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  1. Elective proximal lower limb amputation in spinal cord injury patients with chronic pressure ulcers: improve quality of life, function, and shorten hospital stay. Case report
    Yusmido YA, Hisamud-Din N, Mazlan M
    Eur J Phys Rehabil Med, 2014 Oct;50(5):557-60.
    PMID: 24694951
    Pressure ulcers are common among patients with spinal cord injury and can be very challenging to treat. The treatment involves multidisciplinary approach and ranges from simple pressure relieve and wound dressings to a more radical treatment like proximal lower limb amputations, especially in chronic cases with potential detrimental effects to physical and mental health.
  2. Incomplete paraplegia caused by extramedullary hematopoiesis in a patient with thalassemia intermedia
    Hisamud-Din N, Mustafah NM, Fauzi AA, Hashim NM
    Spinal Cord Ser Cases, 2017;3:17020.
    PMID: 28503326 DOI: 10.1038/scsandc.2017.20
    INTRODUCTION: Extramedullary hematopoiesis (EMH) is the production of blood cell precursors outside the bone marrow that occur in various hematological diseases. In patients with thalassemia intermedia, ineffective erythropoiesis drives compensatory EMH in the liver, pancreas, pleura, spleen, ribs and spine.

    CASE PRESENTATION: We describe a patient with thalassemia intermedia who presented with acute neurological symptoms caused by paraspinal EMH, which responded well to combination therapy of steroid, hypertransfusion, laminectomy and excision of pseudotumor and hydroxyurea therapy to boost the formation of fetal haemoglobin.

    DISCUSSION: Prompt recognition of EMH based on clinical presentation and typical radiological findings should be made. Early treatment is recommended to prevent irreversible damage to the spinal cord.

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