Anaesthetic experience of the first nine patients in Singapore who underwent closed embolisation of cerebral arteriovenous malformations is reported. Six patients had neurolept analgesia and three had general anaesthesia.
The purpose of this study was to optimise the testing paradigm for isolating the contributions of chromatic and achromatic mechanisms to the human spectral sensitivity function. Spectral sensitivity was determined for a test spot size of 1.2 deg presented with various spatial and temporal masks on a large, 10 deg background field of moderate intensity (1000 td) and colour temperature, CT = 2700 K. Sinusoidal temporal presentation (1 Hz) and a masking annulus of between 3 and 10 min of arc surrounding the test spot, was found to be most effective in separating chromatic from achromatic mechanisms. Square-wave (1 Hz) temporal presentation combined with the annulus was slightly less selective. The presence of the annulus did not affect the shape of flicker detection at 25 Hz which is a measure of the luminosity (achromatic) spectral sensitivity function.
Variable parameters in chemiluminescence assay, one of the methods used to assess the functional capacity of neutrophils, were evaluated for suitable adaptation locally. The use of pooled normal human serum as compared to single normal human serum in opsonizing particles for phagocytosis was found to exhibit lower chemiluminescence activity (reduction range of 30%-50%). A similar degree of depression was observed when the particles were opsonized using normal human serum in comparison to that using autologous serum. Different intensity of chemiluminescence was also noted when the opsonized particle used was the Oxford strain of Staphylococcus aureus (NCTC 6571) in contrast to a strain of Staphylococcus aureus isolated from a patient. The results obtained warrant clinicians to deliver appropriate samples as best they can when the chemiluminescence assay is requested.
Multiple-choice questions (MCQ) are widely used to evaluate students in the health sciences, including anatomy. Unusual responses in 90 simple MCQ examinations have been identified and classified as to cause, including a number of illustrated examples. About one-quarter of these errors were attributable to the teacher and could have been avoided by a critical analysis of the questions before use. The increasing use of sophisticated formats of the MCQ in medical education indicates that teachers need to analyze their questions more carefully before and after actual tests to minimize errors.
A field trial was carried out to study the effect of lambdacyhalothrin on Anopheles maculatus in trap huts in Jeram Kedah, Negeri Sembilan, Malaysia. Two trap huts were built, of which one was sprayed with lambdacyhalothrin at a dosage of 25 mg ai/m2 and the other served as control. Eight collectors commenced collecting mosquitos from 1900 to 2400 hours, two each indoors and outdoors. Bioassay was also carried out in the treated and control huts to determine susceptibility of adult mosquitos to lambdacyhalothrin. In the treated hut more mosquitos were present during the pre- spraying period. Lambdacyhalothrin gave a mortality of 100% against An. maculatus for 8 months.
The ability to visualise valvular vegetations by echocardiography is a significant advantage in the management oj patients with infective endocarditis. In this report the M-Mode and Cross-Sectional echocardiographic appearances oj infective endocarditis affecting the aortic valve are described. The uses and limitations of echocardiography are discussed.
The authors, a psychiatrist and a clinical psychologist, have successfully treated two cases of phobic neurosis by simple behaviour therapy consisting of Jacobson's muscle relaxation technique and systemic desensitisation, at the University Hospital, Kuala Lumpur. The two patients, who were literally housebound because of the unpleasant symptoms of their illness, were able to mobilise themselves again following therapy. The authors feel that general practitioners with some basic training in these methods will be able to bring relief to such afflicted patients. Using the same technique, other conditions such as insomnia, alcoholism and sexual deviations can also be treated.
A simple and sensitive double-antibody radioimmunoassay for human growth hormone (HGH) was developed, optimised and validated. The anti-hGH sera raised in 2 rabbits were highly specific with low cross-reactions of 0.19% and 0.3% with human placental lactogen and 0.21% and 0.13% with human prolactin. The mean sensitivity of the assay determined from 28 assays was found to be 0.4 +/- 0.2 mIU/L. Mean recovery of added exogenous hGH was 98.8 +/- 6.8%. Linearity studies of samples diluted at 1:2, 1:4 and 1:8 gave values of 101.3 +/- 5.3%, 109.6 +/- 13.4% and 97.3 +/- 13% respectively of those expected. The reproducibility of the assay was good; within assay coefficient of variation for serum samples with GH concentrations of 2.7, 13.6 and 28.2 mU/l ranged from 5.1 to 8.3% while the inter-assay precision varied from 4.9 to 10.3%. The in-house assay showed good correlation (r = 0.96, p less than 0.001) with a commercial HGH RIA kit (Dainabot, Japan). A reference normal adult fasting GH level of less than 7 mIU/l was established from 95 samples assayed by this method.
