Percentile head circumference charts, from six to eleven years of age, for boys and girls are presented. These can be used to monitor the head circumference of Malaysian children.
The plasmid profiles of 66 strains of penicillinase-producing Neisseria gonorrhoeae (PPNG), isolated in Peninsular Malaysia, were determined by agarose gel electrophoresis. All the isolates harboured two common plasmid species, a 4.4 x 10 6 Far-East type R plasmid associated with beta-lactamase production and a 2.6 x 106 plasmid of unknown function. In addition to these two plasmids, 51 (77%) PPNG isolates also carried a 24.5 x 106 conjugative plasmid.
Three cases of acute psychosis during pregnancy had been treated with electroconvulsive therapy (ECT) during their stay in hospital, due to their slow response to anti-psychotic medication. All three responded well to the treatment and two subsequently delivered normal healthy infants and they did not suffer maternal complications. The authors feel that ECT is as safe, if not safer than the use of high dosage of anti-psychotic medication and a review of the world literature appears to confirm this view. In addition, the psychotic process usually settles faster with the use of ECT than with the use of anti-psychotic drugs.
Use of contraceptives by some selected characteristics was studied for married women in the reproductive age range (MWRA) in three south‐east Asian countries. The data were obtained from each country's national family planning/fertility survey conducted around the mid‐seventies. Only the gross relationship between each of the selected characteristics and contraceptive use was compared. The proportion of MWRA using contraceptives for Singapore was almost twice as high as the corresponding proportions for Peninsular Malaysia and Thailand. The pattern of contraceptive use was largely similar for Thailand and Malaysia but different from Singapore. The differences were largely attributed to the absence of a large rural population in Singapore, the apparently greater tendency of women in Singapore to use reversible contraceptive methods for birth spacing and the easier access by women to family planning information and services, particularly sterilisation, than in Peninsular Malaysia and Thailand.
This communication describes the quantitative and qualitative analysis of oestrogen receptors in breast tumour biopsies of Malaysian patients. This preliminary investigation establishes certain rigid criteria that makes possible the classification of patients most likely to respond to hormonal therapy. 20 percent of the patients had oestrogen receptor positive tumours while 60 percent were oestrogen receptor negative.
An analysis of 86 patients sterilized laparoscopically with Hulka clips is presented. We find that the method is simple, acceptable and has minimal complication. The failure rate is similar to that reported by others. However, this method could be done under local anaesthesia thus shortening the hospital stay for the patients. This method has the advantage of safety and prospects for reversal when desired.
In a 10 year period 1971-1980, the records of 944 individual women with benign breast lumps and 228 with primary carcinomata are reviewed. This study describes the age, ethnic distribution of benign and malignant breast tumours in women in Peninsular Malaysia and compares the pattern with Western experience. There are important variations in the incidence pattern between the different races in Peninsular Malaysia and between them and women in Britain and the United States.
The present findings suggest the possible involvement of an active mechanism for transport of iron to the fetus. In all the 19 subjects studied, the cord serum iron levels tended to be higher (129.2 ± 56.8 ug/100ml) than the maternal serum iron levels (74.0 ± 35.9 ug/100ml) at parturition even in maternal iron deficiency. The significant difference (P< 0.001) between cord serum iron levels and the maternal iron levels shows that an active transport mechanism working against a gradient in favour of the fetus exists. The availability of iron to the fetus appears to be dependent on maternal serum iron levels but not on maternal iron stores. This finding serves to stress the importance of iron supplements in pregnancy. A hypothetical model for iron transfer from maternal circulation to fetal circulation is described.
One hundred patients with carcinoma of the cervix stages 1B to 4A were treated with intracavitary high dose rate radiation using a linear cobalt source. All cases have received external beam pelvic irradiation to 4500cGy mid plane in twenty fractions over four weeks. The results in terms of patient compliance and convenience were good while acute and late morbidities were comparable to standard Manchester technique of low dose rate intracavitary therapy as practised in the Institute of Radiotherapy and Oncology General Hospital Kuala Lumpur. The four year actuarial survival rate is 76% for stage II and 48% for stage III. All three stage IV patients died within 1 year. Four out of seven stage I patients are alive (minimum follow-up 18 months, longest 43 months). One died of systemic spread at 33 months while one is lost to follow up.
Chromosome analysis on different breed types of water buffaloes (Bubalus bubalis) was undertaken to identify their karyotypes and to determine the pattern of chromosome segregation in crossbred water buffaloes. Altogether, 75 purebred and 198 crossbred buffaloes including 118 from Malaysia and 80 from the Philippines, were analyzed in this study. The diploid chromosome number of the swamp buffalo from both countries was 48 and that of the river buffalo was 50, while all F1 hybrids exhibited 49 chromosomes. The F2 hybrids consisted of three different karyotype categories (2n = 48, 2n = 49, and 2n = 50), whereas the backcrosses included two different karyotype categories each, with 2n = 48 and 2n = 49 in the three quarters swamp types and 2n = 49 and 2n = 50 in the three quarters river types. Chi-square tests on pooled data from Malaysia and the Philippines indicated that the distribution of different karyotype categories of F2 animals did not deviate significantly from the 1:2:1 ratio expected if only balanced gametes with 24 and 25 chromosomes were produced by the F1 hybrids. In the three quarters swamp and three quarters river types, the respective karyotypic categories were in ratios approximating 1:1. The distribution of chromosome categories among the F2 hybrids and backcrosses suggests that only genetically balanced gametes of the F1 hybrids are capable of producing viable F2 and backcross generations.
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.
A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.
A case of mucoepidermoid carcinoma of the trachea in a 26-year-old female is presented. Diagnosis was confirmed by histopathology. On the basis of the clinical and histological picture, the tumour is classified as a low grade mucoepidermoid carcinoma. Conservative surgical treatment was the primary mode of treatment. The patient showed no clinical evidence of recurrence twelve months after local resection of the tumour.
This study analyses retrospectively the results of sixteen acute dislocations of the knee at the University Hospital, Kuala Lumpur from 1980 to 1985. The average follow-up was 3.5 years. There were seven posterior, six anterior, one lateral and two postero-lateral dislocations. All were due to motor vehicle accidents except one. There were four patients with popliteal artery injury and two patients with peroneal nerve injury; three required amputations due to late detection. All the peroneal nerve palsies were permanent. The results of surgical treatment appear to be better than conservative management of acute dislocation of the knee.
Thanatophoric dwarfism is a severe form of neonatal shortlimbed skeletal dysplasia. Most infants are stillborn or die soon after birth. This disorder has well defined radiological features which distinguish it from the other forms of neonatal dwarfism. We report two cases where short limbs were detected on sonography and a diagnosis was made on antenatal radiographs and fetography.