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Comparison of knowledge level and attitude towards obstructive sleep apnoea amongst dental and medical undergraduate students of Universiti Sains Malaysia

Selvaraj S, Eusufzai SZ, Asif JA, Bin Jamayet N, Ahmad WMAW, Alam MK

Work, 2021;69(1):173-180.
PMID: 33998580 DOI: 10.3233/WOR-213466

BACKGROUND: Sleep apnoea is a diagnosed condition in which appurtenances interrupt breathing whilst sleeping. The consequence of obstructive sleep apnoea (OSA) includes road traffic accidents due to drowsiness, systemic hypertension, heart disease, diabetes mellitus and neurocognitive disorders. This condition extends the duration of recovery phase after traumatic brain injury.
OBJECTIVE: This study was intended to assess the knowledge and attitude towards OSA and compare it among dental and medical undergraduate students of University Sains Malaysia (USM).
METHODS: In this study, a total of 216 clinical undergraduate students (36 from each year; 108 from medical and 108 from dental school) of University Sains Malaysia (USM) Health campus were recruited for the study by non-probability stratified random sampling method. Total study period was October 2017 to October 2018. A self-administered questionnaire was used to assess the sociodemographic status and OSAKA questionnaire was used to assess knowledge and attitude regarding sleep apnoea of the respondents. Descriptive analysis was carried out to assess the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM. The Mann-Whitney U test was carried out to compare the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM.
RESULTS: Our study findings revealed that 0.9 %and 6.5 %of the dental undergraduate students and medical undergraduate students could answer all the questions correctly regarding knowledge of OSA. Based on the assessment of the difference between medical and dental students in terms of knowledge towards OSA patients, significant difference was observed at the significance level of 95%, where p

Matched MeSH terms: Brain Injuries, Traumatic
Fulltext An epidemiological study of abdominal and pelvic injury trauma in post-mortem cases at Hospital Kuala Lumpur between the year of 2002-2003

Abdul Halim Mansar, Muhammad Aadeel T., Khairul Osman, Sharin Iskandar, A.W.

Jurnal Sains Kesihatan Malaysia, 2008;6(2):65-73.
MyJurnal

The abdominal pelvic cavity has always been regarded as one of the most vulnerable regions of the body. Injuries to this part have been known to be very serious. Based on this a retrospective study was performed on postmortem cases with abdominal and pelvic trauma from 1 October 2002 to 31 January 2003 at the Forensic Institute, Hospital Kuala Lumpur to determine the common pattern of abdomino-pelvic injuries, the injury’s relationship to epidemiological and socio-economic factors, risk organ within the abdominopelvic region and relationship between injuries and survival period. A total of 122 cases abdomino-pelvic were obtained stemming from medico legal postmortems procedures. Results indicated that those aged between 21 to 30 years (38.5%) had the highest incidence of this type of injury. Categorization based on gender showed that males (90.2%) dominated most of the cases. Prevalence based on socio-economic status showed that lower socioeconomy class (52.5%) had the highest incident. This was followed by the middle income (39.3%) and finally the higher income group. The most numerous type of trauma was non-penetrating trauma (94.3%). It was also found that victims with low injury severity score (ISS) had a longer survival period as compared to those with high ISS. It was also noted that victims with two or more region injuries either were spot dead or brought dead. The most common combination of injuries was abdomen, pelvic, chest and limb. In most blunt trauma cases majority of victims had one or two organ involvement while penetrating injuries were difficult to asses. The most common organ involved in this type of trauma was liver (72.1%), pelvic bone (47.5%) and spleen (43.4%). In conclusion, abdomino-pelvic injury is a serious condition and should not be overlooked. Proper attention towards their diagnosis and management is important and so any patient of head injury with coma must be considered as having intra-abdominal injury until proven otherwise.

Matched MeSH terms: Abdominal Injuries
Fulltext Anterior penetrating chest injury with left ventricular thrombus

Ruth Sabrina, S., Nik Azlan, N.M., Adi, O.

