A retrospective study of 100 patients with acute right upper quadrant pain was performed in order to indicate the diagnostic role of ultrasound including the diagnostic role of ultrasound including guided percutaneous procedures in the evaluation of such cases at the General Hospital Kota Bharu (GH, KB). In the majority of these patients the leading clinical consideration was acute cholecystitis. In all the patients the initial sonographic diagnoses were compared with the final diagnoses. In 35 patients (35%) biliary pathology was diagnosed. In this group the conographic correlation was good. In 65 patients (65%) the symptoms were due to non-biliary pathology. In this group ultrasound detected the actual site of pathology in 28%. Ultrasonography which can image multiple organs rapidly is a useful initial screening procedure in patients presenting with acute right upper quadrant pain because it can detect the actual size of pathology in about two-thirds of the cases.
Stop the bleeding - digital pressure, packing. Once the bleeding has stopped, performed coagulation studies. Refer to an ENT surgeon for opinion particularly as you may be dealing with nasopharyngeal carcinoma.
Blood alcohol levels from 155 UKM forensic postmortem cases of various causes of death from August 1988 to mid-September 1989 were studied. 59 cases (38%) were related to fatal road traffic accidents. 13 of these 59 cases (22%) showed blood alcohol levels of more than 50 mg/dl. 11 of these 13 cases (84.6%) revealed blood alcohol levels of more than 100 mg/dl after correction. Further analysis showed 53.8% were Indian, 76.9% aged between 20 and 40 years, 84.6% of the accidents occurred between 8.00 p.m. and 4.00 a.m. and all the alcohol related fatal road traffic accident victims studied in this series were males. This study provides helpful information.
Anaemia still constitutes a public health problem in the world, especially in the developing countries (1). Nutritional deficiency remains a major causative factor (2). During pregnancy, growth of the foetus, placenta and the larger amount of circulating blood in the expectant mother will lead to an increase in the demand for nutrients, especially iron and folic acid. Many women start their lives with insufficient iron stores, but also, because of inadequate child spacing, they have little time to build up their iron levels between pregnancies. In pregnancy, anaemia has been shown to be associated with an increased risk of maternal and fetal morbidity and mortality (3,4,5). Iron and folic acid supplementation is routinely given to pregnant mothers in Malaysia. It is anticipated that pregnant mothers who comply strictly with the prescribed iron supplement will maintain adequate iron stores at parturition. However, the compliance rate among rural mothers in Kelantan is often poor (6). Kelantan is also one of the most socio-economically underdeveloped
Adolescent pregnancy is associated with long term medical and sociological problems. For intervention, it is important to have information on their profile and obstetric outcome. A study was conducted in 1999 on teenage mothers compared to mothers in the 20-34 year age group. Antenatal records of all these mothers registered in a Malaysian semi-rural Health Clinic in 1998 were reviewed and the relevant information was analysed using descriptive statistics and chi-square for comparison in SPSS 7.5. Only 402 (80.9%) of the 497 antenatal records could be included. There were 40 (9.95%) adolescent pregnancies and 362 (90.05%) pregnancies in mothers aged 20-34 years. Pregnant adolescents were more likely to be Malays (85% versus 66%), unmarried (65% versus 5.5%) and less educated (32.5% versus 12.1%). They have a significantly lower rate of contraceptive usage (2.5% versus 20.2%) and tend to come late for their first antenatal visit (55% versus 18.5%). Their pregnancy complications of anaemia and pregnancy induced hypertension were no worse. But they had a significantly higher preterm delivery rate (37.5% versus 21.8%) and their babies were more likely to have low birth weight (32.5% versus 9.9%). Based on this preliminary finding, further investigations should be carried out and polices should include programmes targeted for this group.
A prospective case controlled study was conducted to determine the incidence of asymptomatic bacteriuria in pregnancy (ASB), causative organisms and fetal outcome. Out of 510 antenatal mothers screened, 46 (9%) had ASB. The main organisms isolated were E. coli (16%), Staphylococcus aureus (15%) and Beta-Haemolytic Streptococcus (11%). Oral Nitrofurantoin and Cefuroxime axetil achieved sensitivity levels of 96%. There was no significant difference in period of gestation at birth and birthweight between the control and study groups. The reasons for routine antimicrobial therapy for ASB are discussed.
A study was done in 1987 to find out the attitudes and perceptions of patients toward treatment in the Hospital Universiti Sains Malaysia (HUSM). A similar study was repeated five years later covering both patients and relatives of patients. In 1987, 17% of patients were not satisfied with the treatment mainly because of poor patient-staff relationship. In 1991, 5% of the patients were dissatisfied. The reasons attributed for their dissatisfaction were rudeness of staff, the presence of medical students and attitude of the patients and public of the nurses. There was a positive change of attitude of the aptients and public towards the hospital services after five years. Factors that lead to this improvement like education and better public relations is discussed.
Medical therapy is effective in patients with mild to moderate symptoms of benign prostatic hyperplasia. Selective alpha-1 blockers (e.g. terazosin) and 5 alpha reductase inhibitors (e.g. finasteride) are the main drugs used. Alpha blockers reduce the dynamic component of obstruction while the later reduces the size of the prostate.