Bibliometric Analysis of Malaysian Orthopaedic Journal using Scopus Database.

Introduction: The Malaysian Orthopaedic Journal (MOJ) (ISSN 1985-2533 / 2232-111X) is the official publication of the Malaysian Orthopaedic Association (MOA) and the ASEAN Orthopaedic Association (AOA). In May 2007, MOA published the first standalone issue of MOJ with the aim of disseminating new knowledge and providing updates in orthopaedics, trauma and musculoskeletal research. Since then, MOJ has grown significantly, achieving indexing in numerous databases and attaining a 2nd Quartile (Q2) rank in the Scopus database in 2022. This bibliometric analysis aims to explore the trends and distribution of articles published in MOJ. Materials and Methods: Bibliometric data for MOJ was extracted from the SCOPUS database, covering the years from its indexing to 2022. Information such as authors, country, document type, author's keywords, citations, and other parameters were extracted using the bibliometrix package in the R Studio software. The data were then presented in tables and illustrative graphs using the same software. Results: A total of 305 articles were retrieved from the Scopus database during the study period. Two-thirds of the articles were original articles and review articles. The highest number of citations received by an article is 56, and top ten articles in MOJ were authored by researchers from seven different countries, highlighting the journal's diversity. Despite receiving submissions from various countries, there is minimal collaboration between authors of different countries. Keywords such as "covid-19" and "pandemic" dominate the authors' keyword section due to the once-in-a-life-time COVID-19 which during the study period, resulting in numerous publications related to this issue. Conclusion: This bibliometric analysis reviews all the articles indexed in the Scopus database and provides insight into the contributors' information and the trends in orthopaedic research. By identifying the lack of collaboration between countries, it is hoped that this analysis can inspire more orthopaedic surgeons and researchers to collaborate and produce high-quality publications.

Femoral Neck Non-Union - A Biomechanical Solution with Valgus Sliding Subtrochanteric Osteotomy: A Case Report.

Avascular necrosis and non-union are two most dreaded complications of femoral neck fracture fixations. Hip replacement seems to be a simple solution for this complex problem. However, the long-term efficacy of prosthetic replacement in the young population with higher functional demand is still questionable. Femoral head preserving valgus subtrochanteric osteotomies in properly selected cases have strong support from literature. The conventional technique of valgus subtrochanteric osteotomy involves lateral based wedge resection. Alternatively, a simpler sliding oblique subtrochanteric osteotomy without any wedge removal can also be performed. We hereby describe a successful case of sliding subtrochanteric osteotomy with 135° dynamic hip screw (DHS) plate fixation in treating non-union neck of femur fracture in a young gentleman.

Long-term wear failure analysis of uhmwpe acetabular cup in total hip replacement.

A revision of a metal-on-ultra high molecular weight (UHMWPE) bearing couple for total hip replacement was performed due to aseptic loosening after 23 years in-vivo. It is a major long-term failure identified from wear generation. This study includes performing failure analysis of retrieved polyethylene acetabular cup from Zimmer Trilogy® Acetabular system. The UHMWPE acetabular cup was retrieved from a 61 years old male patient with ability to walk but limited leg movement when he presented to hospital in early 2016 with complaint left thigh pain. It was 23 years after his primary total hip replacement procedure. Surface roughness and morphology condition were measured using 3D laser microscope and Scanning Electron Microscope (SEM) to evaluate and characterize the wear features on polyethylene acetabular cup surface. ATR-Fourier Transform Infra-Red (ATR-FTIR), differential scanning calorimetry (DSC) and gel permeation chromatography (GPC) were used to characterize the chemical composition of carbon-oxygen bonding, crystallinity percentage and molecular weight of the polymer liner that might changes the mechanical properties of polyethylene. Nano indentation is to measure hardness and elasticity modulus where the ratio of hardness to elastic modulus value can be reflected as the degradation of mechanical properties. A prominent difference of thickness between two regions resulted from acentric loading concentration was observed and wear rate were measured. The linear wear rate for thin side and thick side were 0.33 mm/year and 0.05 mm/year respectively. Molecular weight reduction of 57.5% and relatively low ratio of hardness to elastic modulus (3.59â€¯× 10-3) were the indicator of major mechanical properties degradation happened on UHMWPE acetabular cup. This major degradation was contributed by oxidation and polishing wear feature accompanied with delamination, craters, ripple and cracks were the indication of extensive usage of UHMWPE from the suggested life span of acetabular cup application.

