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Estimation of body height from spinal length measurements using post-mortem computed tomographic images

Zyoud TYT, Abdul Rashid SN, Suppiah S, Mahmud R, Kabeer A, Abd Manaf R, et al.

Malays J Pathol, 2020 Dec;42(3):423-431.
PMID: 33361724

INTRODUCTION: Post-mortem computed tomography (PMCT) provides information that helps in the determination of the cause of death and corpse identification of disaster victims. One of the methods for corpse identification includes assessment of the body stature. There is a lack of post-mortem imaging studies that focus on the anthropometric assessment of corpses. Our aim was to identify the relationship between cadaveric spine length and autopsy length (AL) among and autopsy length (AL) among a Malaysian population and derive a regression formula for the estimation of corpse body height using PMCT.
MATERIALS AND METHODS: We retrospectively assessed 107 cadavers that had undergone conventional autopsy and PMCT. We made 5 measurements from the PMCT that included cervical length (CL), thoracic length (TL), lumbosacral length (LS), total column length of the spine, excluding the sacrum and coccyx (TCL), and ellipse line measurement of the whole spine, excluding the sacrum and coccyx (EL). We compared these anthropometric PMCT measurements with AL and correlated them using linear regression analysis.
RESULTS: The results showed a significant linear relationship existed between TL and LS with AL, which was higher in comparison with the other parameters than the rest of the spine parameters. The linear regression formula derived was: 48.163 + 2.458 (TL) + 2.246 (LS).
CONCLUSIONS: The linear regression formula derived from PMCT spine length parameters particularly thoracic and lumbar spine gave a finer correlation with autopsy body length and can be used for accurate estimation of cadaveric height. To the best of our knowledge, this is the first ever linear regression formula for cadaveric height assessment using only post mortem CT spine length measurements.
Analysis on Target Detection and Classification in LTE Based Passive Forward Scattering Radar

Raja Abdullah RS, Abdul Aziz NH, Abdul Rashid NE, Ahmad Salah A, Hashim F

Sensors (Basel), 2016 Sep 29;16(10).
PMID: 27690051

The passive bistatic radar (PBR) system can utilize the illuminator of opportunity to enhance radar capability. By utilizing the forward scattering technique and procedure into the specific mode of PBR can provide an improvement in target detection and classification. The system is known as passive Forward Scattering Radar (FSR). The passive FSR system can exploit the peculiar advantage of the enhancement in forward scatter radar cross section (FSRCS) for target detection. Thus, the aim of this paper is to show the feasibility of passive FSR for moving target detection and classification by experimental analysis and results. The signal source is coming from the latest technology of 4G Long-Term Evolution (LTE) base station. A detailed explanation on the passive FSR receiver circuit, the detection scheme and the classification algorithm are given. In addition, the proposed passive FSR circuit employs the self-mixing technique at the receiver; hence the synchronization signal from the transmitter is not required. The experimental results confirm the passive FSR system's capability for ground target detection and classification. Furthermore, this paper illustrates the first classification result in the passive FSR system. The great potential in the passive FSR system provides a new research area in passive radar that can be used for diverse remote monitoring applications.
Piper sarmentosum Effects on 11β-Hydroxysteroid Dehydrogenase Type 1 Enzyme in Serum and Bone in Rat Model of Glucocorticoid-Induced Osteoporosis

Mohamad Asri SF, Mohd Ramli ES, Soelaiman IN, Mat Noh MA, Abdul Rashid AH, Suhaimi F

