Mesenteric venous thrombosis has been described to occur in cases where there has been no apparent cause. The diagnosis is usually delayed because the signs and symptoms are non-specific. A case of primary mesenteric venous thrombosis is reported below. Its presentation and pathology are discussed. Treatment is surgery with resection of gangrenous bowel and primary anastomosis. Post-operative anticoagulation is advocated.
INTRODUCTION: This single-group, open-label, prospective, noncomparative, multicenter, Phase IV study explored the efficacy and tolerability of paliperidone palmitate (PP) in hospitalized patients with acute exacerbation of schizophrenia.
METHODS: Asian patients of either sex, between 18 and 65 years of age, diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) with acute exacerbations within the previous 4 weeks, were enrolled. Intramuscular PP was initiated at doses of 150 milligram equivalent (mg eq) (day 1) and 100 mg eq (day 8), followed by a monthly maintenance dose between 75 mg eq and 150 mg eq (days 36 and 64). Primary efficacy endpoint was the change from baseline in the Positive and Negative Syndrome Scale (PANSS) total score (last-observation-carried-forward) at week 13.
RESULTS: Of the 212 enrolled patients, 152 (71.7%) completed the 13-week treatment; withdrawal of consent (24 [11.3%] patients) was the most common reason for study discontinuation. Mean (standard deviation) PANSS total score from baseline (90.0 [17.41]) improved significantly at day 4 (-6.1 [9.27]; 95% confidence interval: -7.38, -4.85; P<0.001) and week 13 endpoint (-23.9 [23.24]; 95% confidence interval: -27.10, -20.78; P<0.001). Similarly, the secondary endpoints (Clinical Global Impression-Severity, Physical and Social Performance, each PANSS subscale, and Marder factor scores) improved significantly from baseline to week 13 endpoint (P<0.001 for all). At week 13, 112/210 (53.3%) patients had a 40% improvement in the PANSS total score (responder rate), and 133/212 (62.7%) patients were ready for hospital discharge. Overall, 139 (65.6%) patients experienced at least one treatment-emergent adverse event (TEAE). Most common (>5%) TEAEs were hyperprolactinemia, constipation, nasopharyngitis, insomnia, increased weight, and tremor. Worsening of schizophrenia (3.3%) and sinus bradycardia (2.0%) were serious TEAEs; no deaths were reported.
CONCLUSION: PP was generally tolerable and efficacious in a hospital setting for the treatment of acute exacerbated schizophrenia with significant improvements in psychotic symptoms, social functioning, and severity of illness.
Melorheostosis is a rare osteosclerotic bone dysplasia. It is usually characterized by dull and aching pain, reduced joint motion and contractures. Classic radiograph findings are of undulating cortical hyperostosis along the length of the bone, simulating a "dripping candlewax appearance". We report two cases of melorheostosis of the ulna bone, diagnosed 6 years apart in two different females in their early 20s. Both the patients presented with the characteristic features of dull and aching pain in the forearm and were treated conservatively. However, we misdiagnosed the first case as bone malignancy and subjected the patient to a biopsy. For the second case, with hindsight we made the correct diagnosis based only on the classic clinical history and radiographs. We believe that the discussion of a misdiagnosed case of melorheostosis with salient findings may be important for clinicians and orthopedicians in day-to-day clinical practice.
Anthropometric Test Devices (ATDs) of different nominal percentile values have long been used as human surrogates in automotive crash testing. The Hybrid III family, which is one of the widely used ATDs in frontal crash test, was designed based on the anthropometry dimensions of US adults. Thus, this paper aims to assess the anthropometric differences between Malaysian adults and Hybrid III dummies in terms of 5th percentile (small female), 50th percentile (midsize male) and 95th percentile (large male). A series of anthropometric parameters of Malaysian adults was obtained from a database of 1321 subjects with 708 males and 613 females. The results revealed that the current midsize male population differs from the ATD’s statures and body weights by about 35 and 40 percentile points, respectively. This demonstrates that the current ATDs are not truly representative of the current Malaysian adults, which may potentially lead to different injury responses in road traffic crashes. Thus, car manufacturers may as well consider this discrepancy issue in developing their future models especially with regards to safety.
An analysis is made of parasite counts made on the first day of treatment in a series of 750 cases of acute subtertian malaria. The analysis affords data of the parasitological intensity of the subtertian infections prevalent in the Kuala Lumpur district of the Malay States during 2 years of normal malarial incidence and severity, and suggests:- 1. (a) That parasite counts made on the first day of treatment are of considerable prognostic reliability. 2. (b) That the counts made during the course of treatment are a useful guide to progress but are open to occasional fallacy. 3. (c) That the extreme limit of tolerance of Asiatic adults for the local strains of P. falciparum is probably in the region of three quarters of a million parasites per c.mm. of peripheral blood.
Citation: ITC Project (March 2012). ITC Malaysia National Report. Findings from Wave 1 to 4 Surveys (2005–2009). University of Waterloo, Waterloo, Ontario, Canada; Universiti Sains Malaysia, Pulau Pinang, Malaysia; and Ministry of Health, Putrajaya, Malaysia
This report presents results of Waves 1 to 4 (2005 – 2009) of the ITC Malaysia Survey – a face-to-face and telephone survey of a cohort of approximately 2,000 adult smokers and, 1,000 youth smokers and non-smokers. Waves 1 to 3 also included a cohort of 1,500 adult non-smokers. The key findings contained in this report provide evidence regarding the attitudes and behaviours of adult and youth smokers and non-smokers to assist policy makers in implementing effective tobacco control policies in Malaysia.
The aim of the present study was to investigate whether there is any difference between individuals with diabetes and without diabetes in their perceived stress, use of coping strategies and psychological well-being. A comparative study was conducted on 240 Bangladeshi adult participants. Among them 120 participants were with diabetes ranging in age from 27 through 56 years (M = 40.10 years