Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.
The purpose of this study was to determine when cuff re-tear commonly occurs in the postoperative period and to investigate the clinical factors that might predispose to an early cuff re-tear.
To evaluate the ultrasound morphology and its clinical outcome among women who had undergone Miniarc™ vs Monarc™ in the treatment of stress urinary incontinence (SUI).
The accumulation of autophagosomes in the terminal step of the autophagic process has recently emerged as a potentially maladaptive process in the septic heart and lung. However, the role of autophagy in the septic liver has not been ascertained. This study was investigated by first examining the entire sequence of the autophagic process in the liver of septic mice. Second, a novel pharmacotherapeutic approach was utilized to treat sepsis with autophagy enhancer/inhibitor. Sepsis was induced by cecal ligation and puncture (CLP). C57BL/6 mice received autophagy enhancer carbamazepine (CBZ), autophagy inhibitor 3-methyladenine (inhibition of autophagosomal formation), or chloroquine (impairment of autophagosomal clearance). We found that the whole autophagic process was activated at 4 h after CLP; however, it did not proceed to completion during the 4- to 24-h time period, as indicated by accumulated autophagosomes and decreased autophagic flux. Carbamazepine, which induced complete activation of the autophagic process, improved CLP survival. This protective effect was also associated with decreased cell death, inflammatory responses, and hepatic injury. However, disruption of autophagosomal clearance with chloroquine abolished the above protective effects in CBZ-treated CLP mice. 3-Methyladenine, which resulted in inhibition of the autophagosomal formation, did not show any above beneficial effects in CLP mice. Impaired autophagosome-lysome fusion resulting in incomplete activation of autophagy may contribute to sepsis-induced liver injury. Treatment with CBZ may serve a protective role in the septic liver, possibly through the effect of complete activation of autophagic process.
We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.
Study a collaboration between Malaysia and Australia
The benefit of wearing a rear seatbelt in reducing the risk of motor vehicle crash-related fatalities and injuries has been well documented in previous studies. Wearing a seatbelt not only reduces the risk of injury to rear-seat passengers, but also reduces the risk of injury to front-seat occupant who could be crushed by unbelted rear-seat passengers in a motor vehicle crash. Despite the benefits of wearing a rear seatbelt, its rate of use in Malaysia is generally low. The objective of this study was to identify factors that are associated with the wearing of a seatbelt among rear-seat passengers in Malaysia. Multinomial logistic regression analysis of the results of a questionnaire survey of 1651 rear-seat passengers revealed that rear-seat passengers who were younger, male, single and less educated and who had a perception of a low level of legislation enforcement, a lower risk-aversion and less driving experience (only for passengers who are also drivers) were less likely to wear a rear seatbelt. There was also a significant positive correlation between driver seatbelt and rear seatbelt-wearing behaviour. This implies that, in regards to seatbelt-wearing behaviour, drivers are more likely to adopt the same seatbelt-wearing behaviour when travelling as rear-seat passengers as they do when driving. These findings are crucial to the development of new interventions to increase the compliance rate of wearing a rear seatbelt.
Matched MeSH terms: Wounds and Injuries/prevention & control*
The use of patient-controlled analgesia (PCA) has been reported to provide effective pain relief, often resulting in less opioid consumption, and is associated with greater patient satisfaction when it is compared to other techniques of analgesia delivery.
Matched MeSH terms: Wounds and Injuries/complications*
The World Health Organization (WHO) estimates that injury will be the second leading cause of morbidity of disease burden worldwide by the year 2020. We conducted a community-based survey to determine the prevalence of recent illness and injury, in Malaysia. The survey was a cross sectional population-based household survey conducted using face to face interviews. The information was on self-reported recent illness and injury (SRRII) over the previous 2 weeks. This study was conducted during April - August 2006 and as a part of the third National Health and Morbidity Survey of Malaysia. A total of 56,710 respondents were interviewed with a response rate of 98.2% (55,660/56,710). The overall prevalence of combined SRRII was 23.6%; for injuries the prevalence was 3.1%. The groups with the highest SRRII were children 0-5 years old (31.2%), males (24.3%), Indians (26.9%), those with secondary education level (22.9%), those earning RM 1,000/ month (25.0%) and rural dwellers (25.5%). Age, sex, ethnicity, and locality were significantly associated with SRRII while monthly household income and educational level were marginally associated. On multivariate analysis, age, gender, race, ethnicity, education, income and locality were significantly associated with SRRII. The most common reported recent illness was related to the respiratory system (42.0%). The information obtained from this survey is useful to policy makers in the Ministry of Health to review and strengthen existing health programs.
Study name: National Health and Morbidity Survey (NHMS-2006)
Matched MeSH terms: Wounds and Injuries/epidemiology*
The purpose of this study was to analyze people's attitudes to disasters by investigating how people feel, behave and think during disasters. We focused on disasters induced by humans, such as terrorist attacks. Two types of textual information were collected - from Internet blogs and from research papers. The analysis enabled forecasting of attitudes for the design of proactive disaster advisory scheme. Text was analyzed using a text mining tool, Leximancer. The outcome of this analysis revealed core themes and concepts in the text concerning people's attitudes. The themes and concepts were sorted into three broad categories: Affect, Behaviour, and Cognition (ABC), and the data was visualized in semantic maps. The maps reveal several knowledge pathways of ABC for developing attitudinal ontologies, which describe the relations between affect, behaviour and cognition, and the sequence in which they develop. Clearly, terrorist attacks induced trauma and people became highly vulnerable.
