Brachymetatarsia is a conditioned which has been described as abnormal short metatarsal bone due to premature closure of the epiphyseal growth plate. It usually involves a single metatarsal bone with the fourth metatarsal being the most common. It may be congenital or acquired. We here report a case in a 53-yearold lady who presented with foot pain and shoe wearing problem. Examination revealed shortening of the bilateral fourth toe and the toes were tilted dorsally. She was diagnosed with bilateral brachymetatarsia and operation was done mainly for cosmetic reasons. Gradual lengthening with distraction osteogenesis was performed using a MiniRail external fixator (Orthofix) and K-wiring of the right fourth metatarsophalangeal joint. Adequate length of fourth metatarsal and good bony union were achieved at the end of treatment.
Osteomyelitis refers to an infection of the bone characterized by progressive inflammatory destruction caused by infecting microorganism. Open fracture carries the risk of developing osteomyelitis from 3 to 50% with a high amputation rate. Salvage of the limb is always a challenge and needs perseverance. We report the case of a 44-year-old male with chronic osteomyelitis with successful multiple limb salvage surgeries. The curative approach to chronic osteomyelitis has the following goals including arrest of infection, pain reduction and salvage of limb and function. With regard to survival and function, the result obtained in this case is more promising compared to above knee amputation.
Mycobacterium tuberculosis (MTB) is a rare cause of prosthetic joint infection. The diagnosis is challenging
especially in cases of latent tuberculosis. QuantiFERON-TB Gold (QFT®) is an interferon-gamma relative assay
(IGRA) which is highly specific and sensitive for detection of MTB infection. We report a case of 76-year-old lady
diagnosed with tuberculous prosthetic joint infection following total knee replacement. Histological examination of
abnormal synovial tissue taken intraoperatively reveals chronic granulomatous lesion and raised suspicion of
tuberculous infection in otherwise asymptomatic patient. The tuberculin skin test, MTB acid-fast stain and
tuberculosis polymerase chain reaction were negative. The diagnosis dilemma was solved with positive result of
QuantiFERON TB Gold Test. The patient was treated with anti-tuberculous drug without any surgical intervention.
At five months follow-up, patient was clinically well with no symptoms and signs of infection.
Skoliosis kongenital adalah perkembangan tulang belakang yang tidak normal yang merangkumi pembentukan sebahagian tulang sahaja, kurangnya pemisahan di antara tulang belakang atau kehilangan bahagian tertentu tulang belakang. Etiologi sebenar skoliosis kongenital masih tidak jelas. Walau bagaimanapun, ia dipengaruhi oleh kecenderungan genetik dan faktor persekitaran. Kami melaporkan siri kes skoliosis kongenital dengan ciri-ciri dismorfik dalam empat orang adik-beradik dan membincangkan mengenai sindrom spondylocostal dysostosis yang mempunyai kaitan dengan skoliosis kongenital. Ciri-ciri dismorfik termasuk hipertelorisme, ‘ptosis’ kedua-dua mata, 'high arch palate', langit-langit yang tinggi dan leher ‘webbed’. Pembedahan instrumentasi tulang belakang dilakukan dalam tiga adik beradik. Semua pesakit pulih dengan baik selepas pembedahan tanpa komplikasi kecederaan saraf. Rawatan susulan pada tahun pertama dan kedua selepas pembedahan menunjukkan tiada perubahan pada kadar lengkung dan tulang belakang telah bercantum.
The present study explores the ability of modified soda lignin (MSL) extracted from oil palm empty fruit bunches (EFB) in removing lead (II) ions from aqueous solutions. The effect of contact time, point zero charge (pH(pzc)) and pH of the solution, initial metal ion concentration and adsorbent dosage on the removal process were investigated. Furthermore, the MSL is characterized by SEM, XRF, FT-IR and surface area analysis. Equilibrium adsorption isotherms and kinetics were investigated. The experimental data were analyzed by the Langmuir, Freundlich and Temkin models of adsorption. The kinetic data obtained at different initial concentrations were analyzed using pseudo-first-order and pseudo-second-order models. The results provide strong evidence to support the hypothesis of adsorption mechanism.