Molecules, 2016 Nov 15;21(11).
PMID: 27854305

Glucocorticoid-induced osteoporosis is one of the common causes of secondary osteoporosis. Piper sarmentosum (Ps) extract possesses antioxidant and anti-inflammatory activities. In this study, we determined the correlation between the effects of Ps leaf water extract with the regulation of 11β-hydroxysteroid dehydrogenase (HSD) type 1 enzyme activity in serum and bone of glucocorticoid-induced osteoporotic rats. Twenty-four Sprague-Dawley rats were grouped into following: G1: sham-operated group administered with intramuscular vehicle olive oil and vehicle normal saline orally; G2: adrenalectomized (adrx) control group given intramuscular dexamethasone (120 μg/kg/day) and vehicle normal saline orally; G3: adrx group given intramuscular dexamethasone (120 μg/kg/day) and water extract of Piper sarmentosum (125 mg/kg/day) orally. After two months, the femur and serum were taken for ELISA analysis. Results showed that Ps leaf water extract significantly reduced the femur corticosterone concentration (p < 0.05). This suggests that Ps leaf water extract was able to prevent bone loss due to long-term glucocorticoid therapy by acting locally on the bone cells by increasing the dehydrogenase action of 11β-HSD type 1. Thus, Ps may have the potential to be used as an alternative medicine against osteoporosis and osteoporotic fracture in patients on long-term glucocorticoid treatment.
Fulltext Emphysematous aortitis: report of two cases and CT imaging findings

Md Noh MSF, Abdul Rashid AM, Ar A, B N, Mohammed Y, A R E

BJR Case Rep, 2017;3(3):20170006.
PMID: 30363220 DOI: 10.1259/bjrcr.20170006

Emphysematous aortitis is a rare condition that manifests through the presence of air within or surrounding the inflamed aorta. Aortic inflammation may result from either an infective or a non-infective cause. Recognition of this rare condition is important as the resultant clinical deterioration may be rapid and lead to inevitable death. Cross-sectional imaging, with its relatively wide availability, proves an important tool in the diagnosis and subsequent management of this condition. We report two such cases encountered in our centre, with particular focus on the imaging findings on CT.
Fulltext Making Health Services Adolescent-Friendly in Northeastern Peninsular Malaysia: A Mixed-Methods Study

Awang H, Ab Rahman A, Sukeri S, Hashim N, Nik Abdul Rashid NR

Int J Environ Res Public Health, 2020 02 19;17(4).
PMID: 32093018 DOI: 10.3390/ijerph17041341

A mixed-methods study was conducted in a Malaysian state beginning with a cross-sectional quantitative study to determine the relationship between clinic characteristics and clinic score of adolescent-friendliness. Subsequently, perceptions of healthcare providers on the facilitating factors for the provision of adolescent-friendly health services were explored qualitatively to support the quantitative findings. Availability of trained healthcare providers, adequate privacy, dedicated adolescent health services team, and adolescent health promotional activities were the clinic characteristics that significantly (p < 0.05) related with clinics' scores of adolescent-friendliness. The facilitating factors required for adolescent-friendly health services were (1) healthcare providers' commitment and prioritization towards adolescent-friendly health services; (2) organizational supports; (3) appropriate clinic settings; and (4) external supports for adolescent health promotional activities. The qualitative findings reaffirmed those of the quantitative study on the significant clinic characteristics required for adolescent-friendly health services. This study provides valuable insight for the Ministry of Health to elicit the required facilitating factors to further improve the quality of adolescent health services in Malaysia.
Fulltext Occupational asthma as a differential diagnosis of adult-onset asthma – a case report

Devaraj NK, Abdul Rashid A, Shamsuddin NH, Abdullah AA, Tan CH, Chow ZY

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):145-147.
MyJurnal

Bronchial asthma causes great morbidity and mortality worldwide. Certain occupations especially those exposed to known triggers of asthma such as animal fur, dusts or solvents may trigger asthma attacks in a previously undiagnosed individual or worsen its’ control in a known asthmatic. This is especially true for adult-onset asthma. This may in turn the health of the affected workers and affect their productivity. Affected workers may be given job reassignment and eligible for medical compensation from Social Security Organisation (SOSCO). This case report will look at how two individuals in very distinct occupation were diagnosed with suspected occupational asthma.
Fulltext Herbal medication triggering lupus nephritis - a case report

