Ankle injuries in sports: anatomical considerations and clinical implications

Ankle injuries are commonly seen in various sports. The main aim of the present review was to highlight the normal anatomy of the ankle, mechanism of injuries related to sports, congenital abnormalities or anatomical variations related to ankle injury and discuss its effective management. A review of literature was done to determine the ankle injuries which occur as a result of various sports related activities. We documented all sports which involved injury to the ankle joint. The anatomy of various structures in the sole of foot and their involvement in injuries were discussed at length. The anatomical knowledge of ankle injury may be beneficial for future diagnosis and treatment purpose

Protective effect of curcumin on experimentally induced arthritic rats

Curcuma longa (turmeric) rhizomes contains curcumin, an active compound which possesses anti-inflammatory effects. Collagen-induced arthritis (CIA) is an accepted experimental animal model of rheumatoid arthritis. The present study aimed to observe the histological changes in the joints of experimental arthritic rats treated with curcumin. Twenty four male Sprague-Dawley (approximately 7 weeks-old) rats were randomly divided into four groups. Three groups were immunized with 150 μg collagen. All rats with established CIA, with arthritis scores exceeding 1, were orally treated with betamethasone (0.5 mg/ml/kg body weight), curcumin (110 mg/ml/kg body weight) or olive oil (1.0 ml/kg body weight) daily, for two weeks. One remaining group was kept as normal control. Treatment with 110 mg/ml/kg curcumin showed significant mean differences in the average white blood cell (WBC) count (p<0.05), cell infiltration, bone and cartilage erosion scores (p<0.05) compared to the olive oil treated group. Pannus formation scores showed that curcumin supplementation successfully suppressed the pannus formation process that occurred in the articular cartilage of the CIA joints. The mean difference for histological scores for the curcumin group was insignificant compared to the betamethasone treated group. It is concluded that supplementation of curcumin has protective effect on the histopathological and degenerative changes in the joints of CIA rats which was at par with betamethasone

Histomorphometric changes in the perirenal adipocytes of adrenalectomized rats treated with dexamethasone

INTRODUCTION: Prolonged steroid treatment administered to any patient can cause visceral obesity, which is associated with metabolic disease and Cushing's syndrome. Glucocorticoids have a profound negative effect on adipose tissue mass, giving rise to obesity, which in turn is regulated by the 11&#946;-hydroxysteroid dehydrogenase type 1 enzyme. Adrenalectomized rats treated with dexamethasone exhibited an increase in visceral fat deposition but not in body weight. OBJECTIVES: The main aim of this study was to determine the effect of dexamethasone on the histomorphometric characteristics of perirenal adipocytes of adrenalectomized, dexamethasone-treated rats (ADR+Dexa) and the association of dexamethasone treatment with the expression and activity of 11 &#946;-hydroxysteroid dehydrogenase type 1 (11 &#946;-hydroxysteroid dehydrogenase type 1). METHODS: A total of 20 male Sprague Dawley rats were divided into 3 groups: a baseline control group (n = 6), a sham-operated group (n = 7) and an adrenalectomized group (n=7). The adrenalectomized group was given intramuscular dexamethasone (ADR+Dexa) 2 weeks post adrenalectomy, and the rats from the sham-operated group were administered intramuscular vehicle (olive oil). RESULTS: Treatment with 120 &#956;g/kg intramuscular dexamethasone for 8 weeks resulted in a significant decrease in the diameter of the perirenal adipocytes (p<0.05) and a significant increase in the number of perirenal adipocytes (p<0.05). There was minimal weight gain but pronounced fat deposition in the dexamethasone-treated rats. These changes in the perirenal adipocytes were associated with high expression and dehydrogenase activity of 11&#946;-hydroxysteroid dehydrogenase type 1. CONCLUSIONS: In conclusion, dexamethasone increased the deposition of perirenal fat by hyperplasia, which causes increases in the expression and dehydrogenase activity of 11 &#946;-hydroxysteroid dehydrogenase type 1 in adrenalectomized rats

Protective effects of palm tocotrienol against glucocorticoid induced osteoporosis via regulation of gene expressions

