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Fulltext Appearance of Acute Inflammatory State Indicates Improvement in Atopic Dermatitis Cases Under Classical Homeopathic Treatment: A Case Series

Mahesh S, Mallappa M, Habchi O, Konstanta V, Chise C, Sykiotou P, et al.

Clin Med Insights Case Rep, 2021;14:1179547621994103.
PMID: 33628071 DOI: 10.1177/1179547621994103

The Continuum theory and the Levels of Health theory propound the idea that return of efficient acute inflammation (high fever) heralds true improvement in chronic inflammatory states. We present 6 cases of atopic dermatitis (AD), which had stability in their improvement for 1 year or more, under classical homeopathy. The cases were retrospectively assessed with selected based on the Hanifin Rajka atopic dermatitis diagnostic criteria and the follow ups evaluated according to changes on SCORing Atopic Dermatitis scale (SCORAD) scale. The pictures are presented as evidence. Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homeopathic intervention was used to assess the effect of homeopathy in these cases. All the cases improved and stabilised with complete skin clearance (those that relapsed within 1 year were not included). These patients had not suffered high fevers/acute inflammatory diseases since onset/aggravation of AD. Five of the 6 cases developed acute inflammatory diseases as the chronic condition improved. The last case showed return of an old, lesser pathology. The control cases - which were selected for non-improvement under classical homeopathy also showed remarkable skin clearance when there was appearance of acute inflammatory states. In this study, there is a mutually exclusive relationship between efficient acute inflammation and chronic inflammation, which is in accordance with the 2 theories considered here. Further scientific studies are necessary to establish the phenomenon at tissue level.

Matched MeSH terms: Follow-Up Studies
Fulltext A protocol on information-motivation-behavioural skills risk of intensive phase treatment interruption among pulmonary tuberculosis patients in urban districts, Selangor

Qudsiah Suliman, Salmiah Md. Said, Nor Afiah Mohd. Zulkefli, Lim Poh Ying, Tan Kit-Aun

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):85-93.
MyJurnal

Introduction: Despite advancement of treatment modalities, Tuberculosis (TB) treatment interruption rate has glob- ally accelerating, calling for greater framework shifting towards psychosocial intervention. Similarly, Selangor state had reported the perturbing TB treatment interruption rate, which was figured persistently above 10% in the interval year of 2014 to 2018, thus signifies an empirical assessment on Information-Motivation-Behavioural skills (IMB) determinants of TB intensive phase treatment. This study aims to determine the time to intensive phase TB treatment interruption and its prognostic factors among newly diagnosed pulmonary Tuberculosis (PTB) smear positive patients in urban district Selangor. Methods: A multi-centric prospective cohort study will recruit 695 newly diagnosed PTB smear positive patients at treatment centres in urban districts, Selangor. This study will utilize validated self-admin- istered questionnaire and standardised data collection form (PROFORMA). At baseline, we will elicit information on IMB models constructs, additionally on socio-demographics, health service factors and clinical characteristics. Meanwhile, four points follow up will be executed to retrieve information on treatment status and time varying effects of body weight, treatment side effects, symptoms improvement and internalised stigma. Finally, survival analysis will be computed to identify the time to intensive phase treatment interruption and its prognostic factors. Conclusion: This study will enlighten IMB model determinants of intensive phase treatment interruption, hence to endeavour psychosocial elements in designing time relevant public health strategies in TB case management.

Matched MeSH terms: Follow-Up Studies
Fulltext Outcome of core out fistulectomy and the ligation of anal fistula tract: A single center experience in Malaysia

