Hereditary stomatocytic ovalocytosis and haemoglobin E are two genes present in 3-5% of Malays. This is a report of a 22 year old Malay college student with homozygous haemoglobin E and hereditary stomatocytic ovalocytosis where the clinical effects seen were the result of the summation of these genes: he was asymptomatic, presenting with moderate jaundice, moderate hepatosplenomegaly, and a mild haemolytic anaemia.
A six year old Malay boy with phenylketonuria is presented. The history, clinical examination, biochemical findings and treatment are described followed by a discussion on phenylketonuria.
The objective of the study was to determine whether discriminant analysis of characteristics of dyspepsia can differentiate peptic ulcer from non-ulcer dyspepsia in a Malaysian population. Two hundred and twenty six patients with dyspepsia were interviewed using a standard history questionnaire before undergoing upper gastrointestinal endoscopy. Forty seven patients had peptic ulcer while 149 others were classified as having non-ulcer dyspepsia. Stepwise logistic regression analysis was done on 25 variables. The study showed that only five of these variables could differentiate peptic ulcer from non-ulcer dyspepsia, namely, nocturnal pain, pain before meals or when hungry, absence of nausea, age and sex. A scoring system was devised based on these discriminant symptoms. At a sensitivity of 51%, the specificity for peptic ulcer was 83%, but only prospective studies will determine if this scoring system is of actual clinical value.
Heat stroke is hardly seen in Malaysia. However, it occurs commonly in Saudi Arabia during the Haj season. Many Malaysian pilgrims are affected every year and some die. Having faced this environmental hazard for eight years, the Malaysian Medical Mission, sent each year to look after our pilgrims, modified its treatment strategy in 1988 and successfully decreased the overall morbidity and mortality of affected patients without the use of sophisticated equipment. A brief account of the management of 17 cases seen in 1988 is given. Only one died following treatment. The rest recovered fully without any residual neurological deficit or other complications.
Drug abuse is a major problem in Malaysia. Serious complications of intravenous drug addiction include septicaemia and infective endocarditis. We present nine cases of endocarditis occuring amongst drug abusers. The tricuspid valve was most frequently involved and the common aetiological organisms were S. aureus and Str. faecalis. There was a high mortality rate of 67% in our study, inspite of appropriate therapy. Early recognition of the disease and aggressive treatment is required to improve the associated mortality.
The finding of a prolonged bleeding time in a patient whose platelet count is normal suggests some abnormality in the function of the platelets. This situation may be due to an inherent platelet defect or to the deficiency of a plasma factor necessary for some aspect of platelet function. Defects of platelet function are also seen in a wide range of disease states and may be caused by many different classes of drugs. Simple methods are available to identify abnormalities in platelet numbers and/or function. Tests of platelet aggregation, using the aggregometer, are now widely used to investigate patients suspected of having platelet disorders. We observed in the last four years that thrombocythopenia is quite common amongst children and bleeding from platelet dysfunction, congenital or acquired, is not rare in Malaysia. This study was done to assess the prevalence of platelet abnormality in a section of the general 'healthy' population of school-going children and to study the possible causes of any abnormalities detected.