Medicine & Health, 2013;8(1):28-32.
MyJurnal

Urban cities are synonym with a high incidence of penetrating chest injuries either from accidents or interpersonal violence. The outcome of penetrating chest wound can vary from immediate death to a prolonged morbidity. We here report a case of 39-year-gentleman who presented to Emergency Department Hospital Raja Permaisuri Bainun, Ipoh, Perak after being stabbed to the chest. His anterior penetrating chest wound was located at the 5th intercostal space medial to the midclavicular line. The stab wound penetrated the myocardium, causing minimal myocardial rupture. He also suffered from left haemothorax and hemopericardium. The haemothorax was drained with insertion of 32 French chest tube. The patient was admitted under the cardiothoracic team and discharged five days later without surgical intervention. He presented again to the Emergency Department with complains of shortness of breath and pleuritic pain. A left ventricular thrombus was detected via echocardiography. Unfortunately, he took his own discharge. Five days later he came again to Emergency Department with sporadic of loss of vision. The mural thrombus dislodged and embolized to the retinal artery causing amaurosis fugax. The patient was treated with aspirin 150mg and his symptoms subsequently resolved.

Matched MeSH terms: Thoracic Injuries
Fulltext The Flail and Pulseless Upper Limb: an Extreme Case of Traumatic Scapulo-thoracic Dissociation

Maria SW, Sapuan J, Abdullah S

Malays Orthop J, 2015 Jul;9(2):54-56.
PMID: 28435612 MyJurnal DOI: 10.5704/MOJ.1507.002

Scapulo-thoracic dissociation is an infrequent injury resulting from high energy trauma which is often associated with severe neurological and vascular injuries which may be unrecognised at the time of presentation. A 24 year-old female presented with bilateral rib fractures, pneumothorax, liver and kidney injuries following a road traffic accident. She also sustained fractures of her right scapula, odontoid, right transverse processes of the thoracic and lumbar vertebrae and a closed fracture of her right femur. Her right upper limb was later noted to be flail and pulseless, due to complete right brachial plexus injury, scapula-thoracic dissociation and subclavian artery avulsion. We managed the upper limb injuries non-operatively, and focused on resuscitation of the patient. Early exploration of the complete brachial plexus injury was not undertaken in spite of the possible associated poor functional outcome as there was no life-threatening indication.

Matched MeSH terms: Vascular System Injuries
Fulltext Needlestick injury: a review of twelve theses among healthcare personnel in Malaysia

Noor Hassim Ismail, Rosnah Ismail, Rampal, K.G.

Malaysian Journal of Community Health, 2009;15(1):47-50.
MyJurnal

Aims : The review was to determine the prevalence of needlestick injury especially among health care personnel and to determine the score of knowledge and compliance to the Standard Universal Precaution.
Method : Twelve theses were reviewed from year 1996 to 2007 of Master in Community Health Science, Master in Community Health and Postgraduate Diploma in Occupational Health of Community Health Department Universiti Kebangsaan Malaysia Medical Center involving of 1645 respondents of health care personnel, support staff and student of nursing and medical. Eleven studies were cross sectional design and only one study was retrospective.
Results : Respondents were dominated by female (74.6%) and Malay ethnicity (65%), as young as 19 years old to 56 years old of age. Majority had received Hepatitis B vaccination (79.4%) but only 37.1% had completed the 3 doses regime. The incidence of episodes of needle stick injury among health care personnel was double (53.7%) compared to final year medical students (20.9%). Needle stick injuries did not occur at random as there were a few health care personnel injured repeatedly. Those who had higher mean or median score for compliance to Standard Universal Precaution were non case of needlestick injury. Work practices had been highlighted in few studies of being risk factors for needlestick injury such as blood withdrawing related activities. Other risk factors were job category, predictive factor for compliance to Standard Universal Precaution, risk perception and training.
Conclusion : Even though the review could not extrapolated to general population of healthcare personnel but it gave some illustrated pictures to what had happened in small clustered locations. Episodes of needle stick injury was 53.7% for past 12 years, it was double in comparison to final year medical students in year 2001. 13.2% were injured repeatedly. The score of knowledge was more the 50% of range but compliance to Standard Precaution made differences in being cases or non cases among respondents. The seroconversion status till date was unknown.

