Central nervous system melioidosis is an unusual infection in humans. This article reports a case of melioidosis presenting as an acute spinal epidural abscess. A discussion of this case and its management together with a brief review of melioidosis of the central nervous system is presented.
This report describes inquiries relating to poisoning cases which were received by the National Poison Centre of Malaysia from the years 1996 to 2000. The study utilized data from the NPC report forms. Only data relating to patient contact with a poison or chemical were included in the analysis. The poison centre received an average of 186 poisoning inquiries per year. Doctors remained the highest group of caller to the poison centre throughout the five-year period. Nearly 50% of all inquiries was regarding pesticide poisoning and this trend remained constant during the five-year period. Overall, the findings showed that poisoning inquiries relating to patient care were lower than in Japan and the United States.
Between 1st January 1999 and 31st December 2000, 152 patients (156 eyes) with open-globe injuries were treated in the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru. The majority were male (88.2%), Malay (63.2%), from the Johor Bahru district (51.3%) and aged between 21 and 30 years (23.7%). Most injuries were workplace-related (41.4%). Lens injury, retinal detachment, endophthalmitis, intraocular foreign bodies and phthisis occurred in 40.4%, 15.4%, 14.7%, 12.2% and 11.5% of eyes respectively. A favourable visual outcome occurred in 55.4% of eyes. Prognostic factors for visual outcome include presenting visual acuity, relative afferent pupillary defect, wound location, lens injury, retinal detachment and endophthalmitis.
Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%), followed by rhinorrhoea (44%), epistaxis (33%), postnasal drip (28%), and snoring (22%). Chronic sinus was the most common associated rhinological finding (50%). Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%), endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7%) and Caldwell-Luc surgery in one patient (5.6%). No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.
Diabetic foot lesions may arise from frictional trauma due to tight or inappropriate footwear, repetitive stresses on parts of the foot, overlying bony prominence generated by walking and accidental trauma to the neuropathic foot. Many diabetics have been found to be unaware of their foot lesion, or know what the precipitating cause was. Based on the assumption that accidental trauma would affect the foot in a random fashion and result in lesions distributed evenly throughout the foot, a study was performed to determine whether foot lesions were distributed evenly or concentrated to certain areas of predilection. It was found that foot lesions were not evenly distributed but concentrated to certain areas of predilection. Even though relatively high proportion of the study population walked about in open slippers and barefeet, the study showed that accidental trauma was not a predominant precipitant of diabetic foot lesions. Diabetic foot lesions tend to occur as a result of cumulative, repetitive trauma to areas of prediliection rather than accidental trauma.
PIP: To determine the acceptability, practicability, and popularity of Depo-Provera as an additional contraceptive method to be offered by the National Family Planning Board NFPB of Malaysia, 550 patients of Sungai Besar, Malaysia, who accepted the Depo-Provera injection method from the start of the injection program, February 23, 1968, until the cutoff date of December 31, 1969, were studied. At the cutoff date, 318 (58%) were still receiving regular injections at 3-month intervals. The remaining 232 women discontinued use of the injection. Of those who discontinued use, 176 (32%) were interviewed, while the other 56 women were lost to follow-up, due mainly to migration. Assuming that 1 injection would protect a woman from getting pregnant for a 3-month period, the retention rates at the end of 12 and 24 months were 63% and 41%. These continuation rates were fairly high and were as good as those for the oral pill, which is the main contraceptive method provided since the beginning of the operational service program of the NFPB in May 1967. Except for a small number of Indian women with a high rate of discontinuation there was not much difference in continuing the method between the Malays (60%) and the Chinese (56%). The younger age group of women seemed to have a higher proportion of discontinuation. The findings showed that amenorrhea (35%)most bothered the women who discontinued the injection method. Irregular bleeding (20%) and other medical side effects (11%) were the other main complaints that caused women to discontinue using the injection as a contraceptive method. It was concluded that Depo-Provera (150 mg) injected once every 3 months appears to be simple, acceptable, popular, and effective as a contraceptive method among women in a rural town in Malaysia.