Six hands from five patients were seen with full-thickness burns following a ritual practice between June 1993 and June 1994. Three hands were treated with excision and medium-thickness split-skin grafts, one patient was treated with a medium-thickness split skin graft taken from the instep of the foot. The first patient with bilateral burns of the palms refused surgery and returned 3 months later with contractures of the palms. The results of the treated hands are presented.
Anaesthetic experience of the first nine patients in Singapore who underwent closed embolisation of cerebral arteriovenous malformations is reported. Six patients had neurolept analgesia and three had general anaesthesia.
The deliberate inhalation of solvents among children and adolescents "for kicks" is becoming more common in the West. It was generally regarded as a relatively harmless practice and consequently little attention had been paid to the isolation of the toxic agent from the variety of substances used. It is now well recognised that solvent abuse not only can result in sudden death but also cause pathological changes to the liver, kidney, brain, heart and lungs. A case of toluene associated death in Malaysia is discussed both from a medico-legal and pathological standpoint.
Data on blood cholinesterase levels in the Malaysian population is lacking. The spectrophotometric method of Ellman was used to determine the red cell, plasma and whole blood cholinesterase (ChE) levels in 407 Malaysian blood donors. The mean+1SD for plasma ChE in females (n = 48) was 2.37 + 0.70 umol/min/ml and 2.76 + 0.75 umol/min/ml in males (n = 359). The mean plasma ChE in males was higher than in females (p < 0.001). The mean+1SD for red cell ChE in females was 9.01 + 1.20 umol/min/ml whereas in males it was 7.69 +1.30 umol/min/ml (the mean red cell ChE in females was higher than in males, p < 0.0001). The mean+1SD for whole blood ChE for females was 4.31+ 0.58 umol/min/ml and for males it was 4.95 + 0.71 umol/min/ml. The mean whole blood ChE in males was higher than in females (p < 0.0001). Sex influenced the plasma, red cell and whole blood ChE. In males the plasma ChE was affected by the race factor. The mean+1SD plasma ChE for the Malay, Chinese and Indian were 2.92 + 0.80, 2.73 + 0.71 and 2.61+ 0.73 respectively (p < 0.002). The age factor in males affected the red cell ChE with 7.88 + 1.32 in the (30-69) age group and 7.47 + 1.23 in the (15-29) age group (p < 0.005). The whole blood ChE in females was affected by blood groups. The mean+1SD whole blood ChE for blood groups A,B and O were 4.19 + 0.42, 3.93 + 0.46 and 4.49 + 0.62 respectively (p < 0.03). The significant difference is between the ChE of group B and O, but the ChE of group A could not be determined to be different from group B or O. These results serve as guidelines for our local population in the evaluation of cholinesterase levels with regard to pesticide poisoning, liver biosynthetic capacity and unusual sensitivity to succinylcholine.
A 16-year-old female from Rantau Panjang, Kelantan reported having diarrhoea for three months. During this period, she lost 15 lb in weight and was treated with antibiotics and anti-spasmodic tablets with no improvement. Stool examinations by private laboratories revealed "worm-like eggs". She was treated for worms with mebendazole which helped to reduce the symptoms but not completely. The patient continued passing out the abnormal "worm-like eggs" which were later identified as pollen grains.
Use of contraceptives by some selected characteristics was studied for married women in the reproductive age range (MWRA) in three south‐east Asian countries. The data were obtained from each country's national family planning/fertility survey conducted around the mid‐seventies. Only the gross relationship between each of the selected characteristics and contraceptive use was compared. The proportion of MWRA using contraceptives for Singapore was almost twice as high as the corresponding proportions for Peninsular Malaysia and Thailand. The pattern of contraceptive use was largely similar for Thailand and Malaysia but different from Singapore. The differences were largely attributed to the absence of a large rural population in Singapore, the apparently greater tendency of women in Singapore to use reversible contraceptive methods for birth spacing and the easier access by women to family planning information and services, particularly sterilisation, than in Peninsular Malaysia and Thailand.
This study analyses retrospectively the results of sixteen acute dislocations of the knee at the University Hospital, Kuala Lumpur from 1980 to 1985. The average follow-up was 3.5 years. There were seven posterior, six anterior, one lateral and two postero-lateral dislocations. All were due to motor vehicle accidents except one. There were four patients with popliteal artery injury and two patients with peroneal nerve injury; three required amputations due to late detection. All the peroneal nerve palsies were permanent. The results of surgical treatment appear to be better than conservative management of acute dislocation of the knee.
Multiple supernumerary teeth without any associated systemic conditions or syndromes are not common. The author reviewed most of the cases reported in the English-language literature from 1969 to the present. It was found that there was a predilection of non-syndrome multiple supernumerary teeth to occur in the mandible. When analyzed according to specific sites for both jaws, there was a predominance of the multiple supernumerary teeth to occur in the premolar area, followed by the molar and the anterior regions respectively. The mandibular premolar region had the highest frequency of occurrence for both jaws combined.
Fifty-one consecutive arthroscopies of the knee were reviewed after an average of eight months follow-up. Thirty-eight patients underwent arthroscopic surgical procedures as well. A meniscus tear was the commonest (68%) primary pathology noted, followed by isolated anterior eructate tears (16%). Excellent/good results were obtained in 80% of arthroscopic partial meniscectomies. Synovial biopsies and loose body removal were all successfully achieved arthroscopically: Arthroscopic knee surgery is a useful and less traumatic technique of obtaining a diagnosis and treating amenable knee lesions compared to open arthrotomy.
This is a report of 13 cases of meningiomas treated in the Neurosurgical Unit, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur, over a period of nine months from September 1982.
Physical abuse of women has been documented since the dawn of history. However, it is not frequent that such patients come for help as such. Rather, they present as part ofrelated complicated problems such as marital discord, attempted suicide, depression and even psychotic illness. Women have been traditionally considered to be the inferior sex and as such, in many countries, social rehabilitation is difficult within the legal rights granted by the provisions of the appropriate laws. Two cases of physical abuse were admitted to the University Hospital in 1981-82 and their difficult rehabilitation is described to highlight the inadequacies of the existing laws under which protection and rehabilitation of the patients were sought. An account of what was and could be done for them is given.
This is a report of clinical features of migraine in Malaysians. Seventeen migraineurs were studied with respect to age, sex, length of disease, headache, aura, nausea, frequency, remission, precipitating factors, relieving factors, family history, coexisting symptoms, coexisting disease, and type of migraine. Similarities and differences between Malaysian and Caucasian migraineurs are discussed.