Matched MeSH terms: Needlestick Injuries
Fulltext Incidence and predictors of early ankle contracture in adults with acquired brain injury

Norhamizan Hamzah, Muhammad Aizuddin Bahari, Saini Jeffery Freddy Abdullah, Mazlina Mazlan

Neurology Asia, 2015;20(1):49-58.
MyJurnal

Objective: To determine the incidence and predictors of early ankle contracture in adults with acquired brain injury. Methods: A prospective cohort study of patients admitted to Neurosurgical Intensive Care Unit (NICU), University Malaya Medical Centre and referred for rehabilitation within a period of 12 months. Adult patients with newly diagnosed acquired brain injury with no prior deformity to lower limbs, Glasgow Coma Scale ≤ 12, no concomitant spinal or lower limb injuries, medical stability at inclusion into the study and agreed to participate for the total duration of assessment (3 months) were recruited. We conducted weekly review of ankle muscle tone and measurement of ankle maximum passive dorsiflexion motion. The end point is reached if ankle contracture developed or completed 3 months post injury assessment. Results: The cohort included 70 patients, of which only 46 patients completed the study. Twenty-eight patients suffered from severe brain injury whilst 18 from moderate brain injury. Out of the 46 patients, 13 (28%) developed ankle contracture at the end of the study period. Abnormal motor pattern was significantly associated with incidence of ankle contracture, which included spasticity (p

Matched MeSH terms: Brain Injuries
Glutamate receptors and transporters as comparative cues to the glutamatergic circuits of the avian and mammalian brain

Islam, M.R., Muzaimi, M., Abdullah, J.M.

Orient Neuron Nexus, 2011;2(1):2-9.
MyJurnal

Glutamate is the principal excitatory neurotransmitter in the central nervous system, and plays important roles in both physiological and pathological neuronal processes. Current understanding of the exact mechanisms involved in glutamate-induced neuronal excitotoxicity, in which excessive glutamate causes neuronal dysfunction and degeneration, whether acute or chronic, remain elusive. Conditions, due to acute insults such as ischaemia and traumatic brain injury, and chronic neurodegenerative disorders such as multiple sclerosis and motor neuron disease, suffer from the lack of translational neuroprotection in clinical setting to tackle glutamate excitotoxicity despite steady growth of animal studies that revealed complex cell death pathway interactions. In addition, glutamates are also released by non-neuronal cells including astrocytes and oligodendroglia. Thus, attempts to elucidate this complexity are closely related to our understanding of the glutamatergic circuitry in the brain. Neuronal cells develop a glutamatergic system at glutamatergic synapses that utilise glutamate as an intercellular signaling molecule to characterise the output, input, and termination of this signaling. As to signal input, various kinds of glutamate receptors have been identified and characterized. Na+-dependent glutamate transporters at the plasma membrane are responsible for the signal termination through sequestration of glutamate from the synaptic cleft. The signal output systems comprise vesicular storage and subsequent exocytosis of glutamate by using vesicular glutamate transporters. Similar to the mammalian brain, the regional differences of glutamatergic neurons and glutamate receptor neurons suggest many glutamatergic projections in the avian brain, as supported by recent evidence of glutamate-related genes distribution. Glutamatergic target areas are expected to show high activity of glutamate transporters that remove released glutamate from the synaptic clefts. This review summarises and compares glutamatergic circuits in the avian and mammalian brain, particularly in the olfactory pathway, the paffial organization of glutamatergic neurons and connection with the striatum, hippocampal-septal pathway, visual and auditory pathways, and granule cell-Purkinje cell pathway in the cerebellum. Comparative appreciation of these glutamatergic circuits, particularly with the localisation and/or expression of specific subtypes of glutamate transporters, would provide the morphological basis for physiological and pharmacological designs that supplement existing animal studies of the current proposed mechanisms that underlie glutamate-induced neuronal excitotoxicity.

