MyMedR

Chest tube injury to left ventricle: complication or negligence?

Haron H, Rashid NA, Dimon MZ, Azmi MH, Sumin JO, Zabir AF, et al.

Ann Thorac Surg, 2010 Jul;90(1):308-9.

PMID: 20609810 DOI: 10.1016/j.athoracsur.2010.01.075

An injury to the left ventricle after a chest tube insertion is a rare but lethal phenomenon that is likely to occur if precautions are not seriously addressed. We present a 15-year-old girl who was diagnosed a left empyema thoracis. An attempt to place a chest drain in this young girl was almost fatal. A left ventricular repair together with thoracotomy and decortication were successful. This case emphasizes the rarity of this lethal complication and the importance of the correct technique for chest tube insertion.

Matched MeSH terms: Heart Injuries/etiology; Heart Ventricles/injuries*

Fulltext The use of preserved bovine pericardium for emergency temporizing graft in corneal perforation

Koay AC, Yew YH, Ngo CT, Loo VP, Intan G, Chua CN

Med J Malaysia, 2008 Dec;63(5):421-2.

PMID: 19803308 MyJurnal

Corneal perforation is an ocular emergency that requires early intervention to avoid permanent visual loss from endophthalmitis or irreversible structural changes. Although tectonic keratoplasty is the best choice for patching a large perforation, a donor cornea is not always immediately available. Consequently, an alternative material is required while awaiting a donor cornea. We report the use of preserved bovine pericardium as a temporizing graft to maintain the ocular integrity in two patients with corneal perforation.

Matched MeSH terms: Eye Injuries, Penetrating/surgery; Corneal Injuries*

Fulltext The prognostic value of early follow-up computerized tomography of the brain in adult traumatic brain injury

Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN

Med J Malaysia, 2006 Oct;61(4):466-73.

PMID: 17243525 MyJurnal

A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.

Matched MeSH terms: Brain Injuries/physiopathology; Brain Injuries/radionuclide imaging*; Brain Injuries/rehabilitation

Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction

Boo NY, Foong KW, Mahdy ZA, Yong SC, Jaafar R

BJOG, 2005 Nov;112(11):1516-21.

PMID: 16225572

To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction.

Matched MeSH terms: Birth Injuries/etiology*; Scalp/injuries*

Fulltext The epidemiology of childhood brain injury in the state of Selangor and Federal Territory of Kuala Lumpur, Malaysia

Tay EL, Lee SWH, Jamaluddin SF, Tam CL, Wong CP

BMC Pediatr, 2016 04 27;16:56.

PMID: 27122016 DOI: 10.1186/s12887-016-0590-1

BACKGROUND: There are limited studies describing the epidemiology of childhood brain injury, especially in developing countries. This study analyses data from the Malaysian National Trauma Database (NTrD) registry to estimate the incidence of childhood brain injury among various demographic groups within the state of Selangor and Federal Territory of Kuala Lumpur.

METHODS: This study analysed all traumatic brain injury cases for children ages 0-19 included in the 2010 NTrD report.

RESULTS: A total of 5,836 paediatric patients were admitted to emergency departments (ED) of reporting hospitals for trauma. Of these, 742 patients (12.7 %) suffered from brain injuries. Among those with brain injuries, the mortality rate was 11.9 and 71.2 % were aged between 15 and 19. Traffic accidents were the most common mode of injury (95.4 %). Out of the total for traffic accidents, 80.2 % of brain injuries were incurred in motorcycle accidents. Severity of injury was higher among males and patients who were transferred or referred to the reporting centres from other clinics. Glasgow Coma Scale (GCS) total score and type of admission were found to be statistically significant, χ (2) (5, N = 178) = 66.53, p

Matched MeSH terms: Brain Injuries/diagnosis; Brain Injuries/etiology; Brain Injuries/epidemiology*

Fulltext Post traumatic stress disorder following an electric shock

Premalatha GD

Med J Malaysia, 1994 Sep;49(3):292-4.

PMID: 7845283

Post Traumatic Stress Disorder (PTSD) is still a diagnosis which is frequently missed even by psychiatric professionals. Each doctor needs to maintain a high level of awareness that patients may have experienced trauma; that PTSD can often occur for a variety of common symptoms; and that it may also be at the root of a persisting treatment-resistant depressive or anxiety state. This case demonstrates that occupational accidents may result in this condition.

