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  1. Fulltext Lipoma Arborescens of the knee: a case report of rare entity
    Ikmal Hisyam Bakrin, Hasni Mahayidin, Khairul Shakir Ab Rahman, Wan Irnawati Wan Ab Rahman, Sazali Satari, Asrul Fahmi Azizan
    Malaysian Journal of Medicine and Health Sciences, 2018;14(3):60-63.
    MyJurnal
    Lipoma arborescens is a non-neoplastic, reactive condition due to chronic synovial inflammation and irritation, characterized by frond-like or villous proliferation of mature adipose tissue covered by hyperplastic synovium. The knee is the most commonly affected site particularly the suprapatellar pouch. We report a case of lipoma arborescens affecting the right knee of an elderly Chinese gentleman associated with bilateral knee and hand osteoarthritis. He presented with progressive worsening of right knee swelling and pain. Partial synovectomy of the right knee was performed and no lesion recurrence was noted at one year post-operation. The clinical and imaging findings, pathological features, together with differential diagnoses were discussed.
    Matched MeSH terms: Pain
  2. Sexual Dysfunction and its Associated Factors After Delivery: Longitudinal Study in Iranian Women
    Banaei M, Moridi A, Dashti S
    Mater Sociomed, 2018 Oct;30(3):198-203.
    PMID: 30515059 DOI: 10.5455/msm.2018.30.198-203
    Introduction: Considering physical and emotional changes affecting women's sexual function in postpartum period.

    Aim: This study was conducted to determine the sexual dysfunction and postpartum-related factors in Bandar Abbas women in 2016.

    Material and Methods: This analytical cross-sectional study used systematic random sampling on 432 postpartum women referred to Bandar Abbas Healthcare Centers. Data were collected by Demographic and Obstetrics Questionnaire and Female Sexual Function Index (FSFI) Questionnaire through interview and were analyzed by using SPSS ver.22 method.

    Results: The overall rate of sexual dysfunction was reported 85.95%. The most common postpartum sexual dysfunction was pain sexual dysfunction during sexual intercourse. The mean score of all types of sexual dysfunction increased over time after delivery except sexual satisfaction so that the mean score of sexual satisfaction did not show significant differences over time. There was a significant relationship between sexual dysfunction with factors such as duration of marriage (p< 0.001), number of children (p<0.001), familial relationship (p=0.028), episiotomy status (P=0.002) and contraceptive method (p=0.001).

    Conclusion: Considering the high prevalence of sexual disorders in this study, healthcare systems need to pay more attention to this area. In order to promote the health status of the family and ultimate of the society, attention to sexual health as well as the early diagnosis and treatment of sexual dysfunction of couples are important, especially during pregnancy and after childbirth.

    Matched MeSH terms: Pain
  3. Fulltext The socio-demographic and clinical factors associated with quality of life among patients with brain pathology in a tertiary referral hospital in Malaysia
    Das, Priscilla, Naing, NyiNyi, Nadiah Wan-Arfah, Naing Noor Jan, K.O., Yee, Cheng Kueh, Rasalingam, Kantha
    JUMMEC, 2019;22(1):50-57.
    MyJurnal
    Background: This paper investigates the quality of life of brain pathology patients in relation to their sociodemographic
    profiles and clinical factors.

    Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100
    patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The
    European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered
    questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning,
    Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea,
    Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study.

    Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean
    score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in
    quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged
    below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared
    to patients who were more than 40 years old. Male patients faced more financial difficulties compared with
    female patients. Patients who were married had increased insomnia compared to the single patients. Employed
    patients had better physical functioning and less financial difficulties compared with patients who were
    unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower
    than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher.
    Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had
    better physical functioning. Meningioma patients had more symptoms of insomnia compared with other
    patients. All the findings were with p value less than 0.05.

    Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and
    clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.
    Matched MeSH terms: Pain
  4. Fulltext An unusual case of portal, splenic and mesenteric venous thrombosis presenting with acute abdomen
    Yeoh, C.N., Cheah, S.K., Maaya, M., Nadiah, R., Raha, A.R., Wan, Mat W.R.
    JUMMEC, 2019;22(1):8-12.
    MyJurnal
    Porto-spleno-mesenteric vein thrombosis is a rare, life-threatening condition of extrahepatic portal venous
    system thrombosis. We report a rare case of a 49-year-old lady with late presentation of acute portal vein
    thrombosis in a non-cirrhotic liver with an incidental finding of left adnexal teratoma. She presented with a
    one-week history of severe abdominal pain associated with vomiting and diarrhea. She gave no history of prior
    risk for venous thromboembolism or liver diseases. Physical examination revealed a tender mass extending from
    suprapubic to left iliac fossa. Abdominal computed tomography scans showed a well-defined fat-containing left
    adnexal mass, likely a benign teratoma, with no involvement of surrounding structures or calcification. There
    was evidence of porto-splenic-mesenteric vein thrombosis with liver infarction, bowel and splenic ischemia.
    Management of the extensive thrombosis causing multi-organ failure includes resuscitation, supportive care
    and treatment of thrombosis. Treatment options include early anticoagulation and if feasible, thrombolysis.
    Matched MeSH terms: Abdominal Pain
  5. Deferasirox in thalassemia: a comparative study between an innovator drug and its copy among a sample of Iraqi patients
    Daher AM, Al-Momen H, Jasim SK
    Ther Adv Drug Saf, 2019;10:2042098619880123.
    PMID: 31636883 DOI: 10.1177/2042098619880123
    Background: The health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral® and its innovator drug deferasirox (Exjade®).

    Methods: A prospective observational study including 223 patients receiving the branded medicine Exjade® and 101 patients receiving the copy Osveral® was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferritin (SF), serum creatinine (SC), and alanine aminotransferase (ALT). Data were analyzed with SPSS version 22 software (SPSS, Chicago, IL, USA).

    Results: The median age of the sample was 8 years. There was no significant difference in gender distribution between the two groups (p = 0.625). Nausea was the most frequently reported adverse effect followed by diarrhea and abdominal pain in both groups. Patients receiving Exjade® had a higher relative reduction of SF at the end of the study compared with the Osveral® group (19.9% versus 9.93%, p = 0.028). SC was found to be significantly higher in the Osveral® group than in the Exjade® group throughout the study period. The mean platelet count was higher in the Exjade® group. ALT was significantly higher among patients receiving Osveral® over the last three months of the study.

    Conclusions: Exjade® showed a better ability to reduce SF, with less liver toxicity, and better hemostasis profile. No congenital anomalies associated with short-term use of both drugs during pregnancy were observed or reported.

    Matched MeSH terms: Abdominal Pain
  6. Fulltext Brain magnetic resonance Imaging of Regular Kratom (Mitragyna speciosa Korth.) users: A preliminary study
    Singh, Darshan, Chye, Yann, Chao, Suo, Yücel, Murat, Grundmann, Oliver, Muhamad Zabidi Ahmad, et al.
    Malaysian Journal of Medicine and Health Sciences, 2018;14(201):1-6.
    MyJurnal
    Mitragyna speciosa (Korth.) or kratom is a native medicinal plant of Southeast Asia. Commonly used by hard labours in harsh working environment, the ingestion of brewed kratom decoction is reported to produce dose-dependent stimulant and opioid-like effects. Kratom is also regularly consumed as a pain killer and as traditional cure for common maladies such as fever and cough. However, it remains unknown whether regular consumption of kratom decoction is associated with brain abnormalities in regular users in traditional settings. Methods: A total of 14 subjects (7 regular kratom users and 7 non-kratom users) voluntarily participated in this cross-sectional study. Face-to-face interviews were conducted with kratom users to determine history of kratom use and later these respondents underwent brain magnetic resonance imaging (MRI). Results: There were no significant differences (p>0.05) in the intracranial volume (ICV), cortical volumes (frontal, parietal, temporal, occipital, or cingulate lobe), or subcortical volumes (striatum, hippocampus, or amygdala), as well as in the diffusion tensor imaging (DTI) metrics, fractional anisotropy (FA) and mean diffusivity (MD) between kratom users and the controls. Conclusion: This preliminary study showed long-term consumption of kratom decoction is not significantly associated with altered brain structures in regular kratom users in traditional settings. However, further study is needed to establish more data for kratom use and its effects.
    Matched MeSH terms: Pain
  7. Fulltext Intra-articular Localized Haemangioma of the Knee Mimicking Localized Pigmented Villonodular Synovitis: A Case Report
    Goki-Kamei GK, Norimasa-Matsubara NM, Teruyasu-Tanaka TT, Koji-Natsu KN, Toshihiro-Sugioka TS
    Malays Orthop J, 2017 Mar;11(1):60-63.
    PMID: 28435577 DOI: 10.5704/MOJ.1703.004
    Intra-articular synovial haemangioma of the knee is a benign tumour. However, diagnostic delay leads to degenerative changes in the cartilage and osteoarthritis due to recurrent haemarthrosis. Therefore, treatment should be performed immediately. We report the case of a localized synovial haemangioma arising from the medial plica in a 38-year old female presenting with pain and restricted range of motion in the right knee joint. Initially, we diagnosed this case as a localized pigmented villonodular synovitis (LPVS) based on MRI and arthroscopic findings and performed only arthroscopic en bloc excision of the mass and synovectomy around the mass for diagnostic confirmation. Fortunately, there was no difference in the treatment approaches for LPVS and localized haemangioma and the synovial haemangioma had not recurred at the 3-month postoperative follow-up with MRI. The patient's clinical symptoms resolved and had not relapsed two years after surgery.
    Study site: Department of Orthopaedics, Miyoshi Central Hospital, Miyoshi, Japan
    Matched MeSH terms: Pain
  8. Fulltext Imbalanced oxidative stress and pro-inflammatory markers differentiate the development of diabetic neuropathy variants in streptozotocin-induced diabetic rats
    Ismail CAN, Aziz CBA, Suppian R, Long I
    J Diabetes Metab Disord, 2018 Dec;17(2):129-136.
    PMID: 30918846 DOI: 10.1007/s40200-018-0350-x
    Purpose: Diabetic neuropathy is a prolonged symptom of diabetes mellitus that affect a number of diabetes mellitus patients. So far, the variants of diabetic neuropathy, either painful (PDN) or non-painful (or painless, non-PDN) response have distinctive clinical entities. This study aims to determine the effects of oxidative stress parameters and pro-inflammatory factors at spinal cord level of streptozotocin-induced diabetic neuropathy rat model.