Abdul Rashid AM, Abd Ghani F, Inche Mat LN, Lim CTS

BMC Complement Med Ther, 2020 Jun 02;20(1):163.
PMID: 32487242 DOI: 10.1186/s12906-020-02971-y

BACKGROUND: Herbal medication is widely used in our region as a mode of alternative medicine. Its contents and combinations are often modified to suit the needs of different populations. These products are said to boost the immune system and may serve as a protective measure against many diseases including Systemic Lupus Erythematosus (SLE). Some even lay claims to be able to cure SLE. Although they are not without side effects, these medications are still preferred due to their widespread availability and affordability, compared to modern medications. However, to date, there have been no reported cases in which these traditional medications can trigger a lupus-like reaction, moreover one involving the kidneys.
CASE PRESENTATION: We report a patient who developed overt lupus nephritis after consuming a course of herbal supplement. Her renal status did not improve upon cessation of the offending drug, and she required immunosuppressive therapy. After one cycle of IV cyclophosphamide, we managed to get the patient into remission - she is now on tapering doses of steroids.
CONCLUSION: We wish to highlight the possibility of consumption of herbal medication and the emergence of drug-induced lupus nephritis. A thorough anamnesis and high index of suspicion of drug-induced lupus nephritis is warranted when a patient on supplements presents with urinary abnormalities.
Fulltext Haemophagocytic lymphohistiocytosis secondary to dengue fever: a case report

Cheo SW, Abdul Rashid WNFA, Ho CV, Ahmad Akhbar RZ, Low QJ, Rajahram GS

Hong Kong Med J, 2021 08;27(4):287-289.
PMID: 34413256 DOI: 10.12809/hkmj208815
Small-field output ratio determination using 6 mol% Ge-doped silica fibre dosimeters

Lam SE, Noor NM, Bradley DA, Mahmud R, Pawanchek M, Abdul Rashid HA

Biomed Phys Eng Express, 2020 Nov 05;6(6).
PMID: 35042836 DOI: 10.1088/2057-1976/abc2a4

This work investigates the suitability of locally fabricated 6 mol% Ge-doped optical fibres as dosimeters for small-field output ratio measurements. Two fabrications of fibre, cylindrical (CF) and flat (FF) fibres, were used to measure doses in small photon fields, from 4 to 15 mm. The findings were compared to those of commercial Ge-doped fibre (COMM), EBT3 film and an IBA CC01 ionization chamber. Irradiations were carried out using a 6 MV SRS photon beam operating at a dose rate of 1000 cGy min-1, delivering a dose of 16 Gy. To minimise the possibility of the fibres failing to be exposed to the intended dose in small fields, the fibres were accommodated in a custom-made Perspex phantom. For the 4 mm cone the CF and FF measured output ratios were found to be smaller than obtained with EBT3 film by 32% and 13% respectively. Conversely, while for the 6 to 15 mm cone fields the FF output ratios were consistently greater than those obtained using EBT3 film, the CF output ratios differed from those of EBT3 film by at most 3.2%, at 6 mm, otherwise essentially agreeing with EBT3 values at the other field sizes. For the 4 to 7.5 mm cones, all output ratios obtained from Ge-doped optical fibre measurements were greater than those of IBA CC01 ionization chamber. The measured FF and CF output ratios for the 7.5 to 15 mm cones agreed with published MC estimates to within 15% and 13%, respectively. Down to 6 mm cone field, present measurements point to the potential of CF as a small-field dosimeter, its use recommended to be complemented by the use of EBT3 film for small-field dosimetry.
Radioluminescence of cylindrical and flat Ge-doped silica optical fibers for real-time dosimetry applications

Oresegun A, Tarif ZH, Ghassan L, Zin H, Abdul-Rashid HA, Bradley DA

Appl Radiat Isot, 2021 Oct;176:109812.
PMID: 34166948 DOI: 10.1016/j.apradiso.2021.109812

