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Fulltext Limb reconstruction surgery with external fixators--university hospital experience

Aik S, Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:86-92.
PMID: 11200049

We are describing 21 limb reconstruction procedures performed in 18 patients with the use of external fixators from 1996 to 1998. The average age of patients was 21, ranging from 1 to 50 years old. Indications for surgery included short limb, non-union, pseudoarthrosis and bone or soft tissue deformities. Average length obtained for cases of limb lengthening was 6 cm. All the seven clubfoot deformities in five children were fully corrected. Equinus deformity recurred in one foot and was treated with supramalleolar osteotomy. Out of the seven cases with infected nonunion and bone loss, three failed to achieve union and required additional bone grafting procedures. One patient with unilateral external fixator for the correction of tibia shortening developed valgus deformity.
Fulltext X-linked hypophosphatemic rickets--a report of 2 cases and review of literature

Yong SM, Aik S

Med J Malaysia, 2000 Sep;55 Suppl C:101-4.
PMID: 11200035

We report two cases of x-linked dominant hypophosphatemic rickets involving a man and his daughter. The family tree consists of 44 members with 13 of them having short stature and bowing of the lower limbs. The study of this family tree strongly suggests an x-linked dominant inheritance.
Fulltext Supracondylar fractures of the humerus in children--an epidemiological study of 132 consecutive cases

Chai KK, Aik S, Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:39-43.
PMID: 11200043

132 consecutive cases of supracondylar fractures of the humerus admitted between July, 1997 and February, 1999 were included in a prospective study. There were 93 boys and 39 girls. The age ranges from one to 14 years old. The non-dominant arm was more often injured. Ethnic Malay constituted the majority. Accidents mainly occurred at home with a peak between 4 pm and 8 pm. Majority was presented within 24 hours of injury. Type III fracture with distal fragment in extension predominated. Nerve injuries occurred in 9 cases in which median nerve was the most commonly affected. There was only one open fracture and it was complicated by absent radial pulse and median nerve injury.
Fulltext Radiofrequency ablation of a misdiagnosed Brodie's abscess

Chan R, Abdullah B, Aik S, Tok Ch

Biomed Imaging Interv J, 2011 Apr;7(2):e17.
PMID: 22291860 DOI: 10.2349/biij.7.2.e17

Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie's abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie's abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment.
A comparison study on hindfoot correction, Achilles tendon length and thickness between clubfoot patients treated with percutaneous Achilles tendon tenotomy versus casting alone using Ponseti method

Chandirasegaran S, Gunalan R, Aik S, Kaur S

J Orthop Surg (Hong Kong), 2019 4 6;27(2):2309499019839126.
PMID: 30947613 DOI: 10.1177/2309499019839126

PURPOSE:: To compare the hindfoot correction using clinical and ultrasonography assessment in clubfoot patients undergoing Achilles tendon tenotomy with patients corrected with casting alone.
METHOD:: A prospective observational study on idiopathic clubfoot patients less than 3 months old. Clinical assessment was done using hindfoot Pirani score and measurement of ankle dorsiflexion. Serial ultrasonography was done to measure the length and thickness of the Achilles tendon pre-hindfoot correction, 3 and 6 weeks post-hindfoot correction. Independent t-test was used to analyse the increase in ankle dorsiflexion, improvement in length and thickness of Achilles tendon between the two groups. Mann-Whitney U test was used to analyse the improvement in hindfoot Pirani score. Pearson correlation test was used for correlation in between clinical severity and ultrasonography assessment.
RESULTS:: Twenty-three patients with bilateral clubfoot and four with unilateral clubfoot were recruited with a total of 50 clubfeet. Each group consists of 25 feet with a mean age of 2 months. Marked improvement in hindfoot correction was noted in tenotomy group compared to non-tenotomy group as evidenced by significant increase in Achilles tendon length, ankle dorsiflexion and improvement of hindfoot Pirani score. No significant difference in Achilles tendon thickness was noted between the two groups. Positive correlation was demonstrated between increase in Achilles tendon length and increase in ankle dorsiflexion as well as improvement in hindfoot Pirani score.
CONCLUSION:: We would like to propose Achilles tendon tenotomy in all clubfoot patients as it is concretely evident that superior hindfoot correction was achieved in tenotomy group.
Body mass index of married Bangladeshi women: trends and association with socio-demographic factors