C. Z. M Salehudin, Azmi Md Nor, Razman Mohd Rus

IIUM Medical Journal Malaysia, 2020;19(1):55-59.
MyJurnal

Fistula-in-ano is a benign anorectal disease which always poses a big dilemma to the surgeons
because of their significant recurrent rate following surgery. Materials and Methods: A cross-sectional study
involving 42 patients undergoing core out fistulectomy in the Hospital Tengku Ampuan Afzan, Kuantan,
Pahang, Malaysia were included in this study. Demographic data of patients were assessed. Endoanal
ultrasound (EAUS) was done prior to the surgery to determine types of fistula and classified using Park’s
classification. Follow up was made post-operatively at 4th week, 2nd month, 3rd month, 4th month, 5th month
and 6th month to look for the duration of healing or recurrence. Results: 5 out of 42 patients were lost to
follow up leaving 37 patients available for the analysis. Mean age of the patient was 38.4 (13.8) years old.
Transphincteric and intersphincteric type of fistula accounted for 54.5% and 40.1%, respectively. 62.2%
(n=23) of patients achieved primary healing after the procedure. The mean for healing duration was 3.7
(3.1) months. Recurrence of the disease was seen only in 37.8% (n=14) of the patients. Conclusions: Even
though we managed to achieve significant success rate cumulatively, recurrence of fistula still impose a
significant challenge toward patient’s management. Therefore, further prospective study with a bigger
sample size is recommended to look into this method to reduce recurrence of fistula.

Matched MeSH terms: Follow-Up Studies
Fulltext Gliosarcoma of a brain: a challenging diagnosis

Nornazirah Azizan, Nor Haizura Ab Rani, Ahmad Toha Samsudin, Fadhli Mustaffa, Firdaus Hayati

Borneo Journal of Medical Sciences, 2020;14(3):39-44.
MyJurnal

Gliosarcoma is a rare primary malignant tumour of the central nervous system. A 28-year-old radiographer without a history of neurological disorder, malignancy or trauma presented with unprovoked seizures. He was symptom-free for 3 years but developed relapsed. Computed tomography of the brain was consistent with anaplastic convexity meningioma which was identical via intraoperative findings. However, the final histology revealed gliosarcoma of the brain. He recovered well postoperatively without any neurological deficit and had completed adjuvant chemo-radiotherapy. He was asymptomatic during follow up with no tumour recurrence. Gliosarcoma with predominant sarcomatous component mimicking a meningioma has prolonged survival as compared to a case with predominant glioblastoma component. Hence, the discordance between clinical, radiological, intraoperative and histopathological findings is a challenge in establishing a diagnosis of gliosarcoma.

Matched MeSH terms: Follow-Up Studies
Fulltext A Novel Restorative Pulmonary Valve Conduit: Early Outcomes of Two Clinical Trials

Morales DL, Herrington C, Bacha EA, Morell VO, Prodán Z, Mroczek T, et al.

Front Cardiovasc Med, 2020;7:583360.
PMID: 33748192 DOI: 10.3389/fcvm.2020.583360

Objectives: We report the first use of a biorestorative valved conduit (Xeltis pulmonary valve-XPV) in children. Based on early follow-up data the valve design was modified; we report on the comparative performance of the two designs at 12 months post-implantation. Methods: Twelve children (six male) median age 5 (2 to 12) years and weight 17 (10 to 43) kg, had implantation of the first XPV valve design (XPV-1, group 1; 16 mm (n = 5), and 18 mm (n = 7). All had had previous surgery. Based on XPV performance at 12 months, the leaflet design was modified and an additional six children (five male) with complex malformations, median age 5 (3 to 9) years, and weight 21 (14 to 29) kg underwent implantation of the new XPV (XPV-2, group 2; 18 mm in all). For both subgroups, the 12 month clinical and echocardiographic outcomes were compared. Results: All patients in both groups have completed 12 months of follow-up. All are in NYHA functional class I. Seventeen of the 18 conduits have shown no evidence of progressive stenosis, dilation or aneurysm formation. Residual gradients of >40 mm Hg were observed in three patients in group 1 due to kinking of the conduit (n = 1), and peripheral stenosis of the branch pulmonary arteries (n = 2). In group 2, one patient developed rapidly progressive stenosis of the proximal conduit anastomosis, requiring conduit replacement. Five patients in group 1 developed severe pulmonary valve regurgitation (PI) due to prolapse of valve leaflet. In contrast, only one patient in group 2 developed more than mild PI at 12 months, which was not related to leaflet prolapse. Conclusions: The XPV, a biorestorative valved conduit, demonstrated promising early clinical outcomes in humans with 17 of 18 patients being free of reintervention at 1 year. Early onset PI seen in the XPV-1 version seems to have been corrected in the XPV-2, which has led to the approval of an FDA clinical trial. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02700100 and NCT03022708.

