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Correlation of Hamstring Tendon Size in Pre-Operative MRI Measurement with Intra-Operative Graft Size in Primary Anterior Cruciate Ligament (ACL) Reconstruction

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Journal of Biosciences and Medicines 2024年第3期12卷 150-158页

作者： Nurhanani Abu Bakar Mohamad Razip Sirat Hairiah Abas Saiful Safuan Md Sani Department of Orthopaedic Hospital Pakar Sultanah Fatimah Muar Malaysia Department of Orthopaedic Hospital Tengku Ampuan Rahimah Klang Malaysia Department of Radiology Hospital Pakar Sultanah Fatimah Muar Malaysia Department of Medicine Clinical Research Center Hospital Kuala Lumpur Kuala Lumpur Malaysia

Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in hospital Pakar sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.

关键词： ACL Reconstruction Pre-Operative MRI Hamstring Tendon

Occurrence of K1 and K2 serotypes and genotypic characteristics of extended spectrumβ-lactamases-producing Klebsiella pneumoniae isolated from selected hospitals in Malaysia

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Asian Pacific Journal of Tropical Medicine 2024年第1期17卷 30-38页

作者： Nurul Syazrah Anuar Hazmin Hazman Sharven Raj Jeyakumar Mohd Nasir Mohd Desa Hasni Idayu Saidi Siti Norbaya Masri Nur Afiza Aziz Nurshahira Sulaiman Department of Biomedical Science Faculty of Medicine and Health SciencesUniversiti Putra Malaysia43400UPM SerdangSelangorMalaysia Department of Medical Microbiology Faculty of Medicine and Health SciencesUniversiti Putra Malaysia43400UPM SerdangSelangorMalaysia Microbiology Unit Department of PathologyHospital Sultanah AminahJalan Persiaran Sultan Abu Bakar80100 Johor BahruJohorMalaysia

Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.Methods:A total of 192 K.pneumoniae isolates were collected and subjected to antibiotic susceptibility,hypermucoviscosity test and multiplex PCR to detect the presence of K1-and K2-serotype associated genes.Multilocus sequence typing(MLST)was performed on ESBL-producing K.pneumoniae isolates presented with K1 and K2 serotypes,followed by phylogenetic analysis.Results:A total of 87 out of 192(45.3%)of the K.pneumoniae isolates collected were ESBL producers.However,only 8.3%(16/192)and 10.9%(21/192)of the total isolates were detected to carry K1-and K2-serotype associated genes,respectively.Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype(P=0.196).However,they were significantly associated with hypervirulent,as demonstrated by the positive string test(P<0.001).MLST analysis revealed that ST23 as the predominant sequence type(ST)in the K1 serotype,while the ST in the K2 serotype is more diverse.Conclusions:Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low,their coexistence warrants the need for continuous surveillance.MLST showed that these isolates were genetically heterogeneous.

关键词： Extended spectrumβ-lactamases Klebsiella pneumoniae Capsular serotypes Genotypic

Isolated blunt iliac artery injury successfully treated with endovascular stent

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Chinese Journal of Traumatology 2022年第4期25卷 242-244页

作者： Ee Peng Lee Tan Jih Huei Tan Chor Lip Henry Bakin Salinawati Mohamad Yuzaidi Imran Alwi Rizal Department of General Surgery Hospital Sultanah AminahJohor BahruMalaysia

Common or external iliac artery injury due to blunt trauma is unusual without an associated pelvic fracture.Here we report on a 62 years old man that sustained left external iliac artery thrombosis due to blunt trauma following fall from motorbike.There was no immediate circulatory compromise.Contrasted CT of abdomen revealed an associated left lower abdominal wall traumatic hernia.The iliac artery was intervened with an endovascular stent to restore luminal flow and the hernia was repaired electively.The entire clinical course and management dilemma are described in this article.

关键词： Iliac artery Stents Blunt injuries

Emergency repair of blunt traumatic bronchus injury presenting with massive air leak

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Chinese Journal of Traumatology 2022年第6期25卷 392-394页

作者： Jun Sen Chuah Zhun Ming Raymond Lim Ee Peng Lee Jih Huei Tan Yuzaidi Mohamad Rizal Imran Alwi Trauma Surgery Unit Department of General SurgeryHospital Sultanah AminahMinistry of Health MalaysiaJohor BahruMalaysia

Blunt traumatic tracheobronchial injury is rare,but can be potentially life-threatening.It accounts for only 0.5%-2%of all trauma cases.Patients may present with non-specific signs and symptoms,requiring a high index of suspicion with accurate diagnosis and prompt treatment.A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident.She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck.Her airway was secured and chest drain was inserted for right sided pneumothorax.CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax,raising the suspicion of a right middle lobe bronchus injury.Diagnosis was confirmed by bronchoscopy.In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak,immediate right thoracotomy via posterolateral approach was performed.The right middle lobar bronchus tear was repaired.There were no intra-or post-operative complications.She made an uneventful recovery.She was asymptomatic at her first month follow-up.A repeated chest X-ray showed expanded lungs.Details of the case including clinical presentation,imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury.A review of the current literature of tracheobronchial injury management was presented.

