A preterm baby was born to a multiparous mother by emergency caesarean section at 36 weeks of gestation. Apart from a depression on the right temporo-parietal region measuring 3 cm x 3 cm x 0.5 cm, no other abnormality was noted. A CT scan of the brain excluded the presence of intracranial haematoma and pressure effect on the brain. Spontaneous reduction of the fracture without any adverse neurological sequelae suggests that these fractures can be managed conservatively in some instances.
The effectiveness of an oil adjuvant vaccine (OAV) incorporating locally isolated strains of Pasteurella haemolytica type 7 and Pasteurella multocida types A and D was compared with that of Carovax (Wellcome Laboratories) in imported cross-bred lambs. The criterion of efficacy was the ability of the vaccines to reduce the extent of pneumonic lesions in vaccinated as against unvaccinated control lambs. The OAV produced at this Institute significantly reduced the lung lesions at P less than 0.05 level compared with its control group when challenged with P. haemolytica alone. However, the vaccine was unsatisfactory against P. multocida or combined P. multocida P. haemolytica challenge. Carovax did not produce any significant reduction in the lung lesions caused by P. haemolytica and/or P. multocida.
A Danish woman aged 28 years who had travelled in the Far East developed cerebral symptoms with headache and visual disturbances. Migraine was suspected. Subsequent CT scanning revealed multiple processes and metastases were suspected. As the patient had travelled in the Far East 1 1/2 years previously, she was examined for neurocysticercosis. This diagnosis was established and the patient was successfully treated with praziquantel. On account of increased travelling activity, the possibility of neurocysticercosis should be borne in mind when dealing with patients with cerebral symptoms and relevant travelling histories.
Calmodulin, an activator protein in most calcium-dependent processes, was isolated to apparent homogeneity from the femurs of 1-day old chicks using phenyl-Sepharose and high performance liquid chromatography. The purified calmodulin was found to produce a 6-fold increase in the activity of alkaline phosphatase isolated from the same source. A Ca2+ concentration of 10(-5) M was required for the activation. Purification of alkaline phosphatase involved acetone precipitation, DEAE-Sephacel and Sephadex G-200 column chromatography. The enzyme was purified to 540-fold and had a specific activity of 10.75 U/mg protein.
Methicillin-resistant Staphylococcus aureus has emerged as an important cause of nosocomial infections in recent years. During 1988 in the Department of Surgery of the University Hospital in Kuala Lumpur, Malaysia, 148 patients were shown to be infected or colonized with these organisms. The patients at risk were those who stay in hospital for greater than 14 days, those over 50 years of age, patients who underwent neurosurgery, cardiothoracic surgery, or were admitted with major burns. Of the 148 patients, 78 (52.7%) were clinically infected, the remaining 70 being colonized. A total of 28 patients died (18.9%) but only five (3.4%) as a direct result of this infection. The estimated annual cost of controlling the organism was found to be approximately MR$250,000. (50,000 pounds). This nosocomial infection therefore represents a serious problem, especially in developing countries where health funding and health facilities are limited.
This paper deals with two patients with typhoid fever in whom hepatic manifestations were the dominant and presenting features of the illness. The ability of typhoid hepatitis to simulate other common infectious diseases in this region is highlighted. It is recommended that typhoid hepatitis should be included in the differential diagnosis of patients presenting with fever and jaundice particularly in the tropics.
Undetected hypertension is an obstacle to effective blood pressure control in the community. A study was done to assess the justification of screening in the outpatient department. Only 13% of all visits to the outpatient department resulted in an attempt to detect hypertension. The common reasons leading to blood pressure measurement were headache and dizziness. Current practice of hypertension detection appeared inadequate and irrational. Nine per cent of all visits to the outpatient department were already accounted for by hypertensives. A screening survey found that 30% of all non-hypertensive patients attending outpatient department aged 30 years or more had blood pressure greater than or equal to 140/90 mmHg. The drop out rate among these newly diagnosed hypertensives was 100%. Existing resources are already inadequate and existing hypertension care has also been shown to be inadequate. Screening can only be expected to considerably increase hypertensive patient load without however any assurance that effective long term care can be delivered. Labelling people as hypertensives in this manner may be harmful. The question of screening cannot be considered individually, separate from the entire problem of hypertension control. Detection must be linked to treatment in a programme designed to promote compliance and capable of delivering adequate care before it can be justified.
