Displaying publications 21 - 40 of 83 in total

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  1. Fulltext Brief report: nail sampling technique and its interpretation
    Leelavathi M, Tzar MN
    Malays Fam Physician, 2011;6(2-3):58-9.
    PMID: 25606224
    The clinical suspicion of onychomyosis based on appearance of the nails, requires culture for confirmation. This is because treatment requires prolonged use of systemic agents which may cause side effects. One of the common problems encountered is improper nail sampling technique which results in loss of essential information. The unfamiliar terminologies used in reporting culture results may intimidate physicians resulting in misinterpretation and hamper treatment decision. This article provides a simple guide on nail sampling technique and the interpretation of culture results.
    Matched MeSH terms: Nails
  2. An intramedullary cement spacer in total hip arthroplasty
    Deshmukh RG, Thevarajan K, Kok CS, Sivapathasundaram N, George SV
    J Arthroplasty, 1998 Feb;13(2):197-9.
    PMID: 9526214
    Revision arthroplasty of the hip is often complicated by infection, bone loss, and perioperative fracture of the femur. A simple, inexpensive spacer that keeps tissue planes intact and prevents soft tissue contracture during the interoperative period of a 2-stage revision is described. This can provide intramedullary support to a fractured or weak femur and enable local antibiotic delivery, as well as permit limited mobilization of the patient. It can be easily fabricated during surgery using universally available materials and can be tailored for specific requirements. Such a spacer was used in 5 cases. The experience is presented, and the technique and pitfalls are discussed.
    Matched MeSH terms: Bone Nails
  3. Fulltext Fungistatic effect of hydroxychloroquine, lessons from a case
    Keshavarzi F
    Med Mycol Case Rep, 2016 Sep;13:17-18.
    PMID: 27709021
    A 50-year-old male was prescribed with hydroxychloroquine (HCQ) after osteoarthritis was diagnosed. He had an old nail infection of Aspergillus niger. A remarkable improvement of the symptoms of fungal nail infection was seen after about four weeks of treatment with HCQ. It was very hard to detect the symptoms in the end of the second month of the treatment, both in the finger and toe nails. The symptoms were clearly recurred after HCQ was discontinued.
    Matched MeSH terms: Nails
  4. 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: Bone Nails
  5. Fulltext A new species of wasp-mimicking clearwing moth from Peninsular Malaysia with DNA barcode and behavioural notes (Lepidoptera, Sesiidae)
    Skowron Volponi MA, Volponi P
    Zookeys, 2017.
    PMID: 29133989 DOI: 10.3897/zookeys.692.13587
    A new species of clearwing moth,Pyrophleps ellawiSkowron Volponi,sp. n., is described from Peninsular Malaysia. Information on the habitat, time and conditions of occurrence, flight and mud-puddling behaviour, functional morphology, and DNA barcode are also provided. Photographs and a supplementary video from the wild demonstrate the postures and behaviour of this species ofPyrophleps, whose remaining members were described only on the basis of pinned specimens. This is the first record of this genus in Peninsular Malaysia.
    Matched MeSH terms: Bone Nails
  6. Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century
    Leung AKC, Lam JM, Leong KF, Sergi CM
    Int J Dermatol, 2019 Nov;58(11):1239-1245.
    PMID: 31006857 DOI: 10.1111/ijd.14464
    Melanonychia striata is characterized by a tan, brown, or black longitudinal streak within the nail plate that runs from the proximal nail fold to the distal part of the nail plate. Melanonychia striata is due to increased activity of melanocytes or melanocytic hyperplasia in the nail matrix with subsequently increased melanin deposition in the nail plate. The most common cause of melanonychia striata associated with melanocytic activation is ethnic melanonychia which occurs in dark-skinned individuals. Other causes of melanonychia striata related to melanocytic activation include pregnancy, chronic local trauma, infections, medications, dermatological disorders, endocrine disorders, alkaptonuria, hemochromatosis, porphyria, graft-vs-host disease, Peutz-Jeghers syndrome, and Laugier-Hunziker syndrome. Causes of melanonychia striata associated with melanocytic hyperplasia include nail matrix melanocytic nevus, nail lentigo, and nail apparatus/subungual in situ and invasive melanoma. In most cases, melanonychia striata is a benign condition, especially in children. Consequently, most investigators advocate a wait-and-see approach. Nail apparatus/subungual melanoma should be suspected if there is an abrupt onset after middle age, personal or family history of melanoma, rapid growth, darkening of a melanonychia band, pigment variegation, blurry lateral borders, irregular elevation of the surface, a bandwidth >3 mm, proximal widening, associated nail plate dystrophy, single rather than multiple digit involvement, and periungual spread of pigmentation onto the adjacent cuticle and/or proximal and/or lateral nail folds (Hutchinson sign). Prolonged follow-up is mandatory for early detection of possible malignant changes.