Investigation has been made of the radioluminescence dose response of Ge-doped silica flat and cylindrical fibers subjected to 6 and 10 MV photon beams. The fibers have been custom fabricated, obtaining Ge dopant concentrations of 6 and 10 mol%, subsequently cut into 20 mm lengths. Each sample has been exposed under a set of similar conditions, with use made of a fixed field size and source to surface distance (SSD). Investigation of dosimetric performance has involved radioluminescence linearity, dose-rate dependence, energy dependence, and reproducibility. Mass for mass, the 6 mol% Ge-doped samples provided the greater radioluminescence yield, with both flat and cylindrical fibers responding linearly to the absorbed dose. Further found has been that the cylindrical fibers provided a yield some 38% greater than that of the flat fibers. At 6 MV, the cylindrical fibers were also found to exhibit repeatability variation of <1%, superior to that of the flat fibers, offering strong potential for use in real-time dosimetry applications.
Fulltext Self-efficacy of foot care behaviour of elderly patients with diabetes

Ahmad Sharoni SK, Mohd Razi MN, Abdul Rashid NF, Mahmood YE

Malays Fam Physician, 2017;12(2):2-8.
PMID: 29423123 MyJurnal

Introduction: Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour.
Aim: To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes.
Methods: A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60 years with specific inclusion criteria were invited to participate in this study. The respondents were interviewed using a set of validated questionnaires. Data were analysed with descriptive and inferential statistics (multiple linear regression) using Statistical Package for the Social Sciences version 20.0.
Results: Levels of foot self-efficacy (mean+31.39; standard deviation=7.76) and foot care behaviour (mean=25.37; SD=5.88) were high. There was a positive significant relationship between foot self-efficacy (β = 0.41, p < 0.001) and gender (β = 0.30, p < 0.001) with foot care behaviour.
Conclusion: Self-efficacy can be incorporated in diabetes education to improve foot care behaviour. High-risk patients should be taught proper foot inspection and protection as well as the merits of skin care to prevent the occurrence of diabetic foot problems.
Fulltext Successful febuxostat desensitization in a patient with febuxostat hypersensitivity: A Malaysian experience

Sulaiman N, Othman AZ, Shahril NS, Abdul Rashid AM, Md Noh MSF

SAGE Open Med Case Rep, 2017;5:2050313X17749080.
PMID: 29318019 DOI: 10.1177/2050313X17749080

Over the years, allopurinol has been widely used as the preferred choice of urate lowering therapy in patients with gout. However, its role in patients with renal impairment is limited; and adverse reactions are well documented. Febuxostat, a newer oral non-purine xanthine oxidase inhibitor has been proven in several trials to be more effective and tolerable compared to allopurinol and may be used in patients with renal impairment. Here, we describe a case of successful febuxostat desensitization in a patient with a history of allopurinol- and febuxostat-induced adverse cutaneous reaction, as well as the protocol utilized.
Selective and simultaneous detection of cadmium, lead and copper by tapioca-derived carbon dot-modified electrode

Pudza MY, Abidin ZZ, Abdul-Rashid S, Yasin FM, Noor ASM, Abdullah J

Environ Sci Pollut Res Int, 2020 Apr;27(12):13315-13324.
PMID: 32020456 DOI: 10.1007/s11356-020-07695-7

