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Fulltext Ganglion of the Flexor Tendon Sheath at the A2 Pulley - Case Report

Gunaseelan P, Jeremy P, Chua CK, Rashdeen F

Malays Orthop J, 2015 Mar;9(1):28-29.
PMID: 28435592 MyJurnal DOI: 10.5704/MOJ.1503.002

There are few reported cases of flexor tendon sheath ganglion arising from the A2 pulley. We report a case of a flexor tendon sheath ganglion in a 17-year old female who presented with pain, triggering and a swelling at the base of her right ring finger. During the excision biopsy, a ganglion measuring 0.5×0.8×0.4 cm in size was removed from the A2 pulley area.

Matched MeSH terms: Pain
Assessment of sitting pressure on Malaysian bus drivers

Ahmad Rasdan Ismail, Mohd Afiq Zainal Rosli, Isa Halim, Baba Md. Deros, Mohd Nizam Ab Rahman, Md. Mustafizur Rahman

Journal of Occupational Safety and Health, 2012;9(3):1-9.
MyJurnal

The main purpose of this study was to establish the comfort zone for bus drivers in a seated position. In addition, this study is to investigate the seated pressure distribution among Malaysian bus drivers. The study consists of 10 bus drivers randomly selected to be a part of this study. The FSA pressure mat was utilized in order to investigate the force distribution of buttock to the seat pan of the drivers’ seat. This device is placed on the driver seat and backrest. Later, the subject would sit on for several minute. The finding reveals that most of the bus drivers feel discomfort by having low back pain and musculoskeletal disorder. The seat pressure distribution of Malaysian busses indicated that the seat not able to absorb high pressure generated from buttock that later may cause the discomfort and restricted the performance of drivers.

Matched MeSH terms: Low Back Pain
Fulltext Dislodged levornogestrel-intrauterine system intra-abdominally without uterine perforation: is it possible?

Ng, Beng Kwang, Lim, PS, Shahizon AMM, Ng, YL, Shafiee MN, Omar MH

Journal of Surgical Academia, 2016;6(1):51-53.
MyJurnal

We report a case of dislodged Levornogestrel-intrauterine system (LNG-IUS, Mirena®) without evidence of uterine perforation. A 37-year-old Para 4+1presented with 3 months history of lower abdominal pain. Examination and imaging showed that the device was not present in the uterine cavity. She underwent laparoscopic retrieval of Mirena®. There was no evidence of uterine perforation intra-operatively. This case illustrated the rare possibility of dislodged Mirena®intra-abdominally without evidence of uterine perforation. The management for missing IUS was reviewed.

Matched MeSH terms: Abdominal Pain
Fulltext A survey on common injuries in recreational badminton players

Muttalib, A., Zaidi, M., Khoo, C.

Malays Orthop J, 2009;3(2):8-11.
MyJurnal

The aim of this descriotive study is to determine the incidence of injuries among recreational badminton players. We evaluated 86 recreational badminton players in the city of Malacca; 35 were excluded for fitting the exclusion criteria. The average recreational badminton player was 36.13 years old and had been playing badminton for the past 17.84 years at a frequency of 2.11 times per week. 39.21% of the recreational badminton players complained of recent injuries in relation to playing badminton. Our data showed that the most common injury sustained by recreational badminton players was pain and stiffness at the shoulder joint. None of the injuries sustained by the players in our data were serious enough to warrant any form of surgical intervention. We conclude that badminton is a sport of relatively low risk and that the majority of related injuries were chronic overuse injuries.

Matched MeSH terms: Pain
Fulltext Modified Harrington Procedure for Acetabular Insuficiency Due to Metastatic Malignant Disease

Faisham, W.I., Muslim, D.A.J., Bhavaraju, V.M.K., Nawaz, A.H., Zulmi, W.

Malays Orthop J, 2009;3(1):36-41.
MyJurnal

Extensive peri-acetabular osteolysis caused by malignant disease process is a major surgical challenge as conventional hip arthroplasty is not adequate. We describe a modified use of the Harrington procedure for acetabular insufficiency secondary to metastatic disease in twelve patients. The procedures include application of multiple threaded pins to bridge the acetabular columns, anti-protrusio cage and cemented acetabular cup. Eleven patients were able to walk pain free and achieved a mean Musculoskeletal Tumour Society Functional Score of 80 (range, 68 to 86).

