IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Outcome of Anterior Cruciate Ligament Reconstruction: A Comparison between Biotransfix Screw and All-Inside Technique
Get PDFIntroduction: Anterior cruciate ligament (ACL) reconstruction has evolved during past decade. All inside technique is introduced aiming for less invasive procedure, bone stock preservation, preservation of tendon at its donor site, better graft positioning and fixation technique. This study is conducted to compare the outcomes of this new technique to the previous biotransfix screw. Materials and method: A cross sectional study was conducted in patients with ACL injury treated with ACL reconstruction surgery in Hospital Sultanah Nur Zahirah, Kuala Terengganu and Hospital Kemaman, Terengganu. Functional outcome with International Knee Documentation Committee (IKDC) score, SF-36 quality of life score and time taken to return to normal activities were evaluated at 18 to 24 months post-operative. Results: Forty patient were recruited, 20 in each group. Of this, 37 were male with age of 25±6.48 years old. 25 were office worker and the rest were field worker. 37.5% were smoker. Patients in biotransfix screw technique operated at 21.3±12.6 months after the injury while those in all inside technique at 17.7±11.9 months(p-value 0.35). BMI was 24.58±4.59. The SF-36 score were similar in both groups with p-value 0.59. Both groups have same IKDC score of 82.99±12.55. Time taken to return to normal activity level was 46.3±19.7 weeks which was similar in both groups(p-value 0.943). Re rupture rate were 10% in biotransfix screw technique and 5% in all inside technique. None of them has any form of infection. There were no correlation between quality of life SF-36 score with age, tobacco use, BMI, duration of injury until operation and occupation of the patient in both techniques. Conclusion: The functional outcome, quality of life and time return to normal activity were similar between patients who had biotransfix screw and all inside technique. There were also no correlations between factors studied with quality of life in both groups
Primary Hemiarthroplasty Following Severe Proximal Humerus Fracture Dislocations with Irretrievable Humeral Head in Young Patients
Get PDFNeer first popularised the use of primary hemiarthroplasty to treat complex proximal humerus fractures, especially when the humeral head is nonviable or not reconstructable with internal fixations, and with younger patients. A 16-year-old boy had a motor vehicle accident and sustained a closed right proximal humerus fracture dislocation without neurovascular injury. Intraoperatively, due to difficulty retrieving the humeral head which dislocated and positioned behind the clavicle, hemiarthroplasty was done to avoid injuring the brachial plexus, vessels and lung. Mr Y, a 34-year-old man similarly sustained closed left proximal humerus fracture dislocation with an irretrievable head. He too underwent hemiarthroplasty. Both patients were followed up for a year with no pain and fairly good range of movement and muscle power. In complex proximal humerus fractures, there is still debate regarding primary hemiarthroplasty. There are risks of secondary displacement of fracture fragments and head necrosis after internal fixation. Neer and Cofield reported over 90% patients had relief of pain and 66% patients had free range of movement post hemiarthroplasty. Other authors described primary malposition and subsequent migration or deficient osseous integration as a complication after prosthesis. In a thirteen-year observational cohort study of 163 patients with hemiarthroplasty, the overall rate of prosthetic survival was 96.9% at one year, 95.3% at five years, and 93.9% at ten years. Of the factors that were assessed, the age is most important due to factors such as degenerative changes in the rotator cuff, osteoporosis, and motivation to achieve a good range of motion. Successful treatment of acute proximal humerus fractures with prosthetic replacement is challenging to orthopaedic surgeons as it requires proper patient evaluation, good surgical technique, especially in soft-tissue tensioning and stability, and meticulous rehabilitation. In young patients with good bone quality and irretrievable head, hemiarthroplasty is a choice
Radiological Findings of Pulmonary Tuberculosis in Patients with and Without HIV Infections