The need for the sensing of environmental pollutants cannot be overemphasized in the twenty-first century. Herein, a sensor has been developed for the sensitive and selective detection of copper (Cu2+), lead (Pb2+) and cadmium (Cd2+) as major heavy metals polluting water environment. A screen-printed carbon electrode (SPCE) modified by fluorescent carbon dots (CDs) and gold nanoparticles (AuNPs) was successfully fabricated for sensing Cu2+, Pb2+ and Cd2+. Differential pulse voltammetry (DPV) and cyclic voltammetry (CV) were deployed for the analysis of ternary analytes. CV was set at a potential range of - 0.8 to + 0.2 V at a scan rate of 100 mV/s, and DPV at a potential range of - 0.8 to + 0.1 V, scan rate of 50 mV/s, pulse rate of 0.2 V and pulse width of 50 ms. DPV technique was applied through the modified electrode for sensitive and selective determination of Cu2+, Pb2+ and Cd2+ at a concentration range of 0.01 to 0.27 ppm for Cu2+, Pb2+ and Cd2+. Tolerance for the highest possible concentration of foreign substances such as Mg2+, K+, Na+, NO3-, and SO42- was observed with a relative error less than ± 3%. The sensitivity of the modified electrode was at 0.17, 0.42 and 0.18 ppm for Cd2+, Pb2+ and Cu2+, respectively, while the limits of detection (LOD) achieved for cadmium, lead and copper were 0.0028, 0.0042 and 0.014 ppm, respectively. The quality of the modified electrode for sensing Cu2+, Pb2+ and Cd2+ at trace levels is in accordance with the World Health Organization (WHO) and Environmental Protection Agency (EPA) water regulation standard. The modified SPCE provides a cost-effective, dependable and stable means of detecting heavy metal ions (Cu2+, Pb2+ and Cd2+) in an aqueous solution. Graphical abstract .
Fulltext Study the effect of various wash-coated metal oxides over synthesized carbon nanofibers coated monolith substrates

Malekbala MR, Soltani S, Abdul Rashid S, Abdullah LC, Choong TSY

PLoS One, 2019;14(7):e0219936.
PMID: 31365558 DOI: 10.1371/journal.pone.0219936

In this research work, carbon nanofibers (CNFs) were synthesized on honeycomb monolith substrates using injection chemical vapor deposition (ICVD) technique. The effect of various wash-coated materials and catalyst promoter on the growth rate of CNFs on monolith substrates were examined. The characteristics of the synthesized CNFs-coated monolith composites were examined using Raman spectroscopy, Brunauer-Emmett-Teller (BET), thermogravimetric analysis (TGA), field emission scanning electron microscopy (FE-SEM), and Transmission electron microscopy (TEM) techniques. According to the textural characterization study, the specific surface area and pore volume of CNFs-coated monolith composites were significantly improved as compared to bare monolith which might be attributed to the growth of highly pure and aligned CNFs over monolith substrate. Besides that, the synthesized CNFs-coated monolith possessed extremely well thermal stability up to the temperature of 550 °C which was corresponded to the strong attachment of highly graphitized CNFs over monolith substrates.
Fulltext A Malaysian Medical Non-Governmental Organization's (NGO) Experience in the Emergency Response for COVID-19, Using the Whole-of-Society Collaborative Concept

Abd Samat AH, Abdul Rashid A, Mohd Yunus NA, Salim AMH, Musa H

Disaster Med Public Health Prep, 2021 Apr 06.
PMID: 33820586 DOI: 10.1017/dmp.2021.106

Non-governmental organizations (NGOs) are one of the important players during a pandemic, including the Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET). During the coronavirus disease (COVID-19) pandemic, IMARET played a key role in assisting health relief efforts in Malaysia. We are sharing this experience as a medical NGO's response to the pandemic. This report presents data from the March 18 to June 10, 2020, retrieved from IMARET's database with approval from the Executive Committee and the IMARET COVID-19 Task Force. We report that IMARET's task force consists of 30 people, mostly medical doctors. Supplies distributed included personal protective equipment with other medical equipment, such as portable ultrasounds and ventilators. IMARET engaged with 33 collaborators and 92 partners and funders. There were 135 volunteers with the majority being medical volunteers. IMARET raised more than RM $3 million (US $740 000) garnering support from over 40 000 donors in 85 days. In conclusion, NGOs play a significant role that effectively enhance and complement the consolidated works by the authorities and public in the effort to overcome COVID-19 challenges.
Fulltext Eco-Friendly Sustainable Fluorescent Carbon Dots for the Adsorption of Heavy Metal Ions in Aqueous Environment

