Twenty patients undergoing various surgical procedures were anaesthetised using hypotensive anaesthesia using labetalol and halothane. The technique is safe, predictable and cheap. This technique also offers the advantage of usage of less blood, thus minimising the complications of transfusion induced diseases like hepatitis and AIDS.
The present study reports on a successful treatment of a single case of obsessive compulsive neurosis using a behavioural technique, namely, systematic desensitisation. Much recent literature has suggested that behavioural techniques may be more helpful with this particularly difficult condition than traditional methods of treatment, such as medication. The present results suggest that the technique of systematic desensitisation may be successfully used in a non-western setting.
Membrane contactors using microporous membranes for acid gas removal have been extensively reviewed and discussed. The microporous membrane acts as a fixed interface between the gas and the liquid phase without dispersing one phase into another that offers a flexible modular and energy efficient device. The gas absorption process can offer a high selectivity and a high driving force for transport even at low concentrations. Using hollow fiber gas-liquid membrane contactors is a promising alternative to conventional gas absorption systems for acid gas capture from gas streams. Important aspects of membrane contactor as an efficient energy devise for acid gas removal including liquid absorbents, membrane characteristics, combination of membrane and absorbent, mass transfer, membrane modules, model development, advantages and disadvantages were critically discussed. In addition, current status and future potential in research and development of gas-liquid membrane contactors for acid gas removal were also briefly discussed.
A series of polyetherimide (PEI) hollow fiber membranes with various polymer concentrations (13-16 wt.%) for CO2 stripping process in membrane contactor application was fabricated via wet phase inversion method. The PEI membranes were characterized in terms of liquid entry pressure, contact angle, gas permeation and morphology analysis. CO2 stripping performance was investigated via membrane contactor system in a stainless steel module with aqueous diethanolamine as liquid absorbent. The hollow fiber membranes showed decreasing patterns in gas permeation, contact angle, mean pore size and effective surface porosity with increasing polymer concentration. On the contrary, wetting pressure of PEI membranes has enhanced significantly with polymer concentration. Various polymer concentrations have different effects on the CO2 stripping flux in which membrane with 14 wt.% polymer concentration showed the highest stripping flux of 2.7 × 10(-2)mol/m(2)s. From the performance comparison with other commercial membrane, it is anticipated that the PEI membrane has a good prospect in CO2 stripping via membrane contactor.
A retrospective review of medical records was carried out to determine the pattern of drug and chemical poisoning cases admitted to a teaching hospital in Malaysia. Medical records of patients admitted during the period January 1987 to December 1995 were reviewed. They accounted for 0.2% of total admissions during the period. While all ages were represented, there was predominance of children, which showed little change throughout the nine-year period. Of all cases of poisoning, 77.8% were unintentional, 12.6% intentional and 9.6% were undetermined. Kerosene, pesticides and medicinal substances remained the common agents associated with poisoning. A significant number of patients sought treatment elsewhere before being admitted to the hospital. Of those who came directly to the hospital, many were presented late in the course of their poisoning. Only seven patients died and none were children. This study supports the need for greater emphasis on prevention of poisoning in children and among farmers in the state.
We used OPT to estimate individual and population pharmacokinetics for carbamazepine (CBZ) in Malaysian epileptic patients attending our Neurology Clinic. We noted that plasma CBZ concentrations and clearances correlated poorly with daily doses and body weights respectively but we found the values for clearance, volumes of distribution, elimination rate constants and half lives to be in good agreement with earlier reports. We conclude that OPT is a simple yet useful program to derive individual and population pharmacokinetic parameters for CBZ for use in dosage adjustments. We also conclude that although the Malaysian population do not differ substantially in handling CBZ, available data for the pharmacokinetic parameters must be used cautiously in applying it to the therapeutic drug monitoring for CBZ in our patients.
We reviewed our data from 122 records of patients taking phenytoin for the treatment of various types of epilepsy and selected 15 (age range 10-43 years old) who were on phenytoin alone to calculate Michaelis-Menten pharmacokinetic parameters. The average Vm and Km for this age group was found to be 8.45 mg/kg/day and 6.72 mg/litre, respectively. Km was independent of age and weight. Vm correlated well with weight but there was no relationship with age.
From 1st January 1986 till 31st December 1986; 273 patients were treated in the Intensive Care Ward. The mortality in the Intensive Care Unit was 24.5%, mortality of patients 60 years and above was 35%. Of 187 patients who had survived, only 105 (56.2%) responded to the questionnaire, 39 (20.9%) did not respond and 43 (23.0%) could not be traced. Of the total discharged alive, 95 (51.9%) survived two years and eight (4.6%) died over the two years. Forty (41%) have returned to normal routine and are satisfied with their life style; 57 (59%) were not satisfied with their life style for various reasons, ill health being one. As regards patients above 60 years; 21 (53.8%) are alive and 10 (47.6%) are happy and satisfied with their life style.