Matched MeSH terms: Pain
Fulltext Synovial Sarcoma of the Extremities. A Diagnosis that is Easily Missed.

Pan, K.L., Prem, S.S., Chan, W.H., Haniza S.

Malays Orthop J, 2009;3(2):12-15.
MyJurnal

Synovial sarcoma of the extremities is an uncommon type of soft tissue sarcoma occuring predominantly in young adults at the para-articular regions. We present a series of 10 patients with an average age of 44 years and include a follow-up of 39 months. Eight patients had a surgical procedure for a mistaken benign lesion. In contrast to other soft tissue sarcomas, the swellings were associated with pain and most were fixed to the underlying structures. Five patients had a local reccurence after many years, stressing the necessity for close and long-term follow-up in these patients.

Matched MeSH terms: Pain
Fulltext Classification, Epidemiology And Aetiology Of Oral Recurrent Aphtous Ulceration / Stomatitis

Zain, R.B.

Ann Dent, 1999;6(1):-.
MyJurnal

The most prevalent oral mucosal lesions are aphthous ulcerations commonly referred to as canker sores. The clinical characteristic of oral recurrent aphthous ulceration/stomatitis(ORAS) is well defined and can be partly described as an oval or rounded ulcer covered by a grey-white or yellowish fibrinous exudate and surrounded by an erythematous halo. There is intense or moderate pain and the ulcers heal in about 10 - 14 days for the more common type and more than 2 weeks for the severe type. Recurrence of the ulcers occurs at intervals within a year or over several years. Variations of ORAS described above have made studies on aetiology and treatment difficult to interpret due to differing descriptions of differing diseases with similar clinical signs and symptoms and possibly differing aetiologies. A classification that was considered useful as a working model for ORAS was formulated in 1978. While the classification of ORAS had been widely accepted since 1978, the cause for ORAS is still unknown and its aetiology in general remains unclear. However, its immunopathogenesis is now becoming more clearly defined.

Matched MeSH terms: Pain
Fulltext An investigation of a dental laboratory worker with chronic low back ache

Lim, Jac Fang, Richard Avoi, Noraziah Bakri, Leonard Masudal, Iskandar Nonche, Adrian Joseph, et al.

Journal of Occupational Safety and Health, 2017;14(2):39-41.
MyJurnal

The low back is usually associated with the lumbar spine which supports the entire weight of the upper body and significantly, is vital to the body mobility. Injury to the surrounding soft tissues can cause mild to debilitating symptoms due to muscle strain and ligament sprain. The causes of injury to the lower back are probably due to sudden twisting movement, poor posture position at work and manual handling of heavy objects or with twisting or bending movements while lifting. An Ergonomic Risk Assessment was carried out on a dental laboratory worker who complained of unresolved low back ache after a year on treatment and follow up at the outpatient department of a health clinic. From the various investigative methods used, it was found that the worker in question was placed in a situation that will over time encourage her to develop musculoskeletal disease. Our recommendations for change include immediate awareness and training in ergonomic principles of work and to report all cases so that appropriate action can be taken, reassess the workstation and environment of work, job enrichment, and creating a conducive environment for work. Once the changes have been implemented, a review will be necessary in three months time.

Matched MeSH terms: Low Back Pain
Fulltext Creating a culture of prevention in occupational safety and health practice: perceived body discomfort in two sitting positions

Sukadarin, E.H., Qian, F.S., Zakaria, J., Deros, B.M., Nawi, N.S.M.

Malaysian Journal of Public Health Medicine, 2018;18(102):47-51.
MyJurnal

Prolonged sitting is one of the factors for back discomfort. Sitting in the same position for long periods of time is worse.
This experimental based study was conducted to achieve three objectives. There were to 1) identify whether is there any
differences between perceived body discomfort among respondents before and after upright sitting, 2) identify whether
is there any differences between perceived body discomfort among respondents before and after slump sitting and 3)
compare the level of perceived body discomfort among respondents after two sitting postures. Thirty young and healthy
adults were recruited as study respondents. Each respondent was asked to sit in a posture either upright or slump for 30
minutes. Respondents were then rated their body discomfort using Borg CR-10 scale before and after sitting. Another
sitting posture was carried out after one day interval. There is a significant difference between perceived body
discomfort among respondents before and after upright and slump sitting. Body discomfort of upright sitting was shown
significantly greater than slump sitting. Although, slump sitting caused less discomfort than upright, but it proven by
previous studies did not provide benefit to occupational safety and health practice in preventing occupational health
related disease.