No full textIntroduction: Radiological manifestation of pulmonary tuberculosis in HIV positive patients is different with HIV negative patients. We aim to determine the differences in chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected patients in HTAA. Materials and method: A retrospective study was conducted in Chest Clinic, Hospital Tunku Ampuan Afzan, Kuantan Pahang. There were 101 chest radiographs with sputum smear-positive retrieved and reviewed. Socio-demographic status and chest radiographs findings were documented and analyzed. Results: Of the 101 patients, 12 patients were HIV positive. Of the 89 HIV negative patients, 96% had consolidation change on chest radiograph, in contrast with HIV positive patients, only 4% among them had this appearance and this is statistically significant (p value less than 0.05). Mediastinal lymphadenopathy is significantly higher (17%) in HIV positive patients compared to HIV negative patients (1%). Normal chest radiographs were more common in HIV positive patients (33%) as compared to HIV negative patients (2%). Conclusion: HIV positive patients with pulmonary tuberculosis exhibit different radiological manifestation on chest radiograph when compared to HIV negative patients
Depression, Anxiety and Sexual Dysfunction in Patients with Diabetes Mellitus With and Without Foot Ulcer
Get PDFIntroduction: Anxiety and depression are both associated with increased morbidity in diabetic population, especially those afflicted with foot ulcer, whereas Erectile Dysfunction (“ED”) and Female Sexual Dysfunction (“FSD”) are amongst the common complication found in diabetes. This study aimed to determine the prevalence of anxiety and depression as primary outcome and sexual dysfunction (“SD”) as a secondary outcome in diabetic patients with and without foot ulcer (“DFU”). Methods: A cross-sectional study was conducted in Hospital Raja Permaisuri Bainun Ipoh, Perak, where 164 diabetic patients were recruited for the purpose of this study. Hospital Anxiety and Depression Scale (“HADS”) were utilised to measure anxiety and depression. International Index for Erectile Function 5 (“IIEF-5”) and the Malay version of Female Sexual Function Index (“MVFSFI”) were used to detect SD. Simple and multiple logistic regressions were referred to in order to evaluate the factors associated with anxiety, depression and SD. Results: In the group with foot ulcer, 36.8% had depressive and anxiety risk respectively compared to without the foot ulcer, 37.5% and 38.5% respectively. Male gender (AOR=6.3,p=0.002,95%CI 1.975, 20.205) and having lower education status (AOR=6.0,p=0.018,95%CI1.36,26.59,) was associated with foot ulcer. High prevalence of SD found in foot ulcer group (52.6%,p=0.006). Those with depression (OR=4.421,95% CI 1.08,18.16,p=0.039) and male gender (OR=18.42,p<0.01,95%CI5.5,-61.62) predicts present of SD. Conclusion: Depression and anxiety prevalent were similar for both with and without diabetic foot ulcer. Several significant predictor factors were identified for DFU group, for anxiety and depression risk and for SD in a diabetes patient. Further studies are required to establish the directional nature of this relationship
Anti-atherosclerotic Effects of Eurycoma Longifolia (Tongkat Ali) in Rats Fed on High-fat Diet
Get PDFAtherosclerosis in cardiovascular disease (CVD) is a growing health problem, especially in developing countries. Hyperlipidemia is known as a dominant risk factor for the development of atherosclerosis. This study was designed to investigate the effects of Eurycoma Longifolia (EL) also known as Malaysian Ginseng/ Tongkat Ali on the testosterone level, biochemical changes of lipid profile and intima media thickness (IMT) in rats fed on high-fat diet. Twenty young, adult male Sprague-Dawley (SD) rats were housed for 12 weeks. After one week of acclimatization, they were randomly divided into four groups of 5 animals each and treated for 12 weeks as follow: Group ND was given only normal diet, group NDEL was given normal diet and EL extracts (15mg/kg) dissolved in distilled water, group HFD was given only high fat diet and group HFDEL was given high fat diet and EL extracts (15mg/kg). Rats which were treated with EL (NDEL and HFDEL) showed a significant increase (p<0.05) in the testosterone levels. There was a significant decrease (p<0.05) in triglyceride (TG) in HFDEL group compered to HFD group. The histological sections of aortas revealed a significant decrease (p<0.05) in IMT in HFDEL as compared with HFD group. No histological changes were observed in NDEL group compared with ND group and there was no significant difference in IMT values between NDEL and ND. These findings suggest that EL is a promising protective agent against atherosclerosis induced by high-fat diet