关键词： Blunt chest trauma Bronchus injury Bronchoscopy Thoracotomy

Migrating fish bone piercing the common carotid artery,thyroid gland and causing deep neck abscess

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World Journal of Clinical Cases 2016年第11期4卷 375-379页

作者： Hafizah Husna Johari Bee-Lian Khaw Zulkifli Yusof Irfan Mohamad Department of Otorhinolaryngology Head and Neck SurgeryHospital Sultanah Bahiyah Department of Otorhinolaryngology Head and Neck School of Medical SciencesUniversiti Sains Malaysia

Foreign body(FB) ingestion is very common in Malaysian population.The most commonly ingested FB is fish bone.Common presenting symptoms include FB sensation,odynophagia and or sharp pricking pain during swallowing.A careful history and physical examination is very important.Despite negative laryngoscopy and rigid esophagoscopy,persistent symptoms warrants further radiographic imaging studies.The FB can migrate extraluminally and involve other important adjacent structures of the neck and along the digestive tract.We report 3 cases of extraluminal migration of fish bone and their complications,which were successfully managed.One case with vascular complication which involve common carotid artery and the other two cases with neck abscess formation involving thyroid gland,retropharyngeal and parapharyngeal abscess.

关键词： Foreign body Migrating Complication Carotid artery Thyroid gland Abscess

Comparison of Cox proportional hazards model,Cox proportional hazards with time-varying coefficients model,and lognormal accelerated failure time model:Application in time to event analysis of melioidosis patients

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Asian Pacific Journal of Tropical Medicine 2022年第3期15卷 128-134页

作者： Kamaruddin Mardhiah Nadiah Wan-Arfah Nyi Nyi Naing Muhammad Radzi Abu Hassan Huan-Keat Chan Faculty of Entrepreneurship and Business Universiti Malaysia KelantanKota BharuKelantanMalaysia Faculty of Health Sciences Universiti Sultan Zainal AbidinKuala TerengganuTerengganuMalaysia Faculty of Medicine Universiti Sultan Zainal AbidinKuala TerengganuTerengganuMalaysia Clinical Research Center Hospital Sultanah BahiyahMinistry of Health MalaysiaAlor SetarKedahMalaysia

Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Methods:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to hospital sultanah bahiyah,Kedah and hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured melioidosis.The prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit methods.The analyses were done by using Stata SE version 14.0.Results:A total of 242 patients(53.4%)survived.In this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC model.In AFT survival analysis,a total of seven significant prognostic factors were identified.The results were found to be only a slight difference between the identified prognostic factors among the models.AFT survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell residuals.Conclusions:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.

关键词： Cox proportional hazards Time-dependent Time-varying Accelerated failure time survival analysis Lognormal Parametric model Time-to-event Melioidosis Mortality

Prolonged conjunctivitis mimicking nodular episcleritis as a manifestation of granulomatosis with polyangiitis-a case report

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Annals of Eye Science 2022年第1期7卷 114-118页

作者： Hong Nien Lee Visvaraja Subrayan sultanah Fatimah Specialist hospital JohorMalaysia University Malaya Specialist Center Kuala LumpurMalaysia

Red eye is common in our daily practice.It ranges from non-inflammatory to inflammatory causes.An extended course of disease should prompt suspicion and the possibility of diagnosis revision.A prolonged conjunctivitis mimicking nodular episcleritis can be presented as a manifestation of granulomatosis with polyangiitis(GPA).A 57-year-old woman complained of eye redness and tearing for two weeks which partially resolved with antibiotics.She was subsequently commenced on topical and oral non-steroidal anti-inflammatory drugs(NSAIDs)and topical anti-allergic.However,in the following reviews she developed cornea thinning and her systemic examination revealed an injected uvula with absence of upper respiratory tract infection.She was investigated for connective tissue disease and found to have raised anti-inflammatory markers and her antinuclear antibody and C-ANCA tests were positive.She was diagnosed with GPA.Her conditions improved followed by the commencement of topical corticosteroid with high dose of systemic corticosteroid,which followed by a tapering regime with oral corticosteroid.Although red eye is common,it is associated with a variety of diseases.GPA manifestation can be as subtle as a red eye.Any prolonged partially treated red eye should prompt suspicion of a more sinister cause.Sensitive detection of other subtle systemic signs is very important.