Matched MeSH terms: Wounds and Injuries/psychology
To describe the bowel programmes utilized by individuals with spinal cord injury; and to determine the association between the outcome of the bowel programmes and various interventions to facilitate defecation.
Understanding the mechanisms underlying the process of regeneration and repair of airway epithelial structures demands close characterization of the associated cellular and molecular events. The choice of an animal model system to study these processes and the role of lung stem cells is debatable since ideally the chosen animal model should offer a valid comparison with the human lung. Species differences may include the complex three-dimensional lung structures, cellular composition of the lung airway as well as transcriptional control of the molecular events in response to airway epithelium regeneration, and repair following injury. In this paper, we discuss issues related to the study of the lung repair and regeneration including the role of putative stem cells in small- and large-animal models. At the end of this paper, the author discuss the potential for using sheep as a model which can help bridge the gap between small-animal model systems and humans.
We report 2 patients with congenital pseudoarthrosis of the tibia who underwent intramedullary Rush rod transfixation through the ankle joint following refracture and nonunion of vascularised fibular grafting 6 and 8 months earlier. After 9 and 5 years, both Rush rods were broken at the level of the ankle joints, while the reconstructed area was solidly united. The growth of the distal tibia increased the distance of the tips of the broken rod and hence the ankle joint motion. The broken tips may damage the articular cartilage and result in valgus deformity of the ankle and limb length discrepancy.
This study aimed to assess the knowledge of blood-borne diseases transmitted through needle stick injuries amongst health-care workers in a tertiary teaching hospital. We also aimed to assess the practices of universal precautions amongst these workers and its correlation with the facts. We carried out a cross-sectional study from January to July 2008 involving various levels of health-care workers in Serdang Hospital, Selangor, Malaysia. A self-administered questionnaire assessing knowledge of blood-borne diseases and universal precautions, and actual practice of universal precautions was used. Two hundred fifteen respondents participated in this study; 63.3% were staff nurses. The mean knowledge score was 31.84 (SD 4.30) and the mean universal practice score was 9.0 (SD 2.1). There was a small, positive correlation between knowledge and actual practice of universal precautions (r = 0.300, n = 206, p < 0.001) amongst the cohort studied. Factors such as age and years of experience did not contribute towards acquisition of knowledge about blood-borne illnesses or the practice of universal precautions.
The facial region has been the most common site of injury following violent episodes. The purpose of this study was to determine the prevalence and pattern of maxillofacial injuries associated with intimate partner violence (IPV) in women treated at a single facility in Malaysia.
Facial burns are common and have a significant impact on patient function and psychosocial well being. Human amnion has been used for many years as a temporary biological wound dressing in the management of partial thickness burns. The observed advantages of human amnion treatment include pain relief, ease of use, prevention of infection and acceleration of wound healing.
Domestic maid violence is an assault and coercive behaviour, which mainly includes physical, psychological and at times sexual too, by employer or household members of employer against a person hired as a domestic help. Maid abuse is well known but poorly documented in scientific literature. This is an important global issue. In this article, two illustrated cases of maid abuse are discussed. Their employers allegedly subjected both the victims to physical and psychological trauma. The physical examination of the victims showed poor state of clothing, nutrition, and presence of injuries of different duration. The bruises were irregular to patterned, and were inflicted by beating. Both cases had eczematous contact dermatitis over palms and soles, paronechia, and sub-ungal fungal infection due to unprotected working in wet conditions. In both cases, external ears were deformed like cauliflowers due to repeated trauma. All cases had multiple injuries of varying duration. In this paper, medico-legal and social issues related to maid abuse are also discussed in detail. A possible solution to minimise maid abuse is also suggested. This paper highlights and document maid abuse.
A teenager college student was fatally injured by burst tyre air pressure while waiting on a public bus stand to catch a bus to reach her college at Kuala Lumpur. She accidentally came near the wheel while boarding when tube and tyre got burst .The air pressure had blown the girl in the air and she subsequently fell on a rough surface. The iron-locking rim of the wheel acted as a missile and hit the girl. She died on her way to the hospital. A medico-legal autopsy was performed which showed extensive injuries in the cranial and chest cavity. Head had large scalp laceration with diffuse separation and gaping from in the vault region; skull bones were fractured. Chest cavity had extensive rib fractures, lacerated lungs and haemo-thorax while externally there was no obvious injury. It requires intensive care management and screening of the victims. Tyre-blast injuries are not so common. This case exposes the hazard due to burst tyre.
In this study, porous hydroxyapatite (HA) samples were fabricated via sponge techniques with the aid of sago as part of the binder mixture. Development processes for the production of porous bone graft substitutes are studied using polyurethane sponge. To obtain the optimum amount of binder for successful fabrication of porous HA were done. Initially, porous HA powder was synthesized using calcium hydroxide and orthorphosphoric acid. Meanwhile, sago was mixed with PVA in a certain ratio to be used as binder for preparing the porous HA. After a series of investigative tests were conducted to characterize the sintered samples, the use of the sago and polymeric mixture was found to successfully aid the fabrication of porous HA samples. In this investigation, comparison of physical and mechanical characteristics between samples prepared using difference techniques was made.
Post-radiation large vessel injury has not received as much attention as microvascular irradiation injury. A few studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy to the head and neck. However, in most of these studies, the irradiated subjects also had other major risk factors for atherosclerosis. In this study, irradiated subjects with major risk factors such as hypertension, diabetes, history of previous cerebrovascular accident and connective tissue disorder were excluded.