Matched MeSH terms: Follow-Up Studies
Outcomes of Subliminal Transscleral Cyclophotocoagulation treatment in glaucoma

Chow JY, Wan Norliza WM, Bastion MC

Med J Malaysia, 2021 03;76(2):236-240.
PMID: 33742635

BACKGROUND: Subliminal transscleral cyclophotocoagulation (SL-TSCPC) is a new alternative therapy to reduce intraocular pressure (IOP) safely and effectively. However, there are few studies regarding SL-TSCPC by Supra 810 laser machine and limited data regarding its effectiveness in moderate severity glaucoma that still has good preservation of vision. This study was conducted to evaluate the outcome of SL-TSPCPC in various types of glaucoma including patients with good vision.
METHODS: A retrospective, non-comparative, analytical case series of all patients who received SL-TSCPC treatment from October 2018 to April 2019 at Hospital Tengku Ampuan Afzan, Pahang, Malaysia. Data was collected during the second week, sixth week, third month and sixth month follow-up. The primary outcome measure gave success rate at six months post-treatment. Secondary measures were changes in visual acuity, mean IOP reduction, mean number of IOP lowering medications reduced and ocular side effects noted during follow-up.
RESULTS: The success rate was 43.8% (seven eyes out of sixteen eyes) at six months post-treatment. The mean IOP reduced from 43.0mmHg±14.8mmHg pre-treatment to 24.7mmHg±12.0mmHg at two weeks post treatment with 42.6% reduction. Subsequently, mean IOP at sixth week, third month and sixth month were 33.8mmHg±16.9mmHg, 35.2mmHg±14.9mmHg, and 29.0mmHg±16.2mmHg respectively. Vision maintained in 13 patients, two patients had improvement in vision however, five patients had deterioration in vision. No serious ocular side effects were noted.
CONCLUSION: Subliminal TSCPC is a safe and alternative method of lowering IOP in moderate to advanced glaucoma over 6 months duration of follow-up. As it has good safety profile and repeatability, it is a good treatment option for patients with uncontrolled glaucoma.

Matched MeSH terms: Follow-Up Studies
Fulltext The psychological well-being of patients with schizophrenia on follow up clinics in three psychiatric hospitals in Malaysia

Zamuna Mat Nor, Idayu Badilla Idris, Faiz Daud, Natrah Abd Rani

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):203-208.
MyJurnal

Introduction: The daily life problems of patients with schizophrenia as well as their symptoms are challenging sit- uations that may interfere with their psychological well-being. The purpose of this study is to investigate the factors affecting the psychological well-being of patients with schizophrenia and factors affecting it. Methods: A cross sec- tional study was conducted to examine the socio-demographic factors, health level, social support and self-esteem of patients with schizophrenia. A total of 255 respondents consisting of patients on follow-up from specialist clinics at three Psychiatric Hospitals in this country were selected to answer the questionnaire. The questionnaires used were the Affect Balance Scale, the Multidimensional Scale of Perceived Social Support Scale and the Rosenberg Self-Esteem Scale for the measurement of the psychological well-being, social support and self-esteem respectively. The data was analysed using Chi-Square and Mann-Whitney U test. Results: A total of 62% of the respondents had positive psychological wellbeing. Socio demographic factors, namely occupation (p=0.007), overall social support (p=0.023), family support (p=0.040), significant others’ support (p=0.046), and self-esteem (p < 0.001), were associ- ated with positive psychological well-being. Conclusion: This study has proven that patients with schizophrenia who regularly received treatment can achieve positive psychological well-being when they have high self-esteem, strong support from their family members as well as people around them and are stable occupation.

