1. The importance of the mental and physical reactions of the amputee. 2. Ideal sites and the technique of amputations are discussed briefly. 3. Rehabilitation and training of the amputee is important if the best results are to be obtained. 4. Some of the special reasons for amputation are considered. 5. The component parts of an artificial limb and their alignment are outlined. 6. Special features in fitting limbs for women and children. 7. Some complications resulting from the wearing of an artificial limb are described. 8. Limb fitting in Malaya has its own peculiar difficulties which time and experience will rectify.
With the increasing ease of travel and the passage of peoples between counkies there is a need to ensure that the recipient country is not burdened by the need for care of ilniiiigrant with health problems as well as the increased risk posed to the local population froni exposure to conun~unicabled isease. To assess the chest radiographs of a selected group of inun~igrantsto ascertain the presence of abnormalities especially the presence of tuberculosis. A total of 250 imniigrants were prospectively evaluated by a PA chest radiograph. The chest radiograph was evaluated by two radiologists for the presence of abnormalities of the heart, lungs, mediastinum and bony rib cage. There were 112 Indonesians, 133 Bangladeshis, one Myanmar, three Pakistanis and one others. Males made-up 222 while there were 28 females. The chest radiograph was diagnostic in all cases. There were 13 cases with enlarged hearts but with no evidence of heart failure. There was only a single inlmigrant who had evidence of active TB though there were 6 others who had evidence of old disease. There was evidence of other infections in five. With regard to the mediastinuni there was a single case with enlarged hila probably secondary to increased cardiac output. There were 21 patients with scoliosis of the spine and two with abnormaIities of the ribs. Even though there was a single case with evidence of TB from this pilot study, from unreported data from the UMMC, there were 15,16 and 23 immigrants treated for TB for 1994,1995 and 1996 respectively. This was mainly seen in the Indonesians followed by the Bangladeshis and Myanmar. We attribute this discrepancy to the biased salnpie in this study where probably only the healthy were seen while those who were not well did not want to participate in this study. In addition, this may also be due to the small sample used in this study. We feel that screening of the immigrants out in the field may be able to detect cases of active TB. As for the large hearts we feel that in the absence of any cardiac symptoms and other radiological changes these are probably due to the increased workload on the heart from physical activities. This is a recognised presentation. The changes in the mediastinum and bony rib cage are probably not very significant.
A survey was done to assess the chest radiographs of a selected group of immigrants. The objective is to ascertain the rpesence of abnormalities especially the presence of tuberculosis. Five hundred and eleven (511) chest radiographs (PA view) were evaluated. majority of the chest radiographs were normal, except for 2 cases of hilar lymphadenopathy, 4 cases of scoliosis and cervical rib, an old case of fracture of the clavicle and a case of cardiomegaly. Only 2 cases of TB were detected.
Facts are presented which suggest that mosquitoes of the Anopheles barbirostris species group that gave me a very uncomfortable night in 1941, whilst serving with the Volunteer forces, were probably A. donaldi. This species is now known to be a vector of human filariasis and probably malaria. Some of the steps are described by which I was led, sixteen years later, to recognise and later name donaldi as a new species. Reasons are given for thinking that around 1918 A. donaldi was present in some numbers at the railway town of Gemas where malaria was a serious problem. H.P. Hacker made a survey at Gemas in 1918 and though the principal vector was probably A. maculatus, 'umbrosus' and 'barbirostris' were the commonest larvae he found.
Anopheles donaldi Reid, a member of the A. barbirostris species group, is a vector of human filariasis and probably malaria. The discovery of some old specimens of this species, collected in Kuala Lumpur town where it no longer occurs, together with evidence from the literature about past malaria in the town, suggest that donaldi may have played a part in transmitting that malaria.