Matched MeSH terms: Electric Injuries/complications; Electric Injuries/epidemiology; Electric Injuries/psychology*

Fulltext Primary repair for injury of medial collateral ligament during total-knee arthroplasty

Jin C, Zhao JY, Santoso A, Song EK, Chan CK, Jin QH, et al.

Medicine (Baltimore), 2019 Sep;98(39):e17134.

PMID: 31574814 DOI: 10.1097/MD.0000000000017134

The aim of this study was to determine whether primary repair for intraoperative injury of the medial collateral ligament (MCL) can achieve satisfactory clinical results when compared to the clinical results of patients with no MCL injury. Simultaneously, we sought to determine the differences between 2 methods of primary repair (anchor suture and staple) in terms of their clinical outcomes.In our institute, 3897 total-knee arthroplasties (TKAs) were performed between 2003 and 2014. Sixty-five patients who suffered an MCL injury during the TKA procedure and in whom the injury was repaired with a suture anchor or staple (suture anchor: 36 vs staple: 29) were studied. A matched group of 65 patients without an MCL injury was selected to serve as the control group. Subjective feelings of instability and functional outcomes were assessed using the knee society (KS) score and the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). Objective stability was evaluated by the measurement of opening angles in extension and at 30° of knee flexion on valgus stress radiographs. The clinical outcomes and stability results were compared between the suture anchor and staple methods.The KS and WOMAC scores in patients who received primary repair of MCL injury during TKA improved from 50.6 ± 13.1 to 87.3 ± 7.3 (P

Matched MeSH terms: Knee Injuries/surgery*; Medial Collateral Ligament, Knee/injuries*

Long Term Follow-up of an Open Bicondylar Hoffa Fracture with a Disrupted Extensor Mechanism: A Case Report

Joseph CM, Rama-Prasad YS, Boopalan P, Jepegnanam TS

Malays Orthop J, 2019 Jul;13(2):59-62.

PMID: 31467656 DOI: 10.5704/MOJ.1907.013

This is the first report of a long-term follow-up of an open bicondylar Hoffa with patella fracture. It is interesting to note the radiological changes of osteoarthritis 15 years after global intra-articular injury of the distal femur. The good clinical outcome is possibly due to the integrity of the knee ligaments and reconstruction of the extensor mechanism in addition to stable anatomical reduction and fixation.

Matched MeSH terms: Knee Injuries

Fulltext Electrical Performance of Polymer-Insulated Rail Brackets of DC Transit Subjected to Lightning Induced Overvoltage

Abd Rahman FA, Ab Kadir MZA, Ungku Amirulddin UA, Osman M

Materials (Basel), 2021 Mar 29;14(7).

PMID: 33805583 DOI: 10.3390/ma14071684

The fourth rail transit is an interesting topic to be shared and accessed by the community within that area of expertise. Several ongoing works are currently being conducted especially in the aspects of system technical performances including the rail bracket component and the sensitivity analyses on the various rail designs. Furthermore, the lightning surge study on railway electrification is significant due to the fact that only a handful of publications are available in this regard, especially on the fourth rail transit. For this reason, this paper presents a study on the electrical performance of a fourth rail Direct Current (DC) urban transit affected by an indirect lightning strike. The indirect lightning strike was modelled by means of the Rusck model and the sum of two Heidler functions. The simulations were carried out using the EMTP-RV software which included the performance comparison of polymer-insulated rail brackets, namely the Cast Epoxy (CE), the Cycloaliphatic Epoxy A (CEA), and the Glass Reinforced Plastic (GRP) together with the station arresters when subjected by 30 kA (5/80 µs) and 90 kA (9/200 µs) lightning currents. The results obtained demonstrated that the GRP material has been able to slightly lower its induced overvoltage as compared to other materials, especially for the case of 90 kA (9/200 µs), and thus serves better coordination with the station arresters. This improvement has also reflected on the recorded residual voltage and energy absorption capacity of the arrester, respectively.