Long term glucocorticoids administration induces oxidative stress which leads to alteration of bone structure and strength. Palm oil is rich in tocotrienol, an antioxidant. It can be used for the prevention of oxidative stress related diseases. The main objective of this study was to determine the mechanism of palm tocotrienol in maintaining the bone structure and strength in glucocorticoidinduced osteoporosis. Thirty two adult male Sprague-Dawley rats, aged 3 months, weighing 300-320 g rats were used in this study. Sixteen rats undergone adrenalectomy and were administered with 120μg/kg/day intramuscular injection of dexamethasone. Eight rats were supplemented with oral palm tocotrienol 60 mg/kg/day (Adrx+Dex+PTT) and the other eight rats were given oral vehicle palm olein 0.1 ml/kg/day (Adrx+Dex). Eight rats underwent sham procedure and were given vehicle palm olein 0.05 ml/kg/day by intramuscularly and oral 0.1 ml/kg/day (Sham). The rats were euthanized after two months of treatments. Eight rats were euthanized after acclimatic action without receiving any treatment (Baseline). The right femurs were used for bone biomechanical strength and histomorphometry analysis while the left for gene expression and oxidative stress enzymes activities. The results indicated that long-term glucocorticoid treatment significantly increased bone resorption marker, CTX (6060.7 ± 410 pg/ml) and decreased bone structure and strength. Osteoblast and osteoclast related genes expressions indicated an increase in bone turnover. Supplementation of palm tocotrienol had maintained serum resorption (2619.4 + 209 pg/ml) marker level and preserved bone structure and strength. Gene expression analysis showed decrease in bone resorption. The findings suggested that palm tocotrienol has potential benefits against glucocorticoid-induced osteoporosis by regulating osteoblast and osteoclast related gene expressions

Sex hormones in Malay and Chinese men in Malaysia: are there age and race differences?

OBJECTIVES: Variations in the prevalence of sex-hormone-related diseases have been observed between Asian ethnic groups living in the same country; however, available data concerning their sex hormone levels are limited. The present study aimed to determine the influence of ethnicity and age on the sex hormone levels of Malay and Chinese men in Malaysia. METHODS: A total of 547 males of Malay and Chinese ethnicity residing in the Klang Valley Malaysia underwent a detailed screening, and their blood was collected for sex hormones analyses. RESULTS: Testosterone levels were normally distributed in the men (total, free and non-sex hormone-binding globulin (SHBG) bound fractions), and significant ethnic differences were observed (

Relationship of Osteoblast and osteoclast-related mRNA expression with the use of piper sarmentosum water extract in the treatment of glucocorticoid-induced osteoporosis

Glucocorticoid-induced osteoporosis is the most common cause of secondary osteoporosis. Expression of bone-related genes may correspond to alteration in bone metabolism with glucocorticoid exposure. Piper sarmentosum (Ps) extract is known to possess antioxidant and anti-inflammatory activities. In this study, we determined the correlation between the effects of Ps leaf extract with mRNA expression of osteoblast and osteoclast related genes in glucocorticoidinduced osteoporotic rats. Sprague-Dawley rats were adrenalectomized and divided into four groups: G1: sham-operated control; G2: adrenalectomized (adrx) control; G3: adrx and given Ps 125 mg/kg/day; and G4: adrx and given GCA 120 mg/kg/day. These rats were given dexamethasone replacement 120μg/kg body weight/day intramuscularly. Treatment with water-based Ps leaf extract 125mg/kg/day and GCA 120 mg/kg/day were given for 2 months. The left femur was dissected out for gene expression analysis. The results showed that Ps leaf extract had increased the osteoprotegerin mRNA expression (p<0.05), whereas GCA increased the osteoprotegerin and osteocalcin mRNA expression (p<0.05). This suggests that Ps leaf extract was able to prevent bone loss due to long-term glucocorticoid therapy by increasing the expression of bone formation related genes. Thus Ps may have the potential to be used as prophylaxis against osteoporosis and osteoporotic fracture in patients on long-term glucocorticoid treatment

Nigella sativa

Nigella sativa seeds (NS) has been used traditionally for various illnesses. The most abundant and active component of NS is thymoquinone (TQ). Animal studies have shown that NS and TQ may be used for the treatment of diabetes-induced osteoporosis and for the promotion of fracture healing. The mechanism involved is unclear, but it was postulated that the antioxidative, and anti-inflammatory activities may play some roles in the treatment of osteoporosis as this bone disease has been linked to oxidative stress and inflammation. This paper highlights studies on the antiosteoporotic effects of NS and TQ, the mechanisms behind these effects and their safety profiles. NS and TQ were shown to inhibit inflammatory cytokines such as interleukin-1 and 6 and the transcription factor, nuclear factor κB. NS and TQ were found to be safe at the current dosage for supplementation in human with precautions in children and pregnant women. Both NS and TQ have shown potential as antiosteoporotic agent but more animal and clinical studies are required to further assess their antiosteoporotic efficacies