Matched MeSH terms: Follow-Up Studies
Fulltext Late asymptomatic medial patella subluxation post total knee arthroplasty

Abilash Kumar, Jeffrey Jayaraj, Jacob Abraham, Premchandran Menon, Manohar Arumugam

Borneo Journal of Medical Sciences, 2021;15(1):61-66.
MyJurnal

Post-operative complications are well known to impair the functional outcomes of total knee arthroplasty (TKA). Patella subluxations post-TKA is a grim complication rendering patients disable post-surgery. Howbeit, medial patella subluxation is a rarely recorded incident altogether. This case report describes a patient post successful TKA two years ago, who was incidentally diagnosed with a medial patellofemoral subluxation during a recent routine yearly follow up. This gentleman, however, had no complaints and the only evident clinical sign was anterior knee skin puckering. A radiograph of the knee confirmed our clinical suspicion of medial patella subluxation. The patient’s symptoms, his expectations, radiological findings, what went wrong during surgery and management of this rare entity were analysed. This rarely reported entity requires a high degree of suspicion especially if the patient complains of instability and peculiar anterior knee pain. Diagnosis is customarily clinical and revision surgery is almost invariably necessary.

Matched MeSH terms: Follow-Up Studies
Fulltext Hyalinizing clear cell carcinoma of the soft palate - a case report

Sharifah Intan Safuraa, Sethu Subha, Muhamad Doi, Sellymiah Adzman

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):333-336.
MyJurnal

Hyalinizing clear cell carcinoma presents as a painless submucosal mass commonly located at the palate and base of tongue. It is a rare tumour and has often been misdiagnosed for other more common tumours with clear cytoplasm, such as acinic cell carcinoma, clear cell oncocytoma or mucoepidermoid carcinoma. HCCC has been reported as a low grade malignant tumour with a high rate of cervical metastases. Due to its rarity, there is no treatment protocol. However, the treatment of choice is wide local excision and the neck disease is treated with neck dissection or ra- diotherapy or both with no conclusive outcome as incidence is too low or underreported with no long term follow up. Our case highlights the diagnosis difficulties in such rare cases, and the need for longer follow up post excision to determine outcome and recurrence rates.

Matched MeSH terms: Follow-Up Studies
Fulltext Incremental Value of Single-photon Emission Computed Tomography-computed Tomography for Characterization of Skeletal Lesions in Breast Cancer Patients

Mahaletchumy T, AbAziz A

World J Nucl Med, 2017 Oct-Dec;16(4):303-310.
PMID: 29033679 DOI: 10.4103/1450-1147.215496

The incremental value of single-photon emission computed tomography-computed tomography (SPECT-CT) over planar bone scintigraphy and SPECT in detecting skeletal lesions in breast cancer patients and its effect on patient management is assessed in this study. This is a prospective study which was conducted over 1-year duration. Whole-body planar scintigraphy, SPECT, and SPECT-CT were performed in 85 breast cancer patients with total of 128 lesions. Correlative imaging and clinical follow-up was used as the reference standard. McNemar's multistep analysis was performed for each patient and each lesion. On patient-wise analysis, 47 patients had equivocal diagnosis on planar bone scintigraphy, 28 on SPECT, and eight on SPECT-CT. On lesion-wise analysis, there were 72 equivocal lesions on planar bone scintigraphy, 48 on SPECT, and 15 on SPECT-CT. Overall, SPECT-CT resulted in a significant reduction in the proportion of equivocal diagnosis on both patient-wise (P < 0.004) and lesion-wise basis (P < 0.004), irrespective of the skeletal region involved. The sensitivity on a per-patient basis was 43%, 58%, and 78% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Similarly, the specificity was 85%, 92%, and 94% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Patient management was correctly altered in 32% of the patients based on SPECT-CT interpretation. Our data suggest that adding SPECT-CT to whole-body imaging significantly improves sensitivity and specificity in diagnosing bone metastases and significantly reduces the proportion of equivocal diagnosis in all regions of the skeleton. The most important outcome is derived from the accurate alteration in patient management clinically by down- and up-staging of patients and a more precise identification of metastatic extent.