    Methods: Thirty Sprague-Dawley rats were randomly assigned to control (non-diabetic), PDN and non-PDN groups (n = 10). The rats were induced with diabetes by streptozotocin injection (60 mg/kg). Tactile allodynia and thermal hyperalgesia were assessed on day 0, 14 (week 2) and 21 (week 3) in the rats. The rats were sacrificed and the spinal cord tissue was collected for the measurement of oxidative stress (malondialdehyde (MDA), superoxide dismutase (SOD) and catalase) and pro-inflammatory markers (interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α)).

    Results: PDN rats demonstrated a marked tactile allodynia with no thermal hyperalgesia whilst non-PDN rats exhibited a prominent hypo-responsiveness towards non-noxious stimuli and hypoalgesia towards thermal input. The MDA level and pro-inflammatory TNF-α was significantly increased in PDN rats whilst catalase was reduced in these rats. Meanwhile, non-PDN rats demonstrated reduced SOD enzyme activity and TNF-α level and increased MDA and catalase activity.

    Conclusion: The changes in oxidative stress parameters and pro-inflammatory factors may contribute to the changes in behavioural responses in both PDN and non-PDN rats.

    Matched MeSH terms: Pain
  9. Fulltext Brodie's Abscess of Posterior Ilium with Gluteal Syndrome, an Unusual Cause of Paediatric Low Back Pain: A Case Report
    Behera G, Poduval M, Patro DK, Sahoo S
    Malays Orthop J, 2017 Jul;11(2):68-71.
    PMID: 29021883 DOI: 10.5704/MOJ.1707.009
    Brodie's abscess is a variety of subacute osteomyelitis with a long duration of presentation and intermittent pain. It usually involves the metaphyseal region of long bones of the lower limbs. Brodie's abscess of pelvic bone is very rare. Involvement of posterior ilium with gluteal syndrome is extremely unusual and can be easily missed or misdiagnosed. We present a 9-year old boy who reported to us with intermittent low back pain of three months duration without any other constitutional symptoms. Clinically, there was mild tenderness over the posterior ilium. Computed tomography showed a lytic lesion in the posterior ilium with a breach in the outer cortex. MRI and bone scan were suggestive of inflammatory pathology. Keeping infective, tubercular and benign bone tumors as differential diagnoses, open biopsy and curettage were done. Staphylococcus aureus was cultured and histopathology was suggestive of osteomyelitis. The patient received appropriate antibiotics for six weeks. He was asymptomatic till 18 months of follow up without any recurrence. We present this case because of its rarity and unusual presentation as gluteal syndrome and low back pain, and its resemblance to other pelvic and sacroiliac joint pathologies which are often missed or misdiagnosed in paediatric patients.