The effect of palm tocotrienol on surface osteoblast and osteoclast in excess glucocorticoid osteoporotic rat model

A balanced interaction between osteoblast and osteoclast plays a major role in maintaining bone strength and structural integrity. Tocotrienol, a palm derivative with potent antioxidant properties showed an anti-osteoporotic effect but little is known about its mechanism of action. Hence, this research was conducted to determine the effects of palm tocotrienol on the surface osteoblast and osteoclast of the the glucocorticoid-induced osteoporotic bones. The study involved 40 male Sprague-Dawley rats weighing 250-300 g which were randomly divided into an equal number of Baseline, Sham, Adrx+Dexa (adrenalectomized with dexamethasone), Adrx+Dexa+ATF (adrenalectomized with dexamethasone supplemented with α-tocopherol) and Adrx+Dexa+PTT (adrenalectomized with dexamethasone supplemented with palm tocotrienol). Bloods were taken prior to sacrifice for serum biomarkers and either tibia or femur was harvested for bone biomarkers, gene expressions analysis and histological studies. A double-blinded experiment was performed to calculate the number of total cells (osteoblasts and osteoclast) with intact nuclei within five fields of view. While serum osteocalcin and gene expression did not show any changes, CTX level was increased in the Adrx+Dexa group but reduced after the supplementation of palm tocotrienol. Supplementation of palm tocotrienol also significantly decrease the osteoclast population (p<0.05) compared to Adrx+Dexa group. In contrast, osteoblast population showed no significant difference across the groups. The result showed that palm tocotrienol acts by modulating the osteoclasts but not osteoblast, which revert the dynamics of bone cells population in the osteoporotic bone to its pre-osteoporotic levels. Supplements of tocotrienol in daily diet may be beneficial in preventing osteoporosis

Anatomy education environment measurement inventory (AEEMI): a cross-validation study in Malaysian medical schools

Background: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia. Methods: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses. Results: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P < 0.001, χ 2/df = 1.965, Root Mean Square of Error Approximation (RMSEA) = 0.018, Goodness-of-fit Index (GFI) = 0.929, Comparative Fit Index (CFI) = 0.962, Normed Fit Index (NFI) = 0.927, Tucker–Lewis Index (TLI) = 0.956) with Cronbach’s alpha values ranging from 0.621 to 0.927. Findings of the cross-validation across institutions and phases of medical training indicated that the AEEMI measures nearly the same constructs as the previously validated version with several modifications to the item placement within each factor. Conclusions: These results confirmed that variability exists within factors of the anatomy education environment among institutions. Hence, with modifications to the internal structure, the proposed model of the AEEMI can be considered universally applicable in the Malaysian context and thus can be used as one of the tools for auditing and benchmarking the anatomy curriculum

Effects of edible bird's nest (EBN) on cultured rabbit corneal keratocytes

<p>Abstract</p> <p>Background</p> <p>There has been no effective treatment or agent that is available for corneal injury in promoting corneal wound healing. Previous studies on edible bird's nest extract (EBN) had reported the presence of hormone-like substance; avian epidermal growth factor that could stimulate cell division and enhance regeneration. This study aimed to investigate the effects of EBN on corneal keratocytes proliferative capacity and phenotypical changes.</p> <p>Methods</p> <p>Corneal keratocytes from six New Zealand White Rabbits were isolated and cultured until Passage 1. The proliferative effects of EBN on corneal keratocytes were determined by MTT assay in serum-containing medium (FDS) and serum-free medium (FD). Keratocytes phenotypical changes were morphologically assessed and gene expression of aldehyde dehydrogenase (ALDH), collagen type 1 and lumican were determined through RT-PCR.</p> <p>Results</p> <p>The highest cell proliferation was observed when both media were supplemented with 0.05% and 0.1% EBN. Cell proliferation was also consistently higher in FDS compared to FD. Both phase contrast micrographs and gene expression analysis confirmed the corneal keratocytes retained their phenotypes with the addition of EBN.</p> <p>Conclusions</p> <p>These results suggested that low concentration of EBN could synergistically induce cell proliferation, especially in serum-containing medium. This could be a novel breakthrough as both cell proliferation and functional maintenance are important during corneal wound healing. The in vitro test is considered as a crucial first step for nutri-pharmaceutical formation of EBN-based eye drops before in vivo application.</p