Matched MeSH terms: Follow-Up Studies
Fulltext The Influence of Medial Comminution in the Treatment Choice of Radial Head Fracture

Touloupakis G, Biancardi E, Theodorakis E, Ghirardelli S, Ferrara F, Gherlinzoni F, et al.

Malays Orthop J, 2020 Nov;14(3):124-128.
PMID: 33403072 DOI: 10.5704/MOJ.2011.019

Introduction: The aim of our retrospective study was to investigate the role of the medial side involvement in the treatment choice of radial head fractures.
Materials and Methods: We searched the databases of our institutions for the surgical procedures diagnosed as "fracture of the radial head" and for the procedures related to "prosthesis of the radial head" and "osteosynthesis of the radial head" in the period from May 2014 to October 2017. The fractures were first classified according to the Mason classification . We then allocated the patients into three study groups according to the site of the fracture, either the medial or lateral side of the radial head : Group A, with an isolated lateral fracture of the radius head; Group B1, with a medial fracture of the radius head with two medial fragments; and Group B2, with a medial fracture of the radius head with multiple medial fragments. We performed a multivariate analysis to identify statistically significant correlation between the pre-operative classifications of Mason and our study, the type of surgical procedure, and the clinical outcome.
Results: Mayo Elbow Performance (MEP) scores determined at the final follow-up of the study (mean 16.6 months, range 12-26 months) was excellent in 17 patients (4 in Group A, 6 in Group B1 and 7 in Group B2), and good in 12 patients (3 in Group A, 7 in Group B1, and 2 in Group B2). One patient showed a poor result in MEP score probably because of an infection and implant removal.
Conclusion: Regarding medial fractures of the radial head, our study showed satisfactory results with a radial head prosthesis for comminuted or multifragmentary radial head fractures. For surgeons with advanced elbow fracture expertise, osteosynthesis could be attempted in a fracture pattern that involved only two medial fragments.

Matched MeSH terms: Follow-Up Studies
Fulltext Two-Year Outcome of Synthetic Annular Ligament Reconstruction in the Elbow: A Case Report

Kesu Belani L, Abdullah S, Harun MH, Narin Singh PSG, Sapuan J

Cureus, 2020 Nov 19;12(11):e11564.
PMID: 33364091 DOI: 10.7759/cureus.11564

Monteggia fracture is commonly treated with open anatomical reduction and fixation of the ulna fracture. The radial head will be automatically reduced once anatomical fixation of the ulna is achieved. However, it is occasionally associated with an irreducible radial head dislocation requiring an open reduction and reconstruction of the torn annular ligament. We describe a case of traumatic Monteggia fracture which underwent initial plating, however post-operative radiograph denoted an irreducible radial head secondary to a ruptured annular ligament. We reconstructed the annular ligament with a synthetic graft sling around the radial neck with an anchor suture. The radial head was stable in all directions after annular ligament reconstruction. A two-year follow-up shows full range of motion of the elbow joint with osteolysis of the radial head, no other operative morbidity was observed.

Matched MeSH terms: Follow-Up Studies
Fulltext Impact of COVID-19 on clinical trials and clinical research: A systematic review

Sathian B, Asim M, Banerjee I, Pizarro AB, Roy B, van Teijlingen ER, et al.

