1.Early Mobilisation in Proximal Humerus Fractures: Is a Stratified Rehabilitation Protocol Safe?
Chua SKK ; Lim CJ ; Wong WSY ; Chua ITH ; Kwek EBK ; Tan BY
Malaysian Orthopaedic Journal 2026;20(No. 1):56-
Introduction: There remains little evidence on rehabilitation
protocols for proximal humerus fractures (PHFs), although
early mobilisation has been associated with positive clinical
outcomes. There may be a potential role in allowing patients
with more stable fractures to undergo an accelerated
rehabilitation process to facilitate quicker return to function,
although it must be balanced with safety concerns of
premature mobilisation and logistical concerns of
implementation with excessive stratification. The study aim
was to report the overall safety and outcomes of a simple and
implementable 2-tier stratified rehabilitation protocol based
on fracture stability adopted by our institution for nonoperatively treated PHFs.
Materials and methods: Patients in our institution (level 1
trauma centre) with non-operatively treated PHFs underwent
a stratified rehabilitation protocol that classified patients into
Accelerated versus Standard arms - with more stable
fractures undergoing an accelerated rehabilitation
programme. The Oxford Shoulder Score (OSS), Quick
Disabilities of the Arm, Shoulder and Hand Score
(QuickDASH), EuroQol-5-Dimensions (EQ5D)
questionnaires, shoulder range of motion (ROM) and grip
strength were measured at six months and one year postinjury. The frequency of adverse events requiring surgical
intervention was noted.
Results: We included 164 patients and 43% (71/164) went
through the accelerated protocol. Overall, patients had
favourable OSS (median[range] 47[44-48]), EQ5D (median
[range] 1.0[0.82-1.00]), QuickDASH scores (median[range]
2.3[0- 10.7]), and shoulder ROM and grip strength above the
requirement for functional activities of daily living at 1 year.
There were no adverse events reported 1-year post-injury.
Conclusion: This study was the first to report the safety and
outcomes of a stratified rehabilitation protocol for PHFs. Our
simple 2-tier stratified rehabilitation protocol which allowed
a shorter period of rehabilitation and earlier return to
function for patients with more stable PHFs is
implementable, safe and had overall favourable functional
outcome scores.
2.Strategi Pencegahan Untuk Gangguan Muskuloskeletal Akibat Kerja dalam Kalangan Ahli Fisioterapi di Malaysia: Kajian Kualitatif
Deepashini Harithasan1*, Lim Pei Sean Harithasan ; Lim Pei Sean
Malaysian Journal of Health Sciences 2026;24(No. 1):106-111
Kajian ini bertujuan untuk mengkaji strategi yang digunakan untuk mencegah gangguan muskuloskeletal akibat
kerja (WMSDs) dalam kalangan ahli fisioterapi dari segi kesedaran, keberkesanan, galakan, dan halangan.
Kajian kualitatif telah dilakukan dalam kalangan ahli fisioterapi di Malaysia menggunakan metodologi
keratan rentas, dengan platform dalam talian digunakan untuk menjalankan temu bual semi-struktur secara
individu. Analisis tematik menunjukkan bahawa 13 peserta menyedari kaedah berbeza yang digunakan oleh
ahli fisioterapi untuk mencegah WMSD. Peserta menyedari kepentingan menggunakan strategi yang berkesan
untuk mencegah WMSD, seperti mengekalkan mekanik badan yang betul (61.5%), melakukan senaman fizikal
(23.1%), memastikan ergonomik tempat kerja yang sesuai (15.4%), mempunyai kakitangan yang mencukupi
(15.4%), menggunakan peralatan (15.4%), dan mempraktikkan teknik memanaskan badan yang betul (7.7%).
Peserta kerap mempromosikan penggunaan alatan dan peralatan (53.8%), mengekalkan mekanik dan postur
badan yang betul (46.2%), dan menerima pendidikan (30.8%) sebagai strategi pencegahan utama. Namun
begitu, terdapat halangan untuk mengambil bahagian dalam langkah pencegahan, seperti kekurangan peralatan,
beban kerja yang tinggi, dan kakitangan yang tidak mencukupi. Penemuan menunjukkan bahawa ahli fisioterapi
sedar dan menyokong idea bahawa melaksanakan strategi khusus boleh membantu mencegah WMSD. Namun
begitu, keputusannya menggariskan kepentingan untuk mempertimbangkan halangan ini untuk meningkatkan
keberkesanan strategi pencegahan dalam intervensi amalan klinikal.
3.Comparison of some skin physiological parameters in Mongolian children
Lkhamdari B ; Saranchimeg O ; Batkhishig G ; Dolgorsuren E ; Oyuntsetseg B ; Lim Seung Bin ; Oyuntsatsral B ; Undram S ; Khurelbaatar Naymdavaa ; Enkhtur Yadamsuren ; Baasanjargal Biziya
Diagnosis 2025;112(1):27-33
Background:
The skin barrier serves as the primary defense against environmental factors. Mongolia’s extreme climate conditions may contribute to skin barrier impairment, increased trans-epidermal water loss (TEWL), and
decreased skin moisture.
