A 32 year old HIV positive intravenous drug user (IVDU) with a promiscuous lifestyle in the past presented with altered behaviour and was diagnosed to have pulmonary tuberculosis, tuberculous meningitis and tuberculous osteomyelitis. After initial response to anti-tuberculous therapy, his symptoms recurred with the appearance of cerebral mass lesions. A presumptive diagnosis of toxoplasma encephalitis was made based on clinical, serological and radiological evidence. He showed clinical improGement with anti-toxoplasmic therapy.
MeSH terms: Acquired Immunodeficiency Syndrome; Case Reports; Diagnosis; Encephalitis; HIV; Life Style; Malaysia; Meningitis; Osteomyelitis; Radiology; Toxoplasma; Tuberculosis; HIV Infections; Drug Users
Medical therapy is effective in patients with mild to moderate symptoms of benign prostatic hyperplasia. Selective alpha-1 blockers (e.g. terazosin) and 5 alpha reductase inhibitors (e.g. finasteride) are the main drugs used. Alpha blockers reduce the dynamic component of obstruction while the later reduces the size of the prostate.
The aim of this study was first to analyse the prescribing habits of primary care doctors with a view to providing feedback which may help them to rationalise their prescribing. This analysis was helped by comparing the prescribing practices in two different settings and thus highlighting anomalous differences. The second aim of this study was to obtain data on the diagnoses being made in primary care settings in Malaysia as this information, though available from other countries, is limited here. Lists of the most commonly prescribed drugs and most common diagnoses made are provided, together with tables showing the most commonly prescribed drugs for the ten most common diagnoses. Differences in prescribing habits between the two settings are discussed and possible reasons are suggested.
MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Hospitals; Humans; Malaysia; Outpatients; Primary Health Care
Ischemic heart disease is a leading cause of morbidity and mortality in Malaysia. Management strategies for this disease have changed dramatically. This article, based on discussions of real cases, reviews current treatment methods for various patient subsets, with acute myocardial ischemia.
This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
MeSH terms: Ambulatory Care Facilities; Asthma; China/ethnology; Chronic Disease; Cross-Sectional Studies; Diabetes Mellitus; Hospitals, General; Humans; Hypertension; India/ethnology; Malaysia/ethnology; Morbidity; Outpatient Clinics, Hospital; Outpatients; Primary Health Care; Respiratory Tract Infections; Public Health Practice
Anaemia still constitutes a public health problem in the world, especially in the developing countries (1). Nutritional deficiency remains a major causative factor (2). During pregnancy, growth of the foetus, placenta and the larger amount of circulating blood in the expectant mother will lead to an increase in the demand for nutrients, especially iron and folic acid. Many women start their lives with insufficient iron stores, but also, because of inadequate child spacing, they have little time to build up their iron levels between pregnancies. In pregnancy, anaemia has been shown to be associated with an increased risk of maternal and fetal morbidity and mortality (3,4,5). Iron and folic acid supplementation is routinely given to pregnant mothers in Malaysia. It is anticipated that pregnant mothers who comply strictly with the prescribed iron supplement will maintain adequate iron stores at parturition. However, the compliance rate among rural mothers in Kelantan is often poor (6). Kelantan is also one of the most socio-economically underdeveloped
MeSH terms: Anemia; Folic Acid; Health Surveys; Humans; Iron; Malaysia; Mothers; Pregnancy; Rural Population; Women