Nepal J Epidemiol, 2020 Sep;10(3):878-887.
PMID: 33042591 DOI: 10.3126/nje.v10i3.31622

Background: The World Health Organization has reported more than 31,186,000 confirmed cases of coronavirus disease-19 (COVID-19), including 962,343 deaths, worldwide as on September 21, 2020. The current COVID-19 pandemic is affecting clinical research activities in most parts of the world. The focus on developing a vaccine for SARS-CoV-2 and the treatment of COVID-19 is, in fact, disrupting many upcoming and/or ongoing clinical trials on other diseases around the globe. On March 18, 2020, the United States Food and Drug Administration (FDA) issued an updated guideline for the conduct of clinical trials during the current health emergency situation. The potential challenges, such as social distancing and quarantines, result in study participants' inaccessibility and trial personnel for in-person scheduled study visits and/or follow-up. Due to the sudden onset and wide-spread impact of COVID-19, its influence on the management of clinical trials and research necessitates urgent attention. Therefore, our systematic review of the literature aims to assess the impact of the COVID-19 pandemic on the conduction of clinical trials and research. The search for the relevant articles for review included the keywords "COVID-19" AND "clinical trial" in PubMed, MEDLINE, Embase, Google scholar and Google electronic databases. Key findings include: delaying subject enrollment and operational gaps in most ongoing clinical trials, which in turn has a negative impact on trial programmes and data integrity. Globally, most sites conducting clinical trials other than COVID-19 are experiencing a delay in timelines and a complete halt of operations in lieu of this pandemic, thus affecting clinical research outcomes.

Matched MeSH terms: Follow-Up Studies
Gut Microbiota and Epilepsy: A Systematic Review on Their Relationship and Possible Therapeutics

Arulsamy A, Tan QY, Balasubramaniam V, O'Brien TJ, Shaikh MF

ACS Chem Neurosci, 2020 Nov 04;11(21):3488-3498.
PMID: 33064448 DOI: 10.1021/acschemneuro.0c00431

Dysbiosis of gut microbiota may lead to a range of diseases including neurological disorders. Thus, it is hypothesized that regulation of the intestinal microbiota may prevent or treat epilepsy. The purpose of this systematic review is to evaluate the evidence investigating the relationship between gut microbiota and epilepsy and possible interventions. A systematic review of the literature was done on four databases (PubMed, Scopus, EMBASE, and Web of Science). Study selection was restricted to original research articles while following the PRISMA guidelines. Six studies were selected. These studies cohesively support the interaction between gut microbiota and epileptic seizures. Gut microbiota analysis identified increases in Firmicutes, Proteobacteria, Verrucomicrobia, and Fusobacteria with decreases in Bacteroidetes and Actinobacteria in epileptic patients. Ketogenic diet, probiotics, and fecal microbiota transplantation (FMT) improved the dysbiosis of the gut microbiota and seizure activity. However, the studies either had a small sample size, lack of subject variability, or short study or follow-up period, which may question their reliability. Nevertheless, these limited studies conclusively suggest that gut microbiota diversity and dysbiosis may be involved in the pathology of epilepsy. Future studies providing more reliable and in depth insight into the gut microbial community will spark promising alternative therapies to current epilepsy treatment.

Matched MeSH terms: Follow-Up Studies
Fulltext Refractive error status of orang asli and Malay-Jawa children in Kuala Langat, Selangor

Fairuz Mohd Nordin, Khairun Najah binti Hasrin, Mohd Zaki Awg Isa, Amalina Othman, Zurin Firdawani Yacob

Journal of Optometry, Eye and Health Research, 2020;2(1):28-33.
MyJurnal

This study aims to determine the refractive error status of Orang Asli children and Malay-Jawa children in Kuala Langat, Selangor. Visual acuity was measured using LEA chart, followed by dry static retinoscopy which the testing eye fogged with 2.00D, and the contralateral eye fogged with 6.00D to determine the refractive errors. The inclusion criteria encompassed all children in the selected village. The exclusion criteria included children who were already on ophthalmology follow-up for known ocular conditions and refused visual acuity assessment or eye examination. In total, 103 ‘Orang Asli’ and 107 normal population children aged 3 to 13 years received refractive assessments. Approximately 18% of reported cases were myopia, 43% were hyperopia, while 39% were emmetropia. Results showed that the ‘Orang Asli’ population was more hyperopic than the Malay-Jawa (U = 4893.500, P > 0.05, r = 0.14). However, both groups were found more hyperopic compared to myopic conditions. In conclusion, both Orang Asli and Malay-Jawa in Kuala Langat, Selangor are more hyperopic and less myopic. This study suggests that refractive error screening is important for preventing visual impairment among children in rural areas.

