Fractured penis has traumatic consequenoes on the patient as both his manhood and procreation ability are threatened. 2 cases of fractured penis successfully treated at the Armed Forces Hospital, Terendak, Melaka by a combination of surgical intervention and splintage are reported and the management discussed.
This is a report of 13 cases of meningiomas treated in the Neurosurgical Unit, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur, over a period of nine months from September 1982.
Four cases of puffer fish poisoning with one death in a family are described. Acute respiratory cessation probably resulted from both depression of the medullary centres and muscular paralysis by the neurotoxin. Artificial ventilation is the single most effective therapeutic measure and should be considered in all severe cases. Delay in treatment may result in death. Anticholinesterases are not known to confer any benefit. Medical staff in coastal hospitals should familiarise themselves with the management of puffer fish poisoning.
This is a report of clinical features of migraine in Malaysians. Seventeen migraineurs were studied with respect to age, sex, length of disease, headache, aura, nausea, frequency, remission, precipitating factors, relieving factors, family history, coexisting symptoms, coexisting disease, and type of migraine. Similarities and differences between Malaysian and Caucasian migraineurs are discussed.
One hundred and fifty two patients were treated for acute renal failure in 1976-1978. Overall mortality was 46 (30.3 percent) and was highest among the surgical patients 15 (51.7 percent) and lowest in patients with outflow tract obstruction 2 (8.7 percent) uncontrolled sepsis was the commonest cause of death.
Hailey-Hailey disease or Chronic Benign Familial Pemphigus is probably rare in this region and to date there is no case report from Malaysia. I report here a Malay patient with this disease but with no family history and who was believed to be suffering from Atopic Eczema for several years. Dapsone effectively controlled the disease in this patient. The clinical features, histology and the therapy are discussed.
This is a study of 148 women seeking induced abortion by doctors. The typical woman in this study was married, with 2 or more children, Chinese, urban, 21-30 years and had completed primary education. She was motivated to defer pregnancy and to a lesser extent to limit family size by resorting to induced abortion.
Thyrotoxic psychosis is an uncommon phenomenon and the presentation is usually of the affective disorders. Three cases manifesting psychotic symptoms akin to schizophrenia are described. The neurobiocheinistry and treatment are discussed.
A prospective study of acute renal failure (ARF) over a three month period showed that 60 out of 22,033 inpatients developed AR"F (Serum creatinine exceeding 0.200 mmol/L). The ARF was oliguric in 22% and nonoliguric in 78%. Poor cardiac output or diminished intravascular volume, nephrotoxins and infections were the main aetiological factors associated with ARF in 85% of cases. Mean peak serum creatinine and blood urea values were higher in the oliguric than the non oliguric group. The oliguric group required dialysis more frequently (53.8% vs 4.3%) and had a higher mortality (53.8% vs 8.5%) than the non oliguric group. Nonoliguric ARF occurs more commonly and has a better prognosis than oliguric ARF. Acute renal failure is a serious condition with significant mortality and remains a frequent occurrence in the setting of large general hospitals. A Previous reports on acute renal failure in Kuala Lumpur comprised patients treated at the Department of Nephrology at the General Hospital Kuala Lumpur, but did not include patients with acute renal failure treated at other departments in the hospital. This report is based on a prospective study of acute renal failure occurring in the General Hospital Kuala Lumpur over a three-month period to evaluate the clinical spectrum of this disease, and its outcome.
Eight longhouses were selected randomly for a goitre survey in the Entabai area of the Sixth Division, Sarawak. 645 subjects were examined and a goitre prevalence of 46.4% (15 years and above) was found. The females had a higher rate of 69.5% as compared with their male counterparts with 24.4%. Below the age of 15 years, prevalence was low and there was not much difference between the two sexes. After the age of 15 years, the prevalence among the females
increased from 40% to almost 80% by the age of 25 years. The males, on the other hand, showed a decrease in prevalence after the age of 15 years and levelled off at about 30%. The females also had much larger goitres than males. About 43% of the households surveyed consumed iodised salt but the rates tend to fluctuate according to supplies. There was however no direct correlation between goitre prevalence and consumption of iodised salt.
The characteristics of 74 patients who attempted suicide in Penang are described. Differences in the incidence and reasons for and methods of attempting were observed among the ethnic groups. There was a higher incidence in females and patients of single status. The majority of patients did not suffer from severe psychiatric disorders, but did encounter chronic inter-personal and intra-familial conflicts. Conflicts with elders were more frequent among female patients, and this finding suggested that young females were faced with a greater degree of role conflicts. Rural to urban shift among the Chinese patients was observed to be associated with a high incidence of attempts. Dwellers of high-rise flat complexes were not over-represented. In view of antecedent social factors, professionals and others besides psychiatrists have a role in the prevention and management of para-suicidal behaviours.
This paper reviews our first 100 consecutive PTCAs done between December 1988 and May 1990. There were 31 females and 69 males and their ages ranged from 37 years to 80 years. The mean age was 57.7 years. We achieved a follow-up rate of 66%. The restenosis rate was 22% of those that we could follow-up. There were 35 simple and 65 complex PTCAs. An average of 1.39 arteries were entered per PTCA. Of the 100 PTCAs done there was a primary success rate of 83%. On closer examination most of the failures were in the total occlusion group. There were 30 total occlusions done and 17 were successfully dilated. The primary success rate for acute total occlusions was 77% and the primary success rate for chronic total occlusions was 41%. Of the 100 PTCAs there were two deaths and only one patient had to go for emergency bypass surgery. The other complications were relatively minor including hypotension, groin bleeding, chills and rigors. This paper documents our initial 100 cases of PTCAs. It shows that our figures are compatible with other centres in this region and those around the world.
Leiomyoma of the caecum is a rare tumour. While leiomyomata are known to arise from any part of the large bowel, caecum is a rare site. The largest series to date is that of Mackenzie" who reviewed 37 cases of myomatous tumours of the colon, two of which were complicated by perforation. More recently, Swerdlow" reported another case of a perforated caecal leiomyoma. We now report a patient who was operated at the stage of abscess formation without perforation.