Cryptosporidium is an intestinal protozoan parasite which causes diarrhoea in animals and has recently been reported to cause similar symptoms in man. Cryptosporidiosis is a zoonotic infection and the first human case was reported in 1976.2 Since then the number of cases has increased by the hundreds especially among patients with acquired immuno-deficiency syndrome (AIDