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Yap NJ, Simpson C, Ng N, Ndou S, Wright E, Scott C, Clement N. 553 Does Patella Implant Design Affect Outcomes? Patella Resurfacing in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Aim
To investigate whether implant design affect (1)incidence of anterior knee pain, (2)patient reported outcomes and (3)reintervention rates in a resurfaced vs non-resurfaced Total Knee Arthroplasty (TKA).
Method
MEDline, pubmed and google scholar studies were evaluated using SIGN assessment tool and data analysis was conducted using Review Manager 5.2 on only randomised controlled trials. Search terms: arthroplasty, replacement, knee (Mesh), TKA, prosthesis, patella, patellar resurfacing, patellar retaining.
Results
33 randomised controlled studies were identified. A total of 11 used the modern “patella-friendly” implants and 22 used the older “patella non-friendly” implants.
There was no significant difference in anterior knee pain rates for either surgical option. When using patella-friendly implant, patella resurfacing results in a statistically higher clinical (P 0.007, MD -0.77) and functional (P < 0.0001, MD -1.87) KSS than the non-resurfaced counterparts, but scores were not clinically significant. When the patella was not resurfaced, there was a significant increased risk of reoperation with “non-patella friendly” implant (p=0.04, OR 1.42, CI 1.01, 2.00), whilst there was no significant difference between reoperation rates for the “patella friendly” implants (OR 1.17, CI 0.59,2.30).
Conclusions
Patella implant design has been shown to significantly improve KSS scores but with no clinical significance. Risk of further procedures was significantly higher in non-resurfaced patella TKAs with “non-friendly” implants, likely due to increased rates of anterior knee pain in these older generation implants leading to secondary resurfacing. However, when utilising “patella-friendly” implants, resurfacing does not lower reintervention rates. This meta-analysis finds no clinical indication to resurface the patellar whilst performing a TKA.
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Affiliation(s)
- NJ Yap
- NHS Tayside , Dundee , United Kingdom
| | - C Simpson
- West of Scotland , Glasgow , United Kingdom
| | - N Ng
- NHS Lothian , Edinburgh , United Kingdom
| | - S Ndou
- NHS Lothian , Edinburgh , United Kingdom
| | - E Wright
- NHS Lothian , Edinburgh , United Kingdom
| | - C Scott
- NHS Lothian , Edinburgh , United Kingdom
- University of Edinburgh , Edinburgh , United Kingdom
| | - N Clement
- NHS Lothian , Edinburgh , United Kingdom
- University of Edinburgh , Edinburgh , United Kingdom
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Ng N, Yap NJ. A Response to "Impact of a National Journal Club and Letter Writing Session on Improving Medical Students' Confidence with Critical Appraisal" [Letter]. Adv Med Educ Pract 2020; 11:51-52. [PMID: 32021543 PMCID: PMC6970511 DOI: 10.2147/amep.s243877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Affiliation(s)
- N Ng
- University of Edinburgh Medical School, Edinburgh, UK
| | - NJ Yap
- University of Dundee, Dundee, UK
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Goh XT, Chua KH, Vythilingam I, Lee PC, Tan TC, Yap NJ, Chai HC, Nissapatorn V, Lim YAL. Genetic diversity of Merozoite Surface Protein-1 gene block 2 allelic types in Plasmodium falciparum isolates from Malaysia and Thailand. Trop Biomed 2019; 36:70-80. [PMID: 33597428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Malaria is the most common vector-borne parasitic disease in Malaysia and Thailand, especially in Malayan Borneo and along the Thailand border areas, but little is known about the genetic diversity of the parasite. Present study aims to investigate the genetic diversity of Plasmodium falciparum isolates in these two countries and eventually contributes to more effective malaria control strategies, particularly in vaccine and antimalarial treatment. One hundred and seventy three P. falciparum isolates were collected from Malaysia (n = 67) and Thailand (n = 106) and genotyped using nested PCR targeting the polymorphic region of MSP-1, block 2. Sequence analysis was conducted to investigate the allele diversity of the isolates. Three allelic families were identified in Malaysian and Thailand P. falciparum isolates, MAD20, K1 and RO33. Sequence analysis revealed that there were 5 different MAD20, 1 K1 and 2 different RO33 for Malaysian isolates. Thailand isolates exhibited greater polymorphism because there were 13 different MAD20, 6 different K1 and 2 different RO33 identified in this study. Multiclonal infections were observed for the isolates in both countries, however, low multiplicity of infection (MOI) was observed for Malaysian (1.1) and Thailand (1.2) isolates. Phylogenetic analysis showed that P. falciparum isolates of Malaysia and Thailand were clustered in the same group for all the allelic families. Population structure of P. falciparum isolates in Malaysia and Thailand exhibit extensive genetic polymorphism but showed high similarities as well as comparable MOI.
