Baby walker associated injuries are occurring in Malaysia. Most are not noticed as paediatricians are more concerned with the treatment of the injury and forget the preventive measures required to overcome this problem. We believe that baby walkers should be banned in Malaysia as the risks of injury far outweighs any benefits. We present 4 cases of baby walker associated scalding injuries.
A family demonstrating autosomal dominant thrombocytopenia is described. A 28-year-old Malay housewife was found to have a platelet count of 40 x 10(9)/l with a low mean platelet volume (6.8 fl) while being investigated prior to ovarian cystectomy. The bone marrow was consistent with immune thrombocytopenia but she failed to respond to appropriate therapy. Five siblings, one parent and one nephew have easy bruising and platelet counts of 39-82 x 10(9)/l. Platelet aggregation studies excluded a major functional defect. Survival of homologous platelets in the circulation was normal. Familial thrombocytopenias are rare but important to differentiate from the common acquired thrombocytopenias in order to spare the patient unnecessary treatments.
Law enforcing authorities need to provide a scientific basis for the identification of any unknown individual. In recent years, dental records comparison has developed into one such credible method of confirming the identity of a deceased. This method is however restricted as dentists are not making and maintaining adequate records of their patients. Fortunately the advent of inexpensive cameras and print processing procedures has enabled the availability of ample antemortem photographs. Photographs in which a person expresses his/her teeth 'gleefully' has provided a sound scientific basis for the identification by comparing dental characteristics of the deceased.
The main objective of this study is to illustrate the role of ductography in the management of nipple discharge. Thirty-six patients had ductography for the investigation of blood-stained or serous nipple discharge. The ductogram findings were reviewed. Ductography showed an intraductal lesion in 13 patients, duct ectasia in 16 and normal ducts in 7. Fourteen patients had surgery. Eight had preoperative ductography using a mixture of methylene blue and contrast media. Histology revealed 5 cases of duct papilloma, 2 cases of epithelial hyperplasia, 4 cases of fibrocystic change and 3 cases of duct ectasia. Twenty had follow-up without surgery and of these, the nipple discharge ceased in 11 patients. Two patients did not come for follow-up. Ductography has a significant role in the management of nipple discharge. Firstly, surgery might be averted in patients with normal ducts or duct ectasia on ductography. Secondly, intraductal methylene blue will demonstrate the abnormal ductal system to the surgeon and allow for a less radical surgery.
Giardiasis, a gastrointestinal disease caused by Giardia intestinalis is endemic in Malaysia. The prevalence rate has been reported to range from 1.4% to 11.1%. The present study was undertaken between 1992-1994 in three health districts in three states viz. Pahang, Negeri Sembilan and Selangor. Seven thousand five hundred and fifty seven (7557) primary school children between the ages of 6-12 years from the lower socio-economic groups were screened. The prevalence was 0.21%. The study suggests that improved water supply, toilet facilities and sanitation have lowered the prevalence of a waterborne disease in the areas surveyed.
A case of combined intra- and extra-uterine pregnancy is reported. Awareness of this condition, a high index of suspicion, the proper interpretation of physical signs and ultrasound findings together with early resort to laparoscopy resulted in a favourable outcome.
Modern concepts concerning the development of breastfeeding programmes are given, with special reference to maternal reflexes, the need for information and the health and nutrition of mothers. Motivation and education are needed for health professionals, families and administrators. Some successful programmes are mentioned including small-scale hospital activities and national programmes, notably the one developed in Brazil.
A female Malay patient with acute lymphoblastic leukemia in remission for one year developed bilateral visual loss. The ophthalmoscopic appearance showed infiltration of optic nerves and retinae by leukemic cells. At that time, her blood, bone marrow and cerebral spinal fluid remained normal. She had received prophylactic cranial irradiation and intrathecal methotrexate as part of the treatment programme. It was likely therefore she had a leukemic relapse from a pharmacologic sanctuary in the eyes. She responded to local irradiation but did not regain her sight. Three months later, she had a bone marrow relapse.
Thirty-one (31) patients undergoing electroconvulsive therapy (ECT) over a three-week period in October 1982 in the Psychiatric Unit, University Hospital, Kuala Lumpur, were studied. The main indications for ECT in these patients were poor response to drug therapy, depression with suicidal ideation, and aggression, which together accounted for 87 percent of all patients started on ECT during this period. The majority of patients (86 percent) showed some improvement, and 73 percent improved by the third ECT. The most common side-effects experienced by patients were memory disturbance (45 percent) and post ECT headache (45 percent). No serious side-effects were encountered.
Forty nine patients with sick sinus syndrome seen at the University Hospital, Kuala Lumpur are reviewed. The ages of patients ranged from 17 to 85 years. There were 21 males and 28 females. The diagnostic criteria were sinus bradycardia in 8 patients (Group I), sinus arrest or sinoatrial block in 24 patients. (Group Il), and bradycardia tachycardia syndrome in 17 patiens (Group Ill). The aetiology was unknown in the majority of patients. Ischaemic heart disease was the commonest known aetiological factor. Patients with symptomatic sinus bradycardia and sinus arrest were initially treated with oral isoprenaline, and if this failed, they were paced. Temporary transvenous pacing was necessary in 27 patients and subsequent permanent pacing performed on 23 patients.
Serum ferritin concentration has been measured in pregnant women at their first antenatal visit. Results were analysed according to trimesters. With progression of the pregnancy there is a fall in serum ferritin concentrations. Haemoglobin and red cell indices cannot be used to predict iron status supplemental iron therapy raised the serum ferritin levels.
This is a review of 20 cases of ameloblastomas diagnosed and treated at the Dental Faculty, University of Malaya, Kuala Lumpur. The clinical features, histological features and treatment methods are presented. Two basic clinical types namely the conventional (solid/multicystic) and unicystic ameloblastomas showed different recurrence rates. Discrepancies between the recurrent rates in this study for conventional ameloblastoma and for unicystic ameloblastoma and those of other reports are discussed. A brief discussion on the treatment modalities used is also presented.
A case of the Klippel-Feil syndrome presenting with schizophrenia is described. The Klippel-Feil syndrome is reported to be associated with abnormalities in many systems of the body, but its association with a schizophrenic illness has not been described.