A cross-sectional national survey was conducted amongst a random sample of medical practitioners registered in 1988 with the Malaysian Medical Council with the purpose of determining their educational needs with regards to continuing medical education (CME). A 91.0% response rate was obtained. It was found that more than 70% wanted a programme that would provide them with new practical skills and new knowledge or advances in specific fields. About 2/3 also wanted their intellectual skills in problem-solving to be further developed. Reinforcement of communication skills appears to be of secondary importance. They would also like a programme of CME to help them monitor and improve their diagnostic accuracy, investigative habits, prescribing pattern, skills in interpreting diagnostic tests and management of common illnesses. As for content areas it was found that the problems they have least confidence in managing come mainly from the disciplines of psychiatry, obstetrics and gynaecology, and emergency and critical care. More than 90% preferred self-learning methods with some group-type activities. Based on these needs it was recommended that a programme of CME be developed with orientation towards a practice-based setting, self-directed learning, utilizing problem-solving approaches and focusing on the major content areas identified. In addition, activities such as small-group discussions, clinical rounds and journal clubs should be encouraged to develop into local network group activities to supplement the self-learning and present lectures and talks.
The emphasis on cow records in Malaysian dairy extension programmes reflects the importance of herd fertility in the economics of dairying. Manual record keeping has not been able to make an impact on management due to difficulties experienced in quality control of the data and in analysing the data to produce useful information for farm managers. Computerised recording systems have been in use in Malaysia since 1985, both on government farms and in the small-holder dairy sector. The aim of both systems is firstly to improve farm efficiency by the provision of information to managers and extension workers and secondly to provide information for departmental planning purposes. The systems used in Malaysia are outlined, and the results over the first three years of operation are summarised.
The author describes a new operative method for treating chronic recurrent subdural hematoma. The subdural pocket is exteriorized so that it is in continuity with the subgaleal space through a limited extradural pocket and an L-shaped linear craniectomy. This procedure has been carried out in two patients with recurrent chronic subdural hematoma, both of whom made complete recoveries despite initial recurrence of the subdural hematoma.
Ultrasound measurement of ocular dimension is the chosen method for assessing axial length when determining dioptric power for intraocular lens. From the current results of 30 cases studied, the mean axial length ranges from 22 to 23 mm. Despite the limitation of the accuracy of the ultrasonic measurements with the 7.5 mHz transducer, the power of intraocular lens can. be determined satisfactorily in accordance with the knowledge of keratometric reading. Hence, high refractive errors could be avoided post-operatively.
The measurement of the ultimate effects of the microbial insecticides on mosquito density is best obtained by assessment of adult populations. The main aims of this study are: (1) to assess the effect of Bacillus thuringiensis israelensis (Bti) FC Skeetal and Bactimos briquettes on the emergence rate of Mansonia bonneae developed from the introduced first-instar stage larvae and (2) to measure the effect of these two formulations of insecticides on Mansonia adult populations emerging from the natural breeding plots. Bti Skeetal and Bactimos briquettes at the lower applied dosages of 2.3 kg/ha and 1 briquette case/20 m2 respectively achieved 39-40% pupation rates and 31.5-34.2% adult emergence rates. At these low applied dosages, there was little or no direct effect on pupation from the surviving larvae and thereafter on the emergence of adults from the pupae. A two-fold increase in dosage, however, produced a drastic decline in the pupation rate and adult emergence rate. The rates dropped to 6.5% (pupation) and 4.3% (adult emergence) of the total larvae for Bactimos briquettes and to merely 1.5% (pupation) and 1.3% (adult emergence) of the total larvae for Skeetal. In studying the effect of Bti on the field populations of Mansonia mosquitos, two plots each were treated with Bactimos at 1 briquette case/10 m2 and Skeetal at 4.6 kg/ha. A wooden pyramid-shaped screened cage was placed on a cluster of host plants for a period of 2 weeks to trap the emerging adult mosquitoes. There were a total of 24 clusters of host plants in each plot.(ABSTRACT TRUNCATED AT 250 WORDS)
Repeatedly catheterising the internal jugular vein percutaneously through the same site, between the heads of the sternomastoid, resulted in soft tissue cleavage planes. The catheter entered the pleural cavity from the superior vena cava, a site remote from the percutaneous entry.
The internal jugular line can be misplaced in spite of respiratory fluctuation, free flow, and reflux with the container lowered below cardiac level. Radiological confirmation is mandatory.
Matched MeSH terms: Catheterization, Central Venous/methods*
The paper discusses the results of 24 cases of Millin's prostatectomy in a District Hospital carried out between April and December 1983. The results show that the blood loss in the operation is usually not more than 600ml and therefore would not pose a strain on the blood bank. Postoperative bleeding is very minimal and again does not tax the nursing staff of an overcrowded, large ward in the District Hospital. The results for the patients are excellent.