1.Outcome of Traumatic Fractures of the Intracapsular Neck of the Femur Treated with Total Hip Arthroplasty in Patients Aged Above 60 Years
Malaysian Orthopaedic Journal 2010;4(3):7-10
This study was undertaken to investigate the outcome of traumatic intracapsular neck of femur fractures treated with total hip arthroplasty (THA). Patients aged ? 60 years who underwent THA for traumatic intracapsular neck of femur fractures from January 2005 to March 2009 were included in the study. Telephone or personal interviews were conducted. There were 49 patients identified within the study period. The mean age was 74.12 years. Most patients were females (81.6%), with a male: female ratio of 1: 4.4. In total, 29 patients were available for outcome scoring. The one-month mortality rate was 4.1%, and the one-year mortality rate was 20.5%. Of the 29 patients 82.8% obtained a Zukerman Functional Outcome Score of good (80 ?100) and 13.8% obtained a score of fair (60 ?80). THA for the treatment of traumatic neck of femur fractures in elderly is a good option with 96.6% of patients obtaining a satisfactory functional outcome, with acceptable morbidity and mortality statistics.
2.Relationship between right ventricular pacing and non-sustained ventricular arrhythmias in patients with dual-chamber pacemaker and normal range left ventricular ejection fraction
Rayan S. EL‑ZEIN ; Anish K. AMIN ; Sreedhar R. BILLAKANTY ; Eugene Y. FU ; Allan J. NICHOLS ; Steven D. NELSON ; James M. KLEMAN ; Gregory A. KIDWELL ; Nagesh CHOPRA
International Journal of Arrhythmia 2020;21(3):e14-
Background:
Right ventricular pacing (RVP) increases heart failure, AF, and death rates in pacemaker patients and ventricular arrhythmias (VAs) in defibrillator patients. However, the impact of RVP on VAs burden and its clinical significance in pacemaker patients with normal range LVEF of > 50–55% remains unknown. We sought to evaluate the relationship of RVP and VAs and its clinical impact in a pacemaker patient population.
Methods:
Records of 105 patients who underwent de novo dual-chamber pacemaker implant or a generator change (Medtronic™ or Boston Scientific™) for AV block and sinus node disease at a tertiary care center between September 1, 2015, and September 1, 2016, were retrospectively reviewed.
Results:
Data from 105 patients (51% females, mean age 76 ± 1 years, mean LVEF 61 ± 0.7%) without history of VAs (98.2%) were reviewed over 1044 ± 23 days. Dependent patients (100% RVP) exhibited the lowest VAs burden when compared to < 100% RVP (isolated PVCs, PVC runs of < 4 beats, and NSVT; p ≤ 0.001). Patients with < 1% RVP also exhibited low VA burden with intermediate RVP (1–99.9%) being most arrhythmogenic for PVC runs (p = 0.04) and for isolated PVCs (p = 0.006). Antiarrhythmics/beta and calcium channel blockers use and stress tests performed to evaluate VAs which were positive requiring intervention did not differ significantly. Burden of > 1/h of PVC runs and increasing PVC runs/h were significantly associated with hospitalization (p = 0.04) and all-cause mortality (p = 0.03), respectively.
Conclusions
In pacemaker patients with normal range LVEF (> 50–55%), 100% RVP is associated with the lowest burden of NSVT. Furthermore, patients with < 1% RVP also exhibit low VA burden; however, intermittent RVP seems to significantly correlate with non-sustained VAs.
3.EPIDEMIOLOGY AND PATTERN OF BRACHIAL PLEXUS INJURY IN NORTHERN MALAYSIA
Choo PT ; Hasan SR ; Lim WK ; Abdul Rahim Z ; Shuib S ; Anoar AF ; Hassan MS ; Chopra S
Malaysian Orthopaedic Journal 2019;13(Supplement A):15-
4.Knee Septic Arthritis: A Diagnostic Dilemma
Ismail NEI ; Choo PT ; Hasan SR ; Selvanathan N ; Chopra S
Malaysian Orthopaedic Journal 2018;12(Supplement A):127-
5.Mortality Rate and Ten Years Survival of Elderly Patients Treated with Total Hip Arthroplasty for Femoral Neck Fractures
Nanchappan NS ; Chopra S ; Samuel A ; Therumurtei L ; Ganapathy SS
Malaysian Orthopaedic Journal 2021;15(No.2):136-142
Introduction: Mortality following traumatic femoral neck
fractures in the elderly (age >60 years) is influenced by many
factors. Addressing some of them may reduce the mortality
rate thus improving patient survival and quality of life.