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Affiliation(s)
- X T Goh
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - I Vythilingam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - P C Lee
- Faculty of Natural Resources, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - T C Tan
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N J Yap
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - H C Chai
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - V Nissapatorn
- Research Excellence Center for Innovation and Health Products (RECIHP) and School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Y A L Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Angal L, Lim YA, Yap NJ, Ngui R, Amir A, Kamarulzaman A, Rohela M. Toxoplasmosis in HIV and non HIV prisoners in Malaysia. Trop Biomed 2016; 33:159-169. [PMID: 33579153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This is the first Malaysian study to determine the trend and risk factors of Toxoplasma gondii infection in HIV and non-HIV among prisoners in terms of socio-demographic and behavioural characteristics, clinical presentations and haematological distributions. Blood samples from 303 participants, comprising 133 HIV positive and 170 HIV negative inmates were collected in EDTA and plain tubes. Two mls of each blood sample in plain tubes were centrifuged at 1500 rpm for 10 minutes and the sera obtained were subjected to ELISA for detection of Toxoplasma IgM and IgG antibody towards Toxoplasma antigen. Seropositive samples for Toxoplasma IgM or both Toxoplasma IgM and IgG were further tested with Novalisa Toxoplasma gondii IgG avidity test to rule out acute from latent infections. Blood in EDTA tubes were sent to Clinical Diagnostic Lab (CDL), University Malaya Medical Centre (UMMC), Kuala Lumpur for complete blood count and differential count analysis. Overall seroprevalence of anti-T. gondii antibodies was detected in 41.9% (127 out of 303) of the participants. Anti-T. gondii antibodies was detected in 63.2% (84 out of 133) of HIV positive subjects and in 25.3% (43 out of 170) of HIV negative subjects. Seroprevalence of anti-T. gondii antibodies was significantly higher in HIV positive than in HIV negative subjects (OR = 5.06; 95% CI = 3.09-8.30; p < 0.001). The rate of T. gondii seropositivity increased significantly in those aged 40 years and above, HIV positive individuals and those with history of drug abuse. White blood cells (WBCs), neutrophils and basophils counts decreased significantly in those infected with Toxoplasma. Creating awareness about T. gondii infection and follow-up of their status is recommended. Moreover, screening of T. gondii infection in HIV-infected individuals should be considered for better treatment and management, including control and prevention.
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Affiliation(s)
- L Angal
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Y A Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N J Yap
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - R Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A Amir
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A Kamarulzaman
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - M Rohela
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Khaw LT, Leerach N, Yap NJ, Jaturas N, Mahboob T, Tan TC, Dungca JZ, LosBaños ZD, Sitthisak S, Chow SC, Lim YAL, Sawangjaroen N, Wiart C, Nissapatorn V. A preliminary screening of potentially antimalarial plants against Plasmodium falciparum in vitro. Trop Biomed 2015; 32:676-683. [PMID: 33557458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Plasmodium is a blood protozoan parasite that is responsible for malaria. To date, Plasmodium falciparum has shown multi-drug resistance, particularly in Thailand, Myanmar and Malaysia. The aim of the study is to screen the plant extracts that can effectively inhibit P. falciparum 3D7, a common lab strain malaria parasite. Nine plants were collected and processed through maceration using hexane, chloroform and ethanol, resulting in 24 crude plant extracts. Of these, extracts from Artabotrys crassifolius, Pericampylus glacus and Leuconotis eugeniifolia showed promising antiplasmodial activities at IC50 of 15.32 to 39.75 µg/mL in a modified schizont maturation assay. Further studies are warranted to explore its efficacies and lead compounds of these three plant extracts for the development of antiplasmodial drugs.
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Affiliation(s)
- L T Khaw
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N Leerach
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N J Yap
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N Jaturas
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - T Mahboob
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - T C Tan
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - J Z Dungca
- School of Science and Technology, Centro Escolar University, Manila, Philippines
| | - Z D LosBaños
- School of Science and Technology, Centro Escolar University, Manila, Philippines
| | - S Sitthisak
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - S C Chow
- School of Medical Science and Health, Monash University, Selangor, Malaysia
| | - Y A L Lim
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N Sawangjaroen
- Department of Microbiology, Faculty of Science and Natural Product Research Centre of Excellence, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - C Wiart
- School of Pharmacy, Faculty of Science, University of Nottingham, Kuala Lumpur, Malaysia
| | - V Nissapatorn
- Department of Parasitology (Southeast Asia Natural Products), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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