In the outbreak of cholera in Perak in 1978, a study on 179 cholera patients (cases) from 8 health districts in the state indicated that those afflicted with the disease were from the rural areas, belonged to the lower socio-economic class and had little or no formal education. Under such conditions, it is expected that personal hygiene may not be satisfactory and person to person contact could play an important role in the transmission of the disease especially among those living in close contact. 34.2 percent of the 164 households of the cholera patients contained injected household contacts. From 1 to 6 infected household contacts per household were found for household size ranging from 2 to 18. Ninetyjive (8.6 percent) of the total 1101 household contacts were injected. Only 8 of these 95 infected household contacts developed clinical symptoms giving a ratio of 1:12 symptomatic to inapparent injections. While most of the contacts probably acquired their infection from the patient who constitutes the index case, the role of the asymptomatic carrier in the transmission ofinjection cannot be underestimated.
Thirty-four case notes of patients in acute renal failure on whom intravenous urograms (IVU) were performed, were reviewed. All patients received high doses of Conray 420 or Urotrast. Delayed films up to 48 hours were routinely done in patients suspected of having obstruction. There were no side effects of the intravenous urogram examination. IVU with high dose contrast material and nephrogram are helpful in differentiating the cause of the acute renal failure, and in excluding outflow obstruction.
Over a two year period, 323 livers were examined using ultrasound. Majority of these cases were icteric and ultrasound could distinguish obstructive from non-obstructive jaundice. Primary and secondary liver tumours were also detected. Liver abscesses, and radiolucent gallstones were picked up by ultrasound, the areas under study being scanned using standard methods as outlined by various ultrasonographists.
The first culture-proven case zn Malaysia of fungal keratitis, due to Fusarium solani, is presented, followed by a brief discussion of mycotic keratitis.
Fifty patients with temporomandibular pain dysfunction syndrome were examined. Seventy-eight percent and 32 percent were female and male respectively. The white collar workers were more frequently affected. Emotional stress, dental malocclusion and a history of trauma were the main causes. Treatment consists of reassurance, relaxed jaw movements and exercises, anxiolytic drugs, thermotherapy, biting appliance, occlusal adjustments and restoration oflost dental units.
Male albino rats were chronically loaded with sodium by giving 1% NaCl solution as the sole source of drinking water. Daily fluid intake, daily urinary output and daily Na+ and K+ excretion rates were compared with control rats receiving tap water for six weeks. At the end ofsix weeks, sodium loaded animals were found to have raised plasma Na+ concentration, lowered plasma K+ concentration and lowered haematocrit value. Sodium loaded rats were also significantly more responsive to the pressor effect of submaximal doses of adrenaline, noradrenaline and angiotensin II given intravenously. It is concluded that the increase in sensitivity to adrenaline and noradrenaline may be due to changes in EGF and alterations of plasma electrolytes concentration. For angiotensin II, additionally, it may be due to low circulating endogenous angiotensin II, consequent of reduction in renin release attributed to chronic sodium loading.
The efficacy of Cary Blair medium was compared with that of Selenite 'F'in the isolation of enteropathogens from 805 cases of diarrhoea. It was shown that use of the Cary Blair medium resulted in a significantly higher rate of isolation. Not only were organisms found which were not isolated from the Selenite 'F' but there was a much higher isolation rate of Salmonella from Cary Blair medium althougn Selenite 'F' is generally considered as an enrichment medium for
Salmonella. The findings indicate that it would be advantageous to introduce Cary Blair medium as the sole transport medium for the isolation of enteropathogensfrom cases ofdiarrhoea.
The effect of an aqueous extract of Vernonia cinerea (VX) on mice was determined. It is suggested that VX contains a depressant agent whose primary effect is that of analgesia.
Numerous aetiopathologic factors have been enumerated as the possible causes of injuries to the common peroneal nerve at knee. This report presents a case of postero-lateral displacement of the upper end of fibula consequent to the displacement of fractured lateral tibial plateau leading to common peroneal nerve palsy which has not been reported before.
3 cases of perforating injury with retention of intra-ocular foreign body are presented. Their clinical presentation, management and final visual results are discussed. Despite the generally poor prognosis associated with these injuries, some cases surprisingly have good visual results.
This study is based on measuring the d.c. (direct current) skin conductance of the acupuncture points representing the heart on the external ear. The subjects were 30 healthy volunteers and 20 cardiac patients. The results obtained showed that the skin resistance of the heart acupuncture loci on the auricle of the cardiac patients were markedly reduced when compared with that of the healthy controls. The value of this method of auricular electroacupuncture diagnosis is discussed.
Cefotaxime [HR 756], a third generation cephalosporin with pronounced antibacterial activity
against the Enterobacteriaceae, was assessed in serious and problem antibiotic resistant infection. Good clinical success was achieved without observed untoward effects. The study suggests that due to its properties, cefotaxime could be used as a first-line antibiotic provided that the clinical situation warrants the use of a cephalosporin or aminoglycoside.
