Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.
Newcastle disease virus (NDV) is one of the most economically important avian virus which affects the poultry industry worldwide. Although NDV is being very actively studied in Malaysia, there are still no studies on its potential as an anticancer agent, a new approach to treating cancer known as virotherapy. Currently, a collaborative research is being undertaken between Universiti Putra Malaysia (UPM), Universiti Sains Malaysia (USM) and Majlis Kanser Nasional (MAKNA) in characterising various local NDV isolates as anticancer agent. This paper describes an overview of the research that have been carried out worldwide in the use of NDV for cancer treatment and also some of our findings in characterising local NDVs with oncolytic properties.
The purpose of this study was to investigate the relationship between heterophoria and refractive error. Thirty-six subjects (11 myopes, 25 emmetropes) participated in this study. Heterophoria was measured with the Free-Space Phoria Card at five different viewing distances (25cm, 33cm, 50cm, 100cm and 300cm). Regardless of the types of heterophoria, the amount of heterophoria reduced towards orthophoric position with increasing viewing distance. Emmetropes and myopes did not show any significant difference in the degree of heterophoria at different viewing distances (F = 0.30, p>0.05) or in the type of heterophoria (c2 = 2, p>0.05).Thirty-six optometry students, aged from 19 to 24 years, participated in this study. All subjects had complete optometric examination within the last two years and did not show any clinical signs of accommodative, fusion, stereopsis or strabismic problems. Written consents were obtained prior to examination. Eleven (8 females, 3 males) of them were myopes (spherical range: -0.25DS to – 10.00DS; cylindrical range: -0.25DC to –0.75DC). Twenty-five (14 females, 11 males) of them were emmetropes (Refraction range: plano - +1.00DS). The majority (10 out of 11) of our myopic subjects. In general, exophores (69%) were most common in this study. Regardless of the type of heterophoria, the amount of heterophoria decreased towards orthophoric position with increasing viewing distances. Our finding are also consistent with the report of fixation disparity at different viewing distance (24).viewing distance. We too report an exo-shift of the heterophoria with decreasing viewing distance 97% of our subjects. One subject however showed an eso-shift for closer distance.
In this study, we examined the effects of acute ingestion of a herbal drink (H) or a coloured water placebo (P) on physiological responses and performance during cycling exercise. Eight healthy and trained male young cyclists (age: 16.0±0.5years) exercised on a cycle ergometer at 72.0±0.8% of the maximal oxygen consumption (VO2max) until exhaustion in a room maintained at 23.9±0.2 oC and 64.2±1.6% relative humidity on two occasions, 1-week apart. During each exercise bout, subjects received 3ml.kg-1 body weight of H or P every 20 minutes in a doubleblind randomised study design. There was no significant difference between H and P trials in the total work time to exhaustion (84.5±5.1 and 82.3±5.6 min respectively). Changes in heart rate, oxygen consumption, plasma glucose concentrations, plasma lactate concentrations, rectal temperature, respiratory exchange ratio and energy expenditure were similar with both type of drinks. Loss of plasma volume was also similar with both drinks. Herbal drink elicited similar physiological responses, thermoregularity responses and exercise performances during endurance cycling when compared to the placebo ingestion. Thus, it can be concluded that the ingredient in the herbal drink did not provide any added advantage to cycling endurance performance. In both the herbal (H) drink and placebo (P) trials, time taken for exhaustion to occur were similar, and they were 84.5 ± 5.1 min and 82.3 ± 5.6 min respectively (p>0.05). The total volume of fluid consumed during exercise was also similar in both drinks, 751.0± 49.6 ml and 727.6 ± 42.7 ml in the H and P trials respectively. As a result of exercise, subjects’ body weight decreased 0.7 ± 0.2 kg (2.6 ± 0.5%) and 0.8 ± 0.2 kg (2.8 ± 0.5%) in the H and P trials respectively, and these values were corrected for the fluid ingested during cycling. The decrease in body weight as expressed both in kg and percentage change of body weight with P did not differ statistically from H. Similar hemoglobin concentrations and hematocrit were noted at each time point during the H trial when compared with P trial. The percentage change of plasma volume relative to the preexercise level is shown in Figure 1. Plasma volume declined significantly (p
MeSH terms: Blood Glucose; Body Temperature; Body Weight; Energy Metabolism; Heart Rate; Hematocrit; Hemoglobins; Humidity; Male; Oxygen Consumption; Plasma Volume; Temperature; Water; Exercise; Lactic Acid
