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Biomedical subjects

S Harwant

Publications and source records attributed to S Harwant.

At least 19 recordsLinked to original sources
PubMed2003

Spinal cord injury without radiological abnormality (SCIWORA).

SCIWORA or Spinal Cord Injury Without Radiological Abnormality; is a pre-MRI term that includes injuries to the spinal cord in the absence of radiological (plain radiographs, tomographs and CT scans) evidence of injury to the spinal column or cord. It occurs in skeletally immature spines because of the inherent plasticity of the bony structures in this age group. The prognosis is dependent on the extent of cord damage, and the role of active management is limited. A high index of suspicion is needed to establish a diagnosis. This diagnostic accuracy can be improved with the free availability of MRI scanning for the spines. We describe three cases of SCIWORA with a minimum follow-up of three years and a review of current literature.

Child, Preschool↗
PubMed2001

Factors influencing the outcome of arthrodesis for congenital kyphosis and kyphoscoliosis.

Sixty-five patients with congenital kyphosis and kyphoscoliosis who underwent spinal arthrodesis are reviewed to determine the factors that influenced the outcome of arthrodesis. Mean follow up after surgery was 6 years and 6 months with all patients having a minimum of 2 years follow up. A satisfactory outcome, or a stable arthrodesis was defined as a loss of correction of less than 10 degrees from the time of surgery till review. An unsatisfactory outcome, or unstable arthrodesis was considered when there was more than 10 degree loss. Type of vertebral anomaly and type of arthrodesis procedure were significantly influenced stability of arthrodesis, whereas age when arthrodesis was performed and size of curve at surgery were not significantly related to stability of arthrodesis.

Adolescent↗
PubMed2001

Crash simulation of lower limb with motorcycle basket.

Lower limb injuries are the main cause of temporary and permanent disability among motorcyclists in Malaysia. They cause non-fatal but serious injuries requiring hospitalisation. Detailed studies on factors influencing lower limb injuries are justified in an attempt to reduce the occurrence of these injuries. This study presents a computer simulation of the crash behaviour of the basket of a small-engined motorcycle with the lower limb using finite element (FE) methods. The results suggest that the extensive deformation of the motorcycle basket may reduce the risk of injury to the lower limb. The behaviour of the basket during collision is analogous to the crumple zone of automobiles.

Accidents, Traffic↗
PubMed2001

Knee crepitus from an unusual source.

A case report of a missed appendicitis presenting with abdominal wall necrotising fasciitis which extended up to the right knee. This subcutaneous collection in the prepatella region of the right knee presented as a crepitus and mimicked an intraarticular pathology.

Aged↗
PubMed2001

Functional outcome of proximal humeral fractures.

The functional outcome of 27 patients (16 males, 11 females) with a proximal humeral fracture was evaluated using the Simple Shoulder Test. Fifteen patients were also assessed using the Constant system. The mean age of the patients was 46.3 years (range 16-90 years) and the mean follow-up was 14 months (range 6-29 months). There were ten 2-part fractures, eight minimally displaced fractures, two 3-part fractures, three 4-part fractures, three 1-part fracture-dislocations and one 3 parts fracture-dislocation. Twenty-four fractures were treated conservatively and 3 surgically. Thirteen patients (48%) regained full function on the simple shoulder test and almost all regained range of movement sufficient for activities of daily living. Six patients were not able to return to their previous job. All patients were pain free at rest and were able to sleep on the affected side comfortably, although 9 patients had pain with activity, even though most pain were mild in nature. The mean Constant scores for the fractured arm and the normal arm were 72.5 points and 91 points respectively. The strength of shoulder abduction was reduced by a mean of 34%. Although the outcome was generally satisfactory, there was nevertheless a statistically significant deterioration of function following the fracture.

Adolescent↗
PubMed2001

The need for scoliosis screening in Malaysia.

Conflicting recommendations exist on the issue of scoliosis screening in the general population. Worldwide, opponents cite the relative inaccuracy of screening tests, cost-ineffectiveness and psychosocial effect of 'labelled' patients but advocates quote the successes in many centres and the advantages of timely intervention. We studied 205 patients with idiopathic scoliosis and found they presented at relatively later ages and with curves that showed rapid annual progression. We suggest that screening in Malaysia may identify patients early for treatment besides promoting health awareness.

Adolescent↗
PubMed2001

An audit of the Scoliosis Service at Hospital Kuala Lumpur.

This is a study of patients referred to the Scoliosis Service of Hospital Kuala Lumpur. Three hundred and thirty five (335) consecutive patients who were seen between 1985 and 2000 were reviewed to determine the presentation of scoliosis, the treatment received and the compliance to follow up. Data were determined by measuring the frontal spinal radiographs. Two hundred and ninety eight (298) patients met inclusion criteria. Idiopathic scoliosis accounted for 203 patients (68.1%), 31 (10.4%) were neuromuscular scoliosis; and 44 (14.8%) had congenital scoliosis. Twenty-five point five percent of patients had surgery, 10.4% were treated with brace, while the remaining 69.1% of patients were observed, or had no treatment at all. Congenital scoliosis patients had better compliance compared to idiopathic or neuromuscular scoliosis patients.