Key words - cefotaxime [HR 756], serious surgical infection, antibiotic resistant infection.
A study was carried out in theJengka Triangle in Pahang to find out the prevalence and a practical cum effective method of treatment and control of scabies. Scabies was the commonest skin lesion among the 5590 people examined. its prevalence being 11.6%. Both sexes were equally affected. Prevalence was high among children and teenagers, the worst affected being the 10 to 14. 2 to 4, 15 to 19 and 5 to 9 year olds. The problem of scabies in Jengka could be due to inadequate and irregular water supply, plus lack of mothers' supervision of the personal hygiene of their children aged > 2 years. The persistence of scabies since 1976 is very likely due to the people's non-compliance with standing instructions on treatment with Benzyl benzoate emulsion A comparative study of treatment of scabies with Gamma Benzene Hexachloride [GBH] and with Benzyl benzoate emulsion [BBE] showed GBH to be the medication of choice. It was more effective and convenient, giving 97.9% cure rate with one application. A hot bath was not necessary. The patients preferred GBH to BBE since it was painless and without side-effects. The cost of treatment with GBH [1 application] was also much less than that with BBE [2 applications]. Only 28.7% of the cases and contacts complied with instructions to do 2nd application of the medication on their own, making it imperative that application be done by the health Staff or under their direct supervision. The majority [87.2%] complied with instructions to place their used clothes in large polythene bags and air these in the sun for two days. This procedure should replace the instructions to boil personal clothes as it is just as effective. yet more convenient and economical. A regular, biannual screening of all kindergarten and primary school children is recommended. Application of GBH to all scabies cases and all close contacts should be done by the health worker. The whole body from neck to soles of feet should have the application, and the people should be instructed to bathe only after 24 hours. They are to go to the nearest clinic or hospital on the 7th day for second application of GBH, if the itchness or lesions persist or reappear. Such supervised medication is possible and will minimise misuse of GBH.
74 cases of radiologically proven urinary calculi between 1975 and 1979 were analysed by race, sex and age. The relative frequency of single and multiple stones was also studied. The disease was found in all the ethnic groups present in Limbang except for the Punans. Possible reasons for this observation of their apparent absence were given. The absence of patients from one of the Malay Kampongs in Limbang town was also noted.
Two outbreaks of mushrooms poisoning involving 3 and 9 soldiers respectively with one death on 9 March 1980 in Perak are described. The symptoms were compatible with muscarine [a neurotoxin] poisoning which was detected in the stomach contents of the dead soldier and the mushrooms consumed by one group.
Seven non-anthletes [21-26 yrs] and five athletes [23-29 yrs] have participated in the study of cardiovascular and metabolic responses to 15 minutes isometric leg exercise at 15% of each of their maximal voluntary contraction force [MVC]. Oxygen consumption [V02 ]. heart rate [HR] and blood pressure (BP]. were measured during resting. exercise and recovery! periods. The results show that there were a significant increase in V02. HR and BP of the two groups studied during exercise, but no significant difference between groups has been found. This study indicates that although cardiovascular response between the rwo groups was not significantly different, 15 minutes isometric leg exercise at 15% MVC has challenged this system in a such a way to fulfill the metabolic requirement of the
working muscle ill both groups. This finding was
discussed in light of the available literatures.
This is a study of 110 married men as to their attitudes to family planning. Most of the respondents approved of family planning. There is a reluctance to plan families before the first child. more among the Malays than among the Indians. Majority of the respondents [81%] have discussed family planning with their wives, and are also willing to allow their wives to practise family planning. Induced abortion is not favoured by the respondents especially the Malays. Only half the respondents are practising family planning and it appears that the better educated approve as well as practise family planning more than those with less education. A large proportion [89%] of respondents are interested in learning more about family planning.
Study site: Army Garrison Hospital, Port Dickson, Negeri Sembilan, Malaysia
Electrocardiographic features of the Woljf-Parkinson-White syndrome may be seen in normal individuals and in those with congenital or acquired heart disease. Predisposition to tachyarrhythmias and its misinterpretation are common. In this report a case of Wolff-Parkinson-White syndrome in a 25 year old Malay male who presented with cardiac arrhythmias is described. Echocardiographic findings and the role of echocardiography are discussed.
A total of 346 paediatric in-patients in the University Hospital in Kuala Lumpur was examined for infection with Enterobius vermicularis using two anal swabs taken on two consecutive days. 24% of these children. whose mean age was 6 years [range 2-14 years] were infected. The infection was more prevalent among children between the ages of 5-11 years. There is only a slight difference in the distribution of infection among Malay. Chinese and Indian children. There is no significant difference in the prevalance of infection between boys and girls.