A teenage male was admitted to a hospital in the United Kingdom following the ingestion of strychnine. The typical spasms of strychnine poisoning were observed and he died during the fourth convulsion. The post mortem findings are presented, and strychnine poisoning is discussed.
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.
The twenty-fifth reported case of squamous odontogenic tumor is presented. The patient was a 39-year-old Chinese Malaysian male. The lesion was asymptomatic and did not recur after excision. It is important to distinguish this type of lesion from squamous odontogenic tumor-like proliferation. The rest of Malassez is thought to be responsible for the histogenesis of the lesion. Better understanding will only be achieved when more cases are reported and studied.
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.
A case is described of subdural spinal lipoma with posterior fossa extension and the world literature is reviewed. A high proportion of high cervical lipomas extend into the posterior cranial fossa. Many cases were probably missed in the pre-computed tomography era. Those cases with posterior fossa growth are more likely to be found in infants or those cases with symptoms dating from birth; most present with quadriparesis. All cases of high cervical lipoma demonstrated by myelography should be submitted to brain computed tomography in order to exclude posterior fossa extension and demonstrate the presence of hydrocephalus.
A child with massive hepatosplenomegaly was diagnosed on bone marrow biopsy to have Gaucher's disease. The clinical progress in this form of Gaucher's disease is highlighted and the clinical diagnosis correlated with published criteria.
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.
Adults who present with sleep walking as a primary complaint is unusual. Two such cases are presented and their association with night terrors and sleep talking discussed. Psychosocial stresses exacerbate sleep walking and acts of violence during the episode can be potentially lethal.
A case of fictitious illness in a young Malaysian Indian male is reported and its relation to the more usual presentation of factitious disorders is discussed. Pathogenesis of this condition and its management are also suggested. Factitious disorders present not uncommonly in this country and it is important for the general duty medical officer and primary care physician to be familiar with this condition.
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.