Public health administrations are responsible for monitoring the availability and use of foods. The information required can be obtained cheaply and easily by asking schoolchildren about the foods they have consumed. When the mean weights of adults is low and the number of kinds of food in use is small, nutritional problems probably exist and must be investigated. The same indicators may also be useful in the identification of families affected by poverty.
Internal jugular vein ectasia is a venous anomaly commonly presenting as a unilateral neck swelling in children and adults. Literature reports of bilateral presentation are rare. Bilateral Doppler ultrasonography is the diagnostic investigation of choice. The possible pathology, aetiology and management are discussed. Conservative management of bilateral cases is recommended in uncomplicated cases.
An immunization survey was carried out in early 1983 in a military community. The survey covered 192 children from 147 families. 98% had BCG scars. and 94% had completed their primary course of immunization against diphtheria, pertussis, tetanus and poliomyelitis. The acceptance rate for booster was however low. The time frame for the immunization was also not adhered to strictly. An immunization register has been started in all centres for recall of defaulters. Publicity has also been mounted to ensure all are aware of the immunization programme.
In a two year period between 1985 and 1986, eight children presented with impacted blunt foreign bodies in the oesophagus were successfully treated by removal using a Foley catheter without anaesthesia. There were no complications. All patients were discharged well after one or two days in hospital. The technique is safe, rapid and easy to perform.
Fifty-one consecutive arthroscopies of the knee were reviewed after an average of eight months follow-up. Thirty-eight patients underwent arthroscopic surgical procedures as well. A meniscus tear was the commonest (68%) primary pathology noted, followed by isolated anterior eructate tears (16%). Excellent/good results were obtained in 80% of arthroscopic partial meniscectomies. Synovial biopsies and loose body removal were all successfully achieved arthroscopically: Arthroscopic knee surgery is a useful and less traumatic technique of obtaining a diagnosis and treating amenable knee lesions compared to open arthrotomy.
A series of 18 cases of tuberculous encephalopathy (TBE) in children studied between June 1983 and October 1984 at Queen Elizabeth Hospital, Kota Kinabalu is presented. The data suggest that: the incidence is not as rare as previously thought; the occurrence of TBE is related to the absence of BCG vaccination; the presentation is often late; laboratory data, although helpful is not often confirmatory; early treatment is the key to better outcome; the clinical picture should outweigh laboratory diagnosis in the initial assessment and management.
One hundred and fifty two patients were treated for acute renal failure in 1976-1978. Overall mortality was 46 (30.3 percent) and was highest among the surgical patients 15 (51.7 percent) and lowest in patients with outflow tract obstruction 2 (8.7 percent) uncontrolled sepsis was the commonest cause of death.
A total of 346 paediatric in-patients in the University Hospital in Kuala Lumpur was examined for infection with Enterobius vermicularis using two anal swabs taken on two consecutive days. 24% of these children. whose mean age was 6 years [range 2-14 years] were infected. The infection was more prevalent among children between the ages of 5-11 years. There is only a slight difference in the distribution of infection among Malay. Chinese and Indian children. There is no significant difference in the prevalance of infection between boys and girls.
A case of benign cystic teratoma, sufficiently large to present as an abdominal mass with pressure signs on the right ureter in a two-year old child is presented, the lowest age in this country recorded.
Eight longhouses were selected randomly for a goitre survey in the Entabai area of the Sixth Division, Sarawak. 645 subjects were examined and a goitre prevalence of 46.4% (15 years and above) was found. The females had a higher rate of 69.5% as compared with their male counterparts with 24.4%. Below the age of 15 years, prevalence was low and there was not much difference between the two sexes. After the age of 15 years, the prevalence among the females
increased from 40% to almost 80% by the age of 25 years. The males, on the other hand, showed a decrease in prevalence after the age of 15 years and levelled off at about 30%. The females also had much larger goitres than males. About 43% of the households surveyed consumed iodised salt but the rates tend to fluctuate according to supplies. There was however no direct correlation between goitre prevalence and consumption of iodised salt.
Two cases of girls seen in Sarawak with the diagnosis of Rett Syndrome are reported. Their ages were 6 and 2 years respectively at the time of the report. Diagnosis is made clinically as there is as yet no scientific marker. Specific diagnostic criteria were met. There was a history of slowing of development followed by loss of previously acquired skills, changes in emotional development and behaviour and the definite emergency of stereotyped behaviour especially hand wringing in both girls. Onset was early in both girls, around nine months. Both girls are profoundly retarded mentally but the regression appeared to be static at present.
A review of patients with diphtheria seen in the Paediatric Unit, Alor Star General Hospital, from January 1985-March 1987 is reported. Their clinical presentation, diagnosis, treatment and outcome were analysed and discussed. Clinical awareness regarding the diagnosis of diphtheria is emphasised.
A survey of Kayans of Long A tip, Baram, Sarawak, was conducted in 1986 as part of the pre-requisite to the development of a primary health care system for the people of the Baram. A total of 178 Kayans of all ages were surveyed for decayed, missing and filled teeth. Of the aggregate 39.3% did not have any decayed teeth, 37.6% had no missing teeth and 93.8% had not had any fillings. Compared with their neighbouring Penans, the Kayans of Long A tip had a relatively better dental status.
A rare case of extrarenal Wilms' tumour in a Kadazan child is presented with a description of its clinical and pathological features. The possible origin of this tumour is discussed