Parasitological and serological investigations for lymphatic filariasis were performed on 450 immigrants detained at the lmmigration Centre at Semenyih, Selangor, West Malaysia. The country of origin of these immigrants were Indonesia, The Philippines, Myanmar, Bangladesh, India and Pakistan. Brugia malayi adult worm homogenate (BmAH) antigen was used for the detection of antiifilarial IgG. A monoclonal antibody-based ELISA (MAb.XC3-ELISA) specific for filarial circulating antigens and non-phosphorylcholine reactive was used to detect antigenemia in these immigrants. Parasitologically 67 (14.89 %) were positive for W. bancrofti and 54 (12.0%) for Brugia malayi. Serologically 63% had antifilarial IgG titre to the BmAH antigen. While Bancroftian filariasis is now unknown in Peninsular Malaysia, the potential of it to be reintroduced into Peninsular Malaysia by the immigrant population is discussed. KEYWORDS: Lymphatic filariasis, immigratits, antifilarial IgG, antigenemia
Meta-analysis is a method of review that summarises the results of previous research of the same particular issue in a systematic and quantitative way. A meta-analysis that properly combines results from different studies will average out differences caused by random variation and produce a more precise estimate of the true effect. It may also detect and investigate heterogeneity among studies thus providing a deeper understanding of clinical dilemmas and guidance on resolving them, in this way a meta-analysis will be a better guide to practice than an individual study. Meta-analysis also has its limitations as it is largely dependent on the quality of published data and requires careful planning and execution of a valid protocol, together with cautious interpretation of the results. KEYW'ORDS: Quantitative Review, CritinJ Appraisal, Overall Effect, Publintion Bias.
This paper describes a case of invasive arnoebiasis in a 72 year old woman. About 1 week prior to admission she had right iliac fossa pain and physical examination suggested perforated appendix or carcinoma of caecum. Laparotomy revealed perforation of caecum. Histopathology of tissue removed showed abundant trophozoites of Entamoeba histolytica. After surgery treatment was instituted and patient had an uneventful recovery. KEYWORDS: Rupture of caecum, amoebiasis
Many tests are available for the diagnosis of H. pylori infection. Broadly they can be divided into invasive- endoscopy biopsy based tests and non-invasive tests. Of the endoscopy biopsy based tests the rapid urease tests (RUT) have been found to be the most convenient, accurate and inexpensive tests and they have therefore been recommended by several consensus panels and working parties as the test of choice during endoscopy. Several RUTS are available; some are commercial: CLO test, Pyloritek, Helicobacter urease test, H. yylori test and others- "homemade". We strongly recommend the "homemade" 1 min rapid urease test using an unbuffered solution as originally described by Arvind et al. This test has been shown to be easy to prepare, inexpensive and accurate on field-testing. Several factors affect the accuracy of the RUT. The larger the size of biopsy samples, the quicker is the postive reaction time. With the CLO test, warming the tests to 37'C has also been shown to hasten the reaction time. The effect of blood on the RUT poses an important problem in testing. It is vitally important to determine the H. yylori status in patients with bleeding peptic ulcers as the recurrence of bleeding has been shown to be markedly reduced or virtually abolished with H. yylori eradication. While the results of studies have not been entirely consistent, it is likely that presence of blood does reduce the sensitivity of the RUT. It is therefore sensible that in patients with bleeding ulcers, the RUT should not be the sole endoscopy biopsy test used and that samples should also be taken for histological examination.
During the period 1996-1998, 134 patients suspected of having ocular toxoplasmosis were seen in the Ophthalmology Clinic of the University Hospital, Kuala Lumpur. Clinical presentations in these patients ranged from poor vision to severe retinal detachment. Of these patients, 72% were confirmed positive for Toxoplasma gondii infection by serological methods. Chorioretinjtis and vitritis were found to be the most apparent symptoms, both having 100%correlation with serological positivity, This was followed by uveitis, floaters, and retinal detachment with correlation at 78%, 75%and 75%, respectively. However, there was no correlation between level of serotitre and ocular presentations. KEYWORDS: Toxoplasmosis, serology, chorioretinitis, uveitis
Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.831nm). Complete closure of the PDA was achieved in all patients. KEYWORDS: Patent ductus arteriosus, transcatheter device closure
Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.83mm). Complete closure of the PDA was achieved in all patients.
From August 1999 to January 2001, twelve chemotherapy naive patients with locally advanced and metastatic non-small cell lung cancer (NSCLC) in our hospital received vinorelbine and cisplatin. Ten patients had stage IV disease while two had stage HI disease. Patients' performance status (PS) were as follows: four had PS 1, six had PS 2, and one each PS 3 and 4. A total of 46 cycles were given as scheduled. Only major haematological toxicities were noted; one patient each with Grade 3 anaemia, Grade 3 and Grade 4 leucopenia, two had Grade 3 neutropenia and 5 had Grade 4 neutropenia without associated mortality. Three patients had Grade 3 alopecia and one had Grade 3 phlebitis. After three cycles, three patients demonstrated partial response and two had stable disease. For the four patients who completed 6 cycles, two demonstrated stable disease and two partial response. Symptom improvement was reported in all but one patient. Performance status was better in four, stable in six but declined in two patients. In conclusion, in patients with locally advanced and metastatic NSCLC, vinorelbine/cisplatin is a well-tolerated and active regimen, offering symptom palliation and improved performance status in a significant proportion of patients. KEYWORDS; Vinorelbine, lung cancer, chemotherapy.
