There is increasing evidence that insomnia is a common complaint. Furthermore, physicians tend to institute treatment without adequate assessment of the patients with insomnia. For the purpose of management, cases are presented on the basis of classification. A survey of doctor's knowledge and practice in the primary care department is discussed. Management principles and problems are outlined.
The need to deliver teaching material in medical education using the internet is compelling in view of the many advantages that the internet provides. The internet has enabled organizations, in particular institutions of higher education to conduct various courses entirely electronically and without regard to physical geographical boundaries. The term CAL is used to denote the employment of the Internet for the delivery of teaching material, conduct of discussion, as;sessment of performance and interaction between students and teachers. This study reviews reports of the use and evaluation of Computer-Aided-Learning (CAL) in teaching various major disciplines in medicine.
Six cases of children of divorced parents are discussed. Their presentations are described and other relevant findings are mentioned. It is interesting to note that in the majority of the cases, the caretakers had difficulties in looking after the children and hence brought them to seek treatment.
Study site: Psychiatric clinic, Universiti Kebangsaan Malaysia
Blood alcohol levels from 155 UKM forensic postmortem cases of various causes of death from August 1988 to mid-September 1989 were studied. 59 cases (38%) were related to fatal road traffic accidents. 13 of these 59 cases (22%) showed blood alcohol levels of more than 50 mg/dl. 11 of these 13 cases (84.6%) revealed blood alcohol levels of more than 100 mg/dl after correction. Further analysis showed 53.8% were Indian, 76.9% aged between 20 and 40 years, 84.6% of the accidents occurred between 8.00 p.m. and 4.00 a.m. and all the alcohol related fatal road traffic accident victims studied in this series were males. This study provides helpful information.
A retrospective study of 100 patients with acute right upper quadrant pain was performed in order to indicate the diagnostic role of ultrasound including the diagnostic role of ultrasound including guided percutaneous procedures in the evaluation of such cases at the General Hospital Kota Bharu (GH, KB). In the majority of these patients the leading clinical consideration was acute cholecystitis. In all the patients the initial sonographic diagnoses were compared with the final diagnoses. In 35 patients (35%) biliary pathology was diagnosed. In this group the conographic correlation was good. In 65 patients (65%) the symptoms were due to non-biliary pathology. In this group ultrasound detected the actual site of pathology in 28%. Ultrasonography which can image multiple organs rapidly is a useful initial screening procedure in patients presenting with acute right upper quadrant pain because it can detect the actual size of pathology in about two-thirds of the cases.
A retrospective analysis of 49 patients with 55 liver abscesses evaluated by diagnostic ultrasonography was made. The sonographic appearances were varied and non-specific. 96% of the abscesses were in the right lobe of the liver. Sonographic features which were frequently observed include (a) predominantly hypoechoic internal echotexture (64%) (b) distal sonic enhancement (98%) (c) well-defined margin with an abrupt transition between normal liver parenchyma and lesion (96%) and (d) absence of wall echoes (89%). A combination of these features has considerable diagnostic value. Distal sonic enhancement is of particular diagnostic importance. In equivocal cases the diagnosis can be quickly determined by percutaneous needle aspiration under ultrasound guidance.
Stool samples obtained from 120 Malay children, aged below 6 years, in Mukim Ijok, Kuala Selangor, were tested. Enteric pathogens were found in 7.5% of specimens. Enteropathogenic Escherichia coli (EPEC) was the most common enteric pathogen isolated (6.7%) followed by Salmonella spp (0.83%). The rate of isolation was independent of age and sex.
The aim of the study was to determine the factors associated with diabetic control among Non Insulin Dependent Diabetes Mellitus (NIDDM) in a Felda settlement area. METHODS: We analyzed the anthropometric and metabolic data of sixty three NIDDM patients in Felda Sg Koyan, Raub, Pahang. Diabetic control, was measured by glycated hemoglobin (HbA1) and fructosamine; it showed a strong correlation (r=12.8 and p-0.001). With the use of a multivariate regression model, which was adjusted for sex, age, dhration of diabetes, body mass index (BMI) and systolic blood pressure, we found that the occurrence of higher fructosamine was associated with significantly higher HbA1 (F =7.8, p=0.01). RESULTS: Obesity was present in 72% of diabetic patients with BMI>25 and had a mean duration of diabetes of 6+4 years. Mean HbAl among males (6.8 + 1.6%) were significantly different (p 0.05) to diabetic control. CONCLUSIONS: The study showed that males have a better diabetic control than females. Poor control was observed among diabetics who had diabetes for more than five years.