For a complete overall rehabilitation of cleft palate patients a multi-disciplinary approach should be adopted. Plastic and Head and Neck Surgeons in whom most of the treatment are entrusted should be concerned not only at achieving palatal function and cosmetic acceptability but also the various other problems associated with cleft palate especially hearing loss. In this study, 66 patients with repaired and unrepaired cleft palates were examined for the presence of hearing loss due to middle ear effusion. The incidence of middle ear effusion was high (57.6%). It was also found that only eight of these patients (12.1%) ever complained of hearing loss or any associated symptoms and repair of the cleft palate did not influence the incidence of middle ear effusion. As such, screening should be done in all cleft palates and otolaryngologists should therefore play an important role in the multi-disciplinary team which should comprise the paediatrician, plastic surgeon, speech therapist, orthodontist and dental specialist.
A report of 25 cases of neurosyphilis seen in University Hospital, Kuala Lumpur since 1970. Classical form of the disease still constitute the majority of the patients with often long delay before diagnosis.
Non-haemoglobin liver iron was estimated in 275 presumably normal individuals from Kuala Lumpur and Singapore at necropsy. Liver Iron concentrations were highest during the first two years after birth but declined sharply during childhood. They then rose gradually and reached a value of 20 mg/100gm in adult males. Liver iron concentrations of childbearing women remained low and it was only after menopause that values in women rose to those of males. Liver iron stores increased with age to a plateau of about 300 mg in adults, suggesting that this value may represent the adult size for liver iron store. Among the three major ethnic groups in Malaysia and Singapore, Chinese, being in a better socio-eonomic class, had larger liver iron stores. The median liver iron concentrations of Malaysians and Singaporeans, on the whole, were lower than those reported from western populations and as many as 35 per cent of the women were in a subclinical state of iron deficiency.
A retrospective study of 62 cases of myasthenia gravis in Malaysia is reviewed. It shows an apparent prevalence among the ethnic Chinese compared with the Malay and Indian. The incidence of male and female and their average age of onset are similar. Unlike the western figure, among those with age of onset less than 20 years. both sexes are equally affected. The symptomatology, morbidity and mortality and incidence of thymoma are the same as those
reported elsewhere.
A patient with organophosphate poisoning who survived the acute phase and subsequently developed delayed neuropathy is presented. The features of this form of delayed neuropathy are described and the implications in our local context discussed.
The trial was carried out at a commercial pig farm in Bukit Pelanduk, Negeri Sembilan, Malaysia. The objective of the study was to assess the efficacy of supplemental iron in drinking water and iron in paste form in comparison with the iron dextran injection. A total of 12 litters were used divided into three treatments : iron dextran injection (ID), Fedexx" - iron in paste form (IP) and Opti-iron" - iron in drinking water (IW). Hemoglobin level and growth performance parameters were monitored weekly over a period of 28 days. ID piglets had significantly higher (p < 0.05) body weight and weekly weight gain compared with IW piglets at 21 and 28 days of age whereas no significant different (p > 0.05) results were found between IP and IW piglets. Hemoglobin level from days 0 to 28 showed statistical difference (p > 0.05) between piglets in IP and IW groups. Mild anemia was found in IP piglets but not for ID and IW piglets compared with normal value (> 9 g/dL). Hemoglobin (Hb) levels were positively correlated (p < 0.05, r = .47) with body weight at 28 days of age. In conclusion, pigs supplemented with iron in paste form and drinking water had poorer growth performance than iron dextran injection piglets. Piglets given iron in paste form had mild anemia. It is advisable to give multiple doses of oral iron to piglets in order to prevent iron deficiency anemia. During the first 4 weeks of life, the body weights of the piglets increased by up to 5-fold. The dietary requirement for iron during this period is 7 mg per day but only 1 mg per day can be supplied by the sow's milk (Cunha, 1977; Miller and Ullrey, 1997; Roberts, 1998). The need to provide the piglets with an adequate amount of iron before weaning is therefore imperative because sow's milk alone will not meet the iron requirements of rapid growth and expanding blood volume (Hannan, 1971). Several different methods can be used to offer iron to preweaning piglets. The most common administration method for iron in piglets is through an intramuscular injection of iron dextran complex at 3 days of age. A single dose of 200 mg/ml iron-dextran is effective against iron deficiency anemia. However, the method is very stressful to the piglets. They will suffer more pain if a greater dosage of iron is given intramuscularly. Furthermore, poor iron injection techniques may cause considerable trauma to the muscles, staining of hams or create abscesses and lead to downgrading of the carcasses (Roberts, 1998). Since there are several drawbacks to the iron injection, alternative methods need to be considered in intensive farming i.e. supply iron orally (Miller and Ullrey, 1997). The oral administration of iron has two advantages: cost and the fact that absorption is regulated by the intestinal mucosae. However, oral administration requires multiple doses. This is because a single dose may not be sufficient to protect the piglets from iron deficiency anemia for the first 4 weeks post-partum. The iron bioavailability in oral iron depends greatly on iron status of animals (Amine et al., 1972; Susan and Wright, 1985). In addition, dietary factors such as amino acids and protein sources (Martinez et al., 1981), pectin content, phytate (Morris and Ellis, 1982) and the other minerals (Elvehjem and Hart, 1932; Hedges and Kornegay, 1973; Suttle and Mills, 1966) may also influence the bioavailability of iron. Oral iron can be given as paste or drinking water. Early administration of oral iron within the first few days of life will meet the iron needs of the suckling pig. However, it is critical to administer early before gut closure to large molecules (Harmon et al., 1974; Thoren-Tolling, 1975). This study was conducted to determine the efficacy of iron supplementation in drinking water or paste form in comparison with the injection of iron compounds in suckling pigs.
