MyMedR

Fulltext Orthopaedic infections

Choon DSK

Med J Malaysia, 2004 Dec;59(5):571-2.

PMID: 15889556

Matched MeSH terms: Bone Diseases, Infectious/etiology*; Bone Diseases, Infectious/therapy*

Current strategies in multiphasic scaffold design for osteochondral tissue engineering: A review

Yousefi AM, Hoque ME, Prasad RG, Uth N

J Biomed Mater Res A, 2015 Jul;103(7):2460-81.

PMID: 25345589 DOI: 10.1002/jbm.a.35356

The repair of osteochondral defects requires a tissue engineering approach that aims at mimicking the physiological properties and structure of two different tissues (cartilage and bone) using specifically designed scaffold-cell constructs. Biphasic and triphasic approaches utilize two or three different architectures, materials, or composites to produce a multilayered construct. This article gives an overview of some of the current strategies in multiphasic/gradient-based scaffold architectures and compositions for tissue engineering of osteochondral defects. In addition, the application of finite element analysis (FEA) in scaffold design and simulation of in vitro and in vivo cell growth outcomes has been briefly covered. FEA-based approaches can potentially be coupled with computer-assisted fabrication systems for controlled deposition and additive manufacturing of the simulated patterns. Finally, a summary of the existing challenges associated with the repair of osteochondral defects as well as some recommendations for future directions have been brought up in the concluding section of this article.

Matched MeSH terms: Bone Diseases/therapy*

Contracted pelvis and disproportion

LLEWELLYN-JONES D

Med J Malaya, 1958 Sep;13(1):65-9.

PMID: 13589372

Matched MeSH terms: Bone Diseases*

Fulltext Relationship between body composition and bone mineral density in healthy postmenopausal Chinese women in Malaysia

Chee, Winnie Siew Swee, Ting, Geik Poh, Tan, Soon Yean, Chan, Siew Pheng, Zaitun Yassin, Suriah Abdul Rahman

Jurnal Sains Kesihatan Malaysia, 2007;5(2):29-38.

MyJurnal

Kehilangan jisim tulang adalah lebih ketara selepas menopaus. Jangka masa menopaus dan umur yang meningkat dikaitkan dengan penurunan jisim tubuh tanpa lemak, peningkatan lemak badan dan peningkatan berat badan. Kajian ini melihat sumbangan relatif jisim tubuh tanpa lemak dan lemak badan ke atas ketumpatan mineral tulang (KMT) di kalangan 139 wanita Cina posmenopaus sihat di Kuala Lumpur. KMT di kawasan seluruh tubuh, tulang belakang ( L2-L4), leher femur dan keseluruhan tulang pinggul diukur dengan alat dual-energy X-ray absorptiometry (DxA). Hasil kajian mendapati 80% daripada wanita posmenopaus Cina mempunyai jisim tulang yang rendah (osteopenia) manakala 8% daripada mereka mengalami osteoporosis di bahagian tulang belakang atau tulang pinggul. Secara keseluruhan, lemak badan mempunyai korelasi yang positif dengan KMT di semua bahagian diukur (keseluruhan tubuh, r = 0.265, p < 0.001; tulang belakang r = 0.214, p < 0.05, leher femur, r = 0.254, p < 0.001; keseluruhan tulang pinggul r = 0.332, p < 0.001). Jisim tubuh tanpa lemak juga mempunyai korelasi yang positif dengan KMT kebanyakan kawasan diukur (keseluruhan tubuh, r = 0.239, p < 0.001; leher femur r = 0.365, p < 0.001; keseluruhan tulang pinggul r = 0.352, p < 0.001) kecuali tulang belakang. Analisis regresi menunjukkan lemak badan dapat meramal KMT pada keseluruhan badan (p < 0.0001) dan tulang belakang (p < 0.005) manakala jisim tubuh tanpa lemak dapat meramal KMT pada tulang femur dan tulang pinggul (p < 0.0001). Hasil kajian menunjukkan kedua-dua lemak tubuh dan jisim tubuh tanpa lemak memainkan peranan dalam mempengaruhi KMT, di mana lemak badan memainkan peranan yang lebih di kalangan wanita posmenopaus. Oleh itu, wanita posmenopaus perlu elakkan mempunyai berat badan yang terlalu rendah (kurang lemak badan) dan mengekalkan jisim tubuh tanpa lemak untuk mencegah osteoporosis.

