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  1. Mohd Salim NS, Umar MA, Shaharudin S
    J Taibah Univ Med Sci, 2018 Dec;13(6):576-581.
    PMID: 31435381 DOI: 10.1016/j.jtumed.2018.10.007
    Objectives: The isokinetic evaluation of the ankle joint is important in determining the effectiveness of the rehabilitation programme for the management of ankle sprains. This study aimed to determine the effects of physiotherapy programme on isokinetic variables in individuals with grade I ankle sprains.

    Methods: Seven patients with acute grade 1 ankle sprain (15 days of ankle sprain) were recruited. They were provided with 7 days of protection, optimal loading, ice, compression, and elevation (POLICE) treatment, and the standard physiotherapy programme consisted of towel stretching and balancing exercises on one leg. Pain scale score was recorded daily during the physiotherapy programme. The isokinetic ankle strengths of the patient's injured and uninjured legs were compared before and after the physiotherapy programme. Isokinetic tests were conducted in painless range of motion for the injured leg.

    Results: Pain was significantly reduced after the patients underwent the standard physiotherapy programme. No significant differences were observed in terms of the ankle peak torque, time to peak torque, and ankle plantar flexion-to-dorsiflexion ratio of the injured and uninjured legs. The injured leg showed significant improvement in terms of ankle eversion-to-inversion ratio (E:I) after 7 days of performing the standard physiotherapy programme.

    Conclusion: Performing the standard physiotherapy programme for 1 week reduces pain and improves the ankle E:I in patients with grade 1 ankle sprain.

    Matched MeSH terms: Pain
  2. Burud IAS, Tata MD, Tak NAB
    J Taibah Univ Med Sci, 2018 Jun;13(3):305-308.
    PMID: 31435339 DOI: 10.1016/j.jtumed.2017.10.004
    Hyperplastic polyps are the most common polypoidal lesions of the stomach showing a varied presentation. They may be asymptomatic; however, occasionally they can cause anaemia and gastric outlet obstruction. Malignant transformation is a serious complication associated with such polyps. We present the case of an elderly woman who complained of epigastric pain and intermittent vomiting. Oesophagogastroduodenoscopy (OGDS) showed a large pedunculated polyp along the lesser curvature of the stomach, 4 cm from the gastro-oesophageal junction, extending into the first part of the duodenum that caused gastric outlet obstruction. Computed tomography reported a soft-tissue mass arising from the incisura and extending through the pylorus into the duodenum (D1 and proximal D2). An endoscopic polypectomy was performed, and histopathological examination reported evidence of early gastric carcinoma. She underwent regular endoscopic follow-up with biopsies performed over 2 years, and the last follow-up showed mild-to-moderate dysplasia at the previous excision site. She underwent a planned laparoscopic wedge resection, and histopathological examination confirmed the presence of a hyperplastic polyp showing low-grade dysplasia.
    Matched MeSH terms: Pain
  3. Amyra Natasha A, Ahmad Syukri A, Siti Nor Diana MK, Ima-Nirwana S, Chin KY
    J Taibah Univ Med Sci, 2018 Apr;13(2):205-209.
    PMID: 31435325 DOI: 10.1016/j.jtumed.2017.06.005
    Background: Individuals aged 30-60 years have a high possibility of experiencing low back pain. However, children and adolescents are not exempted from this problem. This study aimed to determine the relationship between backpack usage and the frequency of low back pain in pre-university students.

    Methods: A total of 101 currently enrolled pre-university students were recruited for this cross-sectional study. They answered a questionnaire about their demographic details and their frequency of backpack usage. Their backpacks were weighed for four consecutive school days. The Roland-Morris Disability Questionnaire and Body Discomfort Chart were used to rate discomfort levels.

    Results: The use and weight of a backpack were not significantly associated with low back pain, as indicated by the Roland-Morris Disability Questionnaire and Body Discomfort Chart (p > 0.05).

    Conclusion: This study did not find an association between the use of a backpack and low back pain in Malaysian pre-university students.

