1.Are Indians and females less tolerant to pain? An observational study using a laboratory pain model.
E Das Gupta ; A H Zailinawati ; A W Lim ; J B Chan ; S H Yap ; Y Y Hla ; M A Kamil ; C L Teng
The Medical journal of Malaysia 2009;64(2):111-3
In Malaysia, it is a common belief among health care workers that females and Indians have lower pain threshold. This experience, although based on anecdotal experience in the healthcare setting, does not allow differentiation between pain tolerance, and pain expression. To determine whether there is a difference in the tolerance to pain between the three main ethnic groups, namely the Malays, Chinese and Indians as well as between males and females. This was a prospective study, using a laboratory pain model (ischaemic pain tolerance) to determine the pain tolerance of 152 IMU medical students. The mean age of the students was 21.8 years (range 18-29 years). All of them were unmarried. The median of ischaemic pain tolerance for Malays, Chinese and Indians were 639s, 695s and 613s respectively (p = 0.779). However, statistically significant difference in ischaemic pain tolerance for males and females Indian students were observed. Possible ethnic difference in pain tolerance in casual observation is not verified by this laboratory pain model. Difference in pain tolerance between genders is shown only for Indians.
Pain Threshold
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Pain
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Indian race
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seconds
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Models
2.Design and fabrication of scaffolds for anatomic bone reconstruction.
Scott J Hollister ; Chia-Ying Lin ; Cheng-Yu Lin ; Rachel D Schek ; Juan M Taboas ; Colleen L Flanagan ; Eiji Saito ; Jessica M Williams ; Suman Das ; Tobias Wirtz ; Paul H Krebsbach
The Medical journal of Malaysia 2004;59 Suppl F():131-2
3.Computed Tomography Pulmonary Angiography during Pregnancy: Radiation Dose of Commonly Used Protocols and the Effect of Scan Length Optimization
Babs M F HENDRIKS ; Roald S SCHNERR ; Gianluca MILANESE ; Cécile R L P N JEUKENS ; Sandra NIESEN ; Nienke G EIJSVOOGEL ; Joachim E WILDBERGER ; Marco DAS
Korean Journal of Radiology 2019;20(2):313-322
OBJECTIVE: To evaluate the radiation dose for pregnant women and fetuses undergoing commonly used computed tomography of the pulmonary arteries (CTPA) scan protocols and subsequently evaluate the simulated effect of an optimized scan length. MATERIALS AND METHODS: A total of 120 CTPA datasets were acquired using four distinctive scan protocols, with 30 patients per protocol. These datasets were mapped to Cristy phantoms in order to simulate pregnancy and to assess the effect of an effective radiation dose (in mSv) in the first, second, or third trimester of pregnancy, including a simulation of fetal dose in second and third trimesters. The investigated scan protocols involved a 64-slice helical scan at 120 kVp, a high-pitch dual source acquisition at 100 kVp, a dual-energy acquisition at 80/140 kVp, and an automated-kV-selection, high pitch helical scan at a reference kV of 100 kVref. The effective dose for women and fetuses was simulated before and after scan length adaptation. The original images were interpreted before and after scan length adaptations to evaluate potentially missed diagnoses. RESULTS: Large inter-scanner and inter-protocol variations were found; application of the latest technology decreased the dose for non-pregnant women by 69% (7.0–2.2 mSv). Individual scan length optimization proved safe and effective, decreasing the fetal dose by 76–83%. Nineteen (16%) cases of pulmonary embolism were diagnosed and, after scan length optimization, none were missed. CONCLUSION: Careful CTPA scan protocol selection and additional optimization of scan length may result in significant radiation dose reduction for a pregnant patient and her fetus, whilst maintaining diagnostic confidence.
Angiography
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Dataset
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Diagnosis
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Female
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Fetus
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Humans
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Pregnancy Trimester, Third
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Pregnancy
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Pregnant Women
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Pulmonary Artery
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Pulmonary Embolism
4.Results of ala carte Posteromedial Soft Tissue Release in Idiopathic Clubfoot
Barik S ; Das L ; Yadav AK ; Arora SS ; Singh V
Malaysian Orthopaedic Journal 2021;15(No.2):89-95
Introduction: The aim of this study is to assess the
outcomes of ala carte posteromedial release in children over
two years of age who were not responding to the Ponseti
method of treatment of idiopathic clubfoot.
Materials and Methods: A retrospective observational
study from September 2013 to August 2015 was conducted
at a tertiary level medical teaching institution. The clubfeet
were classified according to the Harold and Walker
classification. Radiographic parameters assessed were the
talocalcaneal angle (AP, lateral), talus-first metatarsal angle
(AP, lateral) and calcaneal-fifth metatarsal angle. The scar
and the functional score, according to Laaveg and Ponseti,
were evaluated as outcome measures at the final follow-up.
Results: Twenty-four children with a mean age of 43.7 ±
24.7 months were enrolled in the study. There was a total of
36 clubfeet: 21 (65.6%) with a poor functional outcome; 12
(37.4%) with excellent to good scar in both horizontal and
vertical components. There was a statistical significance
between the pre-operative and post-operative radiological
parameters (p<0.05). None of the patients presented with any
limitation of activities of daily living despite the poor
functional outcome in many of the children. There was no
significant association between the qualities of scar
(horizontal, vertical) and the functional outcome with age at
presentation, pre-operative Harold and Walker classification
and pre-operative radiographic angles.
Conclusion: Surgical intervention in terms of ala carte
posteromedial soft tissue release could not produce a good
outcome over four years in CTEV. The threshold for surgery
in CTEV should be high, given the poor results.
5.Sperm retrieval success and testicular histopathology in idiopathic nonobstructive azoospermia.
Arighno DAS ; Joshua A HALPERN ; Annie L DARVES-BORNOZ ; Mehul PATEL ; James WREN ; Mary Kate KEETER ; Robert E BRANNIGAN
Asian Journal of Andrology 2020;22(6):555-559
Prior studies have investigated sperm retrieval rates in men with nonobstructive azoospermia (NOA) secondary to specific etiologies, yet most cases of NOA are idiopathic. We compared sperm retrieval rates and testicular histopathology in idiopathic NOA (iNOA) and nonidiopathic NOA (niNOA). We performed a retrospective review of men with NOA who underwent microdissection testicular sperm extraction (microTESE) between 2000 and 2016. Men with no history of malignancy or cryptorchidism and negative genetic evaluation were considered idiopathic. Multivariable regression determined the association between idiopathic etiology and primary outcomes of sperm retrieval and active spermatogenesis on histopathology. Among 224 men, 86 (38.4%) were idiopathic, 75 (33.5%) were nonidiopathic, and 63 (28.1%) did not undergo genetic testing. Median age and serum testosterone were higher among iNOA or no testing versus niNOA. Median follicle-stimulating hormone (FSH) was lower among iNOA or no testing versus niNOA. A higher proportion of iNOA or no testing versus niNOA had a clinical varicocele. Sperm retrieval rates were similar between iNOA, niNOA, and no testing (41.8% vs 48.0% vs 55.6%, respectively; P = 0.255). Active spermatogenesis was seen in a higher proportion of iNOA or no testing versus niNOA (31.4% and 27.0% vs 16.0%, P = 0.073). On multivariaile analysis, iNOA was not associated with sperm retrieval or spermatogenesis (P = 0.430 and P = 0.078, respectively). Rates of sperm retrieval and spermatogenesis on testis pathology were similar in men with iNOA and niNOA. These data will be useful to clinicians in preoperative counseling for men with NOA and negative genetic evaluation.