Investigating the Potential of Nigella Sativa and Thymoquinone in Salvaging the Embryo from Effects of Toxic Paternal Exposure to Cyclophosphamide
Get PDFBackground: Exposure to cyclophosphamide (CPA) for cancer treatment results in over-production of reactive oxygen species and oxidative stress thus affecting the DNA in male germ cell inducing sperm defects. Our goal is to assess the potential effects of Nigella sativa extract (NSE) and thymoquinone (TQ) on sperm and embryo quality following fertlization of sperm produced from germ cells which have been exposed to the damaging alkylating effects of CPA. Methods: Thirty six male ICR mice were divided into six groups; (I) Vehicle-treated control (normal saline), (II) CPA-only, (III) TQ-only, (IV) NSE-only, (V) CPA followed by TQ and (VI) CPA followed by NSE. Treatment with 200mg/kg CPA and 10mg/kg of both NSE and TQ were given by intraperitoneal injection. Animals were sacrificed at 33 days by cervical dislocation and sperm from caudal epidydymis were taken for analysis and in vitro fertilization (IVF) with eggs from untreated female. Fertilization rates and embryo development were monitored for 5 days. The result were analysed by using SPSS 16.Results: TQ and NSE supplementation to CPA-exposed male mice have no significant effect (p>0.05) on the total number of sperm if compared to CPA-only exposed mice. NSE and TQ supplementation have been shown to have significant effect (p<0.05) on the percentage of motile sperm as well as the number of abnormal sperm. Four types of abnormalities of the sperm were found which includes folded sperm, amorphous, banana-like and the head lacking of the usual hook. Finally, the embryo quality shows a significant improvement by the supplementation of TQ and NSE to CPA-exposed male mice (p<0.05). Conclusion: Overall, both NSE and TQ have indicated chemopreventive potential against the cytotoxicity of cyclophosphamide on the reproductive capacity and fertility
An Audit Of The Referral Letter Received At Klinik Pakar Orthodontik Jln Abd Samad
Get PDFIntroduction: The objectives of this study were to determine the prevalence and the pattern of hypodontia among orthodontic patients in Klinik Pergigian Jalan Sultan Mahmud, Kuala Terengganu. Materials and Methods: This was a retrospective study where 351 orthodontic patients records (comprises of 104 males and 247 females), were reviewed. The records were evaluated by a trained dental officer between October 2016 and June 2017. The Chi-square and Fisher's Exact Tests were carried out for statistical analysis. Results: The prevalence of hypodontia was 10.8%. Thirty-eight (38) patients were found to have at least a single missing tooth. A significant difference was found between males and females having hypodontia (p = 0.048). No significant difference was found for hypodontia patients by races (p = 0.829). The maxillary lateral incisor was the most frequently missing tooth followed by mandibular second premolar and mandibular lateral incisor. Hypodontia cases observed, tended to be more likely occurred in the upper left arch compared to the lower arch. The majority of hypodontia patients had a single missing tooth, but rarely more than 3 missing teeth. Hypodontia patients had mainly Class III malocclusion, however no statistically significant difference was found (p = 0.081). Conclusion(s): The prevalence of hypodontia of this study was within the range of what is being reported in the literature and showed gender significant. In this sample, hypodontia mainly involved maxillary lateral incisors; more prevalent in the upper arch; and mostly observed in patients with Class III malocclusion. Early detection and accurate diagnosis are essential. Therefore, alternative treatment modalities can be well planned under multidisciplinary team approach in restoring the aesthetic and function
Denture Box, A New Invention In Copy Denture Technique: User Overview
