Prevalence and severity of Bertolottis syndrome in Malaysia: A common under diagnosis.

Introduction: Bertolotti's syndrome (BS) is defined as the presence of low back pain (LBP), radiculopathy or both with a dysplastic transverse process (TP) of the fifth lumbar vertebra that is articulated or fused with the sacral base or iliac crest. This study aimed to investigate the prevalence and severity of BS to promote awareness of this disease. Method: A retrospective review of anteroposterior lumbosacral plain radiographs was conducted between 1 January and 31 December 2017. Patients were recruited via systematic randomised sampling and were then interviewed and examined. The severity of BS was measured objectively using the numerical pain rating scale (NPRS) and Oswestry disability questionnaire (ODQ). Data were analysed using IBM SPSS for Windows version 22. Results: The prevalence of BS was 9.6% (16/166). Age significantly affected the severity of BS. The older and younger groups had a mean ODQ score of 42.86% and 24.08%, respectively (P=0.006). There was no significant relationship found between the prevalence of BS and age (P=0.126). Only one patient was diagnosed with BS during medical consultation. The mean NPRS score was 5.5. The majority of the BS cases were of moderate severity (43.8%), followed by those of minimal severity (31.2%) and severe disability (25%). Conclusion: Early diagnosis of BS and orthopaedic referral are crucial to halt its progression. BS should be considered in patients presenting with LBP during assessments of lumbosacral radiographs.

Nanomaterials-Upconverted Hydroxyapatite for Bone Tissue Engineering and a Platform for Drug Delivery.

Hydroxyapatite is a basic mineral that is very important to the human body framework. Recently, synthetic hydroxyapatite (SHA) and its nanocomposites (HANs) are the subject of intense research for bone tissue engineering and drug loading system applications, due to their unique, tailor-made characteristics, as well as their similarities with the bone mineral component in the human body. Although hydroxyapatite has good biocompatibility and osteoconductive characteristics, the poor mechanical strength restricts its use in non-load-bearing applications. Consequently, a rapid increase in reinforcing of other nanomaterials into hydroxyapatite for the formation of HANs could improve the mechanical properties. Most of the research reported on the success of other nanomaterials such as metals, ceramics and natural/synthetic polymers as additions into hydroxyapatite is reviewed. In addition, this review also focuses on the addition of various substances into hydroxyapatite for the formation of various HANs and at the same time to try to minimize the limitations so that various bone tissue engineering and drug loading system applications can be exploited.