A case of penetrating cardiac injury is reported where cardiorrhaphy is done without cardiopulmonary bypass and via a right thoracotomy even though median stelnotoluy is the usual approach. It is also stressed that all precordial stab wounds must be carefully explored. KEYWORDS: Penetrating cardiac injury, Without cardiopulmonary bypass, Right posterolateral thoracotomy, Centrally placed chest injury.
A relTospective study was conducted in Hospital Kuala Lumpur, May, 2001.49 (12.1%) of 406 AIDS patients were diagnosed as opportunistic infections related to the central nervous system. The sex ratio (M:F) was 7.2. The median age was 34 years. The predominant age group for male as same as female was 25-34 years.The majority of the study subjects were Chinese (79.6%), married (49%), unemployed (42.9%) and heterosexuals (95.9%) as the risk behavior related to HlV infection. The most frequent clinical manifestations was headache (71.4%). At the time of diagnosis, the greater number of patients 39 (79.6%) had CD4 count < 200 celVcumm. Outcome of acute therapy the patients had a complete (85.7%), treatment continued (10.3%), and transfer to other hospital (2.00/0). Toxoplasmic encephalitis (7.6%) and cryptococcosis (3.9%) were the frequent cause of focal intracerebral lesions and meningitis in these patients respectively. Oral candidiasis (32.7%) was the most common among other opportunistic infections in this study. KEYWORDS: AIDS, Opportunistic infections. central nervous system, clinical manifestations, outcome.
Chronic fatigue syndrome (CFS) is a chronic debilitating condition affecting both physical and mental functioning. It was first quoted as a 'new disease' spreading in the developed countries. It bei:ame a major issue by doctors, professionals and the media for the past 15 years. CFS was not only affecting the adults but childhood fatigue has also been noted. The CFS patients commonly described themselves to be perfectionists, highly driven, energetic U1d motivated before the condition started. Studies have been focused on the definition, diagnosis and management of CFS. However, the understanding of CFS and what cause it is stili unclear and controversial. Thus the aetiological factors of CFS are reviewed in this article. KEYWORDS; Chronic fatigue syndrome (CFS), Aetiology, Psychiatric disorders, Viral infection, Immunology
The use of steroid therapy and its treatment impact on children hospitalised with viral croup between 1994-1998 were reviewed by comparing 30 patients who received steroid therapy with 65 patients who did not. There was no difference in the socio-demographic and clinical profile between the two groups. The hospital stay (2.8 ± 1.3 vs 3.5 ± 1.2 days, p = 0.02) and duration of documented stridor (1.3 ±0.5 vs 2.8 ± 1.0 days, p = 0.001) were shorter for patients who received steroid therapy although they appeared to have more severe respiratory distress. There were no complications associated with steroid therapy use. Despite reluctance in administering steroid therapy for viral croup, patients who received the treatment had a shorter hospital stay and duration of stridor. KEYWORDS: Croup, steroid therapy, hospital stay.
The use of brain slice preparatiotis has become ilicreasiligly popular among scientists of different disciplines in recent decades for the study of the mammalian central nervous system (CNS) in general and of synaptic phenomena in particular. The in vitro hippocampal slice may be the single most used preparation, among other slices of different parts of the brain areas. The use of brain slices in different experimental work offers certain advantages over the in vivo approaches to the study of the CNS; however, such preparations may have some limitations. This review describes the hippocampal slice technique, explores some of the different types of studies in which it was employed and points out the advantages and limitations of its use. KEYWORDS: Hippocalnpal slices, brain slices, technique, synaptic function, electrophysiology, in vitvo.
A case of chronic fatigue syndrome (CFS) like illness was identified recently. Diagnosis CFS is commonly used in the western countries but not in Malaysia or other parts of Asia. It is probably because the diagnosis of neurasthenia has gradually disappeared especially in the United States and United Kingdom. Neurasthenia is dropped in the DSM-111 and DSM-1V but is still retained in the 10th International Classification of Disease. This paper is reporting the case and discussing the definition of chronic fatigue syndrome. (JUMMEC 2000; 2:103-104).
Head injury contributes to a significant proportion of motorcycle fatalities. The site and pattern of head injury in victims of fatal motorcycle crashes in 1995 were studied retrospectively. The site of impact on the head was determined based on the injuries on the scalp, pattern of skull fractures and injuries of the brain. Of 54 cases, 9 had massive crush injuries. Of the remaining 45 cases, the site of impact was as follows: frontal 21, lateral 14, posterior 4, vertex 1, chin 1 and unascertainable in 4 cases. The majority of injuries occurred on the front and lateral aspects of the skull. Motorcycle helmets are currently tested for impact energy attenuation and penetration test at the vertex. Helmet standards need to take into account site and nature of injury. KEYWORDS: Head injury, motorcycle fatalities, helmet standards.
