To establish a profile of fractures related to sporting activities, to determine the extent to which these injuries resulted in morbidity, and to find suitable target areas for injury prevention, a one-year study was undertaken at Seremban Hospital, Negeri Sembilan, Malaysia, from July 15, 1998 to July 14, 1999. All patients presenting to the Department of Orthopaedic & Traumatology with fractures sustained during sporting activities were enrolled. Fractures related to sporting activities are increasing and an entity to be recognized despite the good function outcome of the treatment. Suitable target areas for injury prevention were found to be football (for males), netball (for females), the second decade of life and competitive sporting events.

Background of study: Non-specific low back pain (LBP) becomes the most common cases in University population. Prolonged sitting has been identified as one of the factors leading to non-specific LBP among University population. The purpose of the study is to identify the change of functional disability in non-specific LBP among university population after PNF and McKenzie method. Methods: A quasi-experimental study involving 36 subjects (students and office workers) from the university population. The study population were selected from students and office worker of KPJ Healthcare University College (KPJUC) who met the inclusion criteria. The subjects were divided into three treatment groups: PNF group, McKenzie group and control group (hot pack and educational home exercise sheet) which underwent 12 treatment sessions distributed over three times in a week for four weeks duration. Subjects were measured on functional disability by Oswestry Disability Index (ODI). Measurement was performed at pre-test, mid-test and post-test. Repeated measures ANOVA was used to analyse the effectiveness of PNF and McKenzie treatments based on the measurement time. Result: This study showed that the PNF and McKenzie gave effect in improving ODI score in within group analysis. However, the results of PNF showed that it has more effect than McKenzie method on functional disability score (p <0.05) after 4 weeks. Conclusion: There was a change in functional disability on non-specific LBP after PNF and McKenzie method. Furthermore, the study findings showed that the PNF exercise has more effect in improving functional disability compared to McKenzie method on non-specific LBP among university population.

Background of the study: One of the factors leading to non-specific low back pain among University students and staff is prolonged sitting. Exercise therapy is one of the mainstays in the management of non-specific low back pain. One of the most common exercise therapy for non-specific low back pain is the McKenzie method, whereas the Proprioceptive Neuromuscular Facilitation (PNF) exercise is seldom been used to treat non-specific low back pain cases. Objective: The purpose of the study was to find the effectiveness PNF and McKenzie method on non-specific low back pain among University population. Methods: A randomized clinical trial involving 36 subjects (students and staffs) from the University population. The subjects were randomly chosen and assigned to three treatment groups: PNF group, McKenzie group and control group (hot pack and educational home exercise sheet) which underwent 12 treatment sessions distributed over three times in a week for four weeks duration. Subjects were measured on pain score using visual analogue scale. Measurement was performed at three points: pretest, mid-test and post-test. Repeated measures ANOVA were used to analyse the difference within each group and ANOVA used between the groups in order to find and compare the effectiveness of three treatments. Result: This study showed that there was significant mean difference between PNF and McKenzie method on pain score (p <0.05) after 4 weeks. Conclusion: The study findings showed that PNF exercise has more effect than McKenzie method on reduction of pain among non-specific low back pain among University population.

Introduction: Drug utilization of analgesics in a private healthcare setting is useful to examine their prescribing patterns, especially the newer injectable cyclooxygenase (COX)-2 inhibitors (coxibs). Objectives: To evaluate the utilization of coxibs and traditional nonsteroidal anti-inflammatory drugs (tNSAIDs) indicated for postoperative orthopaedic pain control using defined daily dose (DDD) and ratio of use density to use rate (UD/UR). Method: A retrospective drug utilization review (DUR) of nonsteroidal anti-inflammatory drugs (NSAIDs) at an inpatient department of a private teaching hospital in Seremban, Malaysia was conducted. Patients’ demographic characteristics, medications prescribed, clinical lab results, visual analogue scale (VAS) pain scores and length of hospital stay were documented. Orthopaedic surgeries, namely arthroscopy, reconstructive, and fracture fixation, were included. Stratified random sampling was used to select patients. Data were collected through patients’ medical records. The DDD per 100 admissions and the indicator UD/UR were calculated with the World Health Organization’s DDD as a benchmark. The inclusion criteria were patients undergoing orthopaedic surgery prescribed with coxibs (celecoxib capsules, etoricoxib tablets, parecoxib injections) and tNSAIDs (dexketoprofen injections, diclofenac sodium tablets). Data were analysed descriptively. This research was approved by the academic institution and the hospital research ethics committee. Result: A total of 195 records of patients who received NSAIDs were randomly selected among 1169 cases. In term of the types of orthopaedic surgery, the ratio of included records for arthroscopy:fracture fixation:reconstructive surgery was 55.4:35.9:8.7. Most of the inpatients had low rates of common comorbidities such as cardiovascular disease as supported by their baseline parameters. The majority were not prescribed with other concomitant prescriptions that could cause drug interaction (74.9%), or gastroprotective agents (77.4%). Overall, DDDs per 100 admissions for all NSAIDs were less than 100, except for parecoxib injections (389.23). The UD/UR for all NSAIDs were less than 100, except for etoricoxib tablets (105.75) and parecoxib injections (108.00). Discussion: As per guidelines, the majority (96.9%) received other analgesics to ensure a multimodal approach was carried out to control pain. From the UD/UR results, the arthroscopy surgery was probably the most appropriate in terms of NSAID utilization. Conclusion: The prescribing pattern of NSAIDs except parecoxib was appropriate based on adverse effect and concurrent medication profile. The findings of this DUR provide insight for a low-risk patient population at a private specialized teaching hospital on the recommended use of NSAIDs for postoperative orthopaedic pain control.