Matched MeSH terms: Follow-Up Studies
Fulltext Preliminary result of effectiveness of education intervention on coping with workplace violence among healthcare workers in health clinics

Mohd Safwan Ibrahim, Ahmad Azuhairi Ariffin, Sri Ganesh Muthiah

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):97-97.
MyJurnal

Introduction: Workers in health sector are exposed 5 times more workplace violence as compared to workers in other sectors. Their consequences can range from mild to severe, affecting the victim, quality of services and orga-nization. The objective is to evaluate the effectiveness of educational intervention on workplace violence among healthcare workers in health clinics. Methods: This study is a single blinded cluster randomized trial to see the ef-fectiveness of education intervention on coping with workplace violence involving 10 cluster clinics with total 82 respondents in each control and intervention group. Data was collected using pretested questionnaire at baseline, 1-month and 6-months post intervention. The analysis used were descriptive, compared mean at baseline, repeated measures of variance and Mixed Model. Results: Response rate 94% at 1-month due to loss to follow up. Majority of the respondents were female (82.3%), and Malays (83.5%). The prevalence of workplace violence was 27.4% and mostly involved psychological violence (95.6%). There were no significant different between control and interven-tion group characteristic at baseline. Repeated measures MANOVA test was conducted to test intervention effect on dependent variables. The results until 1-month time showed significant difference between intervention and control group on combination of the dependent variables over time in coping (F(1,162)=9.51, p=0.002, and η2=0.06), knowledge (F(1,162)=10.47, p=0.001, and η2=0.061) and confidence (F(1,162)=15.65, p

Matched MeSH terms: Follow-Up Studies
Fulltext Modified Short Proximal Femoral Nail for Intertrochanteric Fractures of Femur in Indian Patients - our Experience

Jha V, Ahmed T

Malays Orthop J, 2020 Jul;14(2):72-82.
PMID: 32983380 DOI: 10.5704/MOJ.2007.015

Introduction: Proximal femoral nail (PFN) is a commonly used implant for intertrochanteric fractures which is designed according to western femoral measurements. However, anthropometry of proximal femur in Indian and in general, Asian, are smaller. So a modified short PFN with smaller dimensions was developed. This study analyses the radiological and functional outcome of treatment of intertrochanteric fractures with modified short PFN.
Materials and Methods: A retrospective study analysed 120 adult patients operated between 2014-2017 using modified short PFN for intertrochanteric fractures, having a minimum follow-up of 12 months. Clinical and radiological parameters including tip-apex distance (TAD), position of tip of lag screw in femoral head, lateral slide of lag screw as well as length of anti-rotation screw were measured. Final functional outcome was assessed using Barthel's index and Kyle's criteria.
Results: Good reduction was achieved in 90.83% cases and 79.16% had ideal placement of lag screw in femoral head. Intra-operative difficulties were encountered in 13.33% (n=16). Mean TAD AP (anteroposterior) was 11.8mm, TAD LAT (lateral) was 11.0mm and mean TAD TOT was 22.8mm. Overall mean lateral slide was 3.20mm and it was more in unstable fracture. We had five mechanical failures, one patient with screw breakage without loss of reduction and two peri-implant fractures after union. 81.66% returned to pre-injury levels of activity with 88.33% good to excellent outcome as per Kyle's criteria.
Conclusion: Although, not devoid of complications, modified short PFN results in good functional recovery of patients with intertrochanteric fractures of femur.

