Women who conceived within 4 months of cessation of oral contraceptives have five times more postdatism (term plus 14 days or more) compared to the non pal users. Also postdatism is severe if they conceive within 4 months of cessation of oral contraceptives. In pill users, routine induction. at term plus 14 days would result in unacceptably high induction rate, iatrogenic prematurity and possibly high caesarean rates. This is the conclusion of a prospective study of 186 pill users of which 37 were postdate out of 1496 pregnancies.
Campylobacter Jejuni is being increasingly recognised as a cause of bacteraemia enteritis and two infants with this condition are described. Awareness of the organism. as a possible cause of septicaemia is important because it has special growth requirements and delay in the diagnosis can be detrimental in a disease which usually only responds to erythromycin, gentamicin and chloramphenicol.
Thyrotoxic psychosis is an uncommon phenomenon and the presentation is usually of the affective disorders. Three cases manifesting psychotic symptoms akin to schizophrenia are described. The neurobiocheinistry and treatment are discussed.
The first culture-proven case zn Malaysia of fungal keratitis, due to Fusarium solani, is presented, followed by a brief discussion of mycotic keratitis.
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.
Achondrogenesis is a lethal neonatal chondrodysplasia with extreme micromelia and marked discrepancy between the relatively large head and the decreased trunk length. The affected neonates are usually delivered prematurely, and are stillborn or die soon after birth. Polyhydramnios is frequently present. It is an inherited autosomal recessive disease. The radiographic features are diagnostic.
A study on the oral health status of 198 factory workers (in Antara Steel, Pasir Gudang, Johor) was carried out in November 1986. The subjects were predominantly male (94%) and Malay (91%) with an average age of 27.4 years. The prevalence of caries was 87.4% with a mean DMFT of 7.1 + 5.4. There were 3 subjects with full upper, lower dentures and 16 subjects with partial dentures. Two subjects examined needed dentures but were not wearing them. Thirty five (17.7%) of those examined needed urgent extractions, and 8 needed emergency treatment for fillings. Enamel opacities were found in 141 subjects (75.6%) but only 9 were aware of these defects. Dental health was very poor with 72% examined needing scaling. Seventeen (9%) had gross supra and subgingival calculus. There was a total of 107 (54%) smokers and heavy nicotine stains were found in 41 (20.7%), of the population examined. Examination of soft tissues showed 111 (56%) subjects with recurrent aphthous ulcers whilst 15 (7.6%) suffered from herpes labialis. Five subjects (2.5%) suffered from denture stomatitis whilst the prevalence of other soft tissue lesions was very low.
A prospective study of acute renal failure (ARF) over a three month period showed that 60 out of 22,033 inpatients developed AR"F (Serum creatinine exceeding 0.200 mmol/L). The ARF was oliguric in 22% and nonoliguric in 78%. Poor cardiac output or diminished intravascular volume, nephrotoxins and infections were the main aetiological factors associated with ARF in 85% of cases. Mean peak serum creatinine and blood urea values were higher in the oliguric than the non oliguric group. The oliguric group required dialysis more frequently (53.8% vs 4.3%) and had a higher mortality (53.8% vs 8.5%) than the non oliguric group. Nonoliguric ARF occurs more commonly and has a better prognosis than oliguric ARF. Acute renal failure is a serious condition with significant mortality and remains a frequent occurrence in the setting of large general hospitals. A Previous reports on acute renal failure in Kuala Lumpur comprised patients treated at the Department of Nephrology at the General Hospital Kuala Lumpur, but did not include patients with acute renal failure treated at other departments in the hospital. This report is based on a prospective study of acute renal failure occurring in the General Hospital Kuala Lumpur over a three-month period to evaluate the clinical spectrum of this disease, and its outcome.
The records of the Division of Stomatology were reviewed for the incidence of adenomatoid odontogenic tumour diagnosed between 1968 and 1986. Forty-five cases were found. The prevalence of this tumour according to their age, sex, site and its distribution in the various states in Malaysia are reported. Many features were similar to previous reports of this entity. However the incidence of AOT appears to be higher among the Indians and lower in the Chinese population. It is suggested that this feature may be peculiar to Malaysians.
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.
Delusions are common among psychiatric patients. Delusions of passion can be very systematised and, at the same time, incredible. The delusions can remain fixed for a long time and treatment is usually not satisfactory. One of the exotic and rare psychiatric conditions is de Clerarnbault's Syndrome and the main feature is a pure erotomania. This condition defies satisfactory classification in the current ICD-IX and DSM-III, and remains as one of the most difficult to treat and troublesome syndromes. Two patients who developed the symptoms of erotomania were treated by the University Hospital, Kuala Lumpur in 1982-1983. One had the primary erotomania of de Clerambaults syndrome while the other suffered from erotomania as a secondary symptom which was part of the symptomatology of her primary illness of schizophrenia. Their case histories and the current western concepts on erotomania were described.
Four cases of tropical myositis seen over a period of four months at the Penang General Hospital are reported here. All were young local residents in whom large amounts of pus were found deep within skeletal muscles without an obvious aetiological factor.
This study was conducted to determine lead concentrations in breast milk among urban and rural mothers in Malaysia, and to determine if lead absorption among urban maternal populations in Malaysia poses a potential health hazard to infants through breastfeeding. Milk samples, which were collected from 89 urban and 91 rural mothers, were analyzed by flameless atomic absorption spectrophotometry. The mean lead level in urban samples was 0.0253 microgram/ml, which was significantly higher than that of the rural samples (0.0211 microgram/ml). The estimated daily lead intake of breast-fed infants in Malaysia was well below proposed tolerable levels. There also appeared to be no specific pattern in the milk lead levels at different periods of lactation. The significance of the higher milk lead concentrations in urban mothers is also discussed.
The characteristics of 74 patients who attempted suicide in Penang are described. Differences in the incidence and reasons for and methods of attempting were observed among the ethnic groups. There was a higher incidence in females and patients of single status. The majority of patients did not suffer from severe psychiatric disorders, but did encounter chronic inter-personal and intra-familial conflicts. Conflicts with elders were more frequent among female patients, and this finding suggested that young females were faced with a greater degree of role conflicts. Rural to urban shift among the Chinese patients was observed to be associated with a high incidence of attempts. Dwellers of high-rise flat complexes were not over-represented. In view of antecedent social factors, professionals and others besides psychiatrists have a role in the prevention and management of para-suicidal behaviours.