Accidental organophosphate poisoning may occur in persons coming in close contact with animals being treated toitb organophosphate pesticides. The poisoning may manifest itself as a severe systemic disorder, but can be diagnosed by an alert physician and confirmed by specific tests of reduced cholinesterase activity in the blood, plasma and red blood cells. Treatment is with intravenous atropine. Supportive measures may be necessary.
This study reviews experiences in the management of three cases of lacerations of the vagina following coitus. A brief review of the recent literature is made. Although the extent of injuries can be very variable, the principles of management consist of prompt
resuscitation and arrest of haemorrhage, appropriate surgical repair under general anaesthesia, and systemic or local antibiotic therapy to combat infection. Avoidance of vigorous or abnormal coital practices, especially in single women, in the immediate postpartum period, and in postmenopausal women, can help to reduce the frequency and severity of such injuries.
A retrospective study of nine consecutive cases of triplet pregnancy delivered at the University Hospital showed an incidence of one in 6,349 deliveries. In seven cases the diagnosis was suspected, and confirmed either by radiography or ultrasonography. Pre-eclampsia and polyhydramnios were common ante-natal complications. The perinatal mortality rate was 74 per thousand. Overall, the first triplet had the best outcome in terms of Apgar scores. There were no perinatal deaths in those cases that were delivered by Caesarean section.
A review of our experience of 916 cases ofpartial bilateral vasectomy performed under local anaesthesia at the University Hospital, Kuala Lumpur during the
period between January 1971 and June 1980 is presented. Minor post-operative complications occurred in 5.8% of cases with a low post-operative infection rate of 1.2%. In 35% ofpatients, persistence of non-motile sperms in the semen were seen after at least ten ejaculations in each instance. In four of these cases non-motile sperms continued to persist into the sixth month of follow-up even after at least 50 ejaculations in each instance.
A case of the leopard (multiple lentigines) syndrome is described. To our knowledge this is the first documented case of this rare but interesting syndrome to be reported in this country.
Tuberous sclerosis is a disease with a well known association with renal masses, both cysts and angiomyolipomas. Reported here is a case of a 26 year old woman who had, in addition to angiomyolipomas of the kidneys, adenoma sebaceum, paraungual fibromas, shagreen patches and cerebral tubers.
DDT indoor residual sprayings in the Province of Central Java, Indonesia, for the past 28 years are reoieuied in terms ofAnopheles aconitus resistance to DDT and incidences of malaria. DDT resistance by An. aconitus has continued to increase and spread since its first detection in Central Java in 1962. In most areas malaria transmission is perennial, which appears to be not interrupted by DDT residual spraying of inner walls because of DDT resistance. In searching for alternatives to DDT, fenitrothion was the most effective residual compound among five insecticides tested in village scale trials, giving control for about 13 weeks at 2 g/m2. Because the target species rests largely on the lower portions of walls, when applied at 2 g/m2 to only one horizontal swath between 10 and 85 cm from the ground, this compound was effective for over two months, about one-third less than that found in full coverage applications. For a single application this selective method reduced the amount of insecticide by 65 percent and manpower by 43 percent, and three applications, to compensate for less residual effectiveness, will reduce insecticide use by about 50 percent and manpower by 15 percent, compared to two applications with full coverage. Further field investigations on application of insecticides and the ecology of the DDT-resistant vector continue to be needed in Central Java to reduce further the cost of residual sprayings in malaria control programmes. This review also suggests the possibility of other selective spraying methods and anti-vector methods applicable at the village level by the community.
Consideration. is gzven to the recognition and prevention of carious types of mental retardation due to hazards of environmental origin. Observations are presented on congenital syphilis, congenital toxoplasmosis, congenital rubella, Singapore kernicterus, Japanese B encephalitis, and tuberculous meningitis. Appropriate preventiue measures have resulted in a significant reduction in Singapore of these conditions, and hence in a decreased frequency of environmentally determined mental retardation. and related disabilities.
Abnormal variants of plasma cholinesterase are a rarity in this region and to date there is only one reported case of suxamethonium sensitivity in a Malaysian population. We now report a case of a Malaysian Chinese patient who received suxamethonium, developed prolonged apnoea and on investigation found to be a homozygote for the silent gene. His family was screened for abnormal variants of plasma cholinesterase. The results are discussed.
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.
We report this 21 years old Indian male with the nephrotic syndrome due to membranous nephropathy who later developed numerous epithelial crescents leading to a rapid loss of renal function. The pathogenesis of the crescentic transformation in this type of glomerulopathy is discussed.
The effect of specific alpha[ or alpha2 adrenoceptor agents on the response of rat superior mesenteric-portal vein to field stimulation was investigated. In. a dose related manner, phenylephrine (alpha[ agonist) and yohimbine (alpha2 antagonists) increased while prazosin (alpha[ antagonist) and clonidine (alpha2 agonist) decreased the response of the vein to field stimulation. These effects are the same as those seen with these agents on rat and mouse vas deferens. It is suggested that, as in vas deferens, alpha1 postsynaptic and alpha2 presynaptic receptors exist in rat superior mesenteric-portal vein and that these receptors may be sufficiently sensitive in vein for their existence to be of significance in the action of these agents at clinical doses.
A case of pseudomyxoma peritonei is reported. Pathogenesis, clinical features and modes of treatment are discussed. This patient appears to have responded to laparotomy, paracentesis and instillation of cyclophosphamide intraperitoneally.