Matched MeSH terms: Bone Diseases, Metabolic

Reduced bone mineral density in human immunodeficiency virus-infected individuals: a meta-analysis of its prevalence and risk factors: supplementary presentation

Goh SSL, Lai PSM, Tan ATB, Ponnampalavanar S

Osteoporos Int, 2018 07;29(7):1683.

PMID: 29737369 DOI: 10.1007/s00198-018-4379-y

A meta-analysis was conducted to evaluate the prevalence of osteopenia/osteoporosis in human immunodeficiency virus (HIV)-infected individuals. The prevalence of osteopenia/osteoporosis in HIV-infected and antiretroviral therapy (ART)-treated individuals was significantly higher than respective controls. Evidence regarding bone loss within first year of HIV infection or ART initiation was preliminary.

Matched MeSH terms: Bone Diseases, Metabolic

Testosterone therapy for fractures of bone and certain malignant and non-malignant bone conditions

WOLF J, LOESER AA

Med J Malaya, 1955 Dec;10(2):167-77.

PMID: 13308618

Matched MeSH terms: Bone Diseases*

Fulltext Otitis externa complicated with chloramphenicol ear drops-induced perichondritis

Mohamad I, Johan K, Hashim H, Nik Othman N

Malays Fam Physician, 2014;9(1):28-9.

PMID: 25606295 MyJurnal

Otitis externa is a common condition of the ear. It is manifested as narrowing of the lumen owing to the edematous swelling of the ear canal lining. Perichondritis may occur independently or as a complication of the otitis externa. We report a case of perichondritis after using a topical ear drop. Changing the medication provides immediate resolution of the condition.

Matched MeSH terms: Bone Diseases

Fulltext Rare Presentation of a Rare Disease (Erdheim-Chester disease): A Case Report

Koh T, Fadli M, Vijaya Kumar S, Rao AS

Malays Orthop J, 2012 Nov;6(3):69-71.

PMID: 25279065 MyJurnal DOI: 10.5704/MOJ.1207.020

Erdheim-Chester disease (ECD) was first reported by J. Erdheim and W. Chester, in 1930. There are less than 250 reported cases till date. We report a case of ECD in a 16- year-old Malay male, who initially presented with elusive anemic symptoms with more specific symptoms of bony pain, cardiorespiratory and hepatic involvement evolving as the disease progressed.

Matched MeSH terms: Bone Diseases

Musculoskeletal lesions in yaws

Sengupta S

Clin Orthop Relat Res, 1985 Jan-Feb;?(192):193-8.

PMID: 3967422

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.

Matched MeSH terms: Bone Diseases/diagnosis; Bone Diseases/etiology*; Bone Diseases/radiography

Fulltext Periodontal disease as the initial oral manifestation of langerhans cell histiocytosis - a case report

Ahmad AR, Ismail SM, Zain RB, Mohamad Zaini Z

Ann Dent, 2009;16(1):31-36.

MyJurnal

Langerhans Cell Histiocytosis (LCH) refers to a group of lesions presenting with a spectrum of clinical. features but sharing similar histology. These lesions are rare and treatment has been quite variable with current treatment protocol recommended being dependent on whether it is a unifocal or multi focal bone disease or a multi focal multisystem disease. However, the clinical presentations of LCH are variable and the decision to place into the appropriate clinical types may sometimes be masked by the non-discovery of all the lesions. In the oral maxillofacial area, the clinical features of these lesions may further pose a problem by nondescript manifestations as dental/periodontal/oral mucosal disorders. These oral findings may sometimes lead to inappropriate choice of treatment and delay in the diagnosis of all the lesions involved. This paper describes one such case where LCH manifest itself as a periodontal disease thus leading to delay in identifying all the sites involved and consequently a delay in id~ntifying the appropriate clinical type.

