X-ray based radiological procedure statistics and trend in Malaysia for 1990-1994 is reported; this information allows comparisons to be made with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Report. Additionally it is essential information for health care planners and providers. Malaysia is categorised as a health care level II country based on the UNSCEAR definition. In 1994, the number of physicians, radiologists, x-ray units and x-ray examinations per 1000 population was 0.45, 0.005, 0.065 and 183 respectively. 3.6 million x-ray examinations were performed in 1994, with chest radiography being the commonest study (63%). Information on x-ray examinations, number of hospitals and x-ray units is reported for the Ministry of Health, private practice and teaching hospitals. Examination frequency increased in computed tomography (161%), cardiac procedures (190%), and mammography (240%); while a decrease in barium studies (-23%), cholecystography (-36%), and intravenous urography (-51%) was noted. There is a potential and need to expand and upgrade radiological services.
Leiomyomas are benign neoplasms of smooth muscle origin. They represent rare entities in the oral cavity. A case arising from the incisive papilla region of a 3-month-old infant is described and the histogenesis as well as the biologic potential of this tumor are discussed.
The RSNA International Visiting Professor program gave us an opportunity to live in a different and exciting country for 6 months. We had adequate travel opportunities to visit in Southeast Asia. Most of all, the feeling of appreciation and accomplishment we received from the master students as exemplified by their concern for us made our adventure extremely rewarding. For example, on the day of departure about half the class came to the airport to bid us farewell. This gesture, as well as several farewell parties in our honor, was certainly very gratifying. I enthusiastically recommend the opportunity afforded by the RSNA Visiting Professor program, and, specifically, I am enthusiastic about the program at Universiti Malaya.
Two cases of oral speckled leukoplakia with differing behaviour are presented. This precancerous lesion of unknown aetiology requires early diagnosis for proper management. Candida albicans are frequently found in these lesions. The significance of epithelial dysplasia in relation to treatment is discussed. Surgical removal is the treatment of choice.
A case of carotid body tumour is presented. Pathology, diagnostic investigations, modalities of treatment and prognosis are discussed. With greater awareness of this condition and improvement in diagnostic investigations and surgical techniques, the outlook in managing this condition should be better.
Sexually deviant behaviour is a fairly common phenomenon but because it is socially embarassing, a few cases come forward for consultation and treatment on a voluntary basis. Most cases are referred by the law courts. Two such cases, one of exhibitionism and the other offetishism, were referred to the University Hospital, Kuala Lumpur in 1982. Their development histories were elaborated. A third case of sexual sadism came voluntarily for help out defaulted after the initial session. A review on the current western concepts on sexual deviation is included in the text. It is concluded that although it is generally thought that neurological conditions give rise to deviant sexual behaviour, this assumption should not be arrived at hastily, as many cases of organic mental disorders do not exhibit deviant sexual
behaviour.
A term, Malay male neonate, delivered by spontaneous vertex delivery, was found to have a huge carvenous hemangioma on the anterior chest wall. He developed respiratory failure on the second day of life. Having considered the various options possible, an emergency surgical excision was carried outat the age of 57 hours. The patient recovered after a stormy post-operative period.
A 30 year old Malay male developed bilateral choroiditis followed by vitiligo, poliosis and canities. CT scan showed nodular thickening of the optic nerves. Characteristic abnormalities were seen in visual and brainstem auditory evoked potentials and fluorescein angiography. These findings were in keeping with the diagnosis of Vogt-Koyanagi-Harada syndrome. Treatment with dexamethasone resulted in complete recovery of vision and partial improvement in skin and hair lesions.
The public especially in West Malaysia are becoming more aware of their rights and litigations are on the increase. Fortunately in East Malaysia there are fewer cases. The legal aspects of anaesthesia practice are very much on the lines of British system. Here the cause for compensation or legal action depends on the proof of negligence. Currently in West Malaysia all anaesthetics are being given by medical practitioners. In East Malaysia the anaesthetics are being given mainly by Medical Assistant's who have been trained for about six months to give anaesthesia in all government hospitals. There are guidelines on minimum standard of safety for patients undergoing general anaesthesia, though this is not as elaborate as those in Western countries.