Oral lorazepam is a commonly used premedicant both locally and abroad. We studied its effect on recovery time after minor gynaecological procedures. The results showed a significant prolongation of recovery time.
This paper presents a study of cycles with spontaneous luteinizing hormone (LH) surge in superovulatory Malay women during in vitro fertilization and gamete intrafallopian transfer programmes. Sixteen Malay women underwent ovarian stimulation for ovum pick up at the National Population and Family Development Board, Malaysia. Two cycles showed spontaneous LH surge, and comparisons were made between these two cycles and the cycles without surge. Further observations were made in their characteristics and differences in these two cycles as well as the relationship between progesterone and LH at the time and before the surge.
We report a patient with hyperosmolar non-ketotic hyperglycaemia who presented with chorea and septic arthritis on his knee. The chorea resolved completely and quickly with correction of the metabolic disturbance, only to return just as quickly when his metabolic disturbance subsequently deteriorated as a result of overwhelming septicaemia, suggesting coexisting cerebral ischaemia, although the basis of focal neurological sign in non-ketotic hyperglycaemia remains controversial.
Six of 16 patients presenting to the University Hospital Kuala Lumpur with unilateral recurrent laryngeal nerve paralysis were treated with teflon injection of the paralysed vocal cord. The results are presented and the role of surgical therapy, in particular teflon injection is reviewed.
The use of pressurised metered dose inhalers was assessed among 93 asthmatic patients attending the respiratory out patient clinic between January to October 1989. They were regular users of the inhalers prior to the assessment. 62.4% of the patients were found to use the inhalers incorrectly. Forty three percent made more than one error. The commonest error observed was the failure to actuate and inhale the aerosol together in 41.9%. There was no difference in the occurrence of incorrect performance between different sexes, age groups, duration of inhaler used and previous supervision or no supervision by the doctors.
Study site: Respiratory clinic, Hospital Kuala Lumpur (UKM), Malaysia
There are several reports of beneficial effects of ACE inhibitors in both primary and secondary pulmonary hypertension. However the effect of ACE inhibitors in mitral stenosis is not documented. The authors report three patients with severe mitral stenosis in whom surgery was delayed. They had initial symptomatic improvement with diuretics and sodium restriction, but had recurrence of their symptoms while on treatment. Enalapril not only relieved their symptoms in particular exertional dyspnoea and haemoptysis but prevented recurrence and improved their effort tolerance without causing excessive fall of blood pressure or impairment of renal function.
Blunt trauma to the pancreas is not common. The pancreatic injury can range from simple bruising to complete transection often associated with other visceral injuries. Pseudocyst of the pancreas is a late complication presenting usually within six weeks of the injury. The treatment of choice is distal pancreatectomy.
Adenocarcinoma of the fallopian tube is a rare clinical entity. The incidence of primary tubal carcinoma has been reported as varying from 0.1 to 1.0 percent of all gynaecological malignancies. In Malaysia the incidence is unknown. A case of primary adenocarcinoma of the fallopian tube is reported.
A 60 year old woman with chronic duodenal ulcer not responding to Cimetidine, was changed to Ranitidine. She had symptomatic improvement, but had bilateral breast engorgement and tenderness for which treatment was discontinued. A therapeutic trial on a second occasion had the same side effect which came on more rapidly and quickly. This complication in such severe form and recurrence on rechallenge requiring withdrawal of drug was observed for the first time with any H2 receptor antagonist.
A case of retropharyngeal abscess complicated is reported and its management is outlined. Key words: Retropharyngeal abscess,Complication, Pericardities, Mediastinal abscess
One thousand consecutive cases of carcinoma of the uterine cervix treated in the General Hospital Kuala Lumpur between January 1977 to December 1979 were studied. Epidemiological breakdown by race, age, parity, occupation, stage and histology of the disease were obtained. Treatment complications in survivors available for follow-up were analysed. The Chinese had the highest incidence, followed by the Indians and the Malays. Ninety six percent were squamous cell cancers, the remaining were adenocarcinomas. Eighty percent of patients were seen at an advanced stage (Stage IIB-IV). Late radiation complications were mainly proctitis, cystitis and fistula; (5%, 7.2% and 1.4% respectively). These figures are comparable to many centres but the incidence of cystitis is relatively higher. This is believed to be related to irradiation techniques in these cases.
Information from the national drug abuse monitoring system was analysed to determine the trends in extent and pattern of drug dependence in Malaysia over the period 1970 to 1986. The annual incidence and prevalence rates of reported drug dependents increased by many folds when compared to the early seventies. Generally, the profile of drug dependents identified has remained relatively stable throughout the years. A stable pattern of drug abuse was also noted over this period. Factors influencing the trend patterns are discussed, as well as the implications of these findings for policy purposes.
The abuse of phenylbutazone among rheumatoid arthritis patients has recently become a subject of interest. Unscrupulous manufacturers take advantage of the miraculous analgesic property of phenylbutazone and deliberately add this toxic drug in their preparations without declaring its presence on the label. In a recent survey, many such illicit preparations were seized from Chinese medical halls in Johor and sent to the Department of Chemistry, Johor Bahru for analysis. Here a Gas Chromatograph Mass Selective Detector (GC-MSD) method was developed for the determination of phenylbutazone in illicit traditional preparations.