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.
Two cases of longstanding foreign bodies in the larynx and lower laryngo-pharynx were accurately localised by direct coronal3 and limited axial CT scans of the neck. The relationship of the foreign bodies with the surrounding structures and associated changes are demonstrated clearly.
Talon cusps were observed in a 10-year-old boy and his 12-year-old sister. Although the sister's affected tooth was asymptomatic and free of any occlusal interference, the boy's tooth presented some problems. The affected tooth had displaced the occluding mandibular tooth lingually, and this had resulted in a mid-line shift. To overcome the problem, the talon cusp was ground off and a prophylactic odontotomy performed. Orthodontic treatment was later carried out.
A monoclonal antibody raised against Haemophilus ducreyi was tested for its sensitivity and specificity as an immunofluorescence (IF) reagent using simulated vaginal smears containing H. ducreyi, smears taken from skin lesions of mice infected with H. ducreyi and patients from South Africa, Thailand and Malaysia with clinically diagnosed chancroid. The IF test was more sensitive than culture or Gram staining in the simulated smears, theoretically detecting less than 4 organisms/sample. It detected H. ducreyi in 95% of the animal lesions compared with 14% detected by culture. Immunofluorescence testing identified over 90% of culture-positive cases of chancroid but also detected organisms in some culture-negative cases where clinical evidence for the diagnosis was strong. These results suggest that this antibody may provide a simple, rapid and sensitive means of detecting H. ducreyi in cases of chancroid.
The concept of conversion hallucination is a relatively new one, however there have been several articles written on this phenomena, some attesting to it being a special form of hallucination while others dismissing it altogether. But currently this concept is slowly being accepted among psychiatrists and as such it is important for us to understand some of the concepts. In this case report, the patient presented with clear conversion hallucinations. The case is followed by a discussion on true and pseudo-hallucinations, previous case reports and finally a discussion of conversion hallucinations, viz. the clinical features and the conversion hypothesis.
Thirty one cases of malignant tumours of the maxillary sinus presenting to the Department of Otolaryngology, Universiti Kebangsaan Malaysia over a four year period from 1982 to 1986 are reviewed. 18 cases (58.1%) were squamous cell carcinoma while seven cases (22.5%) were Non-Hodgkin's lymphoma. There were four cases (12.0%) of adenoid cystic carcinoma while in two cases (6.5%) the tumours were undifferentiated. Presentation was generally late. Nasal obstruction, facial swelling and epistaxis were the main presenting symptoms. Nasal involvement was found in 61.3% of cases, while 51.6% had involvement of the palate as well. Metastasis to the cervical lymph node were uncommon (6.5%). Surgery and radiotherapy with or without chemotherapy were the main modes of treatment in the management of malignant tumours of the maxillary sinus.
A case of limy bile, i.e. bile in the gall bladder rendered radio-opaque due to excessive concentration of calcium carbonate, is reported and its pathogenesis discussed.
A 38 year old patient unth. chronic granulocytes leukaemia, subsequently presented untli blast transformation. nineteen. months later. Conventional light microscopy and cytochemistry were not helpful in elucidating the type of blast cell. Electron microscopy however identifies the blasts to be of megakaryocytic series.
A retrospective study of 37 cases of multiple myeloma admitted from 1980 to 1987 to the University Hospital Kuala Lumpur, Malaysia, was carried out to analyse the biodata, clinical presentation, laboratory and radiological profiles. The cases were selected after they had satisfied preset diagnostic criteria. The mean age was 60 years. There was no sex or ethnic preponderance. The most common symptom was bone pain. Pallor was detected in 73% of the patients. Haemoglobin was less than 120 g/L in 95%, and ESR was greater than 100 mm/hr in 70% of cases. Bone marrow and trephine biopsies were diagnostically important. Hypercalcaemia occurred in seven cases out of which three were IgA myelomas. Either serum creatinine or blood urea was raised in nearly 50% of cases. The most common heavy chain paraprotein was IgG while Kappa light chain was the commoner light chain type. 86% of cases had osteolytic lesions. These findings are, in general, similar to those of larger studies on multiple myeloma.
Study site: University Malaya Medical Centre (UMMC)
To our knowledge, meningitis due to Listeria monocytogenes has not previously been reported in Malaysia. We describe here two infants with meningitis due to Listeria monocytogenes occurring within a month of each other in the Universiti Kebangsaan Malaysia Paediatric Unit. The incidence of listeriosis in Malaysia is unknown and it is possible that this infection may have been missed in the past.