    Matched MeSH terms: Low Back Pain
  4. Tamburrelli FC, Perna A, Proietti L, Zirio G, Santagada DA, Genitiempo M
    Malays Orthop J, 2019 Nov;13(3):39-44.
    PMID: 31890109 DOI: 10.5704/MOJ.1911.007
    Introduction: Posterior percutaneous instrumentation may represent a challenge when multiple levels need to be instrumentated, especially when including the upper thoracic spine. The aim of the present study was to evaluate the technical feasibility and the long-term outcome of such long constructs in different surgical conditions. Materials and Methods: This investigation was a retrospective cohort study which included patients who underwent thoraco-lumbar percutaneous fixations. We collected clinical, surgical and radiological data, with a minimum follow-up of 24 months. Health-related quality-of-life, residual pain, instrumentation placement, and complications were studied. Results: A total of 18 procedures were enrolled, in which 182 screws were implanted, (170 positioned in thoracic and 12 in lumbar pedicles, respectively). No surgical complications or hardware failure occurred in our series, 6 out of 182 (3,2%) screws had a partial pedicle breach, without neurological impairment or need for surgical revision. Conclusion: According to our results, a fully posterior percutaneous approach for long thoraco-lumbar spine instrumentation can be considered safe and reproducible, although an adequate training is strictly required.
    Matched MeSH terms: Pain
  5. Md Ismail, N.H., Nik Mohd Alwi N.A.
    JUMMEC, 2019;22(1):13-19.
    MyJurnal
    Oral ulcer is a lesion with multifactorial causes and occurs worldwide. The lesion usually resolved within 14
    days, but the pain may have an impact on the quality of patient’s life. Therefore, having a natural derived
    remedy that can reduce healing time would be a great advantage. This study aims to investigate histological
    sections of buccal ulcer on rats treated with aqueous extract of Piper sarmentosum (AEPS). Glacial acetic acid
    was used to induce buccal ulcer on male Sprague Dawley rats. Control group received normal saline while
    the experimental group received AEPS for treatment. On certain days of post-ulcer induction, buccal ulcer
    tissue samples were harvested, sectioned and stained with Hematoxylin and Eosin (H&E). Histological slides
    were examined for inflammation and scored. The inflammation severity reduced from day 2 to day 12. In the
    experimental group there was a statistically significant differences of inflammation score, particularly on day
    2 with a score of (2.8 + 0.2). Neutrophils were less in the experimental group and the tissue debris clearance
    was faster compared to control group. Full reepithelization was observed on both treated tissue sections on
    day 12 with less severe inflammation. Topical application of AEPS is proven to have anti-inflammatory effect
    by reducing the number of neutrophils during inflammation phase of oral ulcer healing.
    Matched MeSH terms: Pain
  6. Vasiwala R, Mohamad I, Venkateswaran SP, Hamzah SZ
    Indian J Otolaryngol Head Neck Surg, 2019 Nov;71(Suppl 3):1986-1989.
    PMID: 31763280 DOI: 10.1007/s12070-018-1402-8
    Extra nodal nasal NK/T cell lymphoma is relatively a rare type of non-Hodgkin lymphoma. Variable clinical presentation with rapidly progressive necrosis of the cartilaginous and bony wall of the nose and upper respiratory passages leads to delayed diagnosis and treatment. A 43-years-old patient presented with right nasal pain and furuncle-like swelling. The swelling progressed rapidly to cellulitis to the face up to the right eye. Within 2 months, it had advanced to necrosis of the lateral vestibular cartilage, medial maxillary wall, turbinate and nasal septal cartilage. Biopsy reported as non-Hodgkin diffuse T cell (angiocentric T cell) lymphoma.
    Matched MeSH terms: Pain
  7. Kamudin NAF, Rani RA, Yahaya NHM
    J Clin Orthop Trauma, 2018 11 20;11(1):171-174.
    PMID: 32002008 DOI: 10.1016/j.jcot.2018.11.007
    Pes anserine syndrome is a cause of inferomedial knee pain. It occurs in patients with diabetes mellitus, osteoarthritis, rheumatoid arthritis and in overweight patients. It is a challenge to identify the causes of knee pain following knee replacement surgery. We present a case report of pes anserine syndrome in a 79-year-old female who had undergone knee arthroplasty 13 years prior. She was pain free until one year ago when her knee pain resurfaced without any symptoms of infection or history of trauma. She was successfully treated with a combination of stretching exercise and steroid local steroid injection. We want to highlight that such common condition as pes anserine syndrome, could occur in total knee arthroplasty, and should be considered as one of the possible diagnosis.