Matched MeSH terms: Lightning Injuries

Fulltext Subacute Post-Traumatic Ascending Myelopathy (SPAM) in a Spinal Cord Injured Patient - a Rare Presentation: A Case Report

Kassim NK, Hanafi MH, Ibrahim AH, Hasnan N

Malays Orthop J, 2021 Mar;15(1):135-137.

PMID: 33880162 DOI: 10.5704/MOJ.2103.022

The optimisation of blood pressure management is critical in managing hypotensive episodes in patients with spinal cord injury. Improper handling of this preventable factor will negatively impact the patient recovery prognosis. A 42-year-old man was admitted for a complete spinal cord injury after fell from height. He developed subacute neurological deterioration unrelated to the mechanical instability but due to multiple episodes of hypotension occurring one month after the initial injury. After proper management of blood pressure, his deterioration was halted and no further progression. Spinal cord haemodynamics play an important role in mediating the onset of subacute post-traumatic ascending myelopathy. Better education and awareness on Subacute Post-traumatic Ascending Myelopathy (SPAM) especially to the junior healthcare providers are important to hinder this rare but avoidable condition.

Matched MeSH terms: Spinal Cord Injuries

Fulltext Multicenter prospective study on predictors of short-term outcome in disorders of consciousness

Estraneo A, Fiorenza S, Magliacano A, Formisano R, Mattia D, Grippo A, et al.

Neurology, 2020 09 15;95(11):e1488-e1499.

PMID: 32661102 DOI: 10.1212/WNL.0000000000010254

OBJECTIVE: This international multicenter, prospective, observational study aimed at identifying predictors of short-term clinical outcome in patients with prolonged disorders of consciousness (DoC) due to acquired severe brain injury.

METHODS: Patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) or in minimally conscious state (MCS) were enrolled within 3 months from their brain injury in 12 specialized medical institutions. Demographic, anamnestic, clinical, and neurophysiologic data were collected at study entry. Patients were then followed up for assessing the primary outcome, that is, clinical diagnosis according to standardized criteria at 6 months postinjury.

RESULTS: We enrolled 147 patients (44 women; mean age 49.4 [95% confidence interval 46.1-52.6] years; VS/UWS 71, MCS 76; traumatic 55, vascular 56, anoxic 36; mean time postinjury 59.6 [55.4-63.6] days). The 6-month follow-up was complete for 143 patients (VS/UWS 70; MCS 73). With respect to study entry, the clinical diagnosis improved in 72 patients (VS/UWS 27; MCS 45). Younger age, shorter time postinjury, higher Coma Recovery Scale-Revised total score, and presence of EEG reactivity to eye opening at study entry predicted better outcome, whereas etiology, clinical diagnosis, Disability Rating Scale score, EEG background activity, acoustic reactivity, and P300 on event-related potentials were not associated with outcome.

CONCLUSIONS: Multimodal assessment could identify patients with higher likelihood of clinical improvement in order to help clinicians, families, and funding sources with various aspects of decision-making. This multicenter, international study aims to stimulate further research that drives international consensus regarding standardization of prognostic procedures for patients with DoC.

Matched MeSH terms: Brain Injuries/complications; Brain Injuries/diagnosis*; Brain Injuries/physiopathology*

Fulltext Dupuytren's Contracture with Secondary Ulnar Neuropathy

Ng CF

J Neurosci Rural Pract, 2020 Jul;11(3):481-483.

PMID: 32753817 DOI: 10.1055/s-0040-1708459

Dupuytren's disease is a progressive fibrotic condition of the hand. The underlying pathomechanism is not fully known. Dupuytren's contracture can be seen in patients with diabetes mellitus, chronic alcoholism, smoking, or hand trauma. It is uncommon to affect the neurovascular supply causing clinical symptoms. We describe a patient with idiopathic Dupuytren's disease complicated with bilateral ulnar neuropathies and highlight the importance of such rare treatable complication.

Matched MeSH terms: Hand Injuries

Electrical stimulator with mechanomyography-based real-time monitoring, muscle fatigue detection, and safety shut-off: a pilot study

Naeem J, Hamzaid NA, Azman AW, Bijak M

Biomed Tech (Berl), 2020 Aug 27;65(4):461-468.