Matched MeSH terms: Back Pain
Fulltext Discal Cyst of the Lumbar Spine: Case Report of a Rare Clinical Entity

Sanjeevan R, Prabu S, Azizul A, Abdul-Halim Y

Malays Orthop J, 2018 Jul;12(2):56-58.
PMID: 30112131 MyJurnal DOI: 10.5704/MOJ.1807.011

Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc. The patient had immediate relief of his symptoms and no postoperative complications. We recommend that endoscopic surgery can be an effective alternative to conventional open surgery for discal cyst of the lumbar spine.

Matched MeSH terms: Low Back Pain
Fulltext Molecular docking studies of coumarin hybrids as potential acetylcholinesterase, butyrylcholinesterase, monoamine oxidase A/B and β-amyloid inhibitors for Alzheimer's disease

Yusufzai SK, Khan MS, Sulaiman O, Osman H, Lamjin DN

Chem Cent J, 2018 Dec 04;12(1):128.
PMID: 30515636 DOI: 10.1186/s13065-018-0497-z

Coumarins are the phytochemicals, which belong to the family of benzopyrone, that display interesting pharmacological properties. Several natural, synthetic and semisynthetic coumarin derivatives have been discovered in decades for their applicability as lead structures as drugs. Coumarin based conjugates have been described as potential AChE, BuChE, MAO and β-amyloid inhibitors. Therefore, the objective of this review is to focus on the construction of these pharmacologically important coumarin analogues with anti-Alzheimer's activities, highlight their docking studies and structure-activity relationships based on their substitution pattern with respect to the selected positions on the chromen ring by emphasising on the research reports conducted in between year 1968 to 2017.

Matched MeSH terms: Pain
The effect of micro-osteoperforations on the rate of orthodontic tooth movement: A systematic review and meta-analysis

Sivarajan S, Ringgingon LP, Fayed MMS, Wey MC

Am J Orthod Dentofacial Orthop, 2020 Mar;157(3):290-304.
PMID: 32115107 DOI: 10.1016/j.ajodo.2019.10.009

INTRODUCTION: Minimally invasive micro-osteoperforations (MOPs) look promising for a routine acceleration of orthodontic tooth movement (OTM). The objective of this research was to systematically evaluate evidence regarding the effects of MOPs on the OTM rate, treatment duration, and associated complications.
METHODS: Electronic database and hand search of English literature in PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and clinical trial.gov, with author clarification were performed. The selection criteria were randomized controlled trial (RCT) comparing MOPs with conventional treatment involving both extraction and nonextraction. Cochrane's risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation approach were used for quality assessment. Studies were analyzed with chi-square-based Q statistic methods, I2 index, fixed-effects, and random-effects model. Quantitative analysis was done on homogenous studies using Review Manager.
RESULTS: Eight RCTs were included for the qualitative analysis. Meta-analysis of 2 homogenous studies indicated insignificant effect with MOPs (0.01 mm less OTM; 95% CI, 0.13-0.11; P = 0.83). No difference (P >0.05) was found in anchorage loss, root resorption, gingival recession, and pain.
CONCLUSIONS: Meta-analysis of 2 low-risk of bias studies showed no effect with single application MOPs over a short observation period; however, the overall evidence was low. The quality of evidence for MOP side effects ranged from high to low. Future studies are suggested to investigate repeated MOPs effect over the entire treatment duration for different models of OTM and its related biological changes.
TRIAL REGISTRATION NUMBER: PROSPERO CDR42019118642.

Matched MeSH terms: Pain
Fulltext Role of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in Cancer Prevention and Cancer Promotion

Wong RSY

Adv Pharmacol Sci, 2019;2019:3418975.
PMID: 30838040 DOI: 10.1155/2019/3418975

The nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed by medical practitioners in many clinical conditions for the symptomatic treatment of pain and fever. Due to their anti-inflammatory properties, these drugs have been investigated for their anticancer effects in numerous studies. This is because chronic inflammation has long been linked to carcinogenesis. As such, anti-inflammatory drugs are believed to play a role in cancer treatment and prevention. In the past few decades, research has shown that NSAIDs may decrease the risk of certain types of cancer. However, there is also a growing body of research that proves the contrary. Furthermore, NSAIDs are well known for many side effects, including some life-threatening ones. This review will discuss the relationship between chronic inflammation and cancer, the role of NSAIDs in cancer prevention and cancer promotion, and some of the potentially lethal side effects of these drugs.