    Matched MeSH terms: Nails/pathology*; Nails/surgery
  7. Fulltext Biomechanical Analysis of Crossed Pinning Construct in Supracondylar Fracture of Humerus: Does the Point of Crossing Matter?
    Hanim A, Wafiuddin M, Azfar MA, Awang MS, Nik Abdul Adel NA
    Cureus, 2021 Mar 22;13(3):e14043.
    PMID: 33898129 DOI: 10.7759/cureus.14043
    Introduction This appears to be the first biomechanical study that compares the stability of various locations of the crossing points in crossed pinning Kirschner wiring (K-wire) construct in treating pediatric supracondylar humerus fracture (SCHF). Additionally, this study compared the biomechanical stability between crossed pinning K-wire construct and the three-lateral divergent K-wire construct. Methods For the study purpose, 30 synthetic humerus bones were osteotomised at mid-olecranon fossa, anatomically reduced, and pinned using two 1.6-millimeter K-wires in five different constructs. A total of six samples were prepared for each construct and tested for extension, flexion, valgus, varus, internal rotation, and external rotation forces. Results As for crossed pinning K-wire construct, the center crossing point emerged as the stiffest construct in both linear and rotational forces, in comparison to the lateral crossing point, superior crossing, and medial crossing point Conclusion Based on this analysis, it is highly recommended that, if the crossed pinning construct is selected to treat supracondylar humerus fracture, the surgeon should aim for center crossing point as it is the most stable construct. Nevertheless, if lateral and superior crossing points are obtained during the initial attempt of fixation, the fixation may be accepted without revising the K-wire as the stability of these two constructs are comparable and portrayed no significant difference when compared to that of the center crossing point. Additionally, it is essential to avoid the medial crossing point as it is significantly less stable in terms of rotational force when compared to the center crossing point.
    Matched MeSH terms: Bone Nails
  8. Fulltext Assessment of microleakage of few restorative materials after erosion by acidic solution
    Suhaida Sabdi, Wan Zaripah Wan Bakar, Adam Husein
    Archives of Orofacial Sciences, 2011;6(2):26-32.
    MyJurnal
    Some restorative materials are susceptible to erosion but whether it also causes microleakage is still questionable. The aim of this study was to assess the microleakage of few restorative materials after immersion in acidic solution. Standardized ‘U’ shaped cavity of 4mm diameter and 2mm depth were prepared on buccal or lingual surface of 52 human premolar and molar teeth. The teeth were divided into 4 groups which contains 13 samples and 3 controls for each and were restored either with Filtek Z250 (Group 1), Fuji IX (Group 2), Fuji II LC (Group 3), or Silverfill amalgam (Group 4).
    All surfaces were painted with nail varnish leaving only 2mm of tooth structure surrounding the restoration before the study samples were immersed in acidic solution, lemon juice (pH 2.74) and control samples in deionised distilled water for 24 hours. Surface photos for erosion were taken before immersion in methylene blue for 7 days. After sectioning, the assessment of dye penetration was done using Leica Imaging System DMLM (Germany). Photos showed that Fuji IX demonstrated severe erosion but no obvious changes were seen on other materials. Kruskal-Wallis test indicated that microleakage between all four groups were statistically significant. The most significant difference was between Filtek Z250 and Fuji IX (p
    Matched MeSH terms: Nails
  9. Fulltext Multiple nail gun penetrating head injury: a case report
    Sim, S.K., Theophilus, S.C., Noor Azman, A.R.
    International Medical Journal Malaysia, 2013;12(2):75-78.
    MyJurnal
    Intracranial nail gun injury is a rare subset of penetrating head injury. Here we report a case of intracranial nail gun injury in a Vietnamese patient who attempted suicide with no neurological deficit. Three nails were launched. Because the nail head acted as a brake, the launched nail could make a hole into the skull but could not entirely pass it. A rational management strategy should permit these patients to be discharged with no additional injury. Some medical and surgical management in penetrating head injury are discussed. The use of antibiotics and antiepileptic drugs and the retraction of the nail aided by the performance of a craniotomy surrounding the entry point are recommended.