    Matched MeSH terms: Pain
  8. Nadia, Hisamuddin, Nadhirah, Kamarudin, Mohd Roslan, Sulaiman, Wan Mastura, Shaik Mossadeq
    MyJurnal
    Zingiberaceae is one of the largest plant families consisting of rhizomes that are commonly used as spice in soups and curries as well as alternative medications in folklore medicine. Zingiber officinale or commonly known as ginger is extensively employed in Asian, Ayurvedic, Chinese, and Arabian folklore medicine for the treatment of pain, inflammation and various spasm-associated gastric ailments. The past few decades saw rapid advancements in the extraction process of ginger bioactive constituents and validation of their corresponding pharmacodynamic and pharmacotherapeutic activities, and biological properties in vivo and in vitro. Results reported from several biological studies on ginger showed that extracts and compounds from this tuberous rhizome exhibit antiemetic, anticancer, antipyretic, antispasmogenic and antimicrobial activities. This article reviews the effect of Zingiber officinale and its bioactive constituents on isolated organ preparations from several species of animals in view of its potential use as an alternative treatment for muscle spasms and common gastric ailments.
    Matched MeSH terms: Pain
  9. Zin CS, Taufek NH, Ahmad MM
    Front Pharmacol, 2019;10:1286.
    PMID: 31736760 DOI: 10.3389/fphar.2019.01286
    Limited data are available on the adherence to opioid therapy and the influence of different patient groups on adherence. This study examined the patterns of adherence in opioid naïve and opioid existing patients with varying age and gender. This retrospective cohort study was conducted using the prescription databases in tertiary hospital settings in Malaysia from 2010 to 2016. Adult patients aged ≥18 years, receiving at least two opioid prescriptions, were included and stratified into the opioid naïve and existing patient groups. Adherence to opioid therapy was measured using the proportion of days covered (PDC), which was derived by dividing the total number of days covered with any opioids by the number of days in the follow-up period. Generalized linear modeling was used to assess factors associated with PDC. A total of 10,569 patients with 36,650 prescription episodes were included in the study. Of these, 91.7% (n = 9,696) were opioid naïve patients and 8.3% (n = 873) were opioid existing patients. The median PDC was 35.5% (interquartile range (IQR) 10.3-78.7%) and 26.8% (IQR 8.8-69.5%) for opioid naïve and opioid existing patients, respectively. A higher opioid daily dose (coefficient 0.010, confidence interval (CI) 0.009, 0.012 p < 0.0001) and increasing age (coefficient 0.002, CI 0.001, 0.003 p < 0.0001) were associated with higher levels of PDC, while lower PDC values were associated with male subjects (coefficient -0.0041, CI -0.072, -0.010 p = 0.009) and existing opioid patients (coefficient -0.134, CI -0.191, -0.077 p < 0.0001). The suboptimal adherence to opioid medications was commonly observed among patients with non-cancer pain, and the opioid existing patients were less adherent compared to opioid naïve patients. Increasing age and a higher daily opioid dose were factors associated with higher levels of adherence, while male and opioid existing patients were potential determinants for lower levels of adherence to opioid medications.
    Matched MeSH terms: Pain
  10. Khan ESKBM, Thean CAP, Zakaria ZB, Awang MSB, Karupiah RK, Awang MB
    J Orthop Case Rep, 2020;10(2):101-105.
    PMID: 32953668 DOI: 10.13107/jocr.2020.v10.i02.1718
    Introduction: Spinal schwannoma can occur anywhere along the spinal cord but is predominantly seen in the cervical and thoracic region.It composes mainly of well-differentiated schwann cell and is benign in nature. It is typically seen in the peripheral nerves and is commonly associated with neurofibromatosis. Up to 80% of cases, spinal schwannoma is reported to be intradural in location and 15% of cases have both intradural and extradural components. Spinal schwannoma rarely causes conus medullaris syndrome.