Matched MeSH terms: Pain
Fulltext End-to-side nerve transfer in neuropathic pain post brachial plexus injury

Nur Dina, A., Shalimar, A.

JUMMEC, 2013;21(2):71-73.
MyJurnal

We report a case of a 59-year-old gentleman with complete left brachial plexus injury. He presented with
chronic pain over the dorsum of his left hand since the injury eight years ago. Medical treatment had been
optimised but the pain still persist. End-to-side nerve transfer was done involving superficial sensory radial
nerve and median nerve to alleviate the pain. The surgery was considered successful as the patient claimed
that the pain score had reduced a few weeks postoperatively. However, there was no sensory recovery and
functionally no improvement was observed.

Matched MeSH terms: Chronic Pain
Fulltext Carcinoma of stomach detected by routine transabdominal ultrasound

Wong M, Shum S, Chau W, Cheng C

Biomed Imaging Interv J, 2010 10 01;6(4):e39.
PMID: 21611075 DOI: 10.2349/biij.6.4.e39

Assessment of the stomach is not commonly included in routine scanning protocol of upper abdominal ultrasound (USG). However, assessment of the stomach in patients presenting with epigastric pain can yield invaluable results. This paper presents, as an illustration, a case of carcinoma of stomach detected by transabdominal ultrasound. The diagnosis is confirmed by subsequent CT, upper endoscopy and operation.

Matched MeSH terms: Abdominal Pain
Carpal tunnel syndrome: between conservative treatment and those treated surgically after failed conservative treatment

Omar MI

JUMMEC, 2005;8:50-55.

A retrospective study of 102 hands with carpal tunnel syndrome which were treated conservatively initially. Patients who were successfully treated with this method were then compared with those who had failed with this method and had to be treated with surgical decompression. This study found that it took a mean period of about 5.1 months of conservative treatment before deciding on surgery. Generally, the study shows a predominant involvement of the right hand and the female sex as full-time homemakers. Those who finally needed surgery had a longer duration of symptoms prior to consultation. Surgery brought a faster relief from both pain and numbness. It is recommended that conservative treatment be abandoned after a trial period of at least three to five months in order to encourage a speedier recovery.

Matched MeSH terms: Pain
Hirudotherapy in Wound Healing

Nair HKR, Ahmad NW, Lee HL, Ahmad N, Othamn S, Mokhtar NSHM, et al.

Int J Low Extrem Wounds, 2022 Dec;21(4):425-431.
PMID: 32815407 DOI: 10.1177/1534734620948299

Leeches are hermaphrodite, bloodsucking parasitic worms usually found in places with fresh water. Leech therapy existed 3000 years, and it is being used at a different scope. Several species of leeches have been used in medicine, and the most common species used is Hirudo medicinalis. Leeches suck the excess blood, reduce the swelling in the tissues, and promote healing by allowing fresh oxygenated blood to reach the area until normal circulation can be restored. Pain relief from leech therapy is rapid, effective, and long-lasting in many conditions. The aim of this study was to evaluate the efficacy and duration of healing utilizing sterile medicinal leeches, Hirudinaria manillensis, in the management of pain and wound healing. Leech was taken out from its sterile tube by using a pair of non-tooth sterile plastic forceps and gloved hands. Each leech was left in place for as long as it was feeding. Leeches were removed only after they became detached from the patient. The specimen jars containing the used leeches were sealed in either a biohazard bag or in a small yellow clinical waste bin liner securely fastened with a cable tie. The leech was killed by using 70% alcohol prior to disposal into a yellow hazard bin, which undergoes incineration. All 3 patients had improvements in their condition, especially in terms of reduction in the pain and improvement in their sense of balance. All the wounds healed well. Therefore, leech therapy is effective in reducing pain and increasing perfusion to allow the wounds to heal quickly. However, a more robust trial is needed to show significance as the sample size is small.

