1.Influence of Soluble Fillers in Improving Porosity of Handmade Antibiotic-Impregnated Polymethyl Methacrylate (PMMA) Beads: An in-vitro Study
Malaysian Orthopaedic Journal 2016;10(2):6-10
There have been many investigations on non-biodegradable
materials acting as an antibiotic carrier for local drug
delivery systems based on polymethyl methacrylate
(PMMA) beads. However, the material is non-degradable
and non-porous so that less than 5% of the encapsulated drug
is released. In order to obtain better release of the antibiotics,
greater porosity of the beads would be required. Adding
fillers could increase the bead’s porosity, thus improving the
antibiotic release from the beads. The purpose of the study is
to optimize release kinetics of gentamicin from handmade
beads by adding fillers such as glycine and sodium chloride
in different concentrations. Terms of percolation theory will
qualitatively be applied in interpreting the final results.
Model beads were made by blending the antibiotics
(gentamicin) with powdered PMMA, prepared with the
inclusion of glycine and different concentration of sodium
chloride in 100% monomer. To determine the gentamicin
release, beads were placed in phosphate buffered saline
(PBS) and aliquots were taken at designated times to
measure the gentamicin concentration. Addition of glycine
yielded 16 % release of the total amount of gentamicin
incorporated in 24 hours. Subsequent addition of sodium
chloride resulted in an increased gentamicin release, with
little or no difference in gentamicin release once 16 g or
more sodium chloride was added (gentamicin release 100%
of the amount incorporated). In conclusion, addition of
glycine and sodium chloride resulted in an increased release
of gentamicin; however, the combination without sodium
chloride seemed to have an inhibitory effect on the
gentamicin release.
Polymethyl Methacrylate
2.The Efficacy of Flavonoid Antioxidant from Chocolate Bean Extract: Prevention of Myocyte Damage Caused by Reperfusion Injury in Predominantly Anaerobic Sports
HN Rasyid ; YD Ismiarto ; R Prasetia
Malaysian Orthopaedic Journal 2012;6(2):3-6
Background: Use of predominantly anaerobic energy
systems such as that seen in 800-meter athlete runners
disrupts mitochondrial function as an energy source.
Furthermore, it produces free radical substances and causes
myocyte damage. Malondialdehyde (MDA) plasma
concentrations correlate with free radical levels and are
therefore predictive of cell damage. Objective: To analyse
the effect of flavonoid antioxidant from chocolate bean
extract for prevention of lipid peroxidation of myocyte
membranes caused by free radical substances in athletes
partaking in predominantly anaerobic sports. Materials and
Methods: The study of population consisted of 16 junior
athletes who compete in 800-meter races. This was a
randomized experimental study. Subjects were divided into
two groups, chocolate bean extracts and placebo groups, and
then practiced regularly for 14 days. All subjects were
assessed on day 15. Results were analysed statistically using paired t test, ANOVA and Duncan tests. Results:
Concentrations of MDA were reduced in flavonoid group.
Conclusion: Flavonoid antioxidant from chocolate bean
extract may prevent myocyte damage was caused by
reperfusion injury.
3.Is Elevated Hba1c Level Associated with Achilles Tendon Contracture Development in Diabetic Foot Patients?
Malaysian Orthopaedic Journal 2022;16(No.1):70-75
Introduction: Chronic hyperglycemia can increase
extracellular matrix (ECM) accumulation that leads to
tendon fibrosis and subsequent contracture. Considering the
reversibility of fibrosis, it is important to identify factors that
are associated with it. The purpose of this study was to
determine whether elevated HbA1c levels are associated
with the development of Achilles tendon contracture in
diabetes mellitus patients.
Materials and methods: We reviewed 206 patients with
diabetic foot problems between January 2015-December
2019. Demographic data, the presence of Achilles tendon
contracture, and laboratory results were documented and
statistically analysed between patients with contracture and
without contracture.
Results: Patients’ mean age was 58.46 ± 6.67 years old.
Contracture was found in 84 out of 206 patients (40.78%)
patients, with female predominance (45/84 patients; 53%).
While contracture was found significantly associated with
sex difference (0.035) and age groups (p=0.006), there was
no meaningful association with HbA1c level groups
(p=0.324).
Conclusion: Findings do not support the use of HbA1c level
as a sole determinant of Achilles tendon contracture.
Seemingly, there are other confounding factors affecting the
Achilles tendon contracture development in diabetes
mellitus patients. It should be emphasised that albeit the
association between chronic hyperglycemia and contracture
development, the low HbA1c should not be overlooked as
having no risk of Achilles tendon contracture and vice versa.