PMID: 32304295 DOI: 10.1515/bmt-2019-0191

Functional electrical stimulation (FES) has been used to produce force-related activities on the paralyzed muscle among spinal cord injury (SCI) individuals. Early muscle fatigue is an issue in all FES applications. If not properly monitored, overstimulation can occur, which can lead to muscle damage. A real-time mechanomyography (MMG)-based FES system was implemented on the quadriceps muscles of three individuals with SCI to generate an isometric force on both legs. Three threshold drop levels of MMG-root mean square (MMG-RMS) feature (thr50, thr60, and thr70; representing 50%, 60%, and 70% drop from initial MMG-RMS values, respectively) were used to terminate the stimulation session. The mean stimulation time increased when the MMG-RMS drop threshold increased (thr50: 22.7 s, thr60: 25.7 s, and thr70: 27.3 s), indicating longer sessions when lower performance drop was allowed. Moreover, at thr70, the torque dropped below 50% from the initial value in 14 trials, more than at thr50 and thr60. This is a clear indication of muscle fatigue detection using the MMG-RMS value. The stimulation time at thr70 was significantly longer (p = 0.013) than that at thr50. The results demonstrated that a real-time MMG-based FES monitoring system has the potential to prevent the onset of critical muscle fatigue in individuals with SCI in prolonged FES sessions.

Matched MeSH terms: Spinal Cord Injuries

Fulltext Metacarpal Lengthening Of The Thumb Via Distraction Osteogenesis: A Case Report

Chung WH, Eo CK, Muspirah Z, Sood A

Malays Orthop J, 2015 Mar;9(1):41-43.

PMID: 28435597 MyJurnal DOI: 10.5704/MOJ.1503.009

Amputation of the thumb invariably causes marked functional impairment of the hand especially, pinch and grasp functions. In rural areas where highly skilled microvascular surgeries are not available, distraction osteogenesis provides an easy and safe alternative of thumb reconstruction. We report a case of crush injury of the right hand in a 37 year old gentleman in which the right thumb was amputated at the level of the proximal phalanx. Metacarpal lengthening of the thumb was performed by using distraction osteogenesis.

Matched MeSH terms: Crush Injuries

Fulltext A mini review on the basic knowledge on tendon: revisiting the normal & injured tendon

Tan, S.L., Selvaratnam, L., Ahmad, T.S.

JUMMEC, 2015;18(2):1-14.

MyJurnal

Tendon is a dense connective tissue that connects muscle to bone. Tendon can adapt to mechanical forces passing across it, through a reciprocal relationship between its cellular components (tenocytes and tenoblasts) and the extracellular matrix (ECM). In early development, the formation of scleraxis-expressing tendon progenitor population in the sclerotome is induced by a fibroblast growth factor signal secreted by the myotome. Tendon injury has been defined as a loss of cells or ECM caused by trauma. It represents a failure of cells and matrix adaptation to mechanical loading. Injury initiates attempts of tendon to repair itself, which has been defined as replacement of damaged or lost cells and ECM by new cells or new matrices. Tendon healing generally consists of four different phases: the inflammatory, proliferation, differentiation and remodelling phases. Clinically, tendons are repaired with a variety of surgical techniques, which show various degrees of success. In order to improve the conventional tendon repair methods, current tendon tissue engineering aims to investigate a repair method which can restore tissue defects with living cells, or cell based therapy. Advances in tissue engineering techniques would potentially yield to a cell-based product that could regenerate functional tendon tissue.

Matched MeSH terms: Tendon Injuries

Fulltext Analysis of air humidity and temperature for post lightning circumstances

Sharifah Sakinah, Tuan Othman, Jasronita, Jasni, Mohd Nazim, Mohtar

Pertanika Journal of Science & Technology, 2017;25(102):79-86.

MyJurnal

Lightning is a natural phenomenon that generates a high electric field during thunderstorm. It has been
reported that lightning strikes amid storms can occur around 100 times per second. The atmospheric
electric field is an imperative parameter during a thunderstorm. Therefore, monitoring the electric field
and its parameters is the best way for local lightning forecast. The electric field monitoring data can
validate the accuracy of weather prediction in a local area from meteorology department or by using
equipment specially designed to measure this electric field that exists when the phenomenon of lightning occurs. In this paper, the relationship between lightning, air humidity and temperature is discussed to understand the post lightning effect on these electric parameters. Additionally, the characteristics of the parameters are observed and analysed.