Matched MeSH terms: Bone Diseases

Fulltext Giant Cell Reparative Granuloma Mimicking Aneurysmal Bone Cyst in Proximal Phalanx of Toe

Huan CM, Norzila AB

Malays Orthop J, 2016 Mar;10(1):55-56.

PMID: 28435549 MyJurnal DOI: 10.5704/MOJ.1603.011

Giant Cell Reparative Granuloma (GCRG) of phalanx is uncommon. It is a benign osteolytic lesion but can be locally aggressive. GCRG has certain radiology and histological features that are similar to other giant cell lesions of the bone. We present a case report of a young patient with giant cell reparative granuloma of proximal phalanx of left third toe. The bone lesion was successfully treated surgically.

Matched MeSH terms: Bone Diseases

A case report of benign transient hyperphosphatasaemia: What can we learn from this?

Ng RL, Azriyanti AZ

Med J Malaysia, 2018 10;73(5):336-337.

PMID: 30350819 MyJurnal

We report a case of benign transient hyperphosphatasaemia (BTH) which was noted incidentally when the patient was admitted for acute tonsillitis. Blood result showed alkaline phosphatase (ALP) at admission was markedly elevated with value of 2481 U/L [normal range 34 - 104 U/L]. He had no history or physical findings to suggest liver or bone disease. Various blood and radiographic investigations were performed to determine the cause but results were normal. He was followed-up with repeat blood test and the alkaline phosphatase normalised after 42 days.

Matched MeSH terms: Bone Diseases

Fulltext Tocotrienols Regulate Bone Loss through Suppression on Osteoclast Differentiation and Activity: A Systematic Review

Radzi NFM, Ismail NAS, Alias E

Curr Drug Targets, 2018;19(9):1095-1107.

PMID: 29412105 DOI: 10.2174/1389450119666180207092539

BACKGROUND: There are accumulating studies reporting that vitamin E in general exhibits bone protective effects. This systematic review, however discusses the effects of a group of vitamin E isomers, tocotrienols in preventing bone loss through osteoclast differentiation and activity suppression.

OBJECTIVE: This review is aimed to discuss the literature reporting the effects of tocotrienols on osteoclasts, the cells specialized for resorbing bone.

RESULTS: Out of the total 22 studies from the literature search, only 11 of them were identified as relevant, which comprised of eight animal studies, two in vitro studies and only one combination of both. The in vivo studies indicated that tocotrienols improve the bone health and reduce bone loss via inhibition of osteoclast formation and resorption activity, which could be through regulation of RANKL and OPG expression as seen from their levels in the sera. This is well supported by data from the in vitro studies demonstrating the suppression of osteoclast formation and resorption activity following treatment with tocotrienol isomers.

CONCLUSION: Thus, tocotrienols are suggested to be potential antioxidants for prevention and treatment of bone-related diseases characterized by increased bone loss.

Matched MeSH terms: Bone Diseases/drug therapy*; Bone Diseases/pathology; Bone Diseases/prevention & control

Primary hyperparathyroidism: a rare cause of genu valgus in adolescence

Ratnasingam J, Tan AT, Vethakkan SR, Paramasivam SS, Ibrahim L, Lim LL, et al.

J Clin Endocrinol Metab, 2013 Mar;98(3):869-70.

PMID: 23337722 DOI: 10.1210/jc.2012-3839

Matched MeSH terms: Bone Diseases, Metabolic/etiology*; Bone Diseases, Metabolic/radiography*

Fulltext Actinomyces infection of the mastoid: a rare entity

Subha ST, Raman R, Cheah PL, Soo Hoo TS

Med J Malaysia, 2004 Dec;59(5):680-1.

PMID: 15889574

A rare case of mastoid infection caused by actinomyces israelii is presented. This patient underwent exploratory mastoidectomy followed by long term oral pencillin. She responded well to the treatment and has been asymptomatic on follow up to date.