    Study done in India
    Matched MeSH terms: Low Back Pain
  10. Fulltext Pulmonary Embolism Masquerading as Severe Pneumonia: A Case Report
    Payus AO, Rajah R, Febriany DC, Mustafa N
    Open Access Maced J Med Sci, 2019 Feb 15;7(3):396-399.
    PMID: 30834009 DOI: 10.3889/oamjms.2019.114
    BACKGROUND: De novo pulmonary embolism (DNPE) is a term used when pulmonary embolism (PE) occur in the absence of deep vein thrombosis (DVT). Most DNPE cases occur in a patient who had a recent injury to the chest.

    CASE PRESENTATION: However, here we report a case of DNPE with a slightly different presentation where there is no preceding trauma and has symptoms that mimic severe pneumonia. He presented with high fever, dyspnoea and pleuritic chest pain. Despite on 10 L of oxygen supplementation via high flow mask and already given bolus intravenous antibiotic, the patient still tachypnoeic and was persistently in type I respiratory failure. His chest X-ray showed consolidative changes. Upon further investigation revealed no evidence of DVT on Doppler ultrasound and normal D-dimer level. Due to the high index of suspicion by the attending physician, PE was suspected and later confirmed with computed tomography pulmonary angiography scan. He was successfully treated with anticoagulation therapy. The objective of this case report is to share the difficult experience of diagnosing PE when the presentation highly atypical and mimics severe pneumonia.

    CONCLUSION: And with such a masquerading presentation, one can easily miss the diagnosis. To the best of our knowledge, there are very few similar cases reported.