    Case Report: In this case series, all three female patients in their 4th and 5th decades of life presented with conus medullaris syndrome. Lower back pain, radiculopathy, lower limb weakness, and urinary incontinence are their main clinical presentation. Magnetic resonance imaging shows a well-defined intradural, extramedullary mass compressing onto the conus medullary region. These patients undergone microscopic assisted excision of the tumor and had remarkably good early outcome despite the advanced presentation of neurological deficit.

    Conclusion: Despite the late presentation with significant neurological deficit, surgical excision of spinal schwannomas carries a good prognosis postoperatively due to their benign nature and extramedullary location.

    Matched MeSH terms: Low Back Pain
  11. Chu ECP, Lo FS, Bhaumik A
    J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
    PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19
    Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.
    Matched MeSH terms: Neck Pain
  12. Muhamad Farhan Ab Razak, Titi Rahmawati Hamedon, Haidar Rizal Toha
    MyJurnal
    Introduction: Low back pain (LBP) is a common symptom among working population worldwide. Foggers prone to have LBP because there are exposed to physical factors such as lifting heavy object, awkward body posture and vibration. However, LBP had never been studied among the fogger. The objective of this study was to determine the prevalence and the factors associated with LBP. Methods: A cross-sectional study was carried out in all District Health Office in Johor, Malaysia by using a validated self-administered questionnaire and anthropometric measure-ments. Chi-square or Fisher’s exact test was used for inferential statistic and multiple logistic regression was used to determine the associated factors. The significance level was determined at p < 0.05. Results: The response rate was 83.9%. Majority of them are male (99.6%), Malay (95.8%), married (85.8%) and educated up to secondary school (53.5%). Majority of respondents do not have part time job (89.6%) but they work overtime everyday (62.7%). Most of them do four hours overtime daily (77.3%). The prevalence of LBP was 68.5% among respondents. There was a significant association between doing part time job, duration of doing overtime per week, body mass index (BMI) and duration of fogging activities. Finally, the associated factors of LBP were doing overtime for more than 20 hours per week (adjusted OR=1.914, 95% CI [1.102, 3.324], p = 0.021), BMI of more than 23.00 kg/m2 (adjusted OR=2.066, 95% CI [1.090, 3.916], p = 0.026) and having no part time job (adjusted OR=0.135, 95% CI [0.031, 0.599], p = 0.021). Conclusion: Prevention needs to be initiated to change the modifiable factors of LBP in order to reduce the prevalence of LBP among them.
    Matched MeSH terms: Low Back Pain
  13. Nazatul Yusrina Mohamad Yuso, Nor Afiah Mohd Zulkefli, Rosliza Abd Manaf
    MyJurnal
    Introduction: Antenatal period is the best time to promote physical activity among women. However, this oppor-tunity is usually missed due to various factors such perceived harm to the baby, tiredness, difficulty to perform the activities, pelvic and back pain, lack of information, as well as low social support. This study determined the associ-ation of social support with the level of physical activity among pregnant women in the district of Seremban, Negeri Sembilan. Methods: A total of 936 antenatal women met the eligibility criteria and were enrolled in a cross-sectional study using proportionate stratified random sampling. Data on social support from the spouse, family and friend were obtained using a 5-point Likert scale while physical activity was assessed using a short version of the Interna-tional Physical Activity Questionnaire (IPAQ). Statistical analysis was conducted using chi-square test to evaluate the association between the study variables. Results: A total of 880 respondents completed the questionnaire. Out of that, 64.2% were physically inactive. Significant associations were found between social support from the spouse (p < 0.001), family (p = 0.001) and friends (p = 0.004) with the level of physical activity among the respondents. Conclusion: Social support plays a pivotal role in motivating antenatal women to perform physical activity. Thus, health intervention on physical activity among these women should involve the spouse, family members and friends to ensure the success of the program.
    Matched MeSH terms: Back Pain
  14. Tan K, Kwek E
    Malays Orthop J, 2020 Mar;14(1):24-27.
    PMID: 32296478 DOI: 10.5704/MOJ.2003.004
    Introduction: Orthopaedic surgeons are significantly predisposed to musculoskeletal injury, and these injuries can have negative effects on surgeon function and patient outcomes. While this phenomenon has been studied in the non-Asian population of surgeons, no study has been carried out in the local or regional Asian setting. The aim of this study was to determine the prevalence, characteristics and associations of occupational injuries in orthopaedic surgeons and residents, and to assess its functional impact.

