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  1. Mohd-Hanaffi AF, Puji A
    Malays Orthop J, 2022 Nov;16(3):136-138.
    PMID: 36589365 DOI: 10.5704/MOJ.2211.021
    Hip pain is frequently encountered in the athletic community. Femoro-acetabular impingement (FAI) is a common cause of hip pain in young adults. However, it is important to appreciate the uncommon diagnosis and the role of imaging for unexplained hip pain. The pathology behind a posterior hip pain is often misdiagnosed as the cause of hip pain is non-specific, extensive and elusive. We managed to detect the pathology through magnetic resonance arthrography (MRA) of hip with gadolinium enhancement after a series of inconclusive history, physical examination and imaging findings were completed. This particular case vignettes an overlooked osteoid osteoma that leads to the delay in diagnosis and increase morbidity.
  2. A Hamid MS, Hussein KH, Helmi Salim AM, Puji A, Mat Yatim R, Yong CC, et al.
    BMJ Open, 2020 08 20;10(8):e039105.
    PMID: 32820000 DOI: 10.1136/bmjopen-2020-039105
    INTRODUCTION: Hamstring injury among athletes often results in significant morbidity. Currently, there are controversies regarding the clinical use of platelet-rich plasma (PRP) for the treatment of acute hamstring injury.

    METHODS AND ANALYSIS: This study is a single-centre double-blind randomised placebo-controlled trial. Sixty-eight patients will be randomised to receive under ultrasound guidance either a single injection of leucocyte-rich PRP (LR-PRP) or normal saline. All patients will undergo a standardised hamstring rehabilitation programme under the supervision of a sports physiotherapist. Outcome data will be collected before intervention (baseline), and thereafter on a weekly basis. The primary outcome measure is the duration to return-to-play. It is defined as the duration (in days) from the date on which the injury occurred until the patients were pain-free, able to perform the active knee extension test and have regained hamstring muscle strength. Secondary outcome measures include assessment of pain intensity and the effect of pain on to day-to-day functions using the self-reported Brief Pain Inventory-Short Form questionnaire. Both the primary and secondary outcomes were assessed at baseline and thereafter once a week until return to play. Also, hamstring injury recurrence within the first 6 months after recovery will be monitored via telephone. The results of this study will provide insights into the effect of LR-PRP in muscle and may help to identify the best PRP application protocol for muscle injuries.

    ETHICS AND DISSEMINATION: Ethics approval were obtained from the Medical Research Ethics Committee of the University of Malaya Medical Centre. Results of this trial will be submitted for publication in a peer-reviewed journal.

    TRIAL REGISTRATION NUMBER: ISRCTN76844299.

  3. Roslan A, Stanislaus R, Yee Sin T, Aris FA, Ashari A, Shaparudin AA, et al.
    Int J Cardiol Heart Vasc, 2023 Aug;47:101242.
    PMID: 37576081 DOI: 10.1016/j.ijcha.2023.101242
    BACKGROUND: Athletes have changes that can mimic pathological cardiomyopathy.

    METHODS: Echocardiographic study of 50 male, female athletes (MA, FA) and non-athletes (MNA, FNA) age 18 to 30 years. These athletes participate in sports with predominantly endurance component. All participants exhibit no known medical illnesses or symptoms.

    RESULTS: MA have thicker wall (IVSd) than MNA. No MA have IVSd > 1.2 cm and no FA have IVSd > 1.0 cm. Left ventricle internal dimension (LVIDd), left ventricle end diastolic volume index (LVEDVi) is bigger in athletes. None have LVIDd > 5.8 cm. Right ventricle fractional area change (FAC) is lower in athletes. (MA vs MNA, p = 0.013, FA vs FNA, p = 0.025). Athletes have higher septal and lateral e' (Septal e'; MA 13.57 ± 2.66 cm/s vs MNA 11.46 ± 2.93 cm/s, p  1.2 cm and/or LVIDd > 5.8 cm. There is no difference in GLS, RVFWS and GCS but athletes have smaller LArS and LAbS.

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