    Matched MeSH terms: Chest Pain
  11. Fulltext Risk perception of childhood immunisation among the public in Kota Kinabalu, Sabah
    Zaki, R.A., Roffeei, S.N., Hazwan, A.E., Musa, N.
    JUMMEC, 2018;21(2):38-44.
    MyJurnal
    Objective: The study was designed to determine the risk perception of the public population in Kota Kinabalu towards childhood immunisation.
    Methodology: This was a cross-sectional study where self-administered questionnaires were distributed to the public in Kota Kinabalu. The respondents who consented were 18 years old and older. The illiterate persons and the foreigners were excluded. The calculated sample size was 400. Only 313 samples collected were suitable for analysis using SPSS v21.0.
    Results: Fever, pain swelling and allergic reaction were correctly identified as risks of immunisation. Autism, mental retardation and even death could also result from vaccination. Of the total respondents, 76.7% agreed with the practice of childhood vaccination, 70.0% thought that childhood vaccinations were safe and effective and 58.1% felt that its benefit outweighed the risk. Other than that, 32.0% refused childhood vaccination from fear of its risks, and this fear was the main reason for the refusal of childhood vaccination. Age, marital status, race and income were the factors which influenced parental willingness to vaccinate their children (p<0.05).
    Conclusions: Most participants understood the risks of childhood vaccination, but few agreed to the practice of childhood immunisation for herd immunity. Public health campaigns are needed, to increase the understanding and acceptance of childhood vaccination especially in the rural community.
    Keywords: Childhood Immunisation, Parental Risk, Perception, Public Acceptance
    Matched MeSH terms: Pain
  12. Impact of long-term exposure wildfire smog on respiratory health outcomes
    Ontawong A, Saokaew S, Jamroendararasame B, Duangjai A
    Expert Rev Respir Med, 2020 05;14(5):527-531.
    PMID: 32156169 DOI: 10.1080/17476348.2020.1740089
    Background: Air pollution is a global problem and also linked to respiratory diseases. Wildfire smog is a major cause of air pollution in the upper northern area of Thailand. Thus, in the current study, we examined whether long-term exposure to wildfire smog induces lung function changes in a population from the upper northern area of Thailand.Methods: The lung function of 115 participants with long-term exposure smog was determined using peak flow meter.Results: Long-term smoke exposure participants decreased FEV1 (forced expiratory volume in 1 second)/FVC (forced vital capacity) ratio (56.49 ± 23.88 in males and 56.29 ± 28.23 in females) compared with general Thai population. Moreover, the reduction of FVC, FEV1, and peak expiratory flow rate (PEFR) values also showed in both male and female subjects. These results suggest that long-term smoke exposure induces obstructive lung abnormality. Moreover, itchy/watery nose, cough, phlegm, and chest pain also reported in these subjects.Conclusion: Wildfire smog could be induced respiratory pathway inflammation and easily collapsible respiratory airways.
    Matched MeSH terms: Chest Pain
  13. Unexpected sequelae of plantar fasciitis: Iatrogenic calcaneal osteomyelitis following plantar heel injection
    Mohd Khalid SA, Bajuri MY
    Malays Fam Physician, 2019;14(3):80-83.
    PMID: 32175048
    The injection of a local anesthetic in combination with a corticosteroid is an accepted choice in the treatment of plantar fasciitis with recalcitrant heel pain. When the injection is performed properly, post-injection infection is extremely rare. We are reporting a rare case of chronic calcaneal osteomyelitis that developed secondary to a local corticosteroid injection. A 56-year-old lady diagnosed with right plantar fasciitis presented with a 6-month history of pain and a persistent sinus with serous discharge of her right heel following a local infiltration of a corticosteroid. A Magnetic Resonance Imaging demonstrated right calcaneal osteomyelitis with intramuscular abscess. Surgical drainage and debridement were done, followed by antibiotic therapy. A recurrence of infection was not detected throughout the duration of follow-up. It is suggested that a plantar heel injection be done in a more controlled environment, such as in operating theatre, to reduce the risk of infection and to avoid injecting a steroid as compared to platelet-rich plasma (PRP) in view of their safety profiles. However, such an injection should only be offered after conservative treatment has failed, as 80% of patients recover well after initial conservative management.
    Matched MeSH terms: Pain
  14. Fulltext The association between the use of complementary and alternative medicine (CAM) with health-related quality of life (HRQoL) and anthropometric indices among university’s staff
    Halib H, Hamdan NA, Hussin N, Shafie N
    Malaysian Journal of Public Health Medicine, 2017;17 Special(2):74-81.
    Complementary Alternative Medicine (CAM) is broadly used as an adjunct treatment for patients to treat various kinds of disease, prevent disease and to sustain and enhance quality of life of the users. The study is aimed to investigate the association between CAM uses, Health-Related Quality of Life (HRQoL) and anthropometric indices among workers or staffs in Universiti Sultan Zainal Abidin (UniSZA) Gong Badak Campus, Kuala Terengganu. A total of 300 subjects participated in this study and completed the malay version of modified HRQol (SF-12) questionnaires. Anthropometric measurements among the subjects were done. Independent t-test, One-way ANOVA and Pearson correlation were used to test the association and the hypotheses. The prevalence of CAM users was 37.3%. The results showed that bodily pain score domain was significantly higher among non-CAM users. Overall, male had higher Mental Health Composite Score (MCS) score than female. Physical Health Composite Score (PCS) was only correlated negatively with BMI among non-CAM users but negative correlated with body fat percentage in both CAM and non-CAM users. As conclusion, HRQoL had significant negative correlation with body fat percentage among CAM users. No association was found between CAM use and HRQoL scores.
    Matched MeSH terms: Pain
  15. Fulltext Modified Unipolar Hemiarthroplasty for the Treatment of Metastatic Lesions of Proximal Femur with Pathological Fractures: Case Series of Six Patients
    Lim CY, Mat-Hassan S, Awang M, Md-Ariff MF, Hau-Abdullah MA
    Malays Orthop J, 2019 Nov;13(3):21-27.
    PMID: 31890106 DOI: 10.5704/MOJ.1911.004
    Introduction: Proximal femur resection and endoprosthetic reconstruction is the preferred treatment for extensive bony destruction and pathological fractures. Due to the relatively high cost of endoprosthesis, we adopted the modified unipolar hemiarthroplasty (MUH) for reconstruction when the mode of treatment was for palliation. Materials and Methods: This is a retrospective case study of six patients, who had bone and multi-organs metastases with extensive proximal femur involvement with pathologic fractures who underwent resection and MUH reconstruction during the period 2013 to 2017. All patients were classified as Group B / C based on Scandinavian Sarcoma Group survival scoring, with estimated survival of maximum six months. The basic MUH construct consisted of Austin-Moore prosthesis which was secured to a Küntscher nail using cerclage wire and cemented into the femoral canal. Subsequently, the whole length of the prosthesis which remained outside the canal was coated with cement. Results: The mean age was 61.8 years. The mean survival was 3.9 months, post-operation. There was no implant failure during patients' life span; however, a third of the patients developed infection. Wheel chair ambulation was started immediately post-operation for all patients, and two patients progressed to walking frame ambulation. The total cost of each construct was below US$490 in comparison to long-stem hemiarthroplasty (roughly US$ 1700). Conclusion: Our aim was to alleviate pain, facilitate rehabilitation, ease nursing care and improve quality of life for metastatic bone disease patients until end of life. MUH for the treatment of pathological fracture in proximal femoral metastases is a feasible palliative surgical modality in resource-limited settings.