Hossain MG, Bharati P, Aik S, Lestrel PE, Abeer A, Kamarul T

J Biosoc Sci, 2012 Jul;44(4):385-99.
PMID: 22340969 DOI: 10.1017/S002193201200003X

Body mass index (BMI) is a good indicator of nutritional status in a population. In underdeveloped countries like Bangladesh, this indicator provides a method that can assist intervention to help eradicate many preventable diseases. This study aimed to report on changes in the BMI of married Bangladeshi women who were born in the past three decades and its association with socio-demographic factors. Data for 10,115 married and currently non-pregnant Bangladeshi women were extracted from the 2007 Bangladesh Demographic and Health Survey (BDHS). The age range of the sample was 15-49 years. The mean BMI was 20.85 ± 3.66 kg/m(2), and a decreasing tendency in BMI was found among birth year cohorts from 1972 to 1992. It was found that the proportion of underweight females has been increasing in those born during the last 20 years of the study period (1972 to 1992). Body mass index increased with increasing age, education level of the woman and her husband, wealth index, age at first marriage and age at first delivery, and decreased with increasing number of ever-born children. Lower BMI was especially pronounced among women who were living in rural areas, non-Muslims, employed women, women not living with their husbands (separated) or those who had delivered at home or non-Caesarean delivery.
Age at menarche of university students in Bangladesh: secular trends and association with adult anthropometric measures and socio-demographic factors

Hossain MG, Islam S, Aik S, Zaman TK, Lestrel PE

J Biosoc Sci, 2010 Sep;42(5):677-87.
PMID: 20529410 DOI: 10.1017/S0021932010000210

Age at menarche has been shown to be an important indicator for diseases such as breast cancer and ischaemic heart disease. The aim of the present study was to document secular trends in age at menarche and their association with anthropometric measures and socio-demographic factors in university students in Bangladesh. Data were collected from 995 students from Rajshahi University using a stratified sampling technique between July 2004 and May 2005. Trends in age at menarche were examined by linear regression analysis. Multiple regression analysis was used to assess the association of age at menarche with adult anthropometric measures and various socio-demographic factors. The mean and median age of menarche were 13.12+/-1.16 and 13.17 years, respectively, with an increasing tendency among birth-year cohorts from 1979 to 1986. Menarcheal age was negatively associated with BMI (p<0.01), but positively associated with height (p<0.05). Early menarche was especially pronounced among students from urban environments, Muslims and those with better educated mothers. Increasing age at menarche may be explained by improved nutritional status among Bangladeshi populations. Early menarche was associated with residence location at adolescence, religion and mother's education.
Fulltext Pre-hospital delay in patients with myocardial infarction: an observational study in a tertiary care hospital of northern Bangladesh

Rafi A, Sayeed Z, Sultana P, Aik S, Hossain G

BMC Health Serv Res, 2020 Jul 09;20(1):633.
PMID: 32646521 DOI: 10.1186/s12913-020-05505-x

