The effects of Eurycoma longifolia Jack were studied on the libido of sexually experienced male rats after dosing them with 200, 400 and 800 mg/kg body weight twice daily of different fractions of E. longifolia Jack for 10 days. Results showed that E. longifolia Jack produced a dose-dependent increase in mounting frequency of the treated animals with 400 mg/kg of chloroform, methanol, water and butanol fractions resulting in mounting frequencies of 5.3 +/- 1.2, 4.9 +/- 0.7, 4.8 +/- 0.7 and 5.2 +/- 0.1, and 800 mg/kg further increased them to 5.4 +/- 0.8, 5.4 +/- 0.8, 5.2 +/- 0.6 and 5.3 +/- 0.2 respectively but there were no erections, intromissions, ejaculations or seminal emissions during the 20-min observation period which allowed for the measurement of sexual arousal reflected by mounting frequency uninfluenced by other behavioural components. This study provides evidence that E. longifolia Jack is a potent stimulator of sexual arousal in sexually vigorous male rats in the absence of feedback from genital sensation.
The effects of Eurycoma longifolia JACK were studied on the orientation activities of sexually experienced male rats towards receptive females (mounting, licking, anogenital sniffing), environment (exploration, raring, climbing), themselves (genital grooming, non-genital grooming) and mobility (unrestricted, restricted) after dosing them with 200, 400 and 800 mg/kg body weight twice daily for 10 d prior to the test. The results showed that E. longifolia JACK modified the orientation activities of the treated male rats in that they significantly displayed more frequent and vigorous mounting, licking and anogenital sniffing towards the receptive females, and it further intensified self orientation as indicated by the increased grooming of the genitals compared to the controls (p<0.05). In addition, rats treated with 800 mg/kg of methanol, water and butanol extracts of E. longifolia JACK continued to show confinement to a particular area of the cage (around the female), thus showing restriction in movement as compared to the controls (p<0.05). However, the treated males possessed a lack of interest in the external environment as indicated by a reduction in exploration, raring and climbing on the cage wall. Hence, the present study further supports the folk use of E. longifolia JACK as an aphrodisiac.
Comparative surgical audit to monitor quality of care should be performed with a risk-adjusted scoring system rather than using crude morbidity and mortality rates. A validated and widely applied risk adjusted scoring system, P-POSSUM (Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality) methodology, was applied to a prospective series of predominantly general surgical patients at the Sarawak General Hospital, Kuching over a six months period. The patients were grouped into four risk groups. The observed mortality rates were not significantly different from predicted rates, showing that the quality of surgical care was at par with typical western series. The simplicity and advantages of this scoring system over other auditing tools are discussed. The P-POSSUM methodology could form the basis of local comparative surgical audit for assessment and maintenance of quality care.
Acupuncture is used for some conditions as an alternative to medication or surgical intervention. Several complications had been reported, and they are generally due to physical injury by the needle or transmission of diseases. We report a case of life-threatening necrotising fasciitis that developed after acupuncture treatment for osteoarthritis of the knee in a 55-year-old diabetic woman. She presented with multiple discharging sinuses over the right knee. As the patient did not respond to intravenous antibiotics, extensive debridement was performed. She made a good recovery. Since many old diabetic patients with degenerative joint diseases may consider this mode of treatment, guidelines on cleanliness and sterility of this procedure should be developed and practiced.
Achondrogenesis is a lethal neonatal chondrodysplasia with extreme micromelia and marked discrepancy between the relatively large head and the decreased trunk length. The affected neonates are usually delivered prematurely, and are stillborn or die soon after birth. Polyhydramnios is frequently present. It is an inherited autosomal recessive disease. The radiographic features are diagnostic.
An 8-year old boy presented with a right neck swelling which appeared only intermittently. The swelling was well demonstrated by the Valsalva manoeuvre. The differential diagnosis include a laryngocele, a superior mediastinum tumour or cyst and a venous aneurysm. Plain radiography, computerized tomography, ultrasonography and venography were performed. A diagnosis of venous aneurysm was confirmed. Ultrasonography was the best modality for imaging of this rare condition. It is non-invasive and it will also delineate the extent of the lesion. The treatment is expectant. Surgery is reserved for cosmesis and symptomatic aneurysms.