Matched MeSH terms: Brain Injuries
A report on needle stick injuries for the year 2000

Lim JF

Journal of Occupational Safety and Health, 2004;1(2):82-88.
MyJurnal

Workers in the health care industry and related occupations are at risk of occupational exposure to blood borne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other potentially infectious agents. The primary route of occupational exposure to blood borne pathogens is accidental percutaneous (through the skin) injury. Health care workers handle sharp devices and equipment such as hypodermic and suture needles, intravenous blood collection devices, phlebotomy devices, and scalpels. Health care workers with the most involvement in direct patient care e.g., nursing staff, sustain the highest proportion of reported NSIs (needle stick injuries).

Matched MeSH terms: Needlestick Injuries
Fulltext Working Memory From the Psychological and Neurosciences Perspectives: A Review

Chai WJ, Abd Hamid AI, Abdullah JM

Front Psychol, 2018;9:401.
PMID: 29636715 DOI: 10.3389/fpsyg.2018.00401

Since the concept of working memory was introduced over 50 years ago, different schools of thought have offered different definitions for working memory based on the various cognitive domains that it encompasses. The general consensus regarding working memory supports the idea that working memory is extensively involved in goal-directed behaviors in which information must be retained and manipulated to ensure successful task execution. Before the emergence of other competing models, the concept of working memory was described by the multicomponent working memory model proposed by Baddeley and Hitch. In the present article, the authors provide an overview of several working memory-relevant studies in order to harmonize the findings of working memory from the neurosciences and psychological standpoints, especially after citing evidence from past studies of healthy, aging, diseased, and/or lesioned brains. In particular, the theoretical framework behind working memory, in which the related domains that are considered to play a part in different frameworks (such as memory's capacity limit and temporary storage) are presented and discussed. From the neuroscience perspective, it has been established that working memory activates the fronto-parietal brain regions, including the prefrontal, cingulate, and parietal cortices. Recent studies have subsequently implicated the roles of subcortical regions (such as the midbrain and cerebellum) in working memory. Aging also appears to have modulatory effects on working memory; age interactions with emotion, caffeine and hormones appear to affect working memory performances at the neurobiological level. Moreover, working memory deficits are apparent in older individuals, who are susceptible to cognitive deterioration. Another younger population with working memory impairment consists of those with mental, developmental, and/or neurological disorders such as major depressive disorder and others. A less coherent and organized neural pattern has been consistently reported in these disadvantaged groups. Working memory of patients with traumatic brain injury was similarly affected and shown to have unusual neural activity (hyper- or hypoactivation) as a general observation. Decoding the underlying neural mechanisms of working memory helps support the current theoretical understandings concerning working memory, and at the same time provides insights into rehabilitation programs that target working memory impairments from neurophysiological or psychological aspects.

Matched MeSH terms: Brain Injuries, Traumatic
Fulltext Actinomycosis of Distal Phalanx Twenty Years after Flap Reconstruction of Index Finger: A Case Report

Prashant N, Azuhairy A

Malays Orthop J, 2018 Mar;12(1):48-50.
PMID: 29725514 MyJurnal DOI: 10.5704/MOJ.1803.011

Actinomycosis is a chronic granulomatous suppurative infection caused by anaerobic bacteria from genus Actinomyces which are normal flora of mouth, colon and vagina. Actinomycosis of upper extremity is rare. We report a case of actinomycosis of the distal phalanx of finger many years after flap reconstruction. The patient presented with two months' history of chronic discharging sinus from the tip of his right index finger, which had sustained a degloving injury 20 years previously. It had been treated with an anterior chest wall flap which had healed uneventfully but was bulky due to excess tissue from the donor site. Radiograph revealed osetomyelitis changes of distal phalanx. Debulking surgery with curettage of the distal phalanx was done. Wound healing was uneventful. He was treated with six weeks of metronidazole and ciprofloxacin. The discharge from the distal phalanx cultured actinomycosis odontolyticus. Histopathology of the debrided tissue showed chronic inflammation. As far as we are aware, there are no reports of actinomycosis in a flap involving the finger treated previously with a chest wall skin flap. The infection was probably dormant for many years before manifesting as a discharging sinus. Although the finger flap was bulky, it was not problematic until it started to have serous discharge. With a thorough debridement of all infected tissue, six weeks of antibiotic was adequate. Ciprofloxacin was prescribed based on discharge culture sensitivity. Metronidazole was added as actinomycosis is anaerobic. Response was prompt as patient was not immunocompromised. At follow-up six months post-surgery the finger had recovered with good function. If not for the discharging sinus, patient would probably have tolerated his bulky finger for the rest of his life.