Yahaya Pudza M, Zainal Abidin Z, Abdul Rashid S, Md Yasin F, Noor ASM, Issa MA

Nanomaterials (Basel), 2020 Feb 12;10(2).
PMID: 32059384 DOI: 10.3390/nano10020315

The materials and substances required for sustainable water treatment by adsorption technique, are still being researched widely by distinguished classes of researchers. Thus, the need to synthesize substances that can effectively clean up pollutants from the environment cannot be overemphasized. So far, materials in bulk forms that are rich in carbon, such as biochar and varieties of activated carbon have been used for various adsorptive purposes. The use of bulk materials for such purposes are not efficient due to minimal surface areas available for adsorption. This study explores the adsorption task at nano dimension using carbon dots (CDs) from tapioca. The properties of carbon structure and its influence on the adsorptive efficacy of carbon nanoparticles were investigated by energy-dispersive spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR), high resolution transmission electron microscopy (HrTEM), and atomic force microscopy (AFM). The results implied carbon present in CDs are good adsorbents for effective adsorption of heavy metal ions (lead) with removal efficiency of 80.6% in aqueous environment. The adsorption process as explored by both Langmuir and Freundlich isotherms have proven favorability of the adsorption process. Langmuir form two and three have correlation coefficients R2 at 0.9922 and 0.9912, respectively. The Freundlich isotherm confirms CDs as having defined surface heterogeneity and the exponential distribution of active sites. The adsorption of lead unto CDs obeyed the second order kinetic model with coefficient of determination, R2 of 0.9668 and 0.9996 at an initial lead concentration of 20 mg/L and 100 mg/L, respectively. The findings validated the efficiency of CDs derived from tapioca as an excellent material for further utilization in the environmental fields of wastewater pollution detection and clean up, bio-imaging, and chemical sensing applications.
Fulltext Preparations, Properties, and Applications of Polyaniline and Polyaniline Thin Films-A Review

Beygisangchin M, Abdul Rashid S, Shafie S, Sadrolhosseini AR, Lim HN

Polymers (Basel), 2021 Jun 18;13(12).
PMID: 34207392 DOI: 10.3390/polym13122003

Polyaniline (PANI) is a famous conductive polymer, and it has received tremendous consideration from researchers in the field of nanotechnology for the improvement of sensors, optoelectronic devices, and photonic devices. PANI is doped easily by different acids and dopants because of its easy synthesis and remarkable environmental stability. This review focuses on different preparation processes of PANI thin film by chemical and physical methods. Several features of PANI thin films, such as their magnetic, redox, and antioxidant, anti-corrosion, and electrical and sensing properties, are discussed in this review. PANI is a highly conductive polymer. Given its unique properties, easy synthesis, low cost, and high environmental stability in various applications such as electronics, drugs, and anti-corrosion materials, it has attracted extensive attention. The most important PANI applications are briefly reviewed at the end of this review.
Fulltext Safety Evaluation of Oral Toxicity of Carica papaya Linn. Leaves: A Subchronic Toxicity Study in Sprague Dawley Rats

Ismail Z, Halim SZ, Abdullah NR, Afzan A, Abdul Rashid BA, Jantan I

Evid Based Complement Alternat Med, 2014;2014:741470.
PMID: 25530788 DOI: 10.1155/2014/741470