    Materials and Methods: The Nordic Musculoskeletal Questionnaire was sent out to all orthopaedic consultants and residents at two institutions in Singapore, via an email link to an online survey. Separately, further questions on symptom description, severity and treatment were surveyed. Additional information like age, gender, height and weight were obtained as well.

    Results: A total of 87.5% respondents have at least one injury. Neck symptoms (66.1%) were the most prevalent, and back symptoms had the highest median severity score (4.5/10). The 74.1% of these injuries were reported as directly attributable to work. Age was found to be associated with an increase in the total number of anatomical areas affected (p = 0.016). A seated operating position was associated with more severe back pain (p = 0.040).

    Conclusion: There is a high prevalence of occupational injuries sustained in our population of orthopaedic surgeons. Neck symptoms, followed by back and wrist symptoms, were the predominant symptoms in our population. Targeted ergonomic interventions may be considered to prevent specific musculoskeletal injuries in our population of orthopaedic surgeons.

    Matched MeSH terms: Back Pain
  15. Ong TK
    Eur Endod J, 2019;4(3):145-149.
    PMID: 32161902 DOI: 10.14744/eej.2019.03016
    A 27-year-old male patient complained of dental pain on previously root-treated tooth #17. Intentional replantation (IR) was performed. However, the symptoms returned at 10 months of follow-up, and a sinus tract was detected on the buccal gingiva of tooth #17. The patient refused extraction of the tooth and tooth was scheduled for non-surgical retreatment. Root canal retreatment was initiated with the removal of the previous root filling material while leaving the retrograde filling in situ. After 1 month of intracanal medication, the tooth became asymptomatic with complete healing of the sinus tract and the root canal filling was completed. Clinical and radiographic examination at 1 year follow-up revealed endodontic success with complete resolution of periapical radiolucency. This case report shows that non-surgical retreatment could be a viable alternative for failed IR.
    Matched MeSH terms: Pain
  16. Swarna Nantha Y, Yeoh MH, Sharif SM
    Malays Fam Physician, 2019;14(3):60-64.
    PMID: 32175042
    Langerhans cell histiocytosis (LCH) in adults is rare and regarded as an 'orphan disease.' The systemic symptoms of LCH can mimic many other undifferentiated diseases seen at the primary care level. Failure to diagnose and delays in referral are common pitfalls in the management of this disease. We present a case of a 34-year-old woman with referred knee pain who was eventually diagnosed with multi-system LCH 4 years after the initial presentation. The mean age of presentation of LCH symptoms in adults is 33. Bone lesions are the frequent presentation of LCH in this age group. Endocrine involvement in LCH is seen in the form of diabetes insipidus (DI), which remains the most common extraskeletal presentation of LCH in adults. In the case discussed here, a definitive diagnosis of LCH was established through tissue biopsy. The spectrum of undifferentiated symptoms underscores the difficulty and delay in making a diagnosis associated with the condition. Most GPs not only face the predicament of initial recognition but also fail to merge presenting symptoms to form a purposeful referral of this elusive disease to a tertiary care unit.
    Matched MeSH terms: Pain
  17. Mohamad Isa MZ, Mohamed-Yassin MS, Abdul Kadir RF
    Clin Pract, 2020 Mar 31;10(1):1218.
    PMID: 32373307 DOI: 10.4081/cp.2020.1218
    Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.
    Matched MeSH terms: Shoulder Pain
  18. Ong Lay Keat W, Lechmiannandan S, Manoharan D, Lee SB, Nagalingam P
    Int J Surg Case Rep, 2020;73:161-163.
    PMID: 32688238 DOI: 10.1016/j.ijscr.2020.07.013
    INTRODUCTION: Testicular infarction as a result of severe epididymo-orchitis is an uncommon urological emergency, with only a handful of reported cases in literature. We report an even rarer case of bilateral epididymo-orchitis complicated with testicular infarction, resulting in bilateral orchidectomy.