Matched MeSH terms: Degloving Injuries
Fulltext Large leaking descemetocele presenting as a traumatic corneal laceration

Logeswary, K., Jemaima Che-Hamzah, Aida Zairani, M.Z.

Journal of Surgical Academia, 2017;7(1):59-61.
MyJurnal

A 47-year-old healthy Indonesian gentleman, presented with blurring of vision on the left eye associated with pain
and redness after history of foreign body entering the eye. A general practitioner prescribed him some eye drops;
however, his symptoms worsened. A corneal laceration wound measuring 0.5 x 3.5mm with a large stromal abscess
measuring 9.0 x 5.0mm with flat anterior chamber was seen on the left eye. Emergency corneal T&S revealed a large
descemetocele and cyanoacrylate corneal glue was applied on the area. C&S showed Pseudomonas aeruginosa.
Patient was subsequently undergone penetrating keratoplasty as a definitive measure. This case highlights the rapid
progression of pseudomonas keratitis, presented with a large descemetocele, which can be mistaken as an infected
corneal laceration wound. Corneal cyanoacrylate glueing together with corneal suturing is a viable temporary method
for large descemetoceles awaiting definitive surgery.

Matched MeSH terms: Corneal Injuries
Fulltext Taurine protects against retinal and optic nerve damage induced by endothelin-1 in rats via antioxidant effects

Nor Arfuzir NN, Agarwal R, Iezhitsa I, Agarwal P, Sidek S, Ismail NM

Neural Regen Res, 2018 Nov;13(11):2014-2021.
PMID: 30233077 DOI: 10.4103/1673-5374.239450

Endothelin-1 (ET-1), a potent vasoconstrictor, is involved in retinal vascular dysregulation and oxidative stress in glaucomatous eyes. Taurine (TAU), a naturally occurring free amino acid, is known for its neuroprotective and antioxidant properties. Hence, we evaluated its neuroprotective properties against ET-1 induced retinal and optic nerve damage. ET-1 was administered intravitreally to Sprague-Dawley rats and TAU was injected as pre-, co- or post-treatment. Animals were euthanized seven days post TAU injection. Retinae and optic nerve were examined for morphology, and were also processed for caspase-3 immunostaining. Retinal redox status was estimated by measuring retinal superoxide dismutase, catalase, glutathione, and malondialdehyde levels using enzyme-linked immuosorbent assay. Histopathological examination showed significantly improved retinal and optic nerve morphology in TAU-treated groups. Morphometric examination showed that TAU pre-treatment provided marked protection against ET-1 induced damage to retina and optic nerve. In accordance with the morphological observations, immunostaining for caspase showed a significantly lesser number of apoptotic retinal cells in the TAU pre-treatment group. The retinal oxidative stress was reduced in all TAU-treated groups, and particularly in the pre-treatment group. The findings suggest that treatment with TAU, particularly pre-treatment, prevents apoptosis of retinal cells induced by ET-1 and hence prevents the changes in the morphology of retina and optic nerve. The protective effect of TAU against ET-1 induced retinal and optic nerve damage is associated with reduced retinal oxidative stress.

Matched MeSH terms: Optic Nerve Injuries
Fulltext Stem cells research: therapeutic potentials and ethical issues from Islamic perspective

