A case of non-fatal strangulation of the neck by rigging lines of a parachute during military training is presented. It is an unusual but potentially life-threatening injury. Probable factors leading to such injury are discussed.
The pelvic findings of 202 infertile women undergoing diagnostic laparoscopy in Kuala Lumpur, Malaysia were compared to that of 464 infertile women undergoing diagnostic laparoscopy in Aberdeen, United Kingdom. Endometriosis was significantly more common in the women from Kuala Lumpur (51% against 22%, p less than 0.001). There was however no significant difference seen in the severity of the disease (AFS Classification, 1985). These findings confirm our clinical impression that endometriosis is more common in Asian women when compared to Caucasian women.
An opportunity arose in 1985 to become involved in a transition of working practice from hard copy to VDT. Over a two-year period, 161 VDT users and 65 control subjects in the same office environment were regularly and routinely examined for symptoms of asthenopia. The analysis of data shows that there are no significant differences in type, number and frequency of the work-related symptoms between VDT users and non-VDT users. It appears that reporting of symptoms within the group may be random, although certain symptoms do appear more frequently than others. Additionally, it appears that there is a significant difference between male and female users in the frequency of symptom reporting.
Women in an urban, Malay population reported menstrual period lengths that tended to coincide with the lengths of the calendar months in which the periods began. This pattern may be related to the calendar-month pay periods for the population.
Chronic lymphocytic leukaemia (CLL) is rare locally. Seven CLL patients which constituted 0.9% of the total 747 cases of leukaemic patients were diagnosed over a 5 year period. They had similar haematological profiles as Western patients though most of them had advanced disease at presentation. Treatment of CLL patients was palliative and should be reserved for symptomatic patients and/or patients with progressive disease.
2 cases of idiopathic paroxysmal choreoathetosis with late onset and non familial were described. Examinations and investigations were normal and both responded to phenobarbitone.
Three patients presenting with distinct clinical variants of porokeratosis are reported. This article discusses the etiology, classification and response to different modalities of treatment.
Central nervous system involvement in melioidosis is rare. We describe a 48 year old woman who developed septicaemia and a brain abscess due to Pseudomonas pseudomallei. Since there is a continuing practical problem in bacteriological confirmation of the aetiological agent, diagnosis of melioidosis has to be made on clinical suspicion.
A successful excision of a giant cerebral mycotic anuerysm in a young girl with endocarditis is presented. The clinical pictures can be confused with a cerebral abscess. C.T. Scan and angiography are essential in the diagnosis. Rupture of the aneurysm is associated with high mortality and morbidity which can be averted by prompt neurosurgical treatment.
The early Malaysian experience of laparoscopic sterilisation with the Fallope tubal rings, as undertaken at the Obstetrical and Gynaecological Unit of the University Hospital, University of Malaya in Kuala Lumpur, Malaysia is reported in a study of 291 consecutive females that had had the procedure undertaken during the one year period, May 1975 to April 1976. Of the 291 cases, 247 women were sterilised in the "interval" period, 43 after "menstrual regulation" procedure and one after a spontaneous abortion. General anaesthesia was used in all except one case. The salient socio-demographic, contraceptive and reproductive characteristics of study cases are presented and discussed. The technical problems, the early complications and morbidity encountered in this study are presented and discussed in the light of other similar studies, and in relation to sterilisation by laparoscopic tubal electrocoagulation. The overall impression is that laparoscopic sterilisation with the Fallope tubal rings is preferred to that by tubal electrocoagulation, in view of the possible inadvertent serious electrical burns of other structures during the use of the latter procedure.
Two cases of late second trimester extrauterine pregnancy are presented--intraabdominal pregnancy in one and an ampullary pregnancy in another. In the former the diagnosis was made only after attempts at induction of labour for fetal death with prostaglandins failed and in the latter only at laparotomy. The diagnostic and surgical problems encountered are discussed.
Myelodysplastic syndromes appear to be a rare group of blood disorders in Malaysia. It usually affects the elderly and some of the cases were reported to evolve into acute leukemia. We describe our experience with five cases, seen and managed by us over a 5-year period. All patients receiving supportive therapy died with one of them definitely known to transform to acute leukemia. The patient who survives till the time of writing received low dose continuous cytosine arabinoside infusion.
A 35 year old Chinese female with classical presentation of paroxysmal nocturnal haemoglobinuria is reported. The various aspects of these conditions are discussed.
To our knowledge, sickle cell anaemia in pregnancy has not been reported in Malaysia. We describe here such a case with emphasis on modern methods of management.