    Matched MeSH terms: Nails
  10. Fulltext Scales on the scalp
    Adawiyah J, Leelavathi M
    Malays Fam Physician, 2013;8(1):48-49.
    PMID: 25606270 MyJurnal
    A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema. There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in other parts of the body were normal.
    Matched MeSH terms: Nails
  11. Fulltext Ultra-morphological changes of Trichophyton rubrum treated with hydroxychavicol
    Ridzuan, P.M., Nasir Mohamad, Salwani Ismail, Nor Iza A. Rahman, Sanusi, N.A., Rabiatul Adawiyah Umar, et al.
    International Medical Journal Malaysia, 2017;16(2):65-71.
    MyJurnal
    Trichophyton rubrum is a common pathogenic fungal species that is responsible for causing infection on
    human skin, hair and nail. The antifungal-resistant strains complicate the treatment regime.
    Hydroxychavicol (HC) is one of the main compounds from Piper betel leaf that have antifungal potential and
    its mechanism of action has not been studied yet. The objective of this preliminary study to determine the
    antifungal properties of HC against T. rubrum using transmission electron microscope (TEM) on gross and
    ultrastructure of T. rubrum hypha. T. rubrum was treated with HC and miconazole (MI) at concentrations of
    1.25, 2.5, 5 and 10 mg/mL for 1, 3, 5 and 7 days continuously. Generally, fungi structures became more
    severely damaged at increasing treatment duration. Microscopically, the fungi’s cell wall treated with HC
    showed a rough surface, shrinkage and demolition similar to the MI treated group. The fungi organelles were
    also demolished and disorganized. This study revealed that HC has the ability to inhibit T. rubrum growth
    and has potential to be an antifungal agent for skin infections.
    Matched MeSH terms: Nails
  12. Fulltext Scanning Electron Microscopy Study of Retrieved Implants Suggests a Ratcheting Mechanism Behind Medial Migration in Cephalomedullary Nailing of Hip Fractures
    Law GW, Koh J, Yew A, Howe TS
    Malays Orthop J, 2020 Mar;14(1):7-17.
    PMID: 32296476 DOI: 10.5704/MOJ.2003.002
    Introduction: Medial migration is the paradoxical migration of the femoral neck element (FNE) superomedially against gravity with respect to the intramedullary component of the cephalomedullary device, increasingly seen in the management of pertrochanteric hip fractures with the intramedullary nail. We postulate that the peculiar anti-gravity movement of the FNE in the medial migration phenomenon stems from a ratcheting mechanism at the intramedullary nail-FNE interface, which should inadvertently produce unique wear patterns on the FNE that can be seen with high-powered microscopy. By examining the wear patterns on retrieved implants from patients with medial migration, our study aims to draw clinical correlations to the ratcheting mechanism hypothesis.

    Material and Methods: Four FNEs were retrieved from revision surgeries of four patients with prior intramedullary nail fixation of their pertrochanteric hip fractures complicated by femoral head perforation. The FNEs were divided into two groups based on whether or not there was radiographic evidence of medial migration prior to the revisions. Wear patterns on the FNEs were then assessed using both scanning electron microscopy and light microscopy.

    Results: Repetitive, linearly-arranged, regularly-spaced, unique transverse scratch marks were found only in the group with medial migration, corresponding to the specific segment of the FNE that passed through the intramedullary component of the PFNA during medial migration. These scratch marks were absent in the group without medial migration.

    Conclusion: Our findings are in support of a ratcheting mechanism behind the medial migration phenomenon with repetitive toggling at the intramedullary nail-FNE interface and progressive propagation of the FNE against gravity.

    Matched MeSH terms: Bone Nails
  13. Fulltext Incidence of Varus Malalignment Post Interlocking Nail in Proximal Femur Shaft Fractures Comparing Two Types of Entry Points
    Sadagatullah AN, Nazeeb MN, Ibrahim S
    Malays Orthop J, 2017 Nov;11(3):31-35.