The Perioperative Lung Transplant Virome: Torque Teno Viruses Are Elevated in Donor Lungs and Show Divergent Dynamics in Primary Graft Dysfunction.

Primary graft dysfunction (PGD) is a principal cause of early morbidity and mortality after lung transplantation, but its pathogenic mechanisms are not fully clarified. To date, studies using standard clinical assays have not linked microbial factors to PGD. We previously used comprehensive metagenomic methods to characterize viruses in lung allografts >1 mo after transplant and found that levels of Anellovirus, mainly torque teno viruses (TTVs), were significantly higher than in nontransplanted healthy controls. We used quantitative polymerase chain reaction to analyze TTV and shotgun metagenomics to characterize full viral communities in acellular bronchoalveolar lavage from donor organs and postreperfusion allografts in PGD and non-PGD lung transplant recipient pairs. Unexpectedly, TTV DNA levels were elevated 100-fold in donor lungs compared with healthy adults (p = 0.0026). Although absolute TTV levels did not differ by PGD status, PGD cases showed a smaller increase in TTV levels from before to after transplant than did control recipients (p = 0.041). Metagenomic sequencing revealed mainly TTV and bacteriophages of respiratory tract bacteria, but no viral taxa distinguished PGD cases from controls. These findings suggest that conditions associated with brain death promote TTV replication and that greater immune activation or tissue injury associated with PGD may restrict TTV abundance in the lung.

Prognostic role of serum interleukin-18 in Egyptian patients with hepatitis c virus-related hepatocellular carcinoma treated by radiofrequency ablation.

Aim: The aim of this study is to identify the prognostic value of serum interleukin (IL)-18 level in hepatitis C virus (HCV) -related hepatocellular carcinoma (HCC) patients. Materials and Methods: This study was conducted in Tropical Medicine department and HCC unit in Ain Shams University Hospitals. It included 35 patients with HCV associated HCC fit for radio frequency ablation and 20 healthy control subjects. Serum IL-18 level was measured for all participants at the beginning of the study. Patients were followed-up for 1 year then serum IL-18 re-measured at the end of the follow-up period. Results: Pre-intervention serum IL-18 level was significantly higher in patients than healthy control subjects and was associated with bad clinical, laboratory or radiological prognosis. Post follow-up mean value of IL-18 level was significantly lower than pre-intervention level. Conclusion: Higher pre-intervention serum IL-18 level in HCV -related HCC patients level was associated with bad prognosis either clinically, laboratory or radiologically.

Combined Spline and B-spline for an improved automatic skin lesion segmentation in dermoscopic images using optimal color channel.

In a computerized image analysis environment, the irregularity of a lesion border has been used to differentiate between malignant melanoma and other pigmented skin lesions. The accuracy of the automated lesion border detection is a significant step towards accurate classification at a later stage. In this paper, we propose the use of a combined Spline and B-spline in order to enhance the quality of dermoscopic images before segmentation. In this paper, morphological operations and median filter were used first to remove noise from the original image during pre-processing. Then we proceeded to adjust image RGB values to the optimal color channel (green channel). The combined Spline and B-spline method was subsequently adopted to enhance the image before segmentation. The lesion segmentation was completed based on threshold value empirically obtained using the optimal color channel. Finally, morphological operations were utilized to merge the smaller regions with the main lesion region. Improvement on the average segmentation accuracy was observed in the experimental results conducted on 70 dermoscopic images. The average accuracy of segmentation achieved in this paper was 97.21 % (where, the average sensitivity and specificity were 94 % and 98.05 % respectively).

Knee laxity of Malaysian adults: gender differentials, and association with age and anthropometric measures.

