Processing of by-product heavy minerals (amang) from tin mining involves potential exposure to external and internal sources of radioactivity. The radioactivity arises through the presence of thorium and uranium series radionuclides in the various minerals. Monazite is the most radioactive mineral, containing 3% to 7% thorium by weight, while ilmenite is generally the least radioactive mineral containing typically less than 0.05% thorium. External exposure occurs when workers are in close proximity to accumulations or stockpiles of the radioactive minerals, whereas internal exposure occurs when workers are involved in dusty processes. This paper summarizes the nature of the amang industry in South East Asia and presents the results of preliminary measurements of external radiation and airborne radioactivity in twelve Malaysian and Thai plants. Although constrained by a paucity of exposure data, it is concluded that radiation doses to some amang plant workers may approach or exceed international standards and that appropriate control measures are required as a matter of priority, Radiation doses may approach or exceed 100 mSv in situations where workers are exposed to excessive levels of ambient dust and no protective measures are used. Observations and recommendations are made relating to monitoring and surveillance, instruction and training, and engineering and administrative protection measures.
Thirty-eight tibial plateau fractures were treated with open reduction and internal fixation. The fractures were classified into six groups (Hohl's 1991 Classification) and the clinical results were evaluated using the Rasmussen (1973) criteria. The average follow-up period was 2.07 years. Overall there was one excellent, thirty-four (34) good, three fair and no poor results. In three patients with less than a good score there were other associated ipsilateral injuries and delayed mobilisation of the knee joint. There was no direct association between the type of internal fixation and the end result.
Parasuicide has become an increasingly common response to emotional distress in young adults. The general pattern of parasuicide shows variations among the developing countries. The objectives of this study were to determine the pattern of parasuicide and suicide beside comparing the characteristics between different ethnic groups. The study was a retrospective case review of all parasuicide cases treated in Hospital Sungai Bakap and all suicides from the hospital mortuary from January 2001 to December 2005. We collected data concerning demographic data, information on method used and the circumstances. A total of 189 cases of parasuicide were analysed. There was a significant increase of parasuicide from 26.5 per 100,000 persons in 2001 to 32.1 per 100,000 persons in 2005. Seventy two percent of the cases were female. Indians constituted 64 % of the cases, followed by the Chinese (19 %), Malays (13 %) and foreigners (4 %). The age group 18-30 years ranked at the top, constituting 59.7% of the cases. Majority of the cases were by intentional poisoning and only 2 cases (1.1 %) were intentional injuries by sharp objects. In the past 5 years, the agents implicated were drugs (43.9 %), pesticides (23.5 %), household products (11.8 %), and others (20.8 %). Intentional Paracetamol poisoning had doubled from 11.7 % in 2001 to 23.4 % in 2005 while the use of pesticides had decreased from 32 % in 2001 to 17 % in 2005. Only 2 % of the cases had history of underlying disorders like schizophrenia and personalities disorders. As for suicide, the rates remained relatively unchanged at 5 per 100,000 populations. In this study, the demographic characteristics of suicide differ from parasuicide as suicides were associated with higher percentage of males and Chinese. There were 2 peaks in the age group of 31-40 and above 60 years old. The highest mode of suicide was hanging (53.5 %), followed by pesticide poisoning (25.6 %) and inhaled carbon monoxide (9.3 %).There is a need to improve on prevention and interventions for parasuicide and decrease suicide prevalence. Keywords: parasuicide, suicide, self-harm, Penang
Epistaxis is a common problem encountered in clinical practice. It is usually self-limiting and is usually controlled with conservative measures such as nasal compression or ice-packs. Occasionally nasal packing is required. It is rarely severe enough that surgical intervention is warranted. The following report illustrates a patient who presented to us with a rare cause of life-threatening epistaxis that is, a post-traumatic pseudoaneurysm who finally required surgical intervention to control the bleeding.
The quality of laryngoscopy and tracheal intubation with propofol augmented by alfentanil was investigated as an alternative technique for rapid tracheal intubation. 119 patients aged between 18 and 60 years (ASA 1 and 2) undergoing elective surgery were prospectively studied in a randomized double-blind controlled fashion. Tracheal intubation facilitated by suxamethonium 1.0 mg/kg alfentanil 15 mu g/kg alfentanil 30 mu g/kg or saline control was compared after propofol induction. The quality of laryngoscopy and intubation were graded according to jaw relaxation, ease of insertion of the endotracheal tube and coughing on intubation. Failure to intubate occurred in 4% and 17% with alfentanil 15 mu g/kg and saline control respectively Tracheal intubation was successful in all patients with alfentanil 30 mu g/kg and suxamethonium 1.0 mg/kg. Alfentanil 15 mu g/kg was not statistically significantly different from saline (P = 0.112). Alfentanil 30 mu g/kg provided similar overall intubating conditions (P = 0.5) to suxamethonium 1.0 mg/kg. Alfentanil in both dosages effectively attenuated the haemodynamic responses to laryngoscopy and tracheal intubation.
A cross-sectional study was carried out to determine the prevalence of hypertension in the Chinese elderly and to examine its relationship with various behavioural and nutritional risk factors. This study involved 243 Chinese aged 55 years and older in 2 randomly selected Chinese Villages in Seberang Prai Tengah, Penang. The study included an interview, anthropometric assessment and blood pressure measurement. The prevalence of hypertension was 48.1% and out of this, 65 (55.6%) were on anti-hypertensive treatment. There was a significant rise in the prevalence with age. Hypertension was found to be inversely related to per capita income and physical activity (p < 0.05). Hypertension was significantly more common in smokers than non-smokers. Alcohol intake in the elderly was low and not related to hypertension. Obesity was significantly associated with hypertension only among the elderly aged 55-64 years. The dietary intake of sodium, potassium and calcium did not differ significantly between the hypertensive and normotensive elderly.
A case of severe bronchospasm occurring during epidural anaesthesia in a patient undergoing Caesarean section is described. The aetiology of the bronchospasm may have been related to sympathetic nervous blockade allowing unopposed parasympathetically mediated bronchoconstriction.
The aim of this review was to summarise published literature on child abuse and neglect and its consequences in Malaysia, to discuss the implications of the research findings and to identify gaps in the local literature on child abuse and neglect. Medical and social literature in the English language published between the year 2000 to 2015 were searched for, resulting in forty four papers to be reviewed inclusive of a few key papers in the earlier years to provide some background information. The literature shows that child abuse and neglect is an important impact factor on mental health outcomes, involvement in substance abuse and delinquency due to the slant of the research interest from social studies. At least 70% of perpetrators are known to the affected children according to school-based prevalence studies. Safety programs and rehabilitation outcome studies involve small cohort groups. Studies on childhood mortality from child abuse or neglect are very limited. Overall, there are a few comprehensive studies involving school children but overall available studies are too patchy in to advocate for resource allocation, change in statutory procedures or training requirements. More extensive studies looking at the complex interaction of social environment, parenting skills, societal attitudes and responses, resilience factors and child safety nets and statutory response and their impact on different types of abuse or neglect are required.