    PMID: 29326763 MyJurnal DOI: 10.5704/MOJ.1711.013
    Introduction: Osteosynthesis of the femur using an interlocking nail is the gold standard for treating diaphyseal fractures of the femur. There are two established entry points for the antegrade interlocking nails which is the piriformis fossa or the greater trochanter. It has been reported that varus malalignment was frequently seen in proximal femur fracture which were treated with interlocking nail utilizing the greater trochanter entry point. The study was done to find out if the problem was of significance. Materials and Methods: This was a retrospective study which included 179 patients with femur fractures which were treated from January 2013 till September 2015 in one Hospital. They were treated with interlocking nail either by utilizing the piriformis fossa (PF) or the greater trochanter (GT) entry points. Post-operative radiographs of the femur were used to measure the varus deformity. Results: Out of 179 patients, there were 5 patients who were reported to have unacceptable varus malalignment (2.79%). These 5 patients were out of the 88 (5.68%) patients utilizing the greater trochanter as the entry point. The same 5 patients were out 90 patients that were diagnosed with proximal femur shaft fractures (5.55%). Analysis with logistic regression was statistically not significant. Conclusion: There was higher rate of varus malalignment seen in proximal femur shaft fractures treated with interlocking nails utilizing the greater trochanter entry point. The incidence of varus malalignment was not significant statistically.
    Matched MeSH terms: Nails
  14. Rates of pin site infection during distraction osteogenesis based on monthly observations: a pilot study
    Saw A, Chua YP, Hossain G, Sengupta S
    J Orthop Surg (Hong Kong), 2012 Aug;20(2):181-4.
    PMID: 22933675
    To assess the monthly rates of infection of individual pin sites in 7 patients during distraction osteogenesis.
    Matched MeSH terms: Bone Nails/adverse effects*
  15. Fulltext Study of heavy metal levels among farmers of Muda Agricultural Development Authority, Malaysia
    Ghazali AR, Abdul Razak NE, Othman MS, Othman H, Ishak I, Lubis SH, et al.
    J Environ Public Health, 2012;2012:758349.
    PMID: 22536276 DOI: 10.1155/2012/758349
    Heavy metals, particularly cadmium, lead, and arsenic, constitute a significant potential threat to human health. This study was conducted to determine the levels of cadmium, lead, and arsenic in nail samples from farmers at Muda Agricultural Development Authority (MADA), Kedah, Malaysia, and evaluate factors that can contribute to their accumulations. A total of 116 farmers participated in this study. Inductively coupled plasma mass spectrometry (ICP-MS) was used to analyze concentration of heavy metals in the nail samples and questionnaires were given to participants to get demographic, health status, and their agricultural activities data. In this paper, the level of heavy metals was within the normal range and varies according to demographic factors. We found that there were significant correlations between working period with level of lead and arsenic (r=0.315 and r=0.242, resp., P<0.01) and age with lead level (r=0.175, P<0.05). Our findings suggested that agricultural activities could contribute to the accumulation of heavy metals in farmers. Hence, the control of environmental levels of and human exposure to these metals to prevent adverse health effects is still an important public health issue.
    Matched MeSH terms: Nails/metabolism*
  16. Fulltext Is the femoral neck geometry adequate for placement of the proximal femoral nail in the Malaysian population? A review of 100 cases
    Chiu CK, Chan CY, Singh VA
    Med J Malaysia, 2009 Mar;64(1):22-6.
    PMID: 19852315
    Issues that had been encountered during proximal femoral fracture fixation using proximal femoral nail include (i) the adequacy of the femoral neck width in the local population and (ii) the potential difficulty encountered during fixation in certain prefixed angles as determined by the implant. This was a retrospective, descriptive study evaluating the anterior-posterior pelvic radiographs of 100 consecutive patients, from January to August 2007, managed at University Malaya Medical Centre, Kuala Lumpur. The femoral neck width in the population studied was adequate for placement of femoral neck screw and anti-rotation pin or hip pin using the proximal femoral nail implant. (mean = 34.0 +/- 3.7 mm, min = 24.6 mm). There was no significant difference between the working area using an implant angled at 130 degrees or 135 degrees (P = 0.91). Both femoral neck width and neck shaft angle of the Malaysian population studied were not a factor influencing the placement of femoral neck lag screws and anti-rotation pin.
    Matched MeSH terms: Bone Nails*
  17. Fulltext Size of interlocking nails used in the treatment of diaphyseal femoral fractures
    Tan WJ, Kwan MK, Deepak AS, Saw A, Peng BC, Jalalullah W
    Med J Malaysia, 2006 Dec;61 Suppl B:18-22.
