Ischemic heart disease is a leading cause of morbidity and mortality in Malaysia. Management strategies for this disease have changed dramatically. This article, based on discussions of real cases, reviews current treatment methods for various patient subsets, with acute myocardial ischemia.
Contact lenses provide an alternative to spectacles for many people. However, the hazard of bacterial corneal ulcers exists. This article describes a soft contact lens wearer who developed a bacterial corneal ulcer. Prompt diagnosis and treatment is essential for eradication of the infection and prevention of loss of vision.
A study was conducted in an urban slum area of Kuala Lumpur, the capital of Malaysia, to determine the health status of the children under 6 years old and the knowledge and practice associated with diarrhoeal diseases and use of oral rehydration salts (ORS) among mothers in the area. It was seen that the health status of the children was poor with one fifth of them born underweight, 33% experiencing more than 6 spells of illness per year and a high percentage of them suffering from diarrhoeal diseases (4.3%). Child care practice was associated with urban lifestyles with early weaning, short term breast-feeding and early introduction of solid and bottle feeding. Knowledge and practice of mothers concerning child care was inadequate to support healthy living. Knowledge of diarrhoeal diseases and the effectivenss of oral rehydration salts was poor. Only 47.7% of mothers knew about ORS and 27.8% ever used it when their chidlren suffered from diarrhoea. Health care system dependence was shown by the high percentage of mothers immediately bringing to a doctor's attention (75.6%).
Cough associated with angiotensin converting-enzyme (ACE) inhibitor therapy has been reported in Western communities, where its incidence is disputed. We, therefore, reviewed our patients who were treated with captopril primarily for congestive cardiac failure. 19 of 61 patients (31.1%) receiving an ACE inhibitor had volunteered cough as an important adverse effect, compared with only one of 59 patients who recieved other treatment. In 3 patients, the cough was intolerably severe to require discontinuation of treatment. Another 7 patients were withdrawn from ACE inhibitor treatment because of other adverse effects including deteriorating renal function, insomnia, dizzy spells, ageusia and proteinuria, and skin rash. We suggest that although ACE inhibitors are very beneficial in improving the clinical status of congestive heart failure, intolerable adverse effects are not uncommon and might mandate withdrawal in a sizeable minority (16.4%).
Otitis media is a common disease presenting to family practitioners all over the world. There have been many changes in the way these patients were managed over the years. This article attempts to provide an overview to family physicians regarding the latest approach in managing this common condition. Keywords: Otitis, otitis media, otoscopy, eardrops.