    Matched MeSH terms: Pain Management
  16. Fulltext Is Platelet-rich Plasma Injection more Effective than Steroid Injection in the Treatment of Chronic Plantar Fasciitis in Achieving Long-term Relief?
    Soraganvi P, Nagakiran KV, Raghavendra-Raju RP, Anilkumar D, Wooly S, Basti BD, et al.
    Malays Orthop J, 2019 Nov;13(3):8-14.
    PMID: 31890104 DOI: 10.5704/MOJ.1911.002
    Introduction: Plantar fasciitis is characterised by pain in the heel, which is aggravated on weight bearing after prolonged rest. Many modalities of treatment are commonly used in the management of plantar fasciitis including steroid injection. Many studies show that steroid injection provides pain relief in the short term but not long lasting. Recent reports show autologous platelet-rich plasma (PRP) injection promotes healing, resulting in better pain relief in the short as well as long term. The present study was undertaken to compare the effects of local injection of platelet-rich plasma and Corticosteroid in the treatment of chronic plantar fasciitis. Materials and methods: Patients with the clinical diagnosis of chronic plantar fasciitis (heel pain of more than six weeks) after failed conservative treatment and plantar fascia thickness more than 4mm were included in the study. Patients with previous surgery for plantar fasciitis, active bilateral plantar fasciitis, vascular insufficiency or neuropathy related to heel pain, hypothyroidism and diabetes mellitus were excluded from the study. In this prospective double-blind study, 60 patients who fulfilled the criteria were divided randomly into two groups. Patients in Group A received PRP injection and those in Group B received steroid injection. Patients were assessed with visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score. Assessment was done before injection, at six weeks, three months and six months follow-up after injection. Plantar fascia thickness was assessed before the intervention and six months after treatment using sonography. Results: Mean VAS in Group A decreased from 7.14 before injection to 1.41 after injection and in Group B decreased from 7.21 before injection to 1.93 after injection, at final follow-up. Mean AOFAS score in Group A improved from 54 to 90.03 and in Group B from 55.63 to 74.67 at six months' follow-up. The improvements observed in VAS and AOFAS were statistically significant. At the end of six months' follow-up, plantar fascia thickness had reduced in both groups (5.78mm to 3.35mm in Group A and 5.6 to 3.75 in Group B) and the difference was statistically significant. Conclusion: Local injection of platelet-rich plasma is an effective treatment option for chronic plantar fasciitis when compared with steroid injection with long lasting beneficial effect.
    Matched MeSH terms: Pain
  17. Fulltext Demographics of Patients Undergoing Carpal Tunnel Release in an Urban Tertiary Hospital in Malaysia
    Bahar-Moni AS, Abdullah S, Fauzi H, Chee-Yuen SY, Abdul-Razak FZ, Sapuan J
    Malays Orthop J, 2019 Nov;13(3):53-59.
    PMID: 31890111 DOI: 10.5704/MOJ.1911.009
    Introduction: Carpal tunnel syndrome (CTS) is the most commonly encountered neuropathy. The entrapment of the median nerve at the wrist can be corrected with a carpal tunnel release (CTR) procedure. The objective of this retrospective study was to determine the demographic, medical, and surgical characteristics of the patients with CTS who presented for CTR surgery in a tertiary hospital in Malaysia. Materials and Methods: Malaysians patients with CTS who had undergone a CTR during the period from 1st June 2017 to 31st December 2017 were enrolled into the study. Each patient had a minimum follow-up of three months. The demographic data of age, gender, race and occupation, and the comorbid illnesses and associated risk factors were recorded. The prevalence and occurrence of CTS in the dominant or non-dominant hand and the effectiveness of surgical intervention were also noted. Data was collected, analysed and stored in Microsoft Excel and SPSS 25. Results: There was a total of 76 cases of CTR surgeries done in 62 patients in the study. Eighty percent of the patients were female, and most of the patients belonged to the age group of 41-60 years. Malays constituted 74.2% of the patients, and 34% were housewives. Hypertension, dyslipidaemia and diabetes mellitus were the three major comorbidities. Cervical spondylosis was seen in one-fourth of the patients. Bilateral hand involvement was present in 54.8% of patients. 59.7% of CTR surgery was done on the dominant hand alone, 17.7 % CTR on the non-dominant hand alone and 22.6% CTR on both hands. Numbness and pain (50%) were the predominant presenting symptoms. The most positive signs were the Durkan test (77.6%), followed by the Tinel sign at the carpal tunnel and the Phalen's test. At follow-up, three months or more, after the surgery, 75% of the patients showed a satisfactory improvement. Conclusion: Patients, who had undergone CTR, had a higher prevalence of pre-morbid conditions, and a quarter of them presented with associated cervical spondylosis. The most common presentation was a combination of numbness and pain. Many obtained satisfactory improvement post-surgery and thus open surgery could be considered a reliable treatment for CTS.
    Matched MeSH terms: Pain
  18. Fulltext Floating teeth appearance: A radiographic dilemma
    Rahman NA, Harun MH, Rahman SA, Mohammad NSA
    J Taibah Univ Med Sci, 2020 Apr;15(2):160-165.
    PMID: 32368214 DOI: 10.1016/j.jtumed.2020.02.005
    Gorham disease (GD) is an extremely rare disorder that is characterised by massive osteolysis of the affected bone with unknown aetiology and an unpredictable prognosis. Additionally, no standard treatment is available for GD. This article describes a case report of a 61-year-old Malay woman who was diagnosed with GD of the anterior mandible without a prior history of trauma. She presented with pain and mobility of the dentoalveolar segment for 3 months. The radiographic findings showed "floating teeth" with widening of the periodontal ligament space and localized area of bony destruction. Histopathologically, there was proliferation of numerous dilated endothelial-lined channels within the intertrabecular tissue. Some areas of bone were replaced by fibrous connective tissue giving rise to the appearance of a benign fibroosseous lesion. The patient was managed with simple removal of the affected bone segment under local anaesthesia, followed by prosthodontic rehabilitation. Healing of the surgical site was uneventful, and no recurrence was reported at the 3-year follow-up.
    Matched MeSH terms: Pain
  19. Fulltext Psychometric properties of the malay language version of Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire among knee osteoarthritis patients: a confirmatory factor analysis
    Zulkifli MM, Kadir AA, Elias A, Bea KC, Sadagatullah AN
    Malays Orthop J, 2017 Jul;11(2):7-14.
    PMID: 29021872 MyJurnal DOI: 10.5704/MOJ.1707.003
    Introduction: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS) and to evaluate its psychometric properties in patients with knee osteoarthritis (OA). Materials and Methods: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. Results: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/degree of freedom= 2.183) indices to signify a model fit. The Cronbach's alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. Conclusion: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