A retrospective prospective study of 84 cases of subarachnoid haemorrhage, 24 intracranial aneurysms and 18 arteriovenous malformations (AVM's) treated in the University Hospital, Kuala Lumpur, during the post CT-scan era was carried out to verify the relative frequencies of these clinical entities in the Malaysian population. Our results show that aneurysms are commoner than arteriovenous malformations as a cause of subarachnoid haemorrhage and also the most frequent as a whole, thus refuting the previous claims that AVM's are 4 to 10 times more common than aneurysms in this part of the world. Of interest was the internal carotid artery aneurysms accounted for half of the anterior circulation aneurysms and that 2/3 of the AVM's presented with intracranial haemorrhage.
Complicated migraine is not well known. It is associated with transient and protean sensory and motor
nenrological features although disturbance of mood, affect and psyche has also been described.
This paper is based on a study of ten patients suffering from complicated migraine and attempt is made
to describe various neurological symptoms and signs.
It becomes apparent from this study that there arc diverse manifestations of this interesting disorder.
Furthermore complicated migraine seems to affect a younger age group and there may not be any
family history of migraine. In most cases the nenrological symptoms precede the attacks of headaches.
The nenrological deficit may persist after longer periods. Initially, the attacks arc usnally followed by
complete recovery, with repeated attacks there may be residual neurological deficit. Though the exact
aetiology of the migraine remains unknown, it has been suggested that it is due to spasm or oedema of
cerebral vascular system. If the vessels involved are the carotid artery system, the symptoms and signs
obviously would be due to involvement of cerebral hemisphere, whereas affection of basilar artery
would produce signs and symptoms of cerebellar or brain stem deficiency.
At times it may be extremely difficult to differentiate between a typical attack of migraine and headache
due to an underlying pathology e.g. intracranial angioma or space occupying lesions, which may
require investigations such as angiography. The angiography may prove fruitless and cause deterioration
in neurological signs. A careful follow-up should be planned for cases with complicated migraine
to exclude any underlying pathology.
In this study, 13 weeks (October to December 2012) of ovitrap surveillance was conducted in two suburban residential areas in Kampar town, Perak. A total of 17,310 Aedes mosquitoes were found in Taman Kampar Jaya, whereas Taman Juloong recorded a higher number at 19,042. Less than 1% of these were identified as Aedes aegypti, with the remaining confirmed as Aedes albopictus. The female Ae. albopictus were subsequently subjected to WHO standard diagnostic test kits against two pyrethroids (0.05% deltamethrin and 0.75% permethrin) and two organophosphates (1% fenitrothion and 5% malathion). The Ae. albopictus from both research sites were the most susceptible to deltamethrin, recording KT50 and KT95 response values of 15.84 minutes and 16.18 minutes; and 48.18 minutes and 49.44 minutes respectively. This was followed by permethrin (20.57 minutes and 17.52 minutes; 29.54 minutes and 54.54 minutes) and malathion (48.46 minutes and 62.69 minutes; 87.72 minutes and 141.04 minutes). Fenitrothion was found to be least effective towards Ae. albopictus; recording KT50 and KT95 response values of 150.29 minutes and 293.41 minutes for Taman Kampar Jaya, and 203.32 minutes and 408.07 minutes respectively for Taman Juloong. All tested Ae. albopictus showed 100% mortality after 24 hours post exposure. As both residential areas were fogged periodically by the municipal council; alternating between organophosphates and pyrethroids, thus, constant monitoring is crucial in light of the emergence of resistance noted in Ae. albopictus towards fenitrothion.
