MyMedR

Fulltext Bertolotti's syndrome: A commonly missed cause of back pain in young patients

Manmohan S, Dzulkarnain A, Nor Azlin ZA, Fazir M

Malays Fam Physician, 2015;10(2):55-8.

Bertolotti's syndrome must be considered as a differential diagnosis for lower back pain in young people. Treatment, whether conservative or operative, is still debatable. In this paper, we report a case of a 20-year-old girl presenting with lower back pain for 8 years. We administered injection with local anaesthetic and steroid injections within the pseudo-articulation; however, the pain was relieved for 3 weeks. Surgical excision of the pseudo-articulation successfully treated her back pain and the sciatica.

Fulltext A rare case of heterotopic ossification in a newborn: a case report

Khoo S, Felix L, Azura L, Manmohan S, Jeffry A

Malays Orthop J, 2012 Nov;6(3):48-50.

PMID: 25279058 MyJurnal DOI: 10.5704/MOJ.1207.006

Heterotopic ossification (HO) is the growth of bone in soft tissue, and can be broadly classified into neurogenic, genetic and traumatic causes. The pathophysiology of HO remains unknown. This disorder is extremely rare in infants and can mimic or coexist with thrombophlebitis, cellulitis or osteomyelitis. Most importantly, HO has to be differentiated from bone-forming tumours such as osteosarcoma and osteochondroma. We report a case of traumatic HO in a fiveday- old newborn following intravenous cannulation of the right wrist and left ankle, with the latter complicated with osteomyelitis. We highlight the clinical and radiological features of HO and differential diagnoses of soft tissue ossification in early childhood.

Fulltext Complete Recovery of Thoracic Myelopathy after Eleven Months of Paraplegia: A Case Report

Manmohan S, Nor Azlin ZA, Fazir M, Dzulkarnain A, Goh JH

Malays Orthop J, 2015 Mar;9(1):32-34.

PMID: 28435594 MyJurnal DOI: 10.5704/MOJ.1503.004

Instances of neurological recovery after early decompression of the spine in non-traumatic spinal cord compression are well documented. We present a patient with paraplegia of 11 months' duration due to atypical spinal tuberculosis who showed complete neurological recovery in three months.

Fulltext Pre-injury demographic patterns of patients sustaining hip fractures in malaysia

Isnoni I, Mohamad Adam B, Murallitharam M, Tajuddin A, Jaya Purany S, Manmohan S, et al.

Malays Orthop J, 2012 Jun;6(SupplA):11-5.

PMID: 25279068 MyJurnal DOI: 10.5704/MOJ.1211.004

INTRODUCTION: Hip fractures entail a growing economic burden on the health care system. Study is warranted to further our understanding of its patterns and to create increased awareness in health care providers and the public.

MATERIALS AND METHODS: Data was extracted from the ongoing National Orthopaedic Registry of Malaysia (NORM), for the period June 2008 till December 2009. Patients aged 50 years and above without previous pathological fracture hip fractures were included in the study.

RESULTS: Most hip fracture patients were 70 years and above (69.5%) with a mean (SD) age of 73.8 (10.3) years. Females represented the majority of the patients in this study (68.4%). Low energy trauma (i.e. trivial fall) was to the main mechanism of hip fractures in this study (81.3%).

CONCLUSIONS: Aging adults should be made aware of timely preventive strategies (including osteoporosis prevention) fall prevention measures, and encouraged to maintain physically active lifestyles.

KEY WORDS: Hip fracture, pre-fracture status.

Fulltext Brain injury in canine models of cardiac surgery

Blue ME, Wilson MA, Beaty CA, George TJ, Arnaoutakis GJ, Haggerty KA, et al.

J. Neuropathol. Exp. Neurol., 2014 Dec;73(12):1134-43.

PMID: 25383634 DOI: 10.1097/NEN.0000000000000134

Neuropathology and neurologic impairment were characterized in a clinically relevant canine model of hypothermic (18°C) circulatory arrest (HCA) and cardiopulmonary bypass (CPB). Adult dogs underwent 2 hours of HCA (n = 39), 1 hour of HCA (n = 20), or standard CPB (n = 22) and survived 2, 8, 24, or 72 hours. Neurologic impairment and neuropathology were much more severe after 2-hour HCA than after 1-hour HCA or CPB; histopathology and neurologic deficit scores were significantly correlated. Apoptosis developed as early as 2 hours after injury and was most severe in the granule cells of the hippocampal dentate gyrus. Necrosis evolved more slowly and was most severe in amygdala and pyramidal neurons in the cornu ammonis hippocampus. Neuronal injury was minimal up to 24 hours after 1-hour HCA, but 1 dog that survived to 72 hours showed substantial necrosis in the hippocampus, suggesting that, with longer survival time, the injury was worse. Although neuronal injury was minimal after CPB, we observed rare apoptotic and necrotic neurons in hippocampi and caudate nuclei. These results have important implications for CPB in humans and may help explain the subtle cognitive changes experienced by patients after CPB.

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