Perforated appendicitis, with its increased complication rate, today still poses a formidable problem in the Kuala Lumpur General Hospital. Out of 1694 emergency operations performed by our unit in 1987, there were 927 appendicectomies. A retrospective study of these cases showed 126 cases of perforated appendicitis, which were then subjected to detailed analysis. We have a diagnostic accuracy of 81% and perforation rate of 18%. In addition, it is interesting to note the racial differences in the relationship of diagnostic accuracy to perforation rate. Perforation is associated with an increased wound infection rate. Transperitoneal drainage in perforated appendicitis did not lead to a lower incidence of wound infection or improve postoperative performance. Distinguishing between perforated and non-perforated appendicitis may be difficult. Perforation could occur while awaiting operation. We recommend the early administration of systemic antibiotics should appendicectomy be delayed and the cautious use of drains in cases of perforated appendicitis.
The age-corrected incidence of hip fracture in the city of Kuala Lumpur and the surrounding districts has increased from 1981 to 0.7 per 1,000 population in 1989. Women dominated by a factor of 1.3. The mean age was 73 (50-103) years. The increased rate observed was attributed solely to trochanteric fractures among those 70 years and above. There were differences in the various parameters among the different races. The fracture incidence and woman/man ratio were substantially lower than has been reported from developed countries.
The primary objectives of the present work were to produce corncob powder (CCP) from
corncobs and incorporate the CCP into bread formulation in order to develop high fibre bread,
and to investigate the physicochemical and sensory properties of the produced high fibre
bread (HFB). The corncobs were collected and washed before they underwent the grinding
and drying processes. The obtained CCP was incorporated into the bread formulation in three
different proportions (5, 10 and 20%) to partially substitute bread flour in the formulation. All
three bread samples and the control (0% CCP in the formulation) were analysed to obtain their
physicochemical and sensory properties. The incorporation of CCP significantly affected the
texture, colour and volume attributes of the produced breads. Increasing the content of CCP
in the formulation was found to be responsible for firmer, smaller and darker bread loaves as
compared to the composite bread samples. The bread formulation incorporated with 10% CCP
had the highest mean scores (7.00) of overall acceptability among all the other formulations,
and it was comparable to the commercial breads in the current market.