Matched MeSH terms: Follow-Up Studies
Fulltext Cubitus Valgus with Tardy Ulnar Nerve Palsy - Is Anterior Transposition of the Ulnar Nerve Always Necessary? A Case Report

Anuar-Ramdhan IM, Remli R, Abdul-Rashid AH, Ibrahim S

Malays Orthop J, 2020 Jul;14(2):126-129.
PMID: 32983387 DOI: 10.5704/MOJ.2007.010

Tardy ulnar nerve palsy is a known complication of cubitus valgus. The options for treating the ulnar neuropathy include anterior nerve transposition or neurolysis. We report on an 11-year-old boy who had a tardy ulnar nerve palsy due to cubitus valgus resulting from a non-union of a lateral condyle fracture of the humerus. Anterior transposition of the ulnar nerve was not done after the closing wedge osteotomy of the distal humerus. The close wedge osteotomy relieved the tension on the nerve and not transposing the ulnar nerve anteriorly prevented an iatrogenic nerve injury. The patient had no restriction with activities of daily living at the six years follow-up although neurological recovery was incomplete.

Matched MeSH terms: Follow-Up Studies
Fulltext Evaluating the Feasibility of an Innovative Self-Confidence Webinar Intervention for Depression in the Workplace: A Proof-of-Concept Study

Wan Mohd Yunus WMA, Musiat P, Brown JS

JMIR Ment Health, 2019 Apr 26;6(4):e11401.
PMID: 31025943 DOI: 10.2196/11401

BACKGROUND: Depression in the workplace is a very common problem that exacerbates employees' functioning and consequently influences the productivity of organizations. Despite the commonness of the problem and the currently available interventions, a high proportion of employees do not seek help. A new intervention, a webinar (Web-based seminar), was developed, which integrated the use of technology and the traditional guided therapist support to provide accessible help for the problem of depression in the workplace.
OBJECTIVE: The aim of this study was to explore the feasibility, preliminary outcome, and acceptability of the webinar intervention conducted in organizations.
METHODS: In total, 2 organizations were invited to participate, and 33 employees participated in this proof-of-concept study. The webinar intervention consisted of 6 1-hour sessions conducted via the Adobe Connect platform, developed by Adobe Inc. The intervention was developed based on a systematic review, focus group studies, and face-to-face self-confidence workshops that utilized cognitive behavior therapy (CBT). The final webinar intervention used CBT and the coping flexibility approach. The structure of the intervention included PowerPoint presentations, animation videos, utilization of chat panels, and whiteboard features. The intervention was conducted live and guided by a consultant psychologist assisted by a moderator. Study outcomes were self-assessed using self-reported Web surveys. The acceptability of the intervention was assessed using self-reported user experience Web surveys and open-ended questions.
RESULTS: The findings showed: (1) evidence of feasibility of the intervention: the webinar intervention was successfully conducted in 3 groups, with 6 1-hour sessions for each group, with 82% (23/28) participants completing all 6 sessions; (2) positive improvements in depression: the linear mixed effects modeling analysis recorded a significant overall effect of time primarily for depression (F2, 48.813=31.524; Pfollow-up. Individually, 8 subjects showed significant reliable and clinically significant changes, with 3 subjects showing clinically significant change only; and (3) encouraging evidence regarding the acceptability of the webinar intervention among the employees: the user experience score was above average for 4 out of 6 domains measured (perspicuity mean 1.198 [95% CI 0.832-1.564], efficiency mean 1.000 [95% CI 0.571-1.429], dependability mean 1.208 [95% CI 0.899-1.517], and stimulation mean 1.323 [95% CI 0.987-1.659]). The open-ended questions also yielded 52% (47/91) of the responses that reported facilitators, whereas only 12% (11/91) of the responses reported barriers.
CONCLUSIONS: The self-confidence webinar intervention appears to be a potentially feasible, effective, and acceptable intervention for depression in the workplace that merits further investigation.

Matched MeSH terms: Follow-Up Studies
Fulltext Antiretroviral treatment-associated labia majora lipohypertrophy: A rare case and plastic surgical treatment options

Akmal Hisham, Devananthan Ilenghoven, Wan Syazli Wan Ahmad Kamal, Salina Ibrahim, Shah Jumaat Mohd Yussof

Journal of Clinical and Health Sciences, 2017;2:43-47.

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

Matched MeSH terms: Follow-Up Studies

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