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Table of Contents
January-March 2018
Volume 2 | Issue 1
Page Nos. 1-37
Online since Tuesday, February 13, 2018
Accessed 15,674 times.
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EDITORIAL
The changing landscape of surgical education and training
p. 1
Salman Y Guraya
DOI
:10.4103/jmsr.jmsr_43_17
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REVIEW ARTICLES
Educating the educators: Perspectives on surgical education
p. 4
Mohamed Khalid
DOI
:10.4103/jmsr.jmsr_3_18
These are challenging times for Surgical Educators. Limitations on working hours, resource constraints, rapidly evolving technological advances in the way, we communicate and interact, and increasing patient expectations are threatening the traditional and time-tested apprenticeship model of surgical training. It is imperative on the part of today's Surgical Educators to respond to these challenges in ways that enhance and promote the training of future surgeons. This has led to the birth of a new specialty of Surgical Education. Although generic Health Sciences/Medical Education programs are widely available and do serve a useful purpose, it may be argued that surgical trainees have unique needs that may not be adequately addressed by the generic programs. Thus, there is a need for focused Surgical Education programs. This review aims to identify these needs and to discuss the current Surgical Education programs available. It also aims to suggest additional issues that may need to be addressed to make these programs even more useful.
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The role of melatonin receptor genes and estrogen receptor genes in the pathogenesis of adolescent idiopathic scoliosis: A systematic review
p. 8
Sarah A Basindwah, Banan F AlHazmi, Arwaa K Haji, Tasneem M Eid, Salah M Fallatah
DOI
:10.4103/jmsr.jmsr_32_17
Objective:
Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity affecting healthy children. Genetic factors are thought to play a role in the etiology of this condition, along with other factors. The occurrence of the condition in twins, its early onset, and its familial predilection all support the possibility of an underlying genetic cause. This article aims to review the published studies that looked at the association of estrogen and melatonin receptor (
ESR
and
MTNR
) genes with the pathogenesis of AIS, to serve as a guide for future work and opportunities in this field.
Methods:
The following databases were searched: Cochrane, PubMed, Medline, Ovid, ProQuest, and ScienceDirect using relative keywords. The analysis included 14 studies.
Results:
Of 312 identified studies, only 14 studies (nine for
ESR
gene and five for
MTNR
gene) met our inclusion criteria. Only one study found an association between AIS susceptibility and
xbal
polymorphism on
ESR1
gene.
MTNR
genes were found to be associated with AIS occurrence in large populations or when synergizing with other gene single-nucleotide polymorphisms.
MTNR
gene studies showed no relation with curve severity, and none of them considered curve progression, whereas five
ESR
gene studies considered curve progression and severity. Due to the different gene loci examined in various studies, pooled analysis of the results was not possible.
Conclusion:
We reviewed the genetic association of
ESR
and
MTNR
genes. Several studies found supporting evidence for both genes and their association with AIS, despite conflicting results. Further studies on different genes and different ethnic backgrounds are needed.
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ORIGINAL ARTICLES
Prevalence of ankle injuries in physical education and sports classes among saudi high school male students in Riyadh, Saudi Arabia
p. 16
Mohammad A Almalki, Nasser A Alowaime, Abdullah M Alanazi, Ahmed K Alanazi, Nawaf N Alamri, Mohammed A Alaqil, Emad M Masuadi, Nader S Alkenani
DOI
:10.4103/jmsr.jmsr_24_17
Objective:
Physical education and sports classes are mandatory for male high school students in Saudi Arabia. Nevertheless, participation in sports activities increases the risk of injury. This study aims at assessing risk factors and estimating the prevalence of ankle injuries in physical education and sports classes among high school male students in Riyadh, Saudi Arabia.
Methods:
A cross-sectional study was conducted, using a data collection sheet about demographic and clinical characteristics of students and Foot and Ankle Disability Index to measure the degree of disability. Schools were chosen by cluster sampling of the four regions of Riyadh city. Three schools from each region were selected by simple random sampling. In each school, one section randomly selected from each grade, and eleven students were selected from each section by simple random sampling.
Results:
The prevalence of ankle injuries of the included participants (
n
= 399) at the study time, last month, last 6 months, last 12 months, and high school time were 14%, 21.1%, 30.3%, 31.7%, and 34.7%, respectively.
Conclusions:
One-third of students had an ankle injury during the high school time; only one-fifth needed treatment.
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Functional anatomy of the hand: prevalence of the linburg–Comstock anomaly in a young saudi population
p. 21
Mohammed T Alzahrani, Mohammad A Almalki, Turki A Althunayan, Amjaad H Almohawis, Faisal FA Almehaid, Loung V Umedani
DOI
:10.4103/jmsr.jmsr_33_17
Objectives:
Linburg–Comstock (LC) anomaly is a developmental defect, characterized by flexion of thumb causing flexion of the index finger with pain in the wrist and forearm due to a tendinous interconnection between the flexor pollicis longus and flexor digitorum profundus.