An eighteen month old phenotypically and genotypically normal male child was admitted with a left inguinal hernia and a right undescended testis. At operation, he was found to have a uterus, bilateral fallopian tubes, and a vagina in the left hernial sac. Bilateral orchidopexies and excision of the persistent Mullerian duct structures were carried out. This rare case of persistent Mullerian duct syndrome is due to a defect in Mullerian regression, which is in turn controlled by the Mullerian inhibiting substance (MIS). Orchidopexy with excision of the persistent Mullerian duct structures is usually not possible without damage to the vas deferens which is closely adherent to the wall of the uterus. The alternative of leaving the persistent Mullerian duct structures alone and performing a staged or primary orchidopexy has been suggested.
MeSH terms: Humans; Infant; Male; Mullerian Ducts/abnormalities*; Mullerian Ducts/surgery; Disorders of Sex Development/etiology*; Disorders of Sex Development/surgery; Syndrome
A 32 year old male thyrotoxic presenting with gynaecomastia, galactorrhoea and later complicated with hypokalaemic periodic paralysis is presented. The gynaecomastia and galactorrhoea resolved with treatment. To the best of the author's knowledge this combination of association in one patient has not been reported previously.
The effects of functional appliance treatment have been reported in numerous studies in the literature with great variability in the findings. It is generally agreed that they can be used successfully to treat Class II malocclusions in growing and cooperative patients. However, there is a lack of consensus regarding the relative orthodontic and orthopedic correction obtained by functional appliances in Class II correction. Lateral cephalometric radiographs from a sample (n = 36) of patients who had undergone a phase of treatment with activator appliances were measured and analysed for changes using a modified version of the method described by Johnston (Hashim and Godfrey 1990). In this method, the treatment changes were broken down into: tooth movement relative to basal bone; and the translatory growth of the jaws, both with respect to the cranial base and to each other. The results show that the treatment effects were mainly dentoalveolar. There was a slight orthopedic effect on the maxilla, but no significant mandibular growth was observed, above that which can be expected from normal growth.
Five rare cases of nasopharyngeal carcinoma with optic nerve involvement are reported. Computerised Tomographic Scan (CT Scan) studies were performed in four of them. Evidence of intracranial spread of the tumour, from the roof of the fossa of Rosenmuller to the apex of the orbit through the cavernous sinus, was noted in three patients. In one of them there was extracranial extension of the tumour, to the orbit through the posterior ethmoid.
Increased primary plankton productivity was observed in a brackish water lagoon of Terengganu during the study period between January 1988 to December 1988. The lagoon is also the site for the fish cage culture activities of sea bass during the study period. An examination of water quality at the sampling stations during the study period indicated that both the organic and inorganic nutrients were high during the pre-monsoon period. The source of the nutrient in the lagoon was believed to be derived from the agro-based industrial effluents, fertilisers from paddy fields as well as untreated human and animal wastes. This coincided with the peak production of plankton in the surface waters of the brackish water lagoon. During this period both cultured and indigenous fish species were seen to suffer from oxygen asphyxiation (suffocation due to lack of oxygen). The primary productivity values ranged from 9 to 22 μg/L/h during the peak period while the microplankton species were composed of diatom, flagellates and dinoflagellates. Reduction in the primary productivity values were obtained with reduction in sallinity, specially during the peak monsoon months (November to March) corresponding to the Northeast monsoon period.
Marine biofouling causes problems to marine structure and obstructs condenser tubes in cooling systems which use sea water as the coolant. The main purpose of this study is to investigate the seasonal ecology of biofouling organisms such as the green mussel, Perna viridis, the dominant fouling species in the Eastern Johore Straits at the Senoko Power Station. The spawning time and its relationship with environmental conditions were studied. The physical, chemical and biological conditions of the sea at Senoko were monitored for a year. Settling slides were used to study the fouling succession in different monsoon seasons. The study showed that there were two main spawning peaks for the green mussel and that these peaks occurred during the intermonsoon months of November and April. These peaks were also correlated with the bimodal patterns for salinity, dissolved oxyen, bivalve veliger larval density and total plankton biomass of the Eastern Johore Strait water. Succession patterns were similar during the two monsoon seasons, however, the rate of fouling was probably greater during the southwest monsoon months. It is therefore advisable that the control or reduction of biofouling in Eastern Johore Strait should take into account the seasonal fluctuations and spawning of the fouling organisms.