The pharmacodynamics of propranolol were studied in 12 cirrhotic Malay patients. Fifteen healthy Malay volunteers were selected and several clinical parameters were obtained. The effects of three doses of propranolol in reducing the heart rate (HR) of these patients were observed to be significantly different. These differences were seen at dosing of 10 mg vs 20 mg and 10 mg vs 30 mg (P
Prostate cancer is not common in south-east asia and in particular there are only scarce reports on the characteristics of Malaysian men with prostate cancer. A retrospective study where all prostate specimens sent to the pathology department during the period 1st January 1996 to 30th June 1998 were reviewed. A total of 131 prostate specimens were reviewed and these consisted of prostatectomy specimens, transurethral resection specimens and trucut biopsy specimens. Only 114 patients’ case notes were evaluated. Data reviewed were age, race, presenting symptoms, clinical findings and prostate-specific antigen (PSA) level. Overall incidence of carcinoma of the prostate was 19.0%. The incidence of carcinoma of the prostate with serum prostate-specific antigen (PSA) of 4.1 to 20.0 ng/ml was only 10% and 60.5% of patients had evidence of subclinical histological prostatitis. The mean age of men with carcinoma of the prostate was 71.3 years and there was no differences in the incidence of carcinoma of the prostate among the 3 major ethnic groups (Malays, Chinese and Indian). About three-quarter of the patients with carcinoma of the prostate presented with lower urinary tract symptoms, a third had haematuria and about a tenth of patients presented with urinary retention. The majority of patients presented with metastatic disease (66.7%) with a mean PSA of 1476.8 ng/ml. A significant proportion of men with prostatic diseases attending the University of Malaya Medical Center had prostate cancer (19.0%). A small proportion of men with serum PSA in the range of 4.1 to 20.0 ng/ml had prostate cancer and this is thought to be due to the background histological prostatitis. The majority of patients presented late.
The truth often hurts, but only by knowing the truth can proper solutions be found. It has long been recognised that adequate epidemiological data is crucial for the planning and development of cancer programmes. In the First Report of the National Cancer Registry, 26,089 cases were registered among the population in Peninsular Malaysia. Taking into account the estimated 10,656 unregistered cases and the 3750 cases registered in Sabah and Sarawak, the total number of new cancer patients in Malaysia in 2002 would be approximately 40 500. This means that the cumulative lifetime risk of getting cancer was 1 in 4 in Malaysia, a fact which hit the headlines in many of the daily newspapers of the country. Cancer is indeed a serious national health problem. Correlating these registry findings with existing findings from studies on lifestyles, presentation of disease, diagnostic tests, interventions in cancer prevention, treatment, palliation and rehabilitation will be the way to go in defining and refining the strategy against cancer in this country.
MeSH terms: Delivery of Health Care; Diagnostic Tests, Routine; Humans; Life Style; Malaysia; Medicine; Neoplasms; Palliative Care; Registries
A cross-sectional study to determine the prevalence of Human Immunodeficiency Virus (HIV) and HIV associated risk behavior was conducted in February 1998 among 6,324 drug users in 26 drug rehabilitation centres in Malaysia. The majority of respondents were males (97.3%) and Malays (77.8%), administered drugs intravenously (64.6%) and of these 65.4% shared needles. About 78.1% had sexual exposure, of which 55.1% had sex with girl friends, 31.3% with prostitutes and 4.6% with male partners. The HIV prevalence rate in the group was 12.1% and significantly high among injecting drug users (IDU); those sharing needles; those who started addiction at a young age (10-15 years); those who had sexual exposures and had sex with prostitutes.
MeSH terms: Cross-Sectional Studies; Female; Humans; Malaysia; Male; Needles; Surveys and Questionnaires; Risk-Taking; Sexual Partners; HIV Infections; Prevalence; Substance Abuse Treatment Centers; Needle Sharing; Friends; Drug Users; Sex Workers
The profile of admissions staying less than 24 hours admitted to the paediatric wards of University Malaya Medical Center, Kuala Lumpur, over a period of six weeks was reviewed to ascertain the need of a short-stay ward. Ninety-three (22%) of the 428 admissions admitted during the study period were discharged within 24 hours, 56 (60%) were discharged within 12 hours. Major categories of admissions were: elective investigative procedures (43%), and emergency admissions (44%). Reasons for emergency admissions: infections 42%, minor trauma/cerebral concussion 25% and febrile/afebrile seizures 11%. Only 20% required percutaneous oximetry monitoring and 2% required observations more frequently than 2 hourly. There may be a case for a short stay ward in a big paediatric unit in Malaysia.