Perforated appendicitis, with its increased complication rate, today still poses a formidable problem in the Kuala Lumpur General Hospital. Out of 1694 emergency operations performed by our unit in 1987, there were 927 appendicectomies. A retrospective study of these cases showed 126 cases of perforated appendicitis, which were then subjected to detailed analysis. We have a diagnostic accuracy of 81% and perforation rate of 18%. In addition, it is interesting to note the racial differences in the relationship of diagnostic accuracy to perforation rate. Perforation is associated with an increased wound infection rate. Transperitoneal drainage in perforated appendicitis did not lead to a lower incidence of wound infection or improve postoperative performance. Distinguishing between perforated and non-perforated appendicitis may be difficult. Perforation could occur while awaiting operation. We recommend the early administration of systemic antibiotics should appendicectomy be delayed and the cautious use of drains in cases of perforated appendicitis.
Two commercial repellants were evaluated in the laboratory against Leptotrombidium fletcheri chiggers. The active ingredient in one was DEET and in the other was citrus oil. Excito-toxicity effect was studied and it was determined by the time ("escape time") chiggers took to move off filter papers treated with the repellants. All chiggers exposed on filter papers treated with DEET died and did not move off the treated papers. None of the chiggers that were placed on papers treated with citrus oil were killed. Escape times on papers treated with a 2-sec spray of citrus oil were longer than those for the 4- and 8-sec sprays. The weights of citrus oil deposited increased with increasing spray times. Electron microscopy showed that the repellants had no effect on the texture of the filter papers. It was concluded that the spray containing DEET was more effective; however, both repellants should be further evaluated under field conditions for protection against chigger bites.
Duchenne muscular dystrophy (DMD), the commonest X-linked disorder, is a progressive, eventually fatal disease. With the advent of molecular genetics, the Duchenne gene and its protein product, dystrophin, have been characterised. Molecular diagnosis of DMD, identification of carriers and antenatal diagnosis are now possible. We describe here the use, in a Malaysian boy with DMD, of a recent innovation, multiplex polymerase chain reaction (PCR), to obtain molecular diagnosis by detection of dystrophin gene deletions.
Ninety-nine samples of common Chinese medicines were purchased from Chinese medical shops in Singapore and Malaysia and analyzed for mercury, lead, copper, cadmium, cobalt, iron, and nickel. The majority of these medicines were manufactured in China, Hong Kong, and Malaysia. A few of them were of Singapore and Taiwan origin. Atomic absorption method (both flame and flameless) was used for the analyses. Mercury was found to be present in high concentrations in several of the medicines that were for oral consumption.
The first case of Sarcocystis infection is reported from West Malaysia. A cyst was seen as an incidental finding in a biopsy specimen from the larynx of the patient. The cyst and the cystozoites were of the small size with no evidence of cytophaneres or compartments.
The resolvent operator approach is applied to address a system of generalized ordered variational inclusions with ⊕ operator in real ordered Banach space. With the help of the resolvent operator technique, Li et al. (J. Inequal. Appl. 2013:514, 2013; Fixed Point Theory Appl. 2014:122, 2014; Fixed Point Theory Appl. 2014:146, 2014; Appl. Math. Lett. 25:1384-1388, 2012; Fixed Point Theory Appl. 2013:241, 2013; Eur. J. Oper. Res. 16(1):1-8, 2011; Fixed Point Theory Appl. 2014:79, 2014; Nonlinear Anal. Forum 13(2):205-214, 2008; Nonlinear Anal. Forum 14: 89-97, 2009) derived an iterative algorithm for approximating a solution of the considered system. Here, we prove an existence result for the solution of the system of generalized ordered variational inclusions and deal with a convergence scheme for the algorithms under some appropriate conditions. Some special cases are also discussed.
INTRODUCTION: Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced hearing or otalgia.
METHOD: Case report.
RESULTS: We report two cases of young ladies with CC who presented with different otological symptoms. The first case complained of recurrent unilateral ear pain while the second case presented with unilateral reduced hearing. Examination of both cases revealed a whitish mass seen behind an intact tympanic membrane. Both cases underwent surgery and histopathological examinations; findings were consistent with cholesteatoma.
CONCLUSION: There are varieties of clinical presentations of CC and the diagnosis is based on clinical findings.
The aim of this study is to provide evidence on the aphrodisiac property of Eurycoma longifolia Jack. An electric grid was used as an obstruction in the electrical copulation cage in order to determine how much an aversive stimulus the sexually naive male rat for both the treated with E. longifolia Jack and control groups were willing to overcome to reach the estrous receptive female in the goal cage. The intensity of the grid current was maintained at 0.12 mA and this was the intensity in which the male rats in the control group failed to crossover to reach the goal cage. Results showed that E. longifolia Jack continued to enhance and also maintain a high level of both the total number of successful crossovers, mountings, intromissions and ejaculations during the 9-12th week observation period. In conclusion, these results further enhanced and strengthened the aphrodisiac property of E. longifolia Jack.