405 cases of bronchial brushing cytology were evaluated for its effectiveness in detecting pulmonary carcinoma. Cytohistologic findings were correlated whenever endoscopic biopsies were performed. Sputum cytological investigations were also included in this paper to examine the total diagnostic sensitivity of all the three methods combined.
This communication describes a survey on 94 cases of alleged paraquat poisoning for a period of one-and a-half years in Perak state. The highest prevalence of such cases was noted in the district of Batang Padang. The incidences between males and females as well as between married and single persons were found to be equal, 81.9% were Indians and 73.4% were suicidal cases. More than 80% of the cases were in the 10-to-40-years age group.
In a 3 year period 73 cases of perforated peptic ulcers were treated by simple closure. The overall mortality of 3.77 percent is acceptable when compared with other reports. There was a marked male preponderance (11 males: female 1). Biopsy results confirmed the operatiue findings that perforations were seven times more common in gastric peptic ulcers than duodenal ones. The disease affected young adults, the middle aged and elderly, the peak incidence occurring between the fifth and seventh decades oflife. Simple closure was an effective surgical procedure for our group of patients.
A random sample of 102 hypertensives out of a total of 347 in the Malaysian Armed Forces were studied with regard to patient education, knowledge of hypertension and therapy compliance. It was found that for 53 percent, patient education was unsatisfactory and as a result 67 percent had inadequate knowledge of hypertension. Adherance to therapy - drug intake, weight reduction and cessation of smoking - was poor (more than 59 percent, 96 percent and 70 percent failure respectively). There was no significant difference between asymptomatically and symptomatically detected hypertensives.
Fifty-Jour patients with oral lichen planus were studied over a three-year period. The important sites were the cheek mucosa, tongue and gingiva. The reticular pattern was the most common type. The professionals and the white collar workers formed the majority of the cases. Emotional disturbances was a predominant factor in this lesion. The rate of malignant change ranges from one to ten percent. Treatment included reassurance, good oral hygiene, avoidance of hot and spicy foods and topical corticosteroids.
A report of 25 cases of neurosyphilis seen in University Hospital, Kuala Lumpur since 1970. Classical form of the disease still constitute the majority of the patients with often long delay before diagnosis.
This is a report of migraine from Malaysia. 17 migraineurs are studied with respect to age, sex, ethnic group, occupation, age of onset, length of disease,' precipitating factors, relieving factors and family history. Similarities and differences between Malaysians and Caucasians are discussed.
Study site: Neurology clinic, Hospital Kuala Lumpur, Malaysia
A pilot study on the epidemiology of hypertension was carried out in 3 out of the 8 districts in the state of Selangor, namely Klang, Sabak Bernam and UIu Langat. stratified random sampling, 435 households were selected for the study. Eventually 312 (72%) households were surveyed: 963 (94%) out of the 1,030 persons aged 15 years and above living in the selected households were interviewed, and 957 of them were examined. The mean age of the respondents was 33 years. Taking a systolic pressure of more than 140 mmHg and/or diastolic pressure of more than 90 mmHg as hypertension, 1 in every 7 of those equal and mor.e than 15 years of age had hypertension, i.e. 140/0. 5.40/0 had a systolic pressure of equal and more than 160 mmHg, and 4.7% had a diastolic pressure of equal and more than 95 mmHg. The study showed that there was a significant rise in the prevalence rates with age in both sexes. There was no significant difference in the prevalence rates among. the sexes, ethnic groups (Malays, Chinese and Indians) and urban and rural areas. The mean systolic pressure ranged from 112-147 mmHg and diastolic from 69 - 73 mmHg. Hypertension was significantly more common among smokers (18.1%) than nonsmokers. There was no significant relationship between hypertension and tea, coffee and alcohol consumption. Hypertension was significantly more common among those with no physical activity (34.8%) as compared with those with physical activity (13.5%). 67% of the hypertensives were aware of their illness but only 36.1% of them were under treatment.