The concept of primary health care (PHC) according to WHO has been implemented in Malaysia since 1978. The rural health centres which provide the primary health care have developed from about 47 in 1970 to about 772 in 1998. Since the implementation of the health centres there has been significant reduction in morbidity and mortality rates. However due to the emerging issues like changing demographic 'patterns, changing pattern of disease, and increasing demand from the public, the delivery of PHC is being reviewed. Newer programmes and review of the older programmes are being done to address the provision of PHC in the 21st century. The functions and roles of the existing staff in the health centres are being reviewed. This new concept is known as expanded scope of primary health care. The purpose of this paper is to explain the achievements in primary health care and the components of primary health care in the expanded scope.
Nine local plant species were picked randomly and their aqueous extracts have been screened to know their effects on the phagocytic capability and intracellular killing of StapllylococclIs al/rellS bacteria by mouse peritoneal macrophages. Macrophage cultures were incubated with different concentration of each plant extracts forI hour. Among these aqueous extracts, Ageratum conyzoides and Malastoma melabathricum inhibited the phagocytic capability and intracellular killing of Stapllylococclls aureus compared with controls. Elicited (activated) cells have more phagocytic capability and intracellular killing than the resident (normal) macrophages. There were no differences in the viability of cells between treated cells (with extracts) and controls (without extracts). KEYWORDS: Aqueous plant extracts, murine macrophage, phagocytosis.
We describe a rare encounte.r with a 6-year old Indian boy admitted with acute epiglottitis due to Haemophilus influenzae. Acute epiglottitis is an uncommon cause of lifethreatening upper airway obstruction and a rare presentation of invasive Haemophilus influenzae type b (Hib) disease in this region, compared to Ihe more developed West. The cause for this observation is often attributed to differences in the genetic predisposition and socio-economk parameters. The organism subtype and the host response have been shown to determine the type of invasive Hib disease. However, the evidence to explain this difference is poorly understood and remains an intriguing enigma. KEYWORDS: Epiglottitis, Haemophilus influenzae
Improving upon the quality of teaching by teaching staff at all educational institutions is oil very significant objective. Eva luation of teaching performed by individuals at such institutions would be instrumental in assessing the quality of such teaching and a tool towards its improvement. In this article, one scheme for teaching evaluation by students and another by peers are proposed and discussed. Assessment by students may provide contrasting results to those obtained from peers. For a "just and fair'" overalJ assessment of one's teaching., it is recommended that students' evaluation would be combined with those of peers. Results of such an evaluation of teaching should be perceived as being valuable in providing feedback to the teacher and can be utilized for many purposes by academicians and administrators. KEYlVORDS: Academia, classroom teaching., evaluation by peers, evaluation by students, proposed schemes.
Comparison and evaluation of physicochemical properties of the six betamethasone·17-valerate creams available locally were studied. Tests that were conducted include stiffness/hardness, grittiness. colour, odour, homogeneity (phase separation), pH, weight of loss, tackiness (stickiness) and microscopic examination. A point grading system was used 10 assess and compare the products. Results revealed that BetnovateT and CamnovaleT to be the most superior followed by BeavateT, SetrosoneT, BetasoneT and UniflexT
The majority of migrant workers studied in this survey were males Muslims from Bangladesh. The mean age was 30 and the majority were aged between 21-30 years. Although almost all of them had 7-13 years of schooling, the majority were working in the service industry. More than two thrids of the migrant workers were provided with various forms of housing by their employers. Majority of them stated that they had better amenities, such as piped drinking water and sanitary toilets, in Malaysia compared to those in their home countries. From their reports, it appears that the majority did not engage in risk behaviours such as, smoking, alcohol and drug abuse.
We describe the results of serology for parasitic infection of 698 foreign workers. The 698 foreign workers participated included 115 Indonesians, 387 Bangladeshis, 101 Burmese, 81 Pakistanis, 6 Indians, 3 Thais, 3 Filipinoes and 2 others. Blood samples were taken from these workers and eight tests (Amoebiasis, Echinococcosis, Filariasis (bm and wb), Leishmaniasis, Malaria, Schistosomiasis and Trypanosomiasis) were performed on serum separated from the blood. Among the 698 sera tested, 38.1% were found to be positive for at least one parasitic infection. The most common antibody detected in the positive sera was antibody for amoebiasis (28.1%), followed by malaria (26.9%), echinococcosis (18.1%) and schistosomiasis (11.6%). Other tests showed a low percentage of infection with leshmaniasis (6.5%), filariasis (Brugia malayi (3%) and Wuchereria bancrofti (1%)) and trypanosomiasis (1%).
Reproductive health is "a state of complete, mental and social well-being in all matters relating to the reproductive system and to its functions and processes. Implicit in this is the right of men and women to be informed and to have access to safe, effective and affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility, which are not against the law, and the right of access to health-care services that enable women to go safely through pregnancy and childbirth." The survey on Health Problems of Migrant Workers included a section on Women's Health covering aspects of reproductive health. This was based on concerns over reproductive health needs of migrant women workers, particularly since the large majority are in the reproductive age-group, and the utilisation of government healthcare facilities. The latter has implications for the potential burden on public healthcare services in terms of resources and costs. Specifically, the Women's Health section included questions on pregnancy, place of delivery of last baby (born in Malaysia), postnatal care related to this delivery, and mode of payment. For those currently pregnant, questions were asked of sources of antenatal care, postnatal care and respective modes of payment for thsoe services. This section also included questions on current contraceptive practices, source of supplies, and mode of payment for contraceptive methods.