Materials and methods: This study was a retrospective
research using data collected from Hospital Sultanah
Bahiyah, Kedah between the years 2008-2018. We measured
outcomes such as age, gender, hospital stay, default rate,
ambulation post-surgery, American Society of
Anaesthesiologists score (ASA) and surgical timing in
correlation with mortality rate and 10-year survival of
elderly patients treated with Total Hip Arthroplasty for
femoral neck fractures in this centre.
Results: A total of 291 traumatic femoral neck fractures
aged above 60 years post total hip arthroplasty performed
were included. There was higher number of female (n =233)
compared to male (n=53) Estimated 10 years survival from
Kaplan Meier was 42.88% (95% CI: 33.15, 52.54). One year
mortality rate in our study was found to be 18.9%. The
average time to event was 7.1 years (95% CI:33.15, 52.24)
with a mean age group of 75.
Discussion: Total hip arthroplasty patients not ambulating
after surgery had a 4.2 times higher hazard ratio compared to
ambulators. Those with pre-existing systemic disease (ASA
III and IV) were found to have the highest hazard ratio,
almost five times that of healthy patients, after adjusting for
confounding factors. Delay of more than seven days to
surgery was found to be a significant factor in 10-year
survival with a hazard ratio of 3.8, compared to surgery
performed earlier.
Conclusion: Delay of more than 7 days to surgery in 10
years survival was significant with high hazard ratio. It is a
predictor factor for survival in 10 years. A larger sample size
with a prospective design is required to confirm our findings
regarding “unacceptable surgical timing” for femoral neck
fractures in patients above 60 years of age.
6.Mycetoma Pedis - The Importance Of Histological Diagnosis: A Case Series
Then JW ; Khoh PS ; Yeoh CW ; Ooi YJ ; S Chopra
Malaysian Orthopaedic Journal 2018;12(Supplement A):66-
7.Intraspinal Cervical Schwannoma: A Case Report
Thavamany AS ; Then WJ ; Khoh PS ; Chong KL ; Chopra S
Malaysian Orthopaedic Journal 2018;12(Supplement A):165-
8.Another Step To Prevent PCL Reconstruction Failure
Yeoh CW ; Kam ML ; Juhari MS ; Then JW ; S Chopra
Malaysian Orthopaedic Journal 2018;12(Supplement A):212-
9.Prospective evaluation of the diagnostic potential of LipL32 based latex agglutination test for Bovine leptospirosis
Sabarinath, T. ; Behera, S.K ; Chopra, S. ; Deneke, Y. ; Sharma, V. ; Ali, S.A. ; Chaudhuri, P. ; Kumar, A.
Tropical Biomedicine 2019;36(2):367-372
The Livestock Sector of India plays an important role in livelihood security and
socioeconomic development of rural households. Leptospirosis is an important zoonotic
disease responsible for septicaemia, interstitial nephritis, jaundice, abortion, reproductive
problem in most of the animal species. Reproductive disturbances in bovine population is
most often restricted to investigation of brucellosis, however apart from brucellosis, there
are many undiagnosed diseases like leptospirosis that takes a toll in the reproductive
anomalies of cattle and buffalo. Hence, the present study was elucidated to screen the
seroprevalence of Leptospira in cattle and buffalo in various hamlets of North India using
a user friendly screening test i.e. LipL32 latex agglutination test. The overall seropositivity
was found to be 26.01% (230/884) in case of bovine in this study and the LipL32 LAT
showed a profound sensitivity and specificity with level of 94.97% and 99.53% respectively.