We studied the knowledge, attitude and practice of 27 parents of children with Thalassaemia towards their children's disease. The parents' knowledge was satisfactory. Most of them did not reveal details of the disease to their affected children. Some of them had further children despite being explained the risk of recurrence. Parents found it difficult to obtain regular blood donors and some had to resort to 'buying' blood. The Malaysian Association of Thalassaemia has a role to play in the education of patients, their parents and the public.
Bicycle fatalities constituted 5% of road fatalities in 1995. A helmet, properly worn, is the most effective measure to prevent head injury to a cyclist in the event of a crash. We studied the knowledge, attitude and practice of children in two secondary schools (Ipoh and Kulim) with respect to bicycle helmet use before instituting a program for helmet use. Although there were no major differences in knowledge, attitude and practice of students in the two groups, children in the Ipoh program failed to wear helmets while the children in the Kulim program complied over a one year period. The main reason for failure of the helmet progranl in Ipoh were negative peer influence. The Kulim helmet program was integrated with a bicycle safety course conducted by dedicated teachers. The quasi experimental study resulted in increased awareness of the importance of bicycle helmets among school children in Kulim Keywords: Bicycle helmet, road traffic injury, prevention.
Thyroid diseases are common in women, including at the time of pregnancies. Many typical features of hyperthyroidism are common in normal pregnancies and this may delay or mask the diagnosis. Uncontrolled thyrotoxicosis increases the rate of miscarriage, intrauterine growth restriction (IUGR), premature labour and perinatal mortality. Multi-disciplinary efforts are required to achieve optimal control of thyrotoxicosis. Anti-thyroid drugs are safe and should be used with the lowest possible doses. Radioiodine treatment is contraindicated during pregnancy and lactation. Indications of surgery include: compression symptoms, thyroid malignancy, non-compliance to medications or when the patient develop drugs side effects. Keywords: Hyperthyroidism, pregnancy
Thyroid diseases are common in women, including at the time of pregnancies. Many typical features of hyperthyroidism are common in normal pregnancies and this may delay or mask the diagnosis. Uncontrolled thyrotoxicosis increases the rate of miscarriage, intrauterine growth restriction (IUGR), premature labour and perinatal mortality. Multi-disciplinary efforts are required to achieve optimal control of thyrotoxicosis. Anti-thyroid drugs are safe and should be used with the lowest possible doses. Radioiodine treatment is contraindicated during pregnancy and lactation. Indications of surgery include: compression symptoms, thyroid malignancy, non-compliance to medications or when the patient develop drugs side effects
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.
Epistaxis is a common clinical condition and perhaps the most common ENT cause for emergency hospital admission. Commonly epistaxis originates from the anterior septum and is easily controlled with caurterization and packing. Posterior epistaxis is less common, but more difficult to treat. It usually occurs in the elderly and is frequently associated with hypertension, artherosclerosis and conditions that decrease platelets and clotting function. In the elderly and hypertensive patient the source of bleeding is likely from the sphenopalatine area in lateral posterior nasal wall. Intractable posterior epistaxis that persists despite repeated use of nasal packing has been treated in many different ways. Conventional methods of arterial ligation in intractable epistaxis often involve surgical morbidity as well as failure due to arterial anastomosis. Embolization is most effective in hands of an experience radiologist, in patients with epistaxis refractory to arterial ligation, bleeding site difficult to reach surgically or epistaxis due to general bleeding disorder. Endoscopic ligation or clipping of sphenopalatine artery is a relatively simple and effective procedure for control of intractable posterior epistaxis.
471 ovarian tumours were available for study from 1980 to 1987. Epidemiological breakdown by race, age and the histological type of the tumours was obtained. The diagnosis of the individual tumours was based on the World Health Organisation (WHO) histological classification of ovarian tumours. There were 324 (68.8%) benigh and 147 (31.2%) malignant tumours. 253 (53.7%) of the tumours were seen in the Malays. The third decade was the peak age for the benigh tumours, and for the malignant tumours, the fourth and fifth decades. 138 (42.6%) of the benign ovarian tumours were cystic teratomas and 45 (30.6%) of the malignant tumours were cystadenocarcinoma.
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.