Penetrating neck trauma present difficult management issues by virtue of their rarity. Undiagnosed laryngotracheal injuries have serious implications, especially in the context of multiple trauma, where other injuries overshadow that of the laryngotracheal complex. This is a case of a schizophrenic patient with multiple self-inflicted cuts on his throat and abdomen. Injuries include open, comminuted laryngeal complex lacerations with vocal cord avulsion, as well as evisceration of small bowel. Adequate assessment using both direct laryngoscopy and rigid endoscopy, coupled with open exploration, allowed optimal exposure and fixation of the larynx in the anatomical configuration. The post-operative outcome of the airway and voice remained satisfactory at follow-up. A high index of suspicion coupled with adequate surgical approach allowed establishment of a functional larynx.
Larynx/*injuries ; Schizophrenia/complications ; *Self-Injurious Behavior ; Trachea/*injuries ; Vocal Cords/*injuries ; Wounds, Penetrating/*surgery

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.

Breast cancer is the most common cancer among women worldwide and in Malaysia. It has better cure rate if detected early. However, the practice of breast cancer screening in Malaysia is still low. The objective of this study is to determine the knowledge and its associated factors as well as sources of information on breast cancer and breast cancer screening among female staff in a public university in Malaysia. Materials and Methods: This was a cross sectional study conducted in 2005 involving 394 female staff including academic and non-academic staff, which was selected by cluster sampling. A self-administered questionnaire on socioeconomic characteristics and family history of breast cancer was used for data collection. Chi-square Test and Fisher’s Exact Test was used for testing an association using SPSS 12.0. Results: The response rate was 84.3%. Only 50.9% had high knowledge on breast cancer and breast cancer screening and this was significantly associated with occupational status, monthly family income and educational level (p<0.05). The usual source of information was mass media (92.2%) while the most preferred source is the health team (71.4%). Conclusion: As mass media was a major source of information, all types of mass media could efficiently be utilized to disseminate knowledge by presenting specific programmes associated with breast cancer and breast cancer screening.

INTRODUCTION: Sarcopenia is characterised by a progressive and generalised loss of skeletal muscle mass, strength and/or performance. It is associated with adverse health outcomes such as increased morbidity, functional decline and death. Early detection of sarcopenia in community-dwelling older adults is important to prevent these outcomes. Our scoping review evaluates validated screening tools that are used to identify community-dwelling older individuals at risk of sarcopenia and appraises their performance against international consensus definitions. MATERIALS AND METHODS: A systematic search on MEDLINE, PubMed and EMBASE was performed for articles that evaluated the predictive validity measures of screening tools and validated them against at least 1 internationally recognised diagnostic criterion for sarcopenia. RESULTS: Of the 17 articles identified in our search, 8 used questionnaires as screening tool, 2 utilised anthropometric measurements, 3 used a combination of questionnaire and anthropometric measures and 1 used a physical performance measure (chair stand test). The questionnaire Strength, Assistance with walking, Rising from chair, Climbing stairs and Falls (SARC-F) has the highest specificity (94.4-98.7%) but low sensitivity (4.2-9.9%), with the 5-item questionnaire outperforming the 3-item version. When SARC-F is combined with calf circumference, its sensitivity is enhanced with improvement in overall diagnostic performance. Although equation-based anthropometric screening tools performed well, they warrant external validation. CONCLUSION Our scoping review identified 6 candidate tools to screen for sarcopenia. Direct comparison studies in the community would help to provide insights into their comparative performance as screening tools. More studies are needed to reach a consensus on the best screening tool(s) to be used in clinical practice.

Introduction: Proximal femur resection and endoprosthetic reconstruction is the preferred treatment for extensive bony destruction and pathological fractures. Due to the relatively high cost of endoprosthesis, we adopted the modified unipolar hemiarthroplasty (MUH) for reconstruction when the mode of treatment was for palliation. Materials and Methods:This is a retrospective case study of six patients, who had bone and multi-organs metastases with extensive proximal femur involvement with pathologic fractures who underwent resection and MUH reconstruction during the period 2013 to 2017. All patients were classified as Group B / C based on Scandinavian Sarcoma Group survival scoring, with estimated survival of maximum six months. The basic MUH construct consisted of AustinMoore prosthesis which was secured to a Küntscher nail using cerclage wire and cemented into the femoral canal. Subsequently, the whole length of the prosthesis which remained outside the canal was coated with cement. Results:The mean age was 61.8 years. The mean survival was 3.9 months, post-operation. There was no implant failure during patients’ life span; however, a third of the patients developed infection. Wheel chair ambulation was started immediately post-operation for all patients, and two patients progressed to walking frame ambulation. The total cost of each construct was below US$490 in comparison to long-stem hemiarthroplasty (roughly US$ 1700). Conclusion: Our aim was to alleviate pain, facilitate rehabilitation, ease nursing care and improve quality of life for metastatic bone disease patients until end of life. MUH for the treatment of pathological fracture in proximal femoral metastases is a feasible palliative surgical modality in resource-limited settings.