Methods:
We carried out a random cross-sectional study in 2016. Undergraduate students were recruited; we excluded those with inflammation, hand or forearm trauma or surgery. Data were analyzed descriptively and categorically using Microsoft Excel and SPSS-20.
Results:
The study included 331individuals; 164 (49.5%) were male, and 167 (50.5%) were female, out of which 130 (39%) had LC anomaly. The mean age was 23 years (standard deviation ± 5.3). LC anomaly was found bilaterally in 43 (12.9%), in the right hand in 51 (15.4%) and in the left hand in 35 (10.5%). It was found bilaterally in females in 17 (10.1%) participants, and in males in 26 (15.8%),
P
= 0.37. The right-hand dominance was found in 294 (89%) versus left-hand in 37 (11%).
Conclusion:
The prevalence of LC anomaly was 39%, which matches with the global prevalence, the males showed slightly more prevalence of bilateral LC anomaly. The right-hand dominance was found in 89% as opposed to 11% having left-hand dominance.
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Study of outcome of 300 cases of arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstrings tendon graft using anterior cruciate ligament tightrope for femoral fixation
p. 26
Sanjay K Rai, Rohit Varma, Sunit S Wani
DOI
:10.4103/jmsr.jmsr_20_17
Objective:
The aim of treatment of tear of the anterior cruciate ligament (ACL) in any military soldiers is to restore normal/near normal stability and function of the knee, preventing further damage to other knee structures and quick return to duty. We studied the functional outcome of arthroscopic-guided ACL reconstruction using quadrupled hamstring tendon graft (QHTG) and femoral side graft fixation using ACL TightRope and also to evaluate its complications.
Methods:
In this prospective study, evaluation parameters Lachman test, pivot test, and hamstring strength were assessed pre- and post-operatively at 3, 6, 12, 18, and 36 months. Lysholm test was assessed postoperatively.
Results:
A total of 300 male soldiers with a mean age of 26.5 years were evaluated. Injury due to military training, sports, fall, and road traffic accident was a common cause. Preoperatively, all patients had a positive pivot and anterior drawer tests, 4+ score of Lachman test, and 4/5 muscle strength with restriction of movement to <10°. Mean ± standard deviation Lysholm score at 3, 6, and 12 months were 81.19 ± 10.21, 83.86 ± 12.44, and 89.17 ± 8.32, respectively. At the 3
rd
month, negative Lachman test was seen in 83.6% (251/300) of patients, 13.6% (41/300) had 1+ laxity, and 2.6% (8/300) patients had 2+ laxity. None had positive pivot shift test. At 3 and 12 months, 91.3% (274/300) and 100% (300/300) had a grade of 5/5 power in hamstring muscles. Fifteen cases developed postoperative complications such as infection and graft failure.
Conclusion:
Autologous ipsilateral QHTG is a near anatomical and good choice for ACL reconstruction and is associated with fewer complications.
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CASE REPORTS
Skin necrosis following ilizarov application in an adolescent with radial club hand
p. 31
Abdulrahman D Algarni, Muhammad Asif, Saleh Alharby
DOI
:10.4103/jmsr.jmsr_27_17
Congenital radial club hand is a well-recognized congenital malformation of the upper extremity. It is characterized by radial deviation of the hand and shortening of the forearm. Soft-tissue distraction with an Ilizarov fixator followed by ulnar centralization in a staged approach for the Type IV radial club hand is well described in the literature. In this report, we describe a unique complication following Ilizarov application for soft-tissue distraction in a patient with Type IV radial club hand. A longitudinal skin necrosis appeared at the radial side of the forearm and hand that healed spontaneously after the cessation of distraction.
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Primary subacute osteomyelitis of the talus in a child
p. 34
Abdulmuhsen N Alshammari, Mohammad H Alotaibi, Mohamed A Abouelnaga, Abdullah M Almohammadi
DOI
:10.4103/jmsr.jmsr_36_17
Primary subacute osteomyelitis of the talus is very rare in healthy children, and the diagnosis can be delayed or even missed, because of its uncommon presentation. Only a few cases of primary subacute osteomyelitis of the talus have been reported in the literature. In this article, we report a case of primary subacute osteomyelitis of the talus in a child and describe its symptoms, signs, radiographic appearance, and the outcome of the surgical management along with a short course of antibiotics coverage. We present this rare case report and its management to increase the awareness for the possibility of this pathology, and to avoid misdiagnosis.
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