BACKGROUND: Delayed hospital presentation is a hindrance to the optimum clinical outcome of modern therapies of Myocardial infarction (MI). This study aimed to investigate the significant factors associated with prolonged pre-hospital delay and the impact of this delay on in-hospital mortality among patients with MI in Northern Bangladesh.
METHODS: This cross sectional study was conducted in December 2019 in cardiology ward of a 1000-bed tertiary care hospital of Bangladesh. Patients admitted in the ward with the diagnosis of myocardial infarction were included in the study. Socio demographic data, clinical features and patients' health seeking behavior was collected in a structured questionnaire from the patients. Median with interquartile range (IQR) of pre hospital delay were calculated and compared between different groups. Chi-square (χ2) test and binary logistic regression were used to estimate the determinants of pre-hospital delay and effect of pre-hospital delay on in-hospital mortality.
RESULTS: Three hundred thirty-seven patients was enrolled in the study and their median (IQR) pre-hospital delay was 9.0 (13.0) hours. 39.5% patients admitted in the specialized hospital within 6 h. In logistic regression, determinants of pre-hospital delay were patients age (for
Socio-economic and demographic factors influencing nutritional status among early childbearing young mothers in Bangladesh

Islam A, Islam N, Bharati P, Aik S, Hossain G

BMC Womens Health, 2016;16:58.
PMID: 27561311 DOI: 10.1186/s12905-016-0338-y

Early childbearing influences women's health. This study aims to examine the effects of socio-demographic factors on nutritional status of early childbearing mothers in Bangladesh based on Body Mass Index (BMI) as the indicator.
Comparing biomechanical strength of unicortical locking plate versus bicortical compression plate for transverse midshaft metacarpal fracture

Shanmugam R, Jian CYCCS, Haseeb A, Aik S

J Orthop Surg (Hong Kong), 2018 10 3;26(3):2309499018802511.
PMID: 30270746 DOI: 10.1177/2309499018802511

PURPOSE: Metacarpal bone fractures constitute 10% of all fractures. Unstable metacarpal fractures require surgical intervention, which poses danger to flexor tendon either due to bicortical drilling or construct of the implant. Unicortical locking plate fixation may be the solution to preventing flexor tendon injury. Studies have compared locking and compression plates. However, in these studies, the biomechanical properties were tested using the static loading method. This study looks into cyclical loading that is more representative of in vivo conditions, particularly for early rehabilitation. We compared the biomechanical strength of the unicortical locking plate and bicortical compression plate system in a transverse metacarpal fracture, tested with cyclical loading and torsion.
METHOD: Twenty pieces of fourth-generation, biomechanical testing grade, left third metacarpal composite bones were used. Resin was used to create the holding block at both ends of the bone. An oscillating saw with 0.8 mm thick saw blade was used to osteotomize the metacarpal sawbones to create a midshaft transverse metacarpal fracture model. Ten pieces were fixed with a 2.0 mm titanium locking plate via unicortical screw purchase and 10 were fixed with a 2.0 mm, four holes, titanium dynamic compression plate, bicortical purchase of screws. They were subjected to cyclic load to failure testing three-point bending and torsion.
RESULTS: There were no significant difference in stiffness and cyclic three-point bending to failure between the unicortical locking plate group and the bicortical compression plate group. The bicortical compression plate group is stiffer and has a higher cyclic bending load to failure as compared to the unicortical locking plate group.
CONCLUSION: Unicortical locking plate fixation of metacarpal fracture can be reliably applied clinically to produce a strong and stable construct that allows early mobilization of the joints. This will not only reduce the complication rate of metacarpal plating, but also improve the functional outcome of the hand.
The applicability of Greulich and Pyle atlas to assess skeletal age for four ethnic groups

Mansourvar M, Ismail MA, Raj RG, Kareem SA, Aik S, Gunalan R, et al.

J Forensic Leg Med, 2014 Feb;22:26-9.
PMID: 24485416 DOI: 10.1016/j.jflm.2013.11.011

Recently, determination of skeletal age, defined as the assessment of bone age, has rapidly become an important task between forensic experts and radiologists. The Greulich-Pyle (GP) atlas is one of the most frequently used methods for the assessment of skeletal age around the world. After presentation of the GP approach for the estimation of the bone age, much research has been conducted to examine the usability of this method in various geographic or ethnic categories. This study investigates on a small-scale and compares the reliability of the GP atlas for assessment of the bone age for four ethnic groups - Asian, African/American, Caucasian and Hispanic - for a different range of ages.