A survey of lettuce sold in Penang markets showed them to be heavily contaminated with faecal coliforms and nearly half the samples were positive for Salmonella or Shigella. The use of night soil on these vegetables is a likely cause of gastroenteritis.
Achondrogenesis is a lethal neonatal chondrodysplasia with extreme micromelia and marked discrepancy between the relatively large head and the decreased trunk length. The affected neonates are usually delivered prematurely, and are stillborn or die soon after birth. Polyhydramnios is frequently present. It is an inherited autosomal recessive disease. The radiographic features are diagnostic.
This study investigated whether knowledge and attitudes of Malay college students regarding smoking can be positively influenced by educational intervention. The experiment included a pretest to assess the students knowledge and attitudes regarding smoking, a lecture on the health risks associated with smoking, and a posttest given six weeks later to assess whether any changes had occurred. A profile of the typical Malay student smoker was also elicited. Twenty-seven percent of the study population were smokers. Of the men in the sample, 44% were smokers, while less than 4% of the women were smokers. T-tests indicated that knowledge of the health risks associated with smoking was significantly improved for most groups, while attitudes towards smoking were essentially unchanged.
Health indices of 317 healthy elderly Malay females 55 years and older from two rural subdistricts in Negeri Sembilan were collected through personal interviews. About 33% of the respondents perceived their health condition as good to excellent, 63.4% rated their health status compared to a year earlier as about the same, 48.3% had no worry about their health, and 49.2% perceived themselves as physically active as their peers. Arthritis was the major ailment which affected the daily activities of about 64% of the respondents. The classical age-related problems of poor hearing, poor sight and difficulty in chewing were also prevalent among these elderly.
Two cases of tuberculosis of the thoracic spine with extrapleural extension of paravertebral abscesses, presenting radiologically as cold abscesses away from the spine in the PA chest radiograph, are presented. The radiographic features and response to antitubercular drugs are discussed.
Thirty one patients were investigated for the main complaint of easy bruising. These patients had normal platelet count with no past history of immune thrombocytopenia or systemic disorders known to predispose to bruising and a negative drug history. The evaluation of these patients included clinical review (history and physical examination) plus coagulation tests consisting of bleeding time, prothrombin time, partial thromboplastin time, thrombin time, fibrinogen level, FXIII screen and platelet functions test. Seven of the paediatric patients had acquired platelet dysfunction with eosinophilia (APDE). In 17 (94.4%) of the 18 adult patients no abnormality was demonstrated. Hence APDE was the commonest cause of easy bruising in children while the haemostatic defect contributing to easy bruising in adults remained unknown.
A 13 year old girl presented with miliary tuberculosis and active systemic lupus erythematosus (S.L.E.). She responded to a combination of antituberculous drugs and systemic steroids. This case illustrates the fact that S.L.E. presenting in childhood may be rare but not unknown and exemplifies the need for vigilance in detecting life threatening infections in this group of patients.
This report deals with a father and his son who developed acute renal failure following multiple bee stings. The renal lesion in these patients appears to be due to rhabdomyolysis caused by the bee venom. The other mechanisms are also discussed. The need for clinicians to be aware of acute renal failure as a complication of bee stings is stressed.
A case of tetanus occurring after induced abortion is reported. The patient gave a history of low grade fever with chill and rigors, headache, neck pain and Trismus. She subsequently developed respiratory distress. However, incorrect information from the patient resulted in the delay to locate and eradicate the source of infection. Early referral to an intensive care unit for ventilatory assistance was the most appropriate step to save the patient. Complications which occurred during the course of the disease were sometimes difficult to overcome. These complications were probably related to the duration of stay in the intensive care unit. Their incidence could be reduced by more meticulous patient care.
A successful retrieval of a detached segment of a CVP catheter by percutaneous right transfemoral venous route, using a Dotter intravascular retriever basket, is reported. The procedure was monitored under fluoroscopy. Only local anaesthesia, which was infiltrated around the puncture site, was given to the patient. No significant complication was encountered. Successful retrieval of the detached catheter fragment by percutaneous means obviates the need for thoracotomy.
Two cases of longstanding foreign bodies in the larynx and lower laryngo-pharynx were accurately localised by direct coronal3 and limited axial CT scans of the neck. The relationship of the foreign bodies with the surrounding structures and associated changes are demonstrated clearly.
Transurethral Resection of the Prostate (TURP) is now the preferred method for dealing with the obstructing prostate. This procedure was reintroduced to the Penang General Hospital in August 1985. Over the next one and a half years, 100 TURP were performed by the author (NYTL). This paper reviews this initial experience. Of the patients, 17.7% required blood transfusion of one unit each. The mean post operative stay was 4.8 days. There were no immediate deaths. This experience confirms the acceptable results of TURP in the treatment of patients with benign prostatic hypertrophy in the Malaysian context.
An unusual case of proximal migration of a Hakim's valve intracranially into a porencephalic cyst two years after insertion of the ventriculo-peritoneal shunt in a neonate is reported. The underlying cause is discussed. It is recommended that all shunt should be anchored with nonabsorbable suture material properly on to the pericranium.
Coronary artery surgery as we know it today, has undergone rapid evolution since its introduction in the late 1960's, resulting, not surprisingly, in much confusion. In an attempt to present the state of the art, a collective review of the literature, coupled with the experiences with 118 patients is presented and discussed. The modern surgical management of patients with obliterative coronary artery disease is designed to relieve symptoms, prolong life and identify patients at high risk of premature death or myocardial infarction if they were to continue with medical management. Though the most common indication for surgery is persistent limitation of life style by severe symptoms, management is influenced by the strong association between such symptoms and increased mortality. During the short history of coronary bypass surgery, other indications for operation have been influenced by a combination of lessons from the past and hopes for the future. In addition, advances in technology have produced an enormous impetus for improvements in patient evaluation, surgical technique and postoperative care. As these advances continue and as more and more late results of surgery become available, answers to questions about surgery may increasingly be deduced from lessons rather than from hopes. As a result of these changes, an aura of confusion has gradually crept into the scene. It is hoped that this collective review, together with experiences gained from a personal series of 118 patients over a 3 year period from 1984 to 1986, will put into proper perspective, the state of the art of surgical management of coronary artery disease today.
In 1985, 140 (26.1 %) of 536 admissions to the intensive care unit (ICU) were general surgical cases. Retrospective review of 107 of these admissions revealed four factors to be significantly different between survivors and non-survivors, p < 0.01. They were duration of stay, organ system failure, sepsis and complications. The role of the surgeon in an ICU where management is interdisciplinary is emphasised.