This study was carried out to investigate the effects of dietary putrescine (PUT) on broiler's response fed low crude protein (CP) diets. A total of 192 male day old chicks were fed with four dietary treatments including two levels of PUT (0 and 0.03%) and two levels of CP (normal and low) with factorial combinations. Weekly growth performance, nutrient digestibility and intestinal morphology (at the age of 21 days) and liver and intestinal tissue polyamines content were measured. As a result of this study lower dietary CP had a significant (P<0.05) lower body weight gain (BWG) and improved protein efficiency ratio (PER). PUT improved energy efficiency ratio (EER) significantly (P<0.05). Dry matter (DM) digestibility was decreased by lower dietary CP whereas 0.03% PUT significantly (P<0.05) increased it. Low CP caused significant (P<0.05) greater calcium digestibility, while this effect was not found when PUT was added. PUT had no effect on intestine villous height and crypt depth. Polyamine content of intestine and liver was influenced by the age of the birds, while PUT had no effects on them. In conclusion, dietary PUT has beneficial effects on EER in chicks fed CP-deficient diet, indicating possible involvement of PUT in energy metabolism. PUT supplementation did not moderate the reduced BWG of the chicks fed low protein. Intestinal and liver polyamine concentration was mainly affected by dietary CP and age of the birds rather than dietary PUT.
This study examined whether pre-treating palm kernel expeller (PKE) with exogenous enzyme would degrade its fiber content; thus improving its metabolizable energy (ME), growth performance, villus height and digesta viscosity in broiler chickens fed diets containing PKE. Our results showed that enzyme treatment decreased (p<0.05) hemicellulose and cellulose contents of PKE by 26.26 and 32.62%, respectively; and improved true ME (TME) and its nitrogen corrected value (TMEn) by 38% and 33%, respectively, compared to the raw sample. Average daily gain (ADG), feed intake and feed conversion ratio (FCR) of chickens fed on different dietary treatments in the grower period were not significantly different. Although there was no difference in feed intake (p>0.05) among treatment groups in the finisher period, ADG of chickens in the control (PKE-free diet) was higher (p<0.05) than in all treatment groups fed either 20 or 30% PKE, irrespective of with or without enzyme treatment. However, ADG of birds fed with 20% PKE was higher than those fed with 30% PKE. The FCR of chickens in the control was the lowest (2.20) but not significantly different from those fed 20% PKE diets while birds in the 30% PKE diets recorded higher (p>0.05) FCR. The intestinal villus height and crypt depth (duodenum, jejunum and ileum) were not different (p>0.05) among treatments except for duodenal crypt depth. The villus height and crypt depth of birds in enzyme treated PKE diets were higher (p<0.05) than those in the raw PKE groups. Viscosity of the intestinal digesta was not different (p>0.05) among treatments. Results of this study suggest that exogenous enzyme is effective in hydrolyzing the fiber (hemicellulose and cellulose) component and improved the ME values of PKE, however, the above positive effects were not reflected in the growth performance in broiler chickens fed the enzyme treated PKE compared to those received raw PKE. The results suggest that PKE can be included up to 5% in the grower diet and 20% in the finisher diet without any significant negative effect on FCR in broiler chickens.
This study was carried out to investigate the modulatory effects of dietary methionine and n-6/n-3 polyunsaturated fatty acids (PUFA) ratio on immune response and performance of infectious bursal disease (IBD)-challenged broiler chickens. In total, 350 one-day-old male broiler chicks were assigned to 1 of the 6 dietary treatment groups in a 3 × 2 factorial arrangement. There were 3 n-6/n-3 PUFA ratios (45, 5.5, and 1.5) and 2 levels of methionine (NRC recommendation and twice NRC recommendation). The results showed that birds fed with dietary n-6/n-3 PUFA ratio of 5.5 had higher BW, lower feed intake, and superior FCR than other groups. However, the highest antibody response was observed in birds with dietary n-6/n-3 PUFA ratio of 1.5. Lowering n-6/n-3 PUFA ratio reduced bursa lesion score equally in birds fed with n-6/n-3 PUFA ratio of 5.5 and 1.5. Supplementation of methionine by twice the recommendation also improved FCR and reduced feed intake and bursa lesion score. However, in this study, the optimum performance (as measured by BW, feed intake, and FCR) did not coincide with the optimum immune response (as measured by antibody titer). It seems that dietary n-3 PUFA modulates the broiler chicken performance and immune response in a dose-dependent but nonlinear manner. Therefore, it can be suggested that a balance of moderate level of dietary n-6/n-3 PUFA ratio (5.5) and methionine level (twice recommendation) might enhance immune response together with performance in IBD-challenged broiler chickens.