BACKGROUND: Knee laxity measurements have been shown to be associated with some medical conditions such as chronic joint pain and collagen tissue diseases. The aim of this study was to determine the effects of demographic factors and anthropometric measures on knee laxity. MATERIALS AND METHODS: Data were collected from 521 visitors, staffs and students from the University Malaya Medical Centre and University of Malaya between December 2009 and May 2010. Knee laxity was measured using a KT-1000 arthrometer. Multiple regression analysis was used to find the association of knee laxity with age and anthropometric measures. RESULTS: Using ANOVA, knee laxity did not show significant differences among ethnic groups for both genders. The average knee laxity in men was 3.47 mm (right) and 3.49 mm (left); while in women were 3.90 mm (right) and 3.67 mm (left). Knee laxity in women was significantly higher (right knee p<0.01 and left knee p<0.05) than men. Right knee laxity of men was negatively associated with height (p<0.05) and BMI (p<0.05); also a negative association was observed between left knee laxity and BMI (p<0.05). Overweight and obese men had less knee laxity than normal weight and underweight individuals. Elderly men and women (age 55 and above) had lower knee laxity (p<0.01) than young adults (ages 21-39). CONCLUSION: These results suggest that age and body size are important factors in predicting knee laxity.

Acute renal failure and intravascular hemolysis following henna ingestion.

The powder of henna plant (Lawsonia inermis Linn.) is extensively used as a decorative skin paint for nail coloring and as a hair dye. Most reports of henna toxicity have been attributed to adding a synthetic dye para-phenylenediamine (PPD). PPD is marketed as black henna added to natural henna to accentuate the dark color and shorten the application time. PPD toxicity is well known and extensively reported in medical literature. We report a case of a young Saudi male who presented with characteristic features of acute renal failure and intravascular hemolysis following ingestion of henna mixture. Management of PPD poisoning is only supportive and helpful only if instituted early. Diagnosis requires a high degree of clinical suspicion, as the clinical features are quite distinctive.

Unconfined compression properties of a porous poly(vinyl alcohol)-chitosan-based hydrogel after hydration.

A poly(vinyl alcohol) (PVA) hydrogel composite scaffold containing N,O-carboxymethylated chitosan (NOCC) was tested to assess its potential as a scaffold for cartilage tissue engineering in a weight-bearing environment. The mechanical properties under unconfined compression for different hydration periods were investigated. The effect of supplementing PVA with NOCC (20wt.% PVA:5vol.% NOCC) produced a porosity of 43.3% and this was compared against a non-porous PVA hydrogel (20g PVA: 100ml of water, control). Under non-hydrated conditions, the porous PVA-NOCC hydrogel behaved in a similar way to the control non-porous PVA hydrogel, with similar non-linear stress-strain response under unconfined compression (0-30% strain). After 7days' hydration, the porous hydrogel demonstrated a reduced stiffness (0.002kPa, at 25% strain), resulting in a more linear stiffness relationship over a range of 0-30% strain. Poisson's ratio for the hydrated non-porous and porous hydrogels ranged between 0.73 and 1.18, and 0.76 and 1.33, respectively, suggesting a greater fluid flow when loaded. The stress relaxation function for the porous hydrogel was affected by the hydration period (from 0 to 600s); however the percentage stress relaxation regained by about 95%, after 1200s for all hydration periods assessed. No significant differences were found between the different hydration periods between the porous hydrogels and control. The calculated aggregate modulus, H(A), for the porous hydrogel reduced drastically from 10.99kPa in its non-hydrated state to about 0.001kPa after 7days' hydration, with the calculated shear modulus reducing from 30.92 to 0.14kPa, respectively. The porous PVA-NOCC hydrogel conformed to a biphasic, viscoelastic model, which has the desired properties required for any scaffold in cartilage tissue engineering.

Apollo total knee replacements in University Malaya Medical Centre: a short-term outcome.