    PRESENTATION OF CASE: 49 year old gentleman presented with fever, persistent, unresolving pain and scrotal swelling of two weeks duration. Despite close clinical monitoring, timely ultrasounds of the testis and antibiotics there was an inexorable progression to bilateral testicular ischemia.

    DISCUSSION: This is only the second reported case of this nature in published literature. Epididymo-orchitis usually responds well to appropriate antibiotic therapy, although progression to testicular infarction is possible.

    CONCLUSION: Clinical presentation of persistent scrotal pain and oedema in cases of epididymo-orchitis should raise strong suspicion of testicular ischemia or infarction. Despite all efforts, progression to bilateral testicular infarction resulting in castration is a possible catastrophic outcome.

    Matched MeSH terms: Pain
  19. Fatin Amirah Burhanuddin, Moey Soo Foon
    MyJurnal
    Breast cancer is commonest disease amongst women throughout the world and the second leading cause of women’s death. Since 2014, it was reported that approximately 5000 women
    were diagnosed with breast cancer every year in Malaysia. Adoption of mammography screening
    amongst Malaysian women remains under-utilized because it depends on self-initiatives of
    individuals. Amongst the perceived barriers are low knowledge, cost, embarrassment and pain which may then give a negative psychological aspect to health behavior actions. The study aims to determine the level of knowledge and perceived barriers pertaining to mammography amongst female lecturers in Kulliyah of Allied Health Sciences (KAHS), International Islamic University Malaysia (IIUM) Kuantan, Pahang. Methods: A survey was carried out on female lecturers aged 35 years and above in KAHS, IIUM Kuantan. A self-administered questionnaire which consists of three sections; demographic factors, knowledge about breast cancer and perceived barriers pertaining to
    mammography were distributed to 30 respondents. Data was analyzed using SPSS version 19.0.
    Results: The mean age of respondents was 39.9 years old (SD ± 5.15). Majority of respondents possessed good knowledge of breast cancer. The perceived barriers pertaining to mammography amongst respondents were pain and the procedure being expensive. Conclusions: This study found that most female lecturers in KAHS, IIUM Kuantan possessed good knowledge on breast cancer but have fair knowledge pertaining to breast lumps and the best time for breast screening. The perceived barriers amongst respondents were pain and cost of the procedure.
    Matched MeSH terms: Pain
  20. Balakrishnan, Yogambigai, Nor Hasnina Mohd Hassan, Wan Najwa Zaini Wan Mohamed
    MyJurnal
    Osteochondromyxoma is a rare bone tumour. Bone tumours of the talus are also uncommon, and accounts to be between 8% to 23% in tumours of the foot. A 28-year-old man presented with chronic right ankle pain. He had underlying left knee ligament and meniscal injury. Special examination tests for ligament injury were negative. Magnetic Resonance Imaging (MRI) revealed a benign bone lesion of talus with reactive oedema of sinus tarsi. Excision of lesion was done and subsequent histopathological examination confirmed the diagnosis of ostechondromyxoma.
    Matched MeSH terms: Pain
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