We report a patient with unusual manifestations of hyperthyroidism which initially suggested lymphoma. The pathophysiology of these features in thyrotoxicosis is discussed. The need to consider thyrotoxicosis in an otherwise unexplained case of lymphoid hyperplasia will be stressed.
Thirty-eight patients with acute stridor were admitted to the Paediatric Unit of the Alor Setar General Hospital over a three-year period (1984 - 1986). The causes are discussed and retropharyngeal abscess is highlighted as it is often initially overlooked. The clinical presentation and the problems in the diagnosis of the latter are discussedwith reference to the three cases seen.
Key words: Acute stridor in childhood, retropharyngeal abscess
Foreign bodies in the laryngotracheobronchial tree are not uncommon. Their clinical presentations, the radiological and endoscopic findings in sixteen cases that presented to the Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia were reviewed. The technique of removal is also discussed.
Study site: Hospital Kuala Lumpur, Malaysia (UKM unit)
Dexamethasone has recently been shown to block the production of cachectin (implicated in the pathogenesis of cerebral malaria) if administered prior to endotoxin induction of mouse macrophages. Using the hamster cheek pouch-cerebral malaria model, we tested the hypothesis that dexamethasone is effective as a therapeutic agent in severe malaria if given before some yet undefined trigger point in the disease. Infected hamsters were treated with dexamethasone (0.7 mg/kg) daily on days 7-12, 4-12, or 1-12 post-challenge. When treatment was started on day 1, whole body oxygen consumption (used as a measure of erythrocyte transport to sites of diffusion) on day 12 was greater than (P less than 0.05) that of infected control animals, though the degree of anemia was no different in treated and untreated groups. Furthermore, treatment produced a reduction in monocyte accumulation, capillary malfunction, and monocyte/red blood cell aggregate formation observable in the cheek pouch in vivo and a similar reduction in monocyte presence, capillary pathologic change, and multifocal hemorrhage in the brain on postmortem. These data suggest that mediator(s), whose production can be blocked by pretreatment with dexamethasone, are involved in the pathogenesis of disease leading to death of the Plasmodium berghei infected hamster.
A new and rapid malaria immunoperoxidase assay using the enzyme horseradish peroxidase in place of fluorescein isothiocyanate was developed to allow the serological measurement of antimalarial antibody by light microscopy. Acetone-fixed thin blood films prepared from cultured Plasmodium falciparum were used as the source of antigen. This malaria immunoperoxidase assay is as sensitive as, and occasionally more sensitive than, the indirect fluorescent antibody assay. It is easy to perform and the antigen used does not show cross-reactivity with sera from nonmalarial diseases.
If they lived in households without piped water or a toilet, Malaysian infants who did not breast-feed were five times more likely to die after 1 week of age than those who breast-fed, when other significant factors affecting infant mortality were taken into account. This is double the relative risk associated with not breast-feeding for infants born into households with toilets, whether or not they had piped water. Analogously, improvements in toilet sanitation appear to have reduced mortality twice as much among infants who did not breast-feed as among those who did. These findings, from a retrospective survey of infants born to a probability sample of 1,262 women in peninsular Malaysia, confirm the pernicious synergistic effect of poor sanitation and nonbreastfeeding that was postulated previously on theoretical grounds. Promoting and maintaining high initiation of breast-feeding is thus particularly important where poor sanitation is prevalent. Even more affluent areas should not be neglected, however, because socioeconomic improvement, including improved environmental sanitation, is often accompanied by decreased breast-feeding. Although the risk to each nonbreast-fed infant was less in those areas, infants there were less likely to breast-feed in Malaysia, and hence they made up a significant proportion of lives that could be saved by breast-feeding.
MeSH terms: Breast Feeding*; Female; Humans; Infant; Infant Mortality*; Infant, Newborn; Malaysia; Male; Milk, Human; Risk Factors; Sewage*; Social Class; Water Supply
The chromosomes of five gaur (Bos gaurus hubbacki) domestic cattle (B indicus cross B taurus) hybrids (three females, two males) were studied using the leucocyte culture method and centromeric (C) banding technique. All the hybrids had a diploid chromosome number of 2n = 58, made up of two submetacentric autosomes (different in size) and 54 acrocentric autosomes, most of which could be arranged in pairs in descending order of size. The sex (X) chromosomes in females were a pair of submetacentric chromosomes smaller than the submetacentric autosomes. The Y chromosome in males was a small submetacentric chromosome. The C banding patterns were useful in identifying the X and Y chromosomes and the inherited submetacentric autosomes from the gaur sire. Phenotypically, the hybrids resembled normal B indicus cross B taurus calves except for the presence of a distinct hump-like dorsal ridge containing the spinous processes of the third to 11th thoracic vertebrae, upright 'deer-like' ears and long lean legs. The potential of these hybrids as important genetic resources for meat production is stressed.
MeSH terms: Animals; Cattle/genetics*; Chromosome Banding; Female; Hybridization, Genetic*; Karyotyping; Male; Phenotype; Ruminants/genetics*; X Chromosome; Y Chromosome