In 1999, the Department of Social and Preventive Medicine set up its website on the Internet (http://ummc.med.uni.edu.my/sps/. Setting up the website was a whole new experience for the author and many new things were learnt along the way. This paper describes how the website was constructed, the problems, and solutions to all these problems. The experience of the author in setting up the SPM website may be useful to others wishing to set up their own department websites. KEYWORDS: Internet, SPM, website, web page
In early 2001, Nadi IT (the IT department of the UMMC) migrated the UMMC leased line from its old 64 kbps line 10 the 34 Mbps University of Malaya leased line. The migration was a new leuning experience for Nadi IT and many lessons were learnt along the way. This paper describes the ideOll behind the migration process, the reason (or the migration, problems and solutions 10 aU these problems as well as the benefits derived from the migration. The experience of this process m~y be useful to others wishing 10 improve IT facilities without resorting to expensive solutions. KEYWORDS: Internet, leased line, migration
A descriptive study of full-term neonates with jaundice was carried out to determine factors affecting severity of neonatal jaundice for those infants presenting to the hospital from their homes. Severe jaundice (serum bilirubin >=250 µmol/l) was significantly more likely in infants whose mothers consumed traditional herbs during the postpartum period (p<0.001) and if the jaundice was first detected by the parents or relatives rather than by medical personnel (p<0.05). In addition, the interval between detection of jaundice and presentation to hospital was significantly longer in jaundice that was first detected by parents compared to those detected by medical personnel. In conclusion, factors affecting severity of neonatal jaundice for infants who present from home could be influenced by the socio-cultural practices of maternal postpartum use of herbs, the ability of parents to detect jaundice and the urgency of tlie parents in seeking medical treatment once the jaundice was detected. Further studies need to be done to explore the association of these factors with neonatal jaundice more specifically. KEYWORDS: Hyperbilirubinaemia, socio-cultural practices, herbs.
Study site: Paediatric Institute, Kuala Lumpur Hospital, Malaysia
The majority of patients with upper gastrointestinal bleeding due to peptic ulcers stop bleeding spontaneously. The remainder of patients who have persistent or recurrent bleeding will require surgicaJ or endoscopic intervention. Medical therapy provides an attractive alternative to these two treatment options. The advent of H2 antagonists in the mid 19705 revolutionized the treatment of peptic ulcer disease as it provided good ulcer healing with a treatm.ent course of 6-8 weeks. A more potent acid suppressingdassof drugs: the proton-pump inhibitors (PPJ's) were introduced in the late 19805 and provided even better and faster ulcer healing. It was natural that the acid suppressing drugs were also used for the treatment of ulcer bleeding. Intravenous H2 antagonist and more recently intravenous PPJ's have routinely been prescribed in many hospitals as soon itS a bleeding patient is admitted. Critical evaluation of the literature shows, however, that H2 antagonists are no more effective than placebo in stopping ulcer bleeding. The prJ's, on the other hand, have been shown in several clinical studies to have a beneficial effect. The action of acid suppression in stopping ulcer bleeding is believed to be due to its effect in the stabilization of an ulcer clot by providing a high pH milieu and to commence the process of ulcer healing. KEYWORDS: Upper gastrointestinal bleed(UGIB), proton pump inhibitors(PPls), H2 antagonists
A cross-sectional study on the prevalence of smoking among Form 3, 4 and 5 students of a rural national co-educational school was carried out using a selfadministered questionnaire. By the age of 18 years old, three quarters of boys had tried smoking compared with 12% of girls. About a third of boys were still smokers while only 0.7% of girls were still smokers. There was a higher prevalence of smokers among students who stayed with their parents and those who were working part-time. Most smokers knew about the dangerous and addictive effect of cigarette smoking but smoked because of "influence by school peers", "curiosity" and "to increase concentration and decrease tension".
A powder (EWI) made from a mixture of herbs used for the treatment of carbuncles by traditional medicine practitioners in China was investigated for antistaphylococcal activity by agar diffusion, time-kill studies and M.I.C. determinations performed on 17 clinical isolates and a reference strain ATCC 29213. It was found that EW1 had little demonstrable in vitro activity against the clinical isolates tested but inhibited the growth of the ATCC strain at 10 mg/l and retarded its growth in broth culture by an average of 1.5 log reduction in colony count. KEYWORDS: Traditional medicine, anti-staphylococcal activity.