Matched MeSH terms: Lightning Injuries

Fulltext Traumatic brain injury patterns on ct scan: a comparison of motorcyclist versus passenger vehicle patients involved in road traffic accidents

Radhiana Hassan, Muniruddin Mohamad, Muhamad Zaim Azami, Husin Ali, Hafizah Pasi

International Medical Journal Malaysia, 2017;16(11):48-48.

MyJurnal

Traumatic brain injury following road traffic accidents is a common cause
of morbidity and mortality in Malaysia. We aim to determine the differences of traumatic
brain injury patterns based on CT findings among motorcyclist versus passenger vehicle
patients involved in road traffic accidents. (Copied from article).

Matched MeSH terms: Brain Injuries, Traumatic

Fulltext Analysis of ground potential distribution under lightning current condition

Chandima Gomes, Riyadh Z. Sabry

Pertanika Journal of Science & Technology, 2017;25(102):181-188.

MyJurnal

The grounding system of a lightning protection scheme is designed basically to avoid arcing and
dangerous step potentials. The grounding impedance of the system varies depending on soil structure and frequency. This paper describes the effect of harmonic impedance (also called frequency dependence of soil) on potential distribution under lightning strike to a metal tower with single grounding path, for different soil types. The results show that the peak value of ground potential rise (GPR) and step voltage (SP) may reach extremely hazardous values even at distances in the order of 90 m from the tower footing, especially when soil resistivity is high. Hence, we emphasise that, in contrast to power grounding, when designing of grounding systems that are meant to handle transient or high frequency currents as well, the frequency dependent soil parameters should be considered to avoid hazardous situations, especially at locations with a high probability of lightning strikes such as metal towers.

Matched MeSH terms: Lightning Injuries

Computed tomography of the thorax with 3D reconstruction in penetrating chest injury

Michael A, Yahya ZO, Mdrazali I, Hanif H

Med J Malaysia, 2017 02;72(1):75-76.

PMID: 28255150 MyJurnal

Penetrating chest wounds is less common but more deadly then blunt trauma. Majority of penetrating chest trauma can be managed conservatively with observation and simple thoracotomy. This case report highlights a bizarre occupational hazard causing a penetrating chest injury and the option of non-invasive management with the aid of computed tomography with 3D reconstruction.

Matched MeSH terms: Thoracic Injuries

Understanding the multifaceted mechanisms of diabetic wound healing and therapeutic application of stem cells conditioned medium in the healing process

Fui LW, Lok MPW, Govindasamy V, Yong TK, Lek TK, Das AK

J Tissue Eng Regen Med, 2019 12;13(12):2218-2233.

PMID: 31648415 DOI: 10.1002/term.2966

Mesenchymal stem cells (MSCs) transplantation seems to be a promising new therapy for diabetic wound healing (DWH), and currently, arrays of MSCs from various sources ranging from umbilical, adipose to dental sources are available as a treatment modality for this disease. However, it now appears that only a fraction of transplanted cells actually assimilate and survive in host tissues suggesting that the major mechanism by which stem cells participate in tissue repair are most likely related to their secretome level. These include a wide range of growth factors, cytokines, and chemokines, which can be found from the conditioned medium (CM) used to culture the cells. Basic studies and preclinical work confirm that the therapeutic effect of CMs are comparable with the application of stem cells. This review describes in detail the wound healing process in diabetes and the cellular and biological factors that influence the process. Subsequently, through a comprehensive literature search of studies related to wound healing in diabetics, we aim to provide an overview of scientific merits of using MSCs-CM in the treatment of diabetic wound as well as the significant caveats, which restricts its potential use in clinical set-ups. To our best knowledge, this is one of the first review papers that collect the importance of stem cells as an alternative treatment to the DWH. We anticipate that the success of this treatment will have a significant clinical impact on diabetic wounds.

Matched MeSH terms: Wounds and Injuries/drug therapy*; Wounds and Injuries/metabolism; Wounds and Injuries/pathology

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