Che Anuar Che Mohamad, Abdurezak Abdullahi Hashi

International Medical Journal Malaysia, 2018;17(101):65-69.
MyJurnal

The advancement in human stem cell research has promised a viable alternative treatment for a range of ‘incurable diseases’ such as neurological diseases. To date, several studies have documented substantial evidences on the therapeutic properties of stem cells in promoting repair in different diseases including common neurological disorders i.e. ischaemic stroke and spinal cord injury. However, the progress of stem cell research has been surrounded by ethical issues which largely due to the usage of human embryos as one of the sources. These embryonic stem cells which originally derived from human embryo of aborted foetus or already existing human embryonic stem cells (hESCs) lines, has sparked an intense moral and religious argument among people of various faith, including Muslim community. From the therapeutic point of view, amongst the currently available stem cells, hESCs show the greatest potential for the broadest range of cell replacement therapies and are regarded as the most commercially viable. This review focuses on the major ethical issues, particularly to Muslim community, related to human embryonic stem cells research with special emphasis on the moral status of the embryo and the beginning of life according to the Islamic ethics and rulings. In this paper, we also discuss some ethical positions towards embryonic stem cell research in the Islamic world, including official regulations existing in some Muslim countries. We examine the justification and the necessity on the usage of hESCs following the newly discovered Induced Pluripotent Stem Cells (IPSCs) in the laboratory. In addition, we supplement the discussions with the general views and positions from the other two Abrahamic religions i.e. Christianity and Judaism.

Matched MeSH terms: Spinal Cord Injuries
Treatment of the fractures of the jaws

Tratman EK

Journal of the Malaya Branch of the British Medical Association, 1940;3:357-73.

Matched MeSH terms: Wounds and Injuries
Fulltext Arthrofibrosis Following Anterior Cruciate Ligament Reconstruction

Rushdi I, Sharifudin S, Shukur A

Malays Orthop J, 2019 Nov;13(3):34-38.
PMID: 31890108 DOI: 10.5704/MOJ.1911.006

Introduction: Anterior cruciate ligament (ACL) tear is a frequent injury and its reconstruction is among the most commonly performed orthopaedic surgical procedures. ACL reconstruction generally yields good results. However, its recovery can be hampered by the development of postoperative complications. The aim of this study was to review complications following arthroscopic ACL reconstruction done in Hospital Raja Permaisuri Bainun, Ipoh and Hospital Teluk Intan, Perak with the emphasis on arthrofibrosis. Arthrofibrosis is defined as a loss of 15 degrees extension or more, with or without flexion loss compared to the contralateral knee. Materials and Methods: The study is based on a series of retrospective cases, on which medical records of 200 patients who underwent ACL reconstruction surgeries between March 2007 and December 2014 were reviewed. Follow-up treatment records were available for 166 patients (83%). The data was analysed to identify the risk factors for developing complications with an emphasis on arthrofibrosis. Results: Eight patients (5%) developed arthrofibrosis in the post-operative period. Early surgical intervention, preoperative limited range of motion and female gender are the risk factors correlate with arthrofibrosis. However, the type of graft used and meniscal procedure do not have a significant correlation with the development of arthrofibrosis. Other complications encountered are local infections, hypertrophic scar and chronic regional pain syndromes. Conclusion: The 5% incidence of arthrofibrosis following an ACL reconstruction in our centres can be reduced with proper preventive measures which include thorough preoperative evaluation, proper patient selection, restoration of ROM prior to surgery and proper timing of surgery.

Matched MeSH terms: Anterior Cruciate Ligament Injuries
Fulltext Determination of calorie and protein intake among acute and sub-acute traumatic brain injury patients

Abdullah MI, Ahmad A, Syed Saadun Tarek Wafa SWW, Abdul Latif AZ, Mohd Yusoff NA, Jasmiad MK, et al.

Chin J Traumatol, 2020 Oct;23(5):290-294.
PMID: 32423779 DOI: 10.1016/j.cjtee.2020.04.004

PURPOSE: Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu.
METHODS: This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO™ (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015).
RESULTS: Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate. The median length of hospital stay was 2 (IQR = 2.0-3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively.
CONCLUSION: Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

Matched MeSH terms: Brain Injuries, Traumatic
Fulltext Spectrum of penetrating cardiac injuries from flying feathers

Muhamad, N.A.R., Tuan Hairulnizam, T.K., Jessie, D.H., Rashidi, A., Jeewadas, B., Isa, A.Z., et al.