Objective:
To determine and compare skin moisture, TEWL, and skin pH levels in children.
Methods:
A cross-sectional study was conducted in June 2023 with 104 relatively healthy children selected through random sampling. Skin physiological parameters, including skin moisture, skin pH and TEWL were measured following the EEMCO (European Group on Efficacy Measurement of Cosmetics and Other
Topical Products) guidelines using the Multi Skin Test MC750 device (Courage+Khazaka Electronics, Germany) at nine different sites. Data analysis was performed using Microsoft Excel and Stata-14 software.
Results:
Among the participants, 51.9% (n=54) reported having dry skin (p<0.0001). Additionally, 64.5% (n=67) used moisturizers, but their usage did not show a statistically significant difference in skin moisture (p=0.929), skin pH (p=0.378), or TEWL (p=0.332). 14.42% (n=15) had extremely dry skin, while 85.58%
(n=89) had dry skin, with no participants falling within the normal skin moisture range. TEWL showed a moderate inverse correlation with age (r=-0.331, p=0.0006). When analyzed by age groups, skin moisture (p=0.023) and TEWL (p=0.038) differed significantly between groups.
Conclusion
Skin moisture and TEWL significantly differ across age groups. Given that all participants had dry skin, moisturization is crucial. Mongolia’s extreme climate is likely a key contributing factor to childhood skin
dryness.
4.Using the neutral zone for a patient with bone resorption:a case report
Seoyeon PARK ; Jaehyeok RO ; Sangwon PARK ; Hyun-Pil LIM ; Woohyung JANG
The Journal of Korean Academy of Prosthodontics 2025;63(2):114-121
Using the neutral zone concept can increase the stability of the prosthesis. In this case, bimaxillary denture were fabricated using the neutral zone in a patient who had alveolar ridge resorption and inwardly positioned lip. This condition was unfavorable for obtaining stability of the denture, so the force involved in denture had to be minimized. There were differences in the tooth arrangement and shape of the polished surface between the definitive denture made using the neutral zone impression technique and the provisional denture made without using it.
5.Implant-assisted removable partial denture (IARPD) rehabilitation in a patient exhibiting mandibular prognathism due to decreased vertical dimension: a case report
Hye-Kyoung HWANG ; Young-Jun LIM ; Ho-Beom KWON ; Myung-Joo KIM
The Journal of Korean Academy of Prosthodontics 2025;63(1):82-91
The loss of occlusal vertical dimension due to multiple tooth loss and wear can lead to a collapsed occlusion, resulting in both functional and aesthetic problems.This case report describes a patient exhibiting mandibular prognathism as a result of vertical dimension loss. A comprehensive oral rehabilitation involving an increase in vertical dimension was required. A minimal number of implants were placed, and implant-supported surveyed crowns were fabricated, allowing for the design of a stable and retentive implant-assisted removable partial denture. The treatment resulted in both functional and aesthetic improvements. The anterior rotational pattern of the mandible was alleviated, and the implant-assisted partial denture provided clinically high levels of patient satisfaction. This case report details the diagnostic and therapeutic processes involved in this treatment.
6.Full mouth rehabilitation of a crossed-occlusion patient using digital printing technology
Jae-Bok LEE ; Young-Jun LIM ; Ho-Beom KWON ; Myung-Joo KIM
The Journal of Korean Academy of Prosthodontics 2025;63(1):31-39
Crossbite refers to a condition where there are remaining teeth, but none of the teeth are in occlusal contact, resulting in the loss of vertical support. When posterior vertical stop is lost, it is important to appropriately restore this support and create a harmonious occlusal plane. In this case, the patient had lost posterior support but declined surgical intervention due to a history of osteoporosis and the associated risk of medication-related osteonecrosis of the jaw (MRONJ). To restore the vertical space required for prosthetic rehabilitation, the vertical dimension was increased. The missing posterior teeth were replaced using removable partial dentures. Cross-mounting was performed, and the metal copings of the surveyed crowns and the framework of the final removable partial denture were 3D printed. After the treatment was completed, the patient expressed satisfaction with both functions and aesthetics. Regular follow-ups were conducted to monitor oral hygiene and occlusal stability.
7.Editorial for Vol. 35, No. 1
Korean Journal of Aerospace and Environmental Medicine 2025;35(1):1-3
This issue features six papers in aerospace medicine and safety, including four original articles and two reviews, focusing on pilot health, safety management, aerospace education, cardiovascular research in space, and artificial intelligence (AI) guidelines in aviation safety. Two studies analyze aviation medical examinations, highlighting rising pilot disqualification rates primarily due to neurological, cancer-related, and mental health disorders, emphasizing the need for targeted health management strategies. Another paper proposes enhancing the Line Operations Safety Audit methodology to systematically capture positive crew behaviors, competencies, and proactive threat management. A research article explores relationships between selfefficacy, team-member exchange, and academic performance in aviation service students, recommending customized training programs. Additionally, a review discusses cardiovascular therapeutics using microgravity and cosmic radiation environments, revealing potential terrestrial applications for cardiac regeneration and drug development. Finally, guidelines for AI development in aviation safety stress reliable governance, ethics, and transparency. Future research expanding practical implementation and deepening interdisciplinary collaboration in aerospace medicine and safety is anticipated.