Get PDFIntroduction: Copy denture procedure was introduced in 1962 for the construction of spare denture. However, throughout the years, the procedure has undergone developments in terms of the techniques and materials used for the construction of the replica denture. One of the most popular methods to construct the replica is by using soap box. A group of researchers from USIM have invented Denture Box and the product has been registered with Malaysian Industrial design (MY-16-00546-0101). Therefore, a study was conducted to assess the satisfaction of the Denture Box among dentists and dental technologists. Materials and Methods: Participants who attended the Copy Denture Workshop organized by USIM on 13th April 2017 were asked to make a replica denture from soap-box and Denture Box. A pre-tested questionnaire use 5-point Likert scale was distributed to get their feedback regarding Denture Box after the workshop. Results: Based on their experience during the workshop, all participants (n=41) were satisfied and agreed that the box was 100% practical to use with mean score 4.40±0.49. 92.7% of the participants agreed that the invention can reduce the total cost of denture construction (mean score 4.24±0.57) and 85.5% agreed that Denture Box can save time for denture construction (mean score 4.24±0.71). Interestingly, 87.8% of the participants were excited to use the product in future (mean 4.31±0.67). Conclusion(s): Overall satisfaction from using Denture Box was good. Therefore, Denture Box is ready to be commercialised after some design improvement by taking into consideration a few suggestions made by the participants
Influence Of Dentist Gender And Clinical Experience On The Selection Of Posterior Restorative Dental Material: A Preliminary Study
Get PDFIntroduction: Dentist-related factors are one of the major influences on the material selection for restoration of carious and non-carious tooth surface loss. There were conflicting results regarding the impact of dentists' gender and age or length of clinical experience on restorative material selection for posterior dentition. The aims of this study were to determine the influence of gender and clinical experience on posterior restorative material selection among private dental practitioner in Malaysia. Materials and Methods: This is a cross sectional study, and a selfadministered questionnaire was distributed randomly using a simple random method, among general private dental practitioner in Kuala LUMPur. Data gathered then analysed using SPSS version 21.0 and alpha error was set at p10 years working experience) were inclined to choose tooth coloured restorative material over amalgam at 87% and 83.9% respectively. Chi square test revealed non-significant difference in the material selection with relation to gender (p=0.852) and clinical experience (p=0.748). Conclusion(s): The dental practitioner's gender and clinical experience in this study has no influence on the material selection for posterior restorations
Mandibular Morphology Differences Between Edentulous And Dentate Assessed By Panoramic Radiographs
Get PDFIntroduction: Facial profile can be influenced by edentulous condition that can change mandibular morphology that can affect mastication, digestion and psychosocial life. Edentulism causes absence of occlusal mechanical stimulus, decrease the activity of mastication muscles and increase mandibular bone resorption. These changes can be assessed using panoramic radiography by looking at the vertical dimension of the head of the condyle and its shape, ramus, and the angle of the mandible. The aim of the study was to assess the mean value and differences of mandibular morphology in edentulous and dentate patients using panoramic radiography. Materials and Methods: This was an analytical study with cross-sectional approach using purposive sampling methods. 50 dentate and edentulous patients who came to Dentistry Hospital of University of Sumatera Utara were used as sample. Data analysis was done using Independent T test and MannWhitney test. Results: Results showed that the average value of gonial angle, ramus height, condylar height, antegonial notch depth and ramus notch depth in edentulous patients were 125,38 ± 9,51; 35.98mm ± 4.26; 5.58mm ± 0.90; 2.11mm ± 1.04; and 2.73mm ± 0, 88, and the results showed that the average value of mandibular morphology in dentate patients were 123.34 ± 7.07; 38.15mm ± 3.23; 6.95mm ± 1.25; 1.41mm ± 0.77; and 2.15mm ± 0.59. Conclusion(s): There were significant differences in the values of ramus height, condylar height, antegonial notch depth, and ramus notch depth. Difference was also found in gonial angle value, but was not statistically significant