Matched MeSH terms: Pain
Satisfaction and tolerability using virtual reality (VR) as adjunctive treatment during flexible bronchoscopy: a randomized control trial

Sooriyaghandan IV, Mohamad Jailaini MF, Nik Abeed NN, Ng BH, Yu-Lin AB, Shah SA, et al.

BMC Pulm Med, 2023 Jan 10;23(1):10.
PMID: 36627598 DOI: 10.1186/s12890-023-02304-y

BACKGROUND: Patient comfort during invasive and therapeutic procedures is important. The use of virtual reality (VR) devices during flexible bronchoscopy (FB) as a method of distraction to increase patient tolerability and improve satisfaction has not been investigated. We aim to assess the satisfaction and tolerability of participants undergoing FB with or without VR.
METHODS: This was a single-center, open-label study on patients undergoing bronchoscopy, randomized into the control and interventional (VR) groups. The control group received standard care during FB. The interventional group was given a VR device during FB showing nature videos with soothing instrumental music. Pain, breathlessness, and cough were evaluated using a 10 cm visual analogue scale administered before and after FB. Anxiety was assessed using the State-Trait Anxiety Inventory. Satisfaction questionnaire (5-point Likert scale) was given to participants post FB.
RESULTS: Eighty participants enrolled, 40 in each arm. Median (IQR) satisfaction score in the VR group was 5.0 (3.0-5.0), and in the control group was 4.0 (3.0-5.0); (p pain was not significantly different (p = 0.290).
CONCLUSION: VR used during FB led to better participants' satisfaction and tolerability (breathlessness and cough). There was a significantly lower anxiety score in the VR group.

Matched MeSH terms: Pain
Fulltext Survey of postoperative pain in University Hospital Kuala Lumpur

Vijayan R, Tay KH, Tan LB, Loganathan

Singapore Med J, 1994 Oct;35(5):502-4.
PMID: 7701371

One hundred and eighty-three patients undergoing surgery were interviewed twenty-four hours following surgery to assess the quality of pain relief they received in the immediate postoperative period. Interviews were conducted using a standard questionnaire for all patients. They were asked to (1) rate the quality of pain relief they obtained on a Visual Pain Analogue Scale (VPAS-0 being no pain and 10 being the worst imaginable pain); (2) state whether they were happy and satisfied with the pain relief they received; (3) if dissatisfied, they were asked to give their reasons. 37.7% (69 patients) had moderate to severe pain--pain score greater than 6 on the VPAS. Most of these patients had undergone abdominal or major orthopaedic surgery. 32.7% (60 patients) were unhappy with their postoperative pain control. The main reasons for complaint from the patients were that analgesic injections were either not given promptly or were not given at all. The survey also highlighted the inadequate under-administration of narcotic injections in the postoperative period despite orders being written up. It showed there is an urgent need for setting up an Acute Pain Service for better postoperative pain control. An anaesthesiology based Acute Pain Service was started in October 1992.

Matched MeSH terms: Pain Measurement; Pain, Postoperative/drug therapy*; Pain, Postoperative/ethnology
The Effectiveness of Benson's Relaxation Technique on Pain and Perceived Stress Among Patients Undergoing Hemodialysis: A Double-Blind, Cluster-Randomized, Active Control Clinical Trial

Abu Maloh HIA, Soh KL, Chong SC, Ismail SIF, Soh KG, Abu Maloh DI, et al.

Clin Nurs Res, 2023 Feb;32(2):288-297.
PMID: 35915917 DOI: 10.1177/10547738221112759

Benson's relaxation affects many symptoms among hemodialysis patients. A cluster-randomized active control clinical trial with three repeated measures; pre, 1-week, and 1-month post-intervention sought to evaluate the effectiveness of Benson's Relaxation on pain and perceived stress (P&PS) among hemodialysis patients. Two governmental hospitals were randomly assigned to intervention and control. Thirty-six participants were randomly selected; 18 were intervention, and 18 were controlled. The intervention group performed Benson's Relaxation twice a day for 10 minutes for 8 weeks after a training session. The control group received an educational session about Progressive Relaxation. Findings revealed a statistically significant reduction in the PSS-10 and PRI scores between pre-intervention and 1 month after-intervention (p .05). Benson's Relaxation significantly relieved P&PS among hemodialysis patients but not after only 1 week of practicing.

Matched MeSH terms: Pain

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