8.The Causes of Disqualification in Class 1 PilotsDuring Aviation Medical Examinations (2022−2024)in South Korea: A Retrospective Review
Korean Journal of Aerospace and Environmental Medicine 2025;35(1):21-27
Purpose:
The physical and mental fitness of pilots is important for aviation safety. This study analyzes the causes of disqualification among class 1 pilots who underwent aviation medical examinations in South Korea from 2022 to 2024.
Methods:
A retrospective analysis was conducted using data from class 1 pilots who underwent disqualification between 2022 and 2024. The disqualifying conditions were categorized into major groups (e.g., neurological, cancer, mental health, car diovascular).
Results:
Among the 26 disqualified pilots, 92.3% (n=24) were men, and the mean age was 49.4 years old (standard deviation, ±6.9). Neurological conditions were the leading cause (27.0%), followed by cancer-related conditions (23.1%) and mental health disorders (15.4%). Cardiovascular diseases accounted for 11.5%, while falsification of medical records, ophthalmologic issues, musculoskeletal problems, and hearing impairments made up the remaining cases.
Conclusion
These findings emphasize the importance of rigorous medical standards, robust follow-up protocols, and effective management of both chronic and emergent medical conditions in aviation.
9.Trends in Aviation Medical Examinations, Disqualification Rates, and Health-RelatedBehaviors among South Korean Pilots (2000–2024)
Korean Journal of Aerospace and Environmental Medicine 2025;35(1):8-13
Purpose:
Over the past 25 years, aviation medical examinations have become esse ntial for pilot health and safety, paralleling industry advancements. As the number of new and aging pilots increases, the demand for systematic health assessments has also grown. However, comprehensive analyses of pilots’ health behaviors and qualifications, particularly their lifestyle habits, remain scarce.
Methods:
This study analyzed data from the Airmen Medical Certificate Management System (2000–2024), covering age, sex, license type, affiliation, diagnoses, and screening outcomes.
Results:
Aviation medical examinations increased from 2,366 in 2000 to over 10,000 by 2016, peaking at 14,652 in 2019. Disqualification rates rose from 0.2%–0.4% to 0.5%–1.0% post-2016. Commercial pilot certificates issuance surged over threefold since 2011, peaking at 1,688 in 2019. Male’s disqualification rates remained around 1%, while female’s rates increased to over 3% by 2023. The highest disqualification rate was in the 50–59 age group (0.48%). Obesity rates increased (33% to 39%), smoking rates remained stable (20%), and alcohol consumption stayed high (around 60%).
Conclusion
The study highlights the growing demand for aviation medical examinations and rising disqualification rates, particularly among older pilots and female. Targeted health management strategies addressing obesity, smoking, and alcohol consumption are essential to maintain the health and safety of aviation professionals and ensure industry growth and safety.
10.Efficacy and Safety of Dual Delayed-Release Formulation of Esomeprazole in Patients with Gastroesophageal Reflux Disease: A Multicenter, Prospective, Observational Study
The Korean Journal of Gastroenterology 2025;85(1):44-51
Background/Aims:
Gastroesophageal reflux disease (GERD) is a chronic and recurrent condition requiring constant dietary management and medication. This study evaluated the efficacy and safety of HIP1601, a dual delayed-release formulation of esomeprazole, in patients with GERD in a clinical setting.
Methods:
This prospective, multicenter, observational study was conducted at 309 medical institutions in Korea between June 2021 and March 2023. HIP1601 was administered at daily doses of 40 mg or 20 mg to 5,407 patients requiring treatment or prevention of erosive esophagitis. The primary outcome was the improvement rate of GERD symptoms at four weeks. GERD-related symptoms and treatment-emergent adverse events were also analyzed.
Results:
This study included 5,282 patients in the safety analysis set and 5,232 in the full analysis set. At four weeks, the improvement rate of GERD symptoms was 92.1% (95% confidence interval [CI]: 91.3–92.8%). By eight weeks, the improvement rate increased to 94.6% (95% CI: 94.0–95.3%). After HIP1601 administration, the severity scores for all four GERD symptoms decreased to less than 1, with statistically significant changes in the scores (p<0.001). HIP1601 was well-tolerated, with minimal adverse events reported (0.17%), and the treatment-emergent adverse events were mild to moderate in severity.
Conclusions
HIP1601 showed strong efficacy and safety in managing GERD symptoms, with high rates of symptom relief at four and eight weeks. Its extended action and improved symptom control make it a promising therapeutic option for GERD patients.


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