Coastal waters in South Johore, Malaysia are polluted to various degrees. The major pollution sources are domestric wastes from human settlements, agro-based wastes from palm oil mills and rubber processing factories, industrial effluents from industrial estates and discharges from animal farms. These pollution problems have adversely affected resources such as fisheries, recreational potential as well as the general aesthetic quality of the coastal environment particularly the Inner Johore Strait. Hence proper management and control measures are urgently needed to protect and further enhance the water quality to ensure environmentally sustainable development. This study examines various management options to control the pollution in the Inner Johore Strait. The options involve partial opening as well as complete removal of the Causeway to improve the tidal flow for more effective dilution and dispersion of pollutants. Computer simulation models are used to assess the impacts of the proposed options.
In a case study involving preliminary investigations for the feasibility of a beach resort complex in the west coast of Sarawak, Malaysia, since the acceptable quality of recreational water quality had not been specified, existing international standards and practices were reviewed to arrive at acceptable microbiological and physicochemical parametric levels. Water samples were collected on a weekly basis in the proposed beach complex at Tanjong Batu Coastal Reserve and also along the nearby Sungei Batang Kemena and its estuary. It was ascertained that the swimming water quality was acceptable in terms of faecal Coliforms, temperature, pH and dissolved oxygen. However E. Coli counts did indicate a potential risk of 1.68% for gastrointestinal illness and the ubiquitous presence of faecal Streptococci pointed to recent pollution of human or animal origin. Besides, grease and oil contents exceeded the WHO Guideline values. It was hence recommended that an appropriate sanitation or pollution survey should be carried out in the adjacent coastal catchment area and the beach. Also routine water sampling should be undertaken. Such action will help to pinpoint sources of pollution and lead to antipollution measures, thus helping to upgrade swimming water quality and establish swimming water quality standards.
Georgetown of Penang, an old city, is noted for its narrow streets. The existing traffic dispersal system is utterly inadequate to cope with the ever increasing number of cars and motorcycles on the road. The principal objective of this study is to build prediction models of CO to be employed as one of the planning tools in the future design of Penang urban traffic dispersal system. This study involves the monitoring of kerbside CO levels at selected sites and the fitting of hourly-averaged CO data to linear regression models incorporating the residual effect of CO emission due to traffic in the earlier periods and also different categories of vehicles. The best overall regression model appears to be the one based upon the total traffic count of motorcycles. This can be accounted for by the fact that the traffic counts of motorcycles and cars are highly correlated in most cases and that the emissions of CO from motorcycles are more readily detected as they travel closer to the kerb. The inclusion of residual CO in the models significantly improves the correlation coefficient from about 0.4 to about 0.7.
MeSH terms: Automobiles; Benzamides; Cities; Motorcycles; Linear Models
Phenolic chemicals with their very low taste and odour thresholds, high persistence and toxicity, are of growing concern as water pollutants. The compounds are known to exist in raw water as well as in treated water. The level of phenolic priority pollutants in water within the catchment area of the Linggi River Treatment Plant in Negeri Sembilan, Malaysia, which includes the Linggi river basin, was monitored. The 4-aminoantipyrin colourimetric method was used to determine total phenols whereas capillary column gas chromatography was used to determine the individual compounds. The results show that at most sampling stations, particularly those within the Seremban municipality, the level of phenols was found to exceed the recommended Malaysian standard of 2.0 μg/L(-1) for raw water. This is seen as the direct impact of industrial and urbanization of the area and clearly indicates the unhealthy state of the Linggi river. The results also indicate the need to improve the water quality if the river is going to be used as a source of raw water.
MeSH terms: Chromatography, Gas; Cities; Colorimetry; Environmental Pollutants; Malaysia; Phenols; Taste; Urbanization; Water; Water Pollutants; Water Purification; Rivers; Water Quality