Total knee arthroplasty is the most preferred option for treatment of severe osteoarthritis of the knee. We report the short-term outcome of 48 total knee replacements in 31 patients utilizing the Apollo Total Knee System after an average follow-up of 48 months (range 15 to 70 months). Records of all patients who underwent TKA using Apollo Total Knee System were retrospectively reviewed. Functional outcome was evaluated using visual analogue scale for pain rating and the Oxford 12-item questionnaire. Postoperative radiographs of the replaced knees were assessed by using the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Degenerative osteoarthritis was the commonest indication for TKA. The average patient's age was 63.7 years (range, 30-77 years). The mean visual analogue scale for pre- and post-operative pain was eight and zero respectively. The mean Oxford 12-item questionnaire score pre- and post-operatively was 44.8 and 16.5 respectively. Patient satisfaction was notable in 98% of the cases with an average improvement in arc of flexion of 111 degrees. There were four failures; deep infection (one) and aseptic loosening (three) giving rise to a 94% implant survivor. The short-term results of this series is comparable with or better than a number of outcome studies of the Apollo Knee System or other implants of similar design.

Revision total hip arthroplasty using impaction bone grafting technique.

A variety of reconstructive options exist for revision of both femoral and acetabular components in total hip replacement surgery. The use of impaction bone grafting with morsellised allograft has shown promising results in revision total hip arthroplasty. It works as a biologic reconstitution of bone stock defects and provides a solid construct with stable fixation. We present a case of bilateral revision total hip arthroplasty with poor bone stock where reconstructive surgery was done by using impaction bone grafting, mesh and C-stem implants.

Early results of metal on metal articulation total hip arthroplasty in young patients.

We report our early experience of 20 cases of metal on metal articulation total hip arthroplasty in 19 young patients. Avascular necrosis of the femoral head (63%) was the commonest diagnosis for patients undergoing this procedure, followed by osteoarthritis (21%). In general, most of the patients were young and physically active with an average age of 43.1 years (range, 25 to 58 years). The average follow-up period was 18 months (range, 7 to 46 months). The mean total Harris Hip Score preoperatively and at final follow-up was 31 points and 89 points respectively. The mean total Pain Score improved from an average of 11.5 to 41.1 points at final follow-up. Sixteen (84%) of the patients had a good to excellent hip score. There was one dislocation, which stabilized after reduction and conservative management. One case of early infection underwent a two-staged revision.

Seventeen new 14- and 15-crown-formazans: their synthesis and evaluation in spectrophotometric determination of lithium.

A number of new crown-formazans with 14 and 15 membered rings have been synthesized, characterized and investigated as selective spectrophotometric chelating agents for lithium. The effect of sodium ion concentration on the background lithium signal was studied. A comparative study for the sensitivity of these new crown-formazans in spectrophotometric determinations was studied and compared with those reported previously. The three new 14- and 15-crown-formazans 4a-c containing the pyridyl N-oxide at the formazyl carbon showed the highest selectivity to lithium determination in the presence of sodium ion.

Evaluation of some new 14- and 15-crown-formazans as carriers in cesium ion selective electrodes.

A number of new crown-formazans with 14 and 15 membered rings have been investigated as selective neutral carriers in cesium ion selective electrodes. Two plasticizers (NPOE and NPBnE) were studied. The new 14-crown-formazan 4a containing the 4-pyridyl N-oxide at the formazyl carbon exhibited the highest selectivity in cesium ion selective electrodes, especially towards the two low selectivity monovalent ions K(+) and NH4(+). Also, membranes containing the plasticizer NPBnE showed better cesium selectivity relative to most ions than those containing NPOE. Membranes containing 4a and variable compositions of plasticizers, potassium tetrakis-(p-chlorophenyl)borate (KTpClPB), and trioctylphosphine oxide (TOPO) were studied in order to prepare an electrode with the optimum cesium selectivity. The highest selectivity for cesium was achieved with the two electrodes designated d and e with membranes containing the ionophore 4a, NPBnE and KTpClPB with and without TOPO. Selectivities are reported relative to sodium, potassium, barium, calcium, ammonium, lithium, cobalt, and magnesium.

New sites of Bulinus truncatus and indigenous cases of urinary schistosomiasis in Jordan.