Adolescent↗
PubMed2001

The natural history of scoliosis: curve progression of untreated curves of different aetiology, with early (mean 2 year) follow up in surgically treated curves.

We studied the curve progression of untreated curves presenting to the Scoliosis Service of Hospital Kuala Lumpur. One hundred and fifty-two (152) patients were included in this study. The median rate of curve progression of idiopathic scoliosis curves was 7.03 degrees per year, for neuromuscular scoliosis curves was 17.39 degrees per year; and congenital scoliosis curves were 3.67 degrees per year. These rates are similar to the reported rates in the literature. Data for sixty-one (61) surgically treated patients were reviewed to determine the early curve correction of the curves of different aetiology. The mean age of surgery was 14.15 years old, the mean preoperative curve size was 71.61 degrees; and the mean postoperative curve size was 43.78 degrees. The mean duration of follow up after surgery was 2.44 years. The revision and removal of instrumentation rate was 8.3%.

Adolescent↗
PubMed2001

Predictive factors in the evolution of neural deficit in tuberculosis of the spine.

This study was conducted to determine the factors involved in predicting the onset of paraplegia in tuberculosis of the spine. A cross-sectional, case control review of 85 cases of spinal tuberculosis was conducted at the National Tuberculosis Centre in Kuala Lumpur. Sixty-nine of these cases were normal neurologically, whilst 16 cases experienced neural deficit. The data was analysed using backward logistic regression and Fishers exact probability test. The factors studied included symptoms and signs of spinal tuberculosis, common investigations for tuberculosis, and physical factors of the disease. Only the erythrocyte sedimentation rate (ESR) showed a significant difference between the neural deficit and neurologically normal groups. This suggests that the ESR may be a factor in predicting evolution of paraplegia in spinal tuberculosis. In addition, it was noted that a low proportion of patients had positive sputum smear results and bacterial culture growth for mycobacterium tuberculosis suggesting these tests are of limited value for tuberculosis of the spine.

Adolescent↗
PubMed2001

Pattern of primary musculoskeletal sarcomas referred to Institute of Radiotherapy and Oncology, Hospital Kuala Lumpur, 1995-1999.

An epidemiological study of 101 consecutive musculoskeletal sarcomas seen at the Institute of Radiotherapy and Oncology between 1995 and 1999 inclusive was carried out. The commonest sarcomas seen were osteosarcoma, rhabdomyosarcoma, Ewing's Sarcoma, liposarcoma, leimyosarcoma, malignant fibrous histiocytoma and chondrosarcoma; which collectively accounted for 84.2% of the group. Thirty patients (29.7%) presented with metastases. The commonest site of occurrence was lower extremity with 47.5%, followed by 34.7% in the trunk and peritoneum/axial skeleton, 9.9% in the head and neck region; and 7.90 in the upper extremity. We found no apparent relationship between race and incidence osteosarcoma and Ewing's sarcoma, as was reported by previous workers.

Adolescent↗
PubMed2001

Risk factors for infection in total hip replacement surgery at Hospital Kuala Lumpur.

Sixty-seven primary THR surgeries in 57 patients between January 1992 and December 1998 were reviewed after a mean follow-up of 35.9 months. The rate of superficial and deep wound infections were 11.9% and 1.5% respectively. The most common organism in superficial wound infection was Staphylococcus aureus. The factors that were significantly associated with superficial wound infection were diabetes mellitus (p= 0.0230) obesity (p=0.0088). The patients who developed superficial wound infection have a significantly longer duration of surgery compared to patients without infection (p=0.014). However, there was no significant difference between the mean age among patients with and without superficial wound infection (p=0.814).

Adult↗
PubMed2001

Compartment syndrome of the calf and foot following a displaced Salter-Harris type II fracture of the distal tibia: a review of the literature and a case report.

A 14 year-old boy with an epiphyseal fracture of the distal right tibia and fibula developed compartment syndrome of the calf and foot. The diagnosis of compartment syndrome was delayed and a fasciotomy resulted in uncontrolled infection, which ultimately resulted in an above knee amputation. Constant vigilance is necessary in uncooperative or non-complaining patients to detect the signs and symptoms of compartment syndrome, even where the injury is not often associated with this complication. The difficulties in management, following a fasciotomy for delayed diagnosis of compartment syndrome, are discussed.

Adolescent↗
PubMed2001

Neurological deficit after surgery for spinal deformity--the value of normal intra operative wake-up tests in large sagitta curves. A report of two cases from an institution.

Neurological deficit after surgery for spinal deformity is a rare but devastating complication. Factors that have been associated with a post surgical deficit are congenital curves, large curves, kyphotic deformities, anterior and posterior surgery, ligation of multiple anterior vessels and hypotension; controlled or otherwise. Intra operative wake up tests have been used alone or in combination with spinal cord monitoring: to detect evolving neurological deficit in spinal deformity surgery. Despite these checks, major neurological deficits still occur post surgery. This is a report of two cases with normal intra operative wake up tests, but developed neurological deficit twelve hours after the end of surgery.

Adolescent↗