The subchronic toxicity effect of the leaf extract of Carica papaya Linn. in Sprague Dawley (SD) rats was investigated in this study. The extract was prepared by dissolving the freeze dried extract of the leaves in distilled water and was administered orally to SD rats (consisted of 10 rats/sex/group) at 0 (control), 0.01, 0.14, and 2 g/kg body weight (BW) for 13 weeks. General observation, mortality, and food and water intake were monitored throughout the experimental period. Hematological and biochemical parameters, relative organ weights, and histopathological changes were evaluated. The study showed that leaf extract when administered for 13 weeks did not cause any mortality and abnormalities of behavior or changes in body weight as well as food and water intake. There were no significant differences observed in hematology parameters between treatment and control groups; however significant differences were seen in biochemistry values, for example, LDH, creatinine, total protein, and albumin. However, these changes were not associated with histopathological changes. In conclusion, the results suggested that daily oral administration of rats with C. papaya leaf extract for 13 weeks at a dose up to fourteen times the levels employed in traditional medicine practice did not cause any significant toxic effect.
Fulltext Economic burden of hypoglycemia for type II diabetes mellitus patients in Malaysia

Aljunid SM, Aung YN, Ismail A, Abdul Rashid SAZ, Nur AM, Cheah J, et al.

PLoS One, 2019;14(10):e0211248.
PMID: 31652253 DOI: 10.1371/journal.pone.0211248

This study mainly aims to identify the direct cost and economic burden of hypoglycemia for patients with type II diabetes mellitus in Malaysia. A cross-sectional study explored the cost incurred for hypoglycemia among patients admitted to University Kebangsaan Malaysia Medical Centre (UKMMC). The study covered patients aged 20-79 years hospitalized with a primary diagnosis of ICD-10 hypoglycemia and discharged between January 2010 and September 2015 according to the casemix database. A costing analysis was done through a step-down approach from the perspective of health providers. Cost data were collected for three levels of cost centers with the help of a hospital-costing template. The costing data from UKMMC were used to estimate the national burden of hypoglycemia among type II diabetics for the whole country. Of 244 diabetes patients admitted primarily for hypoglycemia to UKMMC, 52% were female and 88% were over 50 years old. The cost increased with severity. Managing a hypoglycemic case requires five days (median) of inpatient stay on average, with a range of 2-26 days, and costs RM 8,949 (USD 2,289). Of the total cost, 30% related to ward (final cost center), 16% to ICU, and 15% to pharmacy (secondary-level cost center) services. Considering that 3.2% of all admissions were hypoglycemia related, the total annual cost of hypoglycemia care for adult diabetics in Malaysia is estimated at RM 117.4 (USD 30.0) million, which translates to 0.5% of the Ministry of Health budget. Hypoglycemia imposes a substantial economic impact even without the direct and indirect cost incurred by patients and other cost of complications. Diabetic management needs to include proper diabetic care and health education to reduce episodes of hypoglycemia.
Surgical outcome of angular deformity correction of lower limbs in rickets: a cross-sectional study

Muhammad AS, Jamil K, Abdul-Rashid AH, Abd-Rasid AF, Aizuddin NA

Eur J Orthop Surg Traumatol, 2024 Jul;34(5):2407-2412.
PMID: 38619601 DOI: 10.1007/s00590-024-03943-5

PURPOSE: This study aims to compare the functional and radiological outcomes following both guided growth surgery (GGS) and acute corrective osteotomy (ACO) correction of angular deformities in children with rickets.
METHODS: A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records. A radiographic evaluation of the leg was performed to determine the tibiofemoral angle. For functional evaluation, the Active Scale for Kids (ASK) and Lower Extremity Functional Scale (LEFS) instruments were used for children below and above 15 years old, respectively.
RESULTS: In terms of the tibiofemoral angle, the GGS group documented greater angle changes compared to the ACO group, but the difference was not significant. In terms of functional outcomes, the overall score percentage of both groups was comparable with the GGS group showing a trend of higher score percentage compared to the ACO group. The GGS group presented no complication while 2 neurovascular injuries and 1 implant failure were recorded in the ACO group.
CONCLUSION: Both GGS and ACO procedures resulted in similar radiographic and functional outcomes for the treatment of rickets in children. GGS may be advantageous in terms of reducing complications of surgery. Nevertheless, the choice of surgical intervention should be made based on the patient's circumstances and the surgeon's preference.

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