Matched MeSH terms: Bone Diseases, Infectious/diagnosis*; Bone Diseases, Infectious/drug therapy

Use of Bone Health Evaluation in Orthopedic Surgery: 2019 ISCD Official Position

Anderson PA, Morgan SL, Krueger D, Zapalowski C, Tanner B, Jeray KJ, et al.

J Clin Densitom, 2019 08 16;22(4):517-543.

PMID: 31519473 DOI: 10.1016/j.jocd.2019.07.013

This position development conference (PDC) Task Force examined the assessment of bone status in orthopedic surgery patients. Key questions included which orthopedic surgery patients should be evaluated for poor bone health prior to surgery and which subsets of patients are at high risk for poor bone health and adverse outcomes. Second, the reliability and validity of using bone densitometry techniques and measurement of specific geometries around the hip and knee before and after arthroplasty was determined. Finally, the use of computed tomography (CT) attenuation coefficients (Hounsfield units) to estimate bone quality at anatomic locations where orthopedic surgery is performed including femur, tibia, shoulder, wrist, and ankle were reviewed. The literature review identified 665 articles of which 198 met inclusion exclusion criteria and were selected based on reporting of methodology, reliability, or validity results. We recommend that the orthopedic surgeon be aware of established ISCD guidelines for determining who should have additional screening for osteoporosis. Patients with inflammatory arthritis, chronic corticosteroid use, chronic renal disease, and those with history of fracture after age 50 are at high risk of osteoporosis and adverse events from surgery and should have dual energy X-ray absorptiometry (DXA) screening before surgery. In addition to standard DXA, bone mineral density (BMD) measurement along the femur and proximal tibia is reliable and valid around implants and can provide valuable information regarding bone remodeling and identification of loosening. Attention to positioning, selection of regions of interest, and use of special techniques and software is required. Plain radiographs and CT provide simple, reliable methods to classify the shape of the proximal femur and to predict osteoporosis; these include the Dorr Classification, Cortical Index, and critical thickness. Correlation of these indices to central BMD is moderate to good. Many patients undergoing orthopedic surgery have had preoperative CT which can be utilized to assess regional quality of bone. The simplest method available on most picture archiving and communications systems is to simply measure a regions of interest and determine the mean Hounsfield units. This method has excellent reliability throughout the skeleton and has moderate correlation to DXA based on BMD. The prediction of outcome and correlation to mechanical strength of fixation of a screw or implant is unknown.

Matched MeSH terms: Bone Diseases/diagnosis*; Bone Diseases/surgery

Mirhosseini NZ, Shahar S, Ghayour-Mobarhan M, Banihashem A, Kamaruddin NA, Hatef MR, et al.

J. Bone Miner. Metab., 2013 Jul;31(4):468-76.

PMID: 23475127 DOI: 10.1007/s00774-013-0433-1

Thalassemia and the blood transfusion complications associated with it predispose children to poor bone health. This study was conducted to determine the prevalence of bone-related abnormalities and identify the bone health predictors within this population. One hundred and forty transfusion-dependent beta thalassemic subjects 8-18 years old in Mashhad, Iran, participated in this cross-sectional study. Anthropometric measures, dietary intake, bone-related biomarkers and bone densitometry, were assessed. The incidence of underweight and short stature was 33.6 and 41.4 %, respectively, which were indicators of malnutrition among thalassemic subjects in this study. Low bone density was detected in the lumbar spine and femoral region in 82 and 52 % of subjects, respectively. Hypocalcemia and hypophosphatemia were seen in 22 and 18.2 %, whilst vitamin D deficiency was present in more than 85 % of thalassemic children and adolescents. The relationships between weight, height and other anthropometric indices, serum calcium and bone markers, intake of macronutrients, zinc and vitamin E with bone mineral density (BMD) and bone mineral content (BMC) in the lumbar spine and femoral area were positively related, indicating that better nutritional status were associated with higher BMD and BMC values. Puberty, gender and serum osteocalcin were negative predictors for BMD and BMC values, whereas age, weight and height were the positive predictors. High incidence of low bone density and deficit in other aspects of bone health among thalassemia patients makes routine bone health assessment necessary for this vulnerable group. Considering influencing factors, dietary counseling and preventive supplementation therapy for this high risk group of children and adolescents may be necessary, although this should be assessed by intervention studies.