    Study site: Outpatient and orthopedic clinics, Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Pain
  20. Fulltext Hemangiopericytoma 11 years later: delayed recurrence of a rare soft tissue sarcoma
    Cheng KP, Wong WJ, Hashim S, Mun KS
    J Thorac Dis, 2017 Sep;9(9):E752-E756.
    PMID: 29221336 DOI: 10.21037/jtd.2017.08.74
    Hemangiopericytomas (HPCs) are uncommon tumours. We present the case of a 41-year-old female with multiple resections at different sites over the course of 11 years. The approach considerations, as well as treatment options and prognosis are discussed. A 41-year-old female with two previous resections for intracranial meningeal HPC in 2004 and 2008, as well as adjuvant radiotherapy, presented in 2015 with left intrathoracic and left hip recurrence confirmed by positron emission tomography/computed tomography (PET/CT). She underwent left proximal femur resection/reconstruction and video-assisted thoracoscopic surgery (VATS) resection of the intrathoracic tumour was attempted. She was discharged home on her 4th post-operative day with minimal pain. There were no neurosensory or motor deficits. Any patient who has been diagnosed with HPC in the past who develops new symptoms should be worked up for recurrence, regardless of the length of disease-free interval, as our case study suggested. There has yet to be a standardized follow-up regime due to the rarity of these tumours. HPC remains a rare soft tissue sarcoma with high recurrence rate. Planned VATS evaluation and resection is possible provided complete resection with clear surgical margins can be achieved, as clear surgical margins offer the best chance of survival.
    Matched MeSH terms: Pain
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