Thirty-two autochthonous cases of Schistosoma haematobium are reported from Ghore As-Safi, Karak Lowlands, Jordan. All infected persons were males (9-46 years-old). New unusual breeding sites for Bulinus truncatus are discovered. The past and current distribution of the snail intermediate host is given.

Long-term prognosis of 69 patients with dermatomyositis or polymyositis.

OBJECTIVES: To assess the long-term prognosis of dermatomyositis and pol myositis. METHODS: 69 patients with dermatomyositis or polymyositis were selected according to the diagnostic criteria of Bohan and Peter and were followed up for a minimum of 6.3 years (for surviving patients) (mean 11.6 years). Clinical and biological features, and pulmonary and muscle parameters were considered as prognostic factors for death. Functional disability was assessed using a 4-stage grading system. RESULTS: 30 deaths (43.5%) occurred mainly due to cardiovascular (8), pulmonary (8), carcinomatous (5) and iatrogenic complications (5). Survival rates were 82.6% at 1 year, 73.9% at 2.66, 7% at 5 and 55.4% at 9. Significant prognostic factors for death (Cox model with time-dependent covariates) were old age (p < 0.0001), dysphonia (p < 0.001), pulmonary interstitial fibrosis (p < 0.02), absence of dysphagia (p < 0.02) and asthenia-anorexia (p < 0.05). Dermatomyositis and polymyositis subgroups had slightly different significant prognostic factors for death: old age, cancer, pulmonary interstitial fibrosis and asthenia-anorexia for dermatomyositis; old age, failure to improve muscle strength in response to treatment after one month, and the absence of myalgia as presenting symptom for polymyositis. At the end of the follow-up, 33/39 surviving patients (84.6%) had no or insignificant muscular disability, whereas 3 children were bedridden due to generalized calcinosis. CONCLUSIONS: High mortality occurred in the first year, and the survival rate decreased continually up to 9 years. The main prognostic factor for death is old age, but dermatomyositis and polymyositis must be considered separately. General features (pulmonary fibrosis, cancer, asthenia-anorexia) are involved in dermatomyositis, whereas muscular symptoms are the most significant in polymyositis. The long-term functional prognosis was fairly good, except for generalized calcinosis, which tended to occur in childhood dermatomyositis.

Determinants of infant mortality and the use of maternity services in Jordan.

PIP: "The 1990 Jordan Population and Family Health Survey (JPFHS) is analyzed by using [a] chi square test to explore some of the determinants of maternity care (antenatal and delivery) and infant death.... The findings presented in this study are compared with the findings of other studies to find out the improvement in the use of maternity services and to explore factors behind the use of such services and factors that affect infant mortality." Results indicate that some determining factors of non-clinic prenatal care and infant mortality are: living in a rural area, the mother's education and age at the birth, high parity, short birth interval, and low birthweight. (EXCERPT)^ieng

Superovulation, IGFBP-1 and birth weight.

In this study, the effect of superovulation on the circulating levels of insulin-like growth factor binding protein-1 (IGFBP-1) has been investigated. IGFBP-1 levels were measured in singleton pregnancies achieved either naturally (n = 203) or following superovulation, in-vitro fertilisation and embryo transfer (IVF-ET) with either pituitary desensitisation with buserelin and superovulation with human menopausal gonadotrophin (b/hMG) followed by IVF-ET (n = 15) or with clomiphene citrate and hMG (CC/hMG) followed by IVF-ET (n = 15, 1st trimester only). The circulating levels of IGFBP-1 were similar in all three groups during the first trimester, and in both normal and b/hMG pregnancies in the second, but were significantly higher during the third trimester in b/hMG pregnancies than in normal pregnancies (P = 0.0002). The birth weights were significantly lower in the b/hMG group (P = 0.04), but not in the CC/hMG group compared with natural conceptions. Gestational age at delivery was similar in control and b/hMG pregnancies, but significantly reduced in CC/hMG pregnancies (P = 0.04). These data suggest that pregnancies achieved following superovulation with b/hMG are associated with elevated levels of IGFBP-1 during the third trimester of pregnancy and reduced birth weight.