Identification of pregnancies that are at greater than average risk is a fundamental component of antenatal care. The objective of this study was to assess the level of appropriate management and outcomes among mothers with hypertensive disorders of pregnancy, postdates and anemia in pregnancy, and to determine whether the colour coding system had any effect on the maternal mortality ratios. A retrospective follow-through study confined to users of government health services in Peninsular Malaysia was carried out in 1997. The study areas were stratified according to their high or low maternal mortality ratios. The study randomly sampled 1112 mothers out of 8388 mothers with the three common obstetric problems in the selected study districts. The study showed that the prevalence of anemia, hypertensive disorders in pregnancy and postmaturity among mothers with these conditions were according to known international standards. There was no significant difference in the colour coding practices between the high and low maternal mortality areas. Inappropriate referrals were surprisingly lower in the areas with high maternal mortality. Inappropriate care by diagnosis and by assigned colour code were significantly higher in the areas with high maternal mortality. The assigned colour code was accurate in only 56.1% of cases in the low maternal mortality areas and in 55.8% of the cases in the high maternal mortality areas and these two areas did not differ significantly in their accurate assignment of the colour codes. The colour coding system, as it exists now should be reviewed. Instead, a substantially revised system that takes cognisance of evidence in the scientific literature should be used to devise a more effective system that can be used by health care personnel involved in antenatal care to ensure appropriate level of care and referrals.
Although only 6.3% of the 221 respondents in this crass-sectional study stated outright that the hospital food served to them was not good, a high proportion of respondents ( 62.0%) supplemented ltaspimlfoad with outside food. When the reasons for supplementation were considered, it is likely that 53.8% ( $5.5%; 95% CI ) of the patients in this study were dissatisfied with hospimlfoudfar some reasons or when particularly with regards t0 variety, attractiveness and sewing lime. The pl‘0]701’l‘i011 of respondents wha were dissatisfied with hospital faud was significantly higher (p
Corporate culture can simply be defined as “The way we do things around here". It comprise of assumptions, values, norms and tangible signs. Ministry of Health has started its culture building in 1991. Prior to this study, there have been two studies to evaluate its implementation. There were two types of respondents, where administered questionnaires were sent to all head of departments and all U3 medical ojjicers in public services in Malaysia, About 50% (n=126) of head of departments and only 18% (n=1321) of medical ojjicers responded. The study shows that at least 83% of head of departments perceived that the three core value of corporate culture has been implemented in their departments. However for rites and rituals, less than habf of them have implemented it. Singing of corporate song is done more in hospital as compared to health. As for medical officer, only 28% of them have received training on corporate culture. Among those who have received training, only a quarter understood the meaning of corporate culture. Doctors were also asked to give opinion on how to generate a caring doctor. About one-third suggested to reduce the workload of doctors. Apart from increasing manpower, workload can also be reduced by reengineering the system and upgrading the doctors’ competency.
Aspek pantang larang dalam pemakanan dan perkhidmatan bomoh merupakan entiti unik dalam budaya masyarakat Orang Asli. Satu kajian irisan lintang di kalangan masyara/cat Orang Asli pinggiran (di Pos Betau) dan pedalaman (Pos Sinderut) Kuala Lipis telah dijalankan pada 25hb September hingga 6 Oktober 1999 bagi mengetahui pola pemakanan dan amalan pantang larang dalam aspek pemakanan yang mempengaruhi tahap pemakanan seseorang. Seramai 255 orang responden telah ditemuduga oleh kakitangan terlatih menggunakan borang soal selidik berpandu dimana 15 orang dari kawasan pinggiran dan 104 orang dari pedalaman. Hasil kajian menuruukkan Orang Asli pinggiran lebih kerap mengombil makanan dalam sehari (p
Influenza has always been wrongly perceived as a minor disease which is no dwerent than common cold. Influenza affecting all age groups cause a considerable morbidity and mortality although the data are not well established in Asia Pacwc. In the United States, it claims similar order of mortality as that due to car accidents. Inflluenza A and B can cause epidemic human disease. New Influenza virus variants develop frequently due to antigenic dry?. The rapid evolution of both influenza A and B virus is responsible for annual influenza epidemics in humans. Although in Malaysia, Influenza Surveillance began in 1954, the disease awareness is still low. It is
prudent to continue the surveillance throughout in order to monitor the seasonal trend, circulating strain as well to prepare us from an epidemic or pandemic. Institute for Medical Research, being the sole WHO National Reference lab in this country committed in improving the Influenza Surveillance which will involve all the states in Malaysia in the near future.