Matched MeSH terms: Bone Diseases/etiology*; Bone Diseases/physiopathology

Fulltext Gradual correction of proximal tibia deformity for Blount disease in adolescent and young adults

Saw A, Phang ZH, Alrasheed MK, Gunalan R, Albaker MZ, Shanmugam R

J Orthop Surg (Hong Kong), 2019 9 19;27(3):2309499019873987.

PMID: 31530084 DOI: 10.1177/2309499019873987

PURPOSE: Management of Blount disease in adolescents and young adults is complex and associated with high risk of morbidities. Gradual correction with external fixator can minimize soft tissue injury and allow subsequent adjustment in degree of correction. This study investigates the surgical outcome and complication rate of gradual correction of neglected Blount disease through single-level extra-articular corticotomy.

METHODS: Patients treated for Blount disease using external fixator from 2002 to 2016 were recruited for the study. We used Ilizarov and Taylor Spatial Frame (TSF) external fixator to perform simultaneous correction of all the metaphyseal deformities without elevating the tibia plateau. Surgical outcome was evaluated using mechanical axis deviation (MAD), tibial femoral angle (TFA), and femoral condyle tibial shaft angle (FCTSA).

RESULTS: A total of 22 patients with 32 tibias have been recruited for the study. The mean MAD improved from 95 ± 51.4 mm to 9.0 ± 37.7 mm (medial to midpoint of the knee), mean TFA improved from 31 ± 15° varus to 2 ± 14° valgus, and mean FCTSA improved from 53 ± 14° to 86 ± 14°. Mean duration of frame application is 9.4 months. Two patients developed pathological fractures over the distracted bones, one developed delayed consolidation and other developed overcorrection.

CONCLUSIONS: Correction of Blount disease can be achieved by gradual correction using Ilizarov or TSF external fixator with low risk of soft tissue complication. Longer duration of frame application should be considered to reduce the risk of pathological fracture or subsequent deformation of the corrected bone.

Matched MeSH terms: Bone Diseases, Developmental/diagnosis*; Bone Diseases, Developmental/surgery

Fulltext Bone mineral density loss, osteoporosis, and fractures in HIV

Labarga P

AIDS Rev, 2013 Jul-Sep;15(3):189-90.

PMID: 24002203

The link between HIV and reduced bone mineral density, including osteopenia and the more severe osteoporosis, is well established. HIV infection has also been associated with an increased risk of fractures. It is so far unclear whether this is due to HIV itself, resulting inflammatory and metabolic changes, antiretroviral toxicity, or some combination of factors. This topic was the focus of major debate at the 7th IAS Conference held in Kuala Lumpur, Malaysia, in early July 2013.

Matched MeSH terms: Bone Diseases, Metabolic/complications; Bone Diseases, Metabolic/drug therapy; Bone Diseases, Metabolic/physiopathology*

Is survival enough for quality of life in Sagliker Syndrome-uglifying human face appearances in chronic kidney disease?

Sagliker Y, Acharya V, Golea O, Sabry A, Bali M, Eyupoglu K, et al.

J Nephrol, 2008 Mar-Apr;21 Suppl 13:S134-8.

PMID: 18446747

It is known that secondary hyperparathyroidism (SH) and particularly skeletal changes is a severe condition in chronic kidney disease (CKD). Sagliker syndrome (SS) is a very prominent feature in CKD including uglifying human face appearances, short stature, extremely severe maxillary and mandibulary changes, soft tissues in the mouth, teeth-dental abnormalities, finger tip changes and severe psychological problems.

Matched MeSH terms: Bone Diseases/etiology*; Bone Diseases/pathology; Bone Diseases/psychology

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