关键词： Granulomatosis with polyangiitis(GPA) episcleritis peripheral ulcerative keratitis(PUK) C-ANCA corticosteroid case report

Unusual cause of hemorrhagic pleural effusion:A case report

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World Journal of Clinical Infectious Diseases 2022年第1期12卷 41-46页

作者： Kee Tat Lee Kar Nim Leong Ting Soo Chow Peng Shyan Wong Department of Medicine Hospital Sultanah BahiyahAlor Setar 05460KedahMalaysia Infectious Disease Unit Department of MedicineHospital Pulau PinangGeorgetown 10990Pulau PinangMalaysia

BACKGROUND Infected aortic aneurysms are uncommon and difficult to treat.We present a case of infected aortic aneurysm with recurrent nontyphoidal Salmonella bacteremia.CASE SUMMARY A 68-year-old gentleman presented with non-specific symptoms and was found to have nontyphoidal Salmonella bacteremia and was treated with intravenous ceftriaxone.However his condition did not improve,and he developed a multiloculated right pleural effusion.Thoracocentesis was done to drain hemorrhagic pleural fluid.Chest computed tomography demonstrated descending thoracic aorta saccular aneurysm with periaortic hematoma likely due to recent bleed and extending to the right pleural cavity.He was referred to cardiothoracic surgery team and was planned for medical therapy in view of hemodynamic stability and no evidence of active leakage.He completed intravenous antibiotic for 5 wk and refused surgical intervention.Unfortunately,he was admitted twice for recurrent nontyphoidal Salmonella bacteremia.Finally,he agreed for surgical intervention and underwent endovascular aortic repair 3 mo later.Postoperatively,his condition remained stable with no recurrence of infection.CONCLUSION Our case highlights the importance of high index of suspicion of infected aortic aneurysm in patients with Salmonella bacteremia with high-risk factors such as atherosclerosis.

关键词： Infected aneurysm Aorta Nontyphoidal Salmonella Pleural effusion Case report

Predictors for success of non-operative management of adhesive small bowel obstruction

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1116-1124页

作者： Zi Qin Ng Vivien Hsu William Wei Han Tee Jih Huei Tan Ruwan Wijesuriya Department of General Surgery St John of God Midland HospitalMidland 6056Western AustraliaAustralia Department of Radiology St John of God Midland HospitalMidland 6056Western AustraliaAustralia Department of General Surgery Hospital Sultanah AminahJohor Bahru 80000JohorMalaysia

BACKGROUND Majority of adhesive small bowel obstruction(SBO)cases can be managed nonoperatively.However,a proportion of patients failed non-operative management.AIM To evaluate the predictors of successful non-operative management in adhesive SBO.METHODS A retrospective study was performed for all consecutive cases of adhesive SBO from November 2015 to May 2018.Data collated included basic demographics,clinical presentation,biochemistry and imaging results and management outcomes.The imaging studies were independently analyzed by a radiologist who was blinded to the clinical outcomes.The patients were divided into group A operative(including those that failed initial non-operative management)and group B non-operative for analysis.RESULTS Of 252 patients were included in the final analysis;group A(n=90)(35.7%)and group B(n=162)(64.3%).There were no differences in the clinical features between both groups.Laboratory tests of inflammatory markers and lactate levels were similar in both groups.From the imaging findings,the presence of a definitive transition point[odds ratio(OR)=2.67,95%confidence interval(CI):0.98-7.32,P=0.048],presence of free fluid(OR=2.11,95%CI:1.15-3.89,P=0.015)and absence of small bowel faecal signs(OR=1.70,95%CI:1.01-2.88,P=0.047)were predictive of the need of surgical intervention.In patients that received water soluble contrast medium,the evidence of contrast in colon was 3.83 times predictive of successful non-operative management(95%CI:1.79-8.21,P=0.001).CONCLUSION The computed tomography findings can assist clinicians in deciding early surgical intervention in adhesive SBO cases that are unlikely to be successful with non-operative management to prevent associated morbidity and mortality.

关键词： Small bowel obstruction Adhesive Conservative Non-operative