Accidental poisoning in children is a preventable condition. It is a problem mainly in children aged 1 to 4 years. This is a descriptive study of accidental poisoning in children below 12 years old admitted to Hospital Seremban from October 15, 1994 to October 14, 1995. A major cause of household accidental poisoning was kerosene ingestion (25%) followed by ingestion of medications (22%), liniment methyl salicylate (12 %), mothballs (12%) and hypochlorinate solution (9%). There was a higher incidence of poisoning in males (50.8%), among Indians (41.2%) and in children from lower social classes (67%). A greater proportion of the accident occurred when the child was taken care by the parents (53 %) and in the house (80%). Most of the poison was ingested from its original package (81%). The immediate action taken was sending the child to the hospital (75%) without carrying out other actions such as washing the child’s mouth. The delay of sending the child to hospital was due to husband not at home (57%). Most of the cases (72.1 %) were discharged well within 1-2 days following admission.
Health impact related to smoking is a critical public health predicament especially in pregnancy. However there is not much data available to describe the magnitude of the problem. Hence this study was conducted to determine the prevalence of smoking and its socioeconomic factors among antenatal mother and their opinion related to tobacco control measures. A cross sectional study was carried out involving newly registered antenatal mothers attending all government health clinics in Penang. Prevalence of ever smoking among antenatal mother is 1.4%, of which 42.4% is still smoking at first antenatal visit. It was found that single mothers are more likely to smoke (OR, 14.23: C12.52-53.27). It was also noted that spouse smoking (OR, 5,14: CI 1.95-17.09), primigravida (OR, 2.7: C1 1.3-5.62), age group less than 30 years old (OR, 2.41; CI 1.03-6.09) and living in urban area (OR, 2.33; CI 1.01 — 6.47) have a higher risk to indulge in smoking behaviour. Muslim OR 0.29; C1 0.14 - 0.60) and Malay (OR 0.22; CI 0.10 - 0.47) pregnant mothers are noted to be less likely to smoke as compared to non Muslim and non Malay. More than 85% of them agreed with the tobacco control measures regardless of their smoking status. Most of respondents agreed the influential people in community L;11T · such as medical personnel, teachers and parents should not smoke.
MeSH terms: Adult; Ambulatory Care Facilities; Cross-Sectional Studies; Humans; Malaysia; Malaysia/ethnology; Maternal-Child Health Centers; Mothers; Parents; Surveys and Questionnaires; Smoking; Socioeconomic Factors; Tobacco; Prevalence
The aim of this study is to describe the epidemiological features of HFMD outbreak in the Hulu Langat District in 2000. Until November 2000, a total of 60 cases were reported and the worst ever reported to the previous years. The mean age of patients was 3.9; 5.8 years with majority of the cases aged between 1 to 4 years old (53.8 per 100,000 of population), male gender (8.3 per 100,000 of populations), and were of Chinese (12.2 per 11 100,000 of populations) and Malay ethnicity (7.2 per 100.000 of populations). All cases were uncomplicated cases and were diagnosed clinically. Most of the notified cases were front the government facilities, which are 44 cases (73.3%). Thirty-five (35) cases (58.4%) were treated as outpatient and 25 cases (41.6%) as in patients (p>0,05). Only 7 cases (11.7%) have history of contact with HFMD patients. The notified cases were mainly from the densely populated areas which were Cheras, Kajang and Ampang. No differences were noted between HFMD cases which have been breasfed for less than 6 month or more, and twenty nine (29) cases (48.3 %) had completed the immunization schedule. In conclusion, the recent emergence of HFMD brings a new challenge, which have to be faced in the prevention and surveillance activities of public health problems in the district.
