The overall incidence of clinical pulmonary tuberculosis in the University of Malaya students was found to be 3.15 per cent. This higher incidence of clinical tuberculosis is in keeping with the general morbidity and mortality figures of tuberculosis in the general public. Among students who were originally enrolled as inactive cases 26.5 per cent developed activity while in university and required treatment. No significant difference was found in the incidence and rate of reactivation of disease in students of various races. No student was obliged to quit studies permanently on account of the breakdown
A survey of 227 patients from 5-60 years of age revealed the presence of positive histoplasmin skin tests in 10.5 per cent. and positive complement-fixation tests in 19-8 per cent. Sputum from 13 of the 37 patients who had a positive complement-fixation test were cultured for H. capsulatum but with negative results. Exposure to infection by the fungus is equally distributed among the different race and age groups. A careful and constant watch should be kept for histoplasmosis in all chest hospitals as a certain number of cases may be present. It tends to elude diagnosis unless specially sought as it resembles the clinical picture of tuberculosis or other granulomatous disease. It presents a field for further investigation and research in Malaya.
Two patients with gout associated with the presence of an abnormal hemoglobin, Hb E, and hypersplenism are presented. Very large sclerotic-rimmed cystic erosions in the sacroiliac joints of both patients are unusual but characteristic of the skeletal lesions of gout. The hyperuricemia may be the result of the disordered nucleic acid metabolism associated with hemoglobin abnormality. The development of hypersplenism very likely accelerated this process and resulted in the clinical and radiographic manifestations of severe gout.
INDEX TERMS: Blood, diseases • Blood, proteins • globin and Hemoglobin Compounds • Sacroiliac Joint trophy
Study site: Hospital Gombak, Selangor, Malaysia