A postal questionnaire survey was carried out among military doctors during June to August 1979 on habits and attitudes to smoking. An 87% response rate was obtained. Smoking prevalence was found to be 50%. 45% of medical officers are heavy smokers. Age at starting influence the amount smoked. Service life had no influence on smoking habits. Attitudes to smoking vary between the different categories of doctors. The habits and attitudes indicate a mental revolution on the part of doctors is required prior to any anti-smoking programme as they have to be sufficiently motivated to lead the fight.
Malignant neoplasms diagnosed histologically in the state of Sabah during the period November 1983 to October 1988 were analysed to determine the distribution of malignant neoplasms according to site, age, sex and major ethnic groups. The five commonest malignant neoplasms in males were carcinomas of the nasopharynx, stomach, skin, lung and liver. In females the five commonest malignant neoplasms were carcinomas of the cervix uteri, breast, ovary, thyroid and skin. There was variation in these frequencies among the major ethnic groups. The most striking of these was the high frequency of nasopharyngeal carcinoma among Kadazan and Chinese males but not in males of the other indigenous groups. A significant number of patients with nasopharyngeal carcinoma was found in the younger age groups and most of the patients in the younger age groups were Kadazans. A relatively high frequency of carcinoma of the stomach, skin and liver was seen among Kadazans and other indigenous groups while carcinoma of the lung was seen relatively frequently among Chinese males. Among females carcinomas of the breast and cervix uteri were the most frequent malignant neoplasms in all the main ethnic groups. Possible reasons for these findings are discussed.
Twelve cases of primary hyperparathyroidism operated by the Universiti Kebangsaan Malaysia Surgical Team from 1978 to 1989 were reviewed. There was a preponderance of Indian females in this series. The majority of the cases presented late and with complications. Renal calculi and bone disease were the commonest complications noted. Of the 12 patients, 9 had single parathyroid adenoma of which 4 were ectopically located, and 2 had hyperplasia of the parathyroids. These were all successfully operated. The remaining patient had 2 failed neck explorations. Failure at initial exploration was due to ectopic location of the glands. Meticulous surgical technique, knowledge of the anatomical variations of location of the parathyroid glands and availability of frozen section facility are essential for successful outcome.
Desmoid tumor of the mandible, or desmoplastic fibroma, is a rare disease with only a few cases reported in the literature. This paper presents the rare case of an elderly male with desmoplastic fibroma of the mandible with an uncommon accompanying proliferative myositis. The case is discussed with emphasis on the clinical presentation, differential diagnosis and treatment of this lesion.
A 59-year-old Chinese man presented with a three month history of penile ulcers and abdominal pain. Syphilis and a gastric malignancy were diagnosed clinically. Biopsy of the genital and stomach ulcers revealed histiocytic granulomata containing numerous intracellular fungal bodies. Histoplasma capsulatum was subsequently cultured from the penile ulcer. Antifungal therapy was instituted. However the patient's general condition deteriorated rapidly and he died within two weeks of admission. A post-mortem liver biopsy showed numerous intracellular fungi.
There are several reports of beneficial effects of ACE inhibitors in both primary and secondary pulmonary hypertension. However the effect of ACE inhibitors in mitral stenosis is not documented. The authors report three patients with severe mitral stenosis in whom surgery was delayed. They had initial symptomatic improvement with diuretics and sodium restriction, but had recurrence of their symptoms while on treatment. Enalapril not only relieved their symptoms in particular exertional dyspnoea and haemoptysis but prevented recurrence and improved their effort tolerance without causing excessive fall of blood pressure or impairment of renal function.
Adenocarcinoma of the fallopian tube is a rare clinical entity. The incidence of primary tubal carcinoma has been reported as varying from 0.1 to 1.0 percent of all gynaecological malignancies. In Malaysia the incidence is unknown. A case of primary adenocarcinoma of the fallopian tube is reported.
A 60 year old woman with chronic duodenal ulcer not responding to Cimetidine, was changed to Ranitidine. She had symptomatic improvement, but had bilateral breast engorgement and tenderness for which treatment was discontinued. A therapeutic trial on a second occasion had the same side effect which came on more rapidly and quickly. This complication in such severe form and recurrence on rechallenge requiring withdrawal of drug was observed for the first time with any H2 receptor antagonist.