    PMID: 17600988
    Fracture of the femur is most commonly treated with interlocking nailing. We conducted this study to describe and analyze the size of femoral interlocking nails used in our local population. This is a retrospective study on reamed intramedullary interlocking nailing procedures performed between 1st July 1998 and 30th June 2003. Demographic data, the diameter and length of femoral nails used were obtained from patient's medical record. A total of 267 procedures were included. The most common diameter used was 10 mm (56.9%), followed by 11 mm (27.0%) and 12 mm (13.1%). Only 2.6% of the nails were less than 10 mm in diameter. The most common nail length was 38 cm (31.1%), followed by 36 cm (24.9%) and 40 cm (19.5%). The longest nail used was 46 cm while the shortest 32 cm. The most commonly used femoral nails were of 10 mm diameter with the length ranging from 36 to 40 cm, which is smaller than those reported in the English literature. Nails with diameter smaller than 10 mm were required in 2.6% of patients.
    Matched MeSH terms: Bone Nails*
  18. Fulltext Distraction osteogenesis over intramedullary nail: a report of two cases
    Sulaiman AR, Munajat I, Liau KM, Salehuddin AY, Shukrimi A
    Med J Malaysia, 2006 Dec;61 Suppl B:48-50.
    PMID: 17600992
    Distraction osteogeneis over intramedullary nail has a benefit of decreasing the time for external fixation thus reducing the rate of associated complications. However, risk of panosteomyelitis is still the major worry. We are reporting two patients who underwent the procedure. The first case was a 13-year-old girl requiring 6 cm of femoral lengthening and the second case was a 17-year-old girl who required 5 cm of tibial lengthening. The healing index was 19.5 days/cm and 14.8 days/cm respectively, compared favorably to 30 days/cm with traditional method of distraction osteogenesis. There were mild pin tract infections and joint stiffness which responded to non-operative treatment.
    Matched MeSH terms: Bone Nails*
  19. Fulltext Drinking water studies: a review on heavy metal, application of biomarker and health risk assessment (a special focus in Malaysia)
    Ab Razak NH, Praveena SM, Aris AZ, Hashim Z
    J Epidemiol Glob Health, 2015 Dec;5(4):297-310.
    PMID: 25944153 DOI: 10.1016/j.jegh.2015.04.003
    Malaysia has abundant sources of drinking water from river and groundwater. However, rapid developments have deteriorated quality of drinking water sources in Malaysia. Heavy metal studies in terms of drinking water, applications of health risk assessment and bio-monitoring in Malaysia were reviewed from 2003 to 2013. Studies on heavy metal in drinking water showed the levels are under the permissible limits as suggested by World Health Organization and Malaysian Ministry of Health. Future studies on the applications of health risk assessment are crucial in order to understand the risk of heavy metal exposure through drinking water to Malaysian population. Among the biomarkers that have been reviewed, toenail is the most useful tool to evaluate body burden of heavy metal. Toenails are easy to collect, store, transport and analysed. This review will give a clear guidance for future studies of Malaysian drinking water. In this way, it will help risk managers to minimize the exposure at optimum level as well as the government to formulate policies in safe guarding the population.
    Matched MeSH terms: Nails/chemistry
  20. Fulltext Halovest treatment in traumatic cervical spine injury
    Razak M, Basir T, Hyzan Y, Johari Z
    Med J Malaysia, 1998 Sep;53 Suppl A:1-5.
    PMID: 10968176
    This is a cross-sectional study on the use of halovest appliance in the Orthopaedic and Traumatology Department, Kuala Lumpur Hospital from June 1993 to September 1996. Fifty-three patients with cervical spine injuries were treated by halovest stabilization. Majority of cases was caused by motor-vehicle accident; others were fall from height at construction sites, fall at home, hit by falling object and assault. The injuries were Jefferson fracture of C1, odontoid fractures, hangman fractures, open spinous process fracture and fracture body of C2, and fracture, and fracture-dislocation of the lower cervical spines. Majority of patients had hospital stay less than 30 days. The use of the halovest ranges from 4 to 16 weeks and the healing rate was 96%. Two patients of lower cervical spine injury had redislocation and one of them was operated. There was one case of non-union of type II odontoid fracture and treated by posterior fusion. Other complications encountered during halovest treatment were minor. They were pin-site infection, pin-loosening, clamp loosening and neck pain or neck stiffness. This method of treatment enables patient to ambulate early and reduces hospital stay. We found that halovest is easy to apply, safe and tolerable to most of the patients.
    Matched MeSH terms: Bone Nails/adverse effects
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