There is a high incidence of tetanus in the Malaysian state of Kelantan. Out of 162 reported cases of tetanus in Peninsular Malaysia during 1979 - 1984, 62 cases were from Kelantan, i.e. 38% of the total reported cases in Peninsular Malaysia. Thus a retrospective study was carried out to analyse the possible factors responsible for this high incidence. 62 cases of tetanus admitted to the General Hospital, Kota Bharu, over a period of 1979 - 1984 were studied.
Neonatal tetanus, though still existing, had been considerably reduced compared to the preceding five-year period (1975-1979). There was notable absence of cases in the two months to four-year age group, 24% of the cases occurred in the 10 - 20 years, and 29% in the age group 25 - 40 years. Since tetanus is a disease preventable by active immunization. l every effort must be taken to improve immunization coverage and increase the public awareness to prevent unnecessary loss of lives.
Intracranial subdural hematoma following lumbar surgery is a devastating but rare complication. It has been implicated due to intracranial hypotension secondary to persistent cerebrospinal fluid leakage. The resultant drop in intracranial pressure presumably causes traction and tearing of venous structures. Patients typically present with postural headaches. However, other symptoms of subdural hematoma, intracranial hypotension and cerebrospinal fluid leak must also be cautioned.
Hip pain is frequently encountered in the athletic community. Femoro-acetabular impingement (FAI) is a common cause of hip pain in young adults. However, it is important to appreciate the uncommon diagnosis and the role of imaging for unexplained hip pain. The pathology behind a posterior hip pain is often misdiagnosed as the cause of hip pain is non-specific, extensive and elusive. We managed to detect the pathology through magnetic resonance arthrography (MRA) of hip with gadolinium enhancement after a series of inconclusive history, physical examination and imaging findings were completed. This particular case vignettes an overlooked osteoid osteoma that leads to the delay in diagnosis and increase morbidity.
Land development, especially construction works, increase storm water volumes and pollution loads into rivers and lakes. The temporary drainage system at construction sites, particularly during the construction stage discharges a large amount of pollutants that can damage the aquatic system of the receiving water bodies. The potential of vegetative swale to alleviate this problem was evaluated. The size of the constructed vegetative swale was 7cm deep, 400cm long and 15cm wide at the bottom, and 17cm wide at the top. The experiment was conducted batch wise by filling the storage tank with the run-off water from the construction site. The water was allowed to flow through a pipe into the retention basin to maintain uniform flow before it entered the swale. The study showed that the run-off infiltrated through the soil at a rate of 489.6 mm/hr. Samples of surface run-off and infiltration water were collected at the end and the bottom of the swale. The results indicate that chemical oxygen demand (COD), total suspended solid (TSS), turbidity, iron and zinc were reduced by 85.4%, 80.8%, 36.4%, 52.8% and 96.0%, respectively, by surface flow and 91.1%, 98.8%, 58.2% 55.5% and 98.1%, respectively, by infiltration. Removal of nitrate and phosphorus by the planted vegetation was 69.4% and 21.1%, respectively, by infiltration. However, nutrient removal by surface flow was negligible. In conclusion, the vegetative swale was able to improve the water quality of the storm water run-off from the construction site from Class V to Class III, according to the Interim National Water Quality Standards for Malaysia.
A young gentleman of Indian descent with oculacutaneous albinism (OCA) was found to have severe pulmonary fibrosis at first presentation. Following investigations, he was diagnosed with Hermansky-Pudlak Syndrome (HPS). It is a genetic condition characterised by albinism, bleeding diathesis and multisystem disorder observed in individuals of particular descents. Although there is no curative treatment apart from lung transplantation, preventive measures to minimise pulmonary insult may change the natural history of the disease. Therefore HPS should be actively sought, monitored and risk factors addressed in individuals with OCA and bleeding diathesis particularly those of Indian descent as they may develop serious complications such as pulmonary fibrosis in the future.
The aim of the current study was to determine the physiological response to feed restriction in female broiler breeders using a range of conventional and novel indicators. One hundred female breeders were subjected to one of five feeding regimens from d 28 to 42 as follows (i) ad libitum feeding (AL), (ii-v) 75, 60, 45, and 30% of ad libitum feed intake. Blood heterophil to lymphocyte ratio (HLR), and plasma circulating corticosterone (CORT), ghrelin (GHR), serotonin (5-HT), and dopamine (DA) and serum acute phase proteins (APP) concentrations together with brain heat shock protein (HSP) 70 level were measured. The results showed a significant effect of feed restriction on blood HLR and plasma CORT, GHR, 5-HT, DA, and brain HSP 70 levels. However, feed restriction had no effect on serum levels of APP of alpha-1 acid glycoprotein, ovotransferin, and ceruloplasmin. Serum levels of 5-HT and GHR varied curvilinearly with the feed restriction level. The relationship between brain HSP 70 and level of feed restriction was negligible. However, significant linear relationships between HLR, CORT, DA, and the level of feed restriction were noted. Thus, these 3 parameters appear to represent a straight forward relation with severity of feed restriction.