A unilateral true ankylosis of the temporomandibular joint of traumatic origin and of 23 years duration is reported. Its pathogenesis and treatment are discussed.
The reasons why 860 patients visited the general medical clinic at the University Hospital, Kuala Lumpur were studied. 75.3% of the patients came for evaluation of symptoms; 12.4% sought checkups for chronic diseases; 4.9% requested diagnostic checkups and screening tests; 4.8% came to renew prescription. Few visits were made for evaluation of injuries, receiving test results or for administrative examination. This profile reflected the function of the clinic as an acute diagnostic centre. Other applications of the results are discussed.
Study site: General Medical Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
A total of 23 patients with psychoses associated with thyrotoxicosis were admitted to the psychiatric unit of a University Hospital over a 13-year period, of which 20 patients were included in this retrospective study. It was found that a parallel relationship between thyrotoxicosis and psychosis appears to exist in six patients, while in the remaining 14 patients, the course of the two disease processes were largely independent of each other. Paranoid delusions and auditory hallucinations were the most prominent psychiatric symptoms. Depression was commonly seen even in patients who were not having an affective illness. In four patients, a mixed schizo-affective psychosis was seen, suggesting that the diagnostic distinction between the affective and schizophrenic reactions are often blurred in psychosis associated with thyrotoxicosis.
We report a retrospective study of all cases of toxic epidermal necrolysis admitted to the adult medical wards of the University Hospital in Kuala Lumpur over a 16 year period from 1967 to 1983. Over this period of time only 7 cases were encountered, suggesting the condition is rare in adults in our country. All the cases were females and the age ranged from 21 to 41 years. Four cases were due to drugs, 2 were idiopathic and one was attributed to Staphylococcal infection. One patient died. The other patients recovered completely with no sequelae.
A total of 45 patients with IgA nephropathy were seen at the Department of Nephrology, General Hospital, Kuala Lumpur and the Department of Medicine, Universiti Kebangsaan Malaysia (National University ofMalaysia) between January 1982 to June 1985. This represents an incidence of 10.7% of all primary glomerulopathies. There does not appear to be any racial predilection and the clinicopathological features generally conforms with those reported elsewhere. However it seems to be as common in females as in males but the latter have a worse prognosis. The high incidence of renal failure and hypertension in our patients within the short follow-up period is noteworthy.
A case of infantile polycystic kidneys diagnosed prenatally by ultrasound is presented here. This condition was confirmed at post-mortem following delivery of the child. The clinical and pathological features of this inheritable disease is discussed.
Porphyrias are uncommon disorders of haem metabolism and we report the first documented case of acute intermittent porphyria in Malaysia. The biochemical, clinical features and the management of this order are discussed.
The efficacy of SEBA-MED. a synthetic detergent recommended for use on eczematous skin (especially seborrhoeic eczema), acne vulgaris, furunculosis and mycosis, was evaluated as an adjunctive agent in the management of childhood eczema. 50 patients with eczema from the Paediatric Skin Outpatient Clinic, University Hospital, were studied. Preliminary results of this trial show that SEBA-MED is well-tolerated as a cleansing agent in childhood eczema with no side effects noted. However, as atopic eczema is associated with dry skin in the majority of cases, the concomitant use of 'refatting' agents (such as SEBA-MED cream/lotion) is recommended.
Study site: Skin clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Acne is one of the most common disorders affecting mankind. Although acne does not cause death, it however produces a lot of discomfort, disfigurement and psychological trauma, particularly in teenagers. Acne vulgaris is a chronic condition involving the pilosebaceous unit of the skin. It is characterised by the presence of comedones, inflammatory papules, pustules or cysts, and eventually by scarring. The end result of acne varies from hyperpigmentation, slight pitting, to extremely disfiguring scars that may develop into keloids. Acne fulminans is a rare disorder and is characterised by sudden explosive appearance of highly inflammatory, tender, crusted, ulcerated lesions involving the back, chest and face. It is one of the most scarring acute dermatologic disorders of young people. A case of acne fulminans in a young female who developed haemolysis due to dapsone is reported here.
In 1985, 140 (26.1 %) of 536 admissions to the intensive care unit (ICU) were general surgical cases. Retrospective review of 107 of these admissions revealed four factors to be significantly different between survivors and non-survivors, p < 0.01. They were duration of stay, organ system failure, sepsis and complications. The role of the surgeon in an ICU where management is interdisciplinary is emphasised.
Thirty-one patients with endoscopically proven chronic gastric ulcer completed a randomised double-blind trial comparing the effects of cimetidine and placebo on ulcer healing. Seventeen patients received cimetidine 400 mg bid and 14 patients received placebo. Repeat endoscopy at six weeks showed that the ulcer had healed in 12 patients (71%) receiving cimetidine and in four patients (29%) receiving placebo (p=O.032). Non-smokers healed their ulcers better than smokers (83% vs 35%, p=O.023). The use of cimetidine was not associated with any adverse effects.
From 1973 to 1982,40 children with respiratory distress was bronchoscoped for suspected foreign body in the trachea-bronchial tree. In 31 children, foreign bodies were found and were successfully removed. The condition appeared to be confined to the early toddler group. Six children had pulmonary complications post-operatively. There was no death. A plea is made for early diagnosis and referral to lessen the likelihood of residual pulmonary damage.
Study site: University Hospital, Kuala Lumpur, Malaysia (current name: University Malaya Medical Centre)
Over the last 8 years, 22 consecutive cases of subarachnoid haemorrhage were found to have no obvious cause on angiography. The age, neurological status and CT-scan appearance in 16 cases were studied together with the completeness and quality of the angiogram. Limited angiography was done in cases with advanced age, poor neurology or severe hypertension. There is a need for more repeat angiographic studies in the presence of vasospasm whether focal or generalised, as indicated by the fact that only 5 out of the 17 cases with vasospasm had repeated satisfactory studies.