Study site: Notified cases from Klinik Kesihatan, hospital, private clinics, Ulu Langat, Selangor, Malaysia
MeSH terms: Ambulatory Care Facilities; Disease Outbreaks; Ethnic Groups; Hospitals; Humans; Immunization Schedule; Malaysia; Male; Outpatient Clinics, Hospital; Outpatients; Population Density; Public Health; Retrospective Studies; Private Facilities
A diarrhoea outbreak had occurred among neonates delivered in a private hospital in Kedah from 15 August to 8 September 2002 involving 27 (55.1%) cases out of a total of 49 deliveries. Thirteen of them (48.1%) were admitted to either government or private hospitals for treatnzent while fourteen of them (51.9%) were managed at home. The main presenting feature was frequent yellowish to greenish watery stool not associated with vomitting. Investigations include active case finding, environmental inspection, sampling of stool specimens, identifying causative agents and identuying human carriers. All the diarrhoea eases (100%) were noted to have received infant formula feeding while in the private hospital. Staphylococcus aureus was isolated hom the milk scoop which was used for milk preparation. Nasal swabs of four (50%) nursing personnel were also positive for Staphylococcus aureus. One of them was positive for methycilline resistant Staphylococcus aureus (MRSA). The milk and water samples showed no signuicant bacterial contamination. Stool samples of these cases were negative for Rotavirus, Vibrio sp., Salmonella sp., Shigella sp. and Entamoeba coli. This outbreak of diarrhoea was noted to have a strong association with infant formula feeding in the hospital. Breastfeeding should be continuously promoted. Baby friendly hospital initiatives in private hospital settings need to be initiated.
The main objective of the study was to determine the oral health status and possible factors influencing oral hygiene in the institutionalized elderly in Sabah. A cross sectional study in all four institutions for the elderly in QM ii Sabah was conducted using oral examination and interview/questionnaires. Qualitative assessment using Focus Group Discussion was carried out in the caregivers of the institutions. Plaque score was used to assess oral hygiene status. A total of 94.0% of inmates were above 55 years old. There were 13.4 % non-respondents in the total sample of 284. Of the n0n—respondents, 42.4 % had mental disorders and this was statistically signnicant. Of those who responded 34.6% had good 33.3% fair and 32.1% poor oral hygiene. 33.5% were completely edentulous, 86.4% had gingivitis which required scaling, 22.0% had decayed teeth and 54.9% required extraction. Gingivitis, decayed teeth and number of teeth for extraction were signwcantly associated with poor oral hygiene. 14.2% had at least one type of oral disease. Dental abscess was the most common muco»cutaneous lesion found. Mental disorders showed a trend towards poor oral hygiene and this was statistically signyicant. Although 40.8% had physical handicap, 23.3% visual impairment and 8.2% hearing impairment, there was no significant association with oral hygiene status. In conclusion, oral health status of the population is poor and treatment needs are high. Although there was high objective need for oral care (88.6%), perceived need was low (32.0%).
MeSH terms: Abscess; Aged; Mental Disorders; Cross-Sectional Studies; Dental Caries; Diagnosis, Oral; Gingivitis; Health Status; Humans; Malaysia; Oral Hygiene; Surveys and Questionnaires; Vision Disorders; Caregivers; Focus Groups; Hearing Loss
The hand, foot, and mouth disease (HFMD) outbreak occurred in the state of Johor, Malaysia in the months 0f October and November 2000 aber the HFMD outbreak started in Singapore in September 2000. The HFMD notification and investigation forms sent to the Epidemiology Unit of the Johor Health Department from district health offices and hospitals during the outbreak were analysed. Patients’ specimens were sent to the Institute for Medical Research, Kuala Lumpur and the Universiti Malaya Medical Centre, Kuala Lumpur for viral isolation. A total of 1,122 HFMD cases were notified during the outbreak period with 2 deaths giving 0.2% casefatality rate. From all the cases, 544 (48.5%) patients were admitted to the hospital while the rest were treated as outpatients. Majority (81.7%) of children with HFMD were aged below 5 years old with the commonest age group (46.9%) being between 1 to 2 years old. Sixty-eight patients had positive specimens for viral isolation belonging to enteroviruses namely Enterovirus 71 (43 cases), Coxsackievirus Type A16 (11), Echovirus 7 (3), and Coxsackievirus Type B (2); and non-enteroviruses namely Herpes Simplex Virus Type 1
(5), and Adenovirus (4). Fever and mouth ulcer were the two most common symptoms among HFMD children but vesicles on palms and soles were more common than rashes in children with positive enteroviral isolation.
Study site: University Malaya Medical Centre (UMMC)