and more frequent occurrences of unfavourable results.
    Matched MeSH terms: Follow-Up Studies
  13. Fulltext Giant sacral chondrosarcoma in an elderly male: a case report
    Chan, H. Z., Wang, C. S., Azuhairy, A., Hau, A., Zulkiflee, O.
    Malays Orthop J, 2014;8(1):79-81.
    MyJurnal
    Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.
    Matched MeSH terms: Follow-Up Studies
  14. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation
    Lee W, Kyaw MO
    Malays Orthop J, 2015 Jul;9(2):26-32.
    PMID: 28435606 MyJurnal DOI: 10.5704/MOJ.1507.008
    The optimal treatment for thoracolumbar fractures (TLF) without neurological deficit remains controversial. Majority of the systematic reviews and meta-analyses have evaluated open operative approaches but have yet to compare the outcomes of minimally invasive percutaneous pedicle fixation (MIPPF) versus non-operative treatment. A retrospective cohort study was performed to compare clinical and radiological outcomes between MIPPF and conservative groups for TLF AO Type A1 to Type B2 during a 2-year follow-up period. Pre-operative plain and CT films were evaluated and decision made for short segment (non-fusion) MIPPF. Patients who refused operation were treated conservatively with three months of body cast, brace, or corset. MIPPF group showed earlier Visual Analog Score(VAS) improvement at six months post-injury (0 vs 6.0- p<0.001), as well as better functional and radiological outcomes (p<0.050) at final follow-up. Progressions of regional kyphosis (RK) were noted in both groups but there was no significant difference within and between them(p>0.050). MIPPF as a method of internal bracing can be pursued in the treatment of TLF, with larger future cohorts and RCTs being called for to support and explore new findings.
    Matched MeSH terms: Follow-Up Studies
  15. Fulltext The mortality and outcome of delirium, dementia and other organic disorders: a two-year study
    Chandrasekaran, Prem Kumar, Jambunathan, Stephen Thevanathan, Nor Zuraida Zainal
    ASEAN Journal of Psychiatry, 2007;8(1):3-8.
    MyJurnal
    This is a cross-sectional, two-year follow up study. The authors determined the varied presentations of delirium, dementia and other organic disorders to assess their mortality and outcome. They described the diagnosis of patients suffering from the psychiatric effects of those organic states and compared their symptom resolution and mortality between those with the acute and chronic varieties during their index hospitalization and again, 24 months later. Although mortality rates did not differ, patients with the acute syndrome had significantly better outcomes in terms of symptom resolution as compared to those with the chronic syndrome (p=0.001). Patients with symptom resolution upon discharge did not show statistically significant lower mortality rates.
    Matched MeSH terms: Follow-Up Studies
  16. Fulltext The importance of long-term follow-up visits for kidney donors
    Makmor, T., Raja Noriza, R.A., Nawi, A., NurulHuda, M.S., Kok Peng, N., Soo Kun, L., et al.
    JUMMEC, 2015;18(2):1-5.
    MyJurnal
    Background: This paper examined the importance and influence of post-transplantation follow-up visits on the quality-of-life (QoL) of living kidney donors in Malaysia.

    Methods: Based on data collected from 80 living kidney donors, the relationship between QoL and the frequency of follow-up visits was examined. QoL was measured using standard SF-8 questions to capture its different dimensions.

    Results: Donors in the 1991–1998 donation cohort have low QoL, especially in the domains of physical and vitality, compared with the other two cohorts (1999–2005 and 2006–2012). The mean scores showed that donors who never went for any follow-up activities visits experience low QoL in most of the categories, particularly those related to physical activities, implying the importance of follow-up activities visits in influencing the donors’ QoL. Lower QoL was recorded for respondents that never received post-transplant treatment.

    Conclusion: Although this study found no serious post-transplant QoL issues in Malaysia, it is still important to set up a donor registry and provide free and mandatory follow-up visits for all donors in order to adequately monitor their health.
    Matched MeSH terms: Follow-Up Studies
  17. Fulltext Morsellized Allograft and Acetabular Reconstruction Cage: Follow – up of 2 to 9 years
    Abbas, A.A., Merican, A.M., Mohamad, J.A.
    Malays Orthop J, 2007;1(1):5-7.
    MyJurnal
    We report the outcome of 32 patients who underwent total hip replacement (THR) augmented with morsellized fresh frozen femoral head allografts and acetabular reconstruction cages. Nine patients underwent primary THR and 23 patients underwent revision THR. Follow-up ranged from two to 9 years. Two most common indications for the procedures as reported in literature were rheumatoid arthritis and aseptic loosening of the hip. All but one patient achieved good outcome with radiographs showing full incorporation of bone grafts and no evidence of loosening of the implants. Morsellized bone grafting used with acetabular reinforcement devices is valuable for addressing severe acetabular deficiencies.
    Matched MeSH terms: Follow-Up Studies
  18. Fulltext Multicompartmental congenital intracranial immature teratoma
    Ganesan, Dharmendra, Sheau, Fung Sia, Narayann, Vairavan, Kumar, Gnana, Lum, Lucy, Chan,Lucy, et al.
    Neurology Asia, 2013;18(1):117-121.
    MyJurnal
    Congenital intracranial tumors are rare and account for 0.5 to 1.5% of all childhood tumours. We report a case of a 3 week old baby presenting with multi compartmental congenital intracranial immature teratoma, first of its kind in the literature. The child had gross total excision in two stages with aid of neuronavigation. The short term outcome was good. The four years of follow-up with serial imaging showed no tumour recurrence with a stable hydrocephalus after shunting. However, there is global developmental delay with full time dependence of care giver.
    Matched MeSH terms: Follow-Up Studies
  19. Fulltext A rare case of recurrent orbital solitary fibrous tumour with intracranial extension
    Ainal Adlin N, Umi Kalthum MN, Amizatul Aini S, Reena Rahayu MZ
    Journal of Surgical Academia, 2016;6(1):59-61.
    MyJurnal
    A 47-year-old lady, presented with progressive proptosis of left eye with deterioration of vision. She had a history of left solitary fibrous tumour and had undergone left frontal craniotomy and orbitotomy in 2004. Surveillance Magnetic resonance imaging (MRI) six years later showed tumour recurrence with intracranial extension. However, she did not follow-up and only presented again 3 years, later. Tumour resection and left exenteration was performed. Histology showed ‘patternless’ pattern of neoplastic cells, and CD34 staining was diffusely positive. Diagnosis of recurrent solitary fibrous tumour with intracranial extension was made.
    Matched MeSH terms: Follow-Up Studies
  20. Fulltext Functional Outcome After Arthroscopic Rotator Cuff Repair - An Early Experience
    Khoo, S.W., Khoo, S.M., Yeong, Y.K., Towil, B.
    Malays Orthop J, 2009;3(2):29-32.
    MyJurnal
    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.
    Matched MeSH terms: Follow-Up Studies
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