Malaysian Journal of Emergency Medicine, 2018;3(1):0-0.
MyJurnal

Flying feather is a traditional street weapon, which is believed to be originated from Philippine. It is a famous weapon in Tawau, Sabah, shot within short distance and being used with the aim to debilitate the victims. Some may even apply poison at the tip of the weapon. We report two cases of severe chest injuries in resulting from flying feathers. Case 1, a 25-year old man sustained left sided hemothorax with anterior right ventricle injury. He underwent thoracotomy and was discharged well. Case 2, a 40-year old man, presented to emergency department with no signs of life, sustained penetrating injury to the left second intercostal muscle, the pericardium and the anterior wall of the right ventricle adjacent to the interventricular septum. These cases highlight the severity spectrum of cardiac injury resulting from flying feathers.

Matched MeSH terms: Heart Injuries
Fulltext Psychometric properties of the malay language version of Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire among knee osteoarthritis patients: a confirmatory factor analysis

Zulkifli MM, Kadir AA, Elias A, Bea KC, Sadagatullah AN

Malays Orthop J, 2017 Jul;11(2):7-14.
PMID: 29021872 MyJurnal DOI: 10.5704/MOJ.1707.003

Introduction: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS) and to evaluate its psychometric properties in patients with knee osteoarthritis (OA). Materials and Methods: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. Results: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/degree of freedom= 2.183) indices to signify a model fit. The Cronbach's alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. Conclusion: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

Study site: Outpatient and orthopedic clinics, Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Knee Injuries
Effect of modified Otago exercises on postural balance, fear of falling, and fall risk in older fallers with knee osteoarthritis and impaired gait and balance: A secondary analysis

Mat S, Ng CT, Tan PJ, Ramli N, Fadzli F, Rozalli FI, et al.

PM R, 2018 03;10(3):254-262.
PMID: 28827207 DOI: 10.1016/j.pmrj.2017.08.405

BACKGROUND: Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited.
OBJECTIVE: To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems.
DESIGN: Randomized controlled trial.
SETTING: University of Malaya Medical Centre.
PARTICIPANTS: Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds.
MAIN OUTCOME MEASURE: Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated.
METHODS: Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months.
RESULTS: Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found.

CONCLUSION: Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes.

LEVEL OF EVIDENCE: I.

Matched MeSH terms: Knee Injuries
Time- and dose-related effects of amyloid beta1-40 on retina and optic nerve morphology in rats

Mohd Lazaldin MA, Iezhitsa I, Agarwal R, Bakar NS, Agarwal P, Mohd Ismail N

Int J Neurosci, 2018 Oct;128(10):952-965.
PMID: 29488424 DOI: 10.1080/00207454.2018.1446953

PURPOSE: Amyloid beta (Aβ) is known to contribute to the pathophysiology of retinal neurodegenerative diseases such as glaucoma. Effects of intravitreal Aβ(1-42) on retinal and optic nerve morphology in animal models have widely been studied but not those of Aβ(1-40). Hence, we evaluated the time- and dose-related effects of intravitreal Aβ(1-40) on retinal and optic nerve morphology. Since oxidative stress and brain derived neurotrophic factor (BDNF) are associated with Aβ-induced neuronal damage, we also studied dose and time-related effects of Aβ(1-40) on retinal oxidative stress and BDNF levels.
MATERIALS AND METHODS: Five groups of rats were intravitreally administered with vehicle or Aβ(1-40) in doses of 1.0, 2.5, 5 and 10 nmol. Animals were sacrificed and eyes were enucleated at weeks 1, 2 and 4 post-injection. The retinae were subjected to morphometric analysis and TUNEL staining. Optic nerve sections were stained with toluidine blue and were graded for neurodegenerative effects. The estimation of BDNF and markers of oxidative stress in retina were done using ELISA technique.
RESULTS AND CONCLUSIONS: It was observed that intravitreal Aβ(1-40) causes significant retinal and optic nerve damage up to day 14 post-injection and there was increasing damage with increase in dose. However, on day 30 post-injection both the retinal and optic nerve morphology showed a trend towards normalization. The observations made for retinal cell apoptosis, retinal glutathione, superoxide dismutase activity and BDNF were in accordance with those of morphological changes with deterioration till day 14 and recovery by day 30 post-injection. The findings of this study may provide a guide for selection of appropriate experimental conditions for future studies.

Matched MeSH terms: Optic Nerve Injuries

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