Transurethral Resection of the Prostate (TURP) is now the preferred method for dealing with the obstructing prostate. This procedure was reintroduced to the Penang General Hospital in August 1985. Over the next one and a half years, 100 TURP were performed by the author (NYTL). This paper reviews this initial experience. Of the patients, 17.7% required blood transfusion of one unit each. The mean post operative stay was 4.8 days. There were no immediate deaths. This experience confirms the acceptable results of TURP in the treatment of patients with benign prostatic hypertrophy in the Malaysian context.
Carcinoma of the biliary tract is a rare complication of choledochal cysts. Furthermore, the greater predisposition of the cyst wall to neoplastic change has been cited as additional justification for cyst excision rather than on-site internal drainage as the primary choice of operation. The report concerns a patient who developed cholangiocarcinoma despite excision of a choledochal cyst and presented with symptoms of biliary obstruction within one year of the operation. Although this is a rare complication, the need for careful long-term follow-up is supported by this observation.
Summary: Home oxygen therapy programme is new in Malaysia. This programme enables children with respiratory insufficiency to be discharged home early.
Materials and Methods: Long term oxygen therapy was initiated using an oxygen concentrator in patients who i) remained hypoxic while breathing room air, ii) experienced desaturations of more than 20% during sleep as seen in patients with severe laryngomalacia and obstructive sleep apnoea syndrome and iii) had pulmonary hypertension with or without polycythemia. The median with first and third quartile values are presented for the quantitative variables.
Results: A total of 71 patients mainly children with bronchopulmonary dysplasia (BPD) (32) and bronchiolitis obliterans (12) were discharged home on this programme. The median age at which home oxygen was initiated in children with BPD was 5.0 (Q1:2 Q3:8) months. The median total duration of oxygen requirement for BPD was 8.0 (Q1:5, Q3:12) months. The median duration of home oxygen dependency was 3.5 (Q1:3, Q3:6) months. However children with bronchiolitis obliterans required longer duration of oxygen therapy compared to children with BPD i.e. median duration of 28 months (Q1:14.5 Q3:66). In other respiratory conditions the mean duration of supplemental oxygen varies some of which may be life long.
Conclusions: This paper has shown the importance of home oxygen program in children with respiratory disorders. It has significantly shortened hospital stay and thus saves hospital costs and prevents prolonged separation from the family.
A survey of Caseous Lymphadenitis (CLA), a bacterial infection in sheep and goats was conducted on small ruminant farms in two districts in Perak, namely Kinta and Hilir Perak. The objective of this survey is to determine the status of CLA infection in small ruminants. A total of 8 farms were screened, involving a total of 579 animals. Agar Gel Precipitation Test (AGPT) and Enzyme Linked Immuno Absorbent Assay (ELISA) were conducted on serum samples obtained from the animals. Results show that 8.5% of the animals had a positive reaction for AGPT test. It was found that 36 samples (17%) were found positive using both AGPT and ELISA methods, 9 samples (4%) were found positive only using AGPT method, 14 samples (6%)were found positive only using ELISA and 157 samples (73%) were found negative using both methods. Since there is no available data on the prevalence of the disease in the country, further epidemiological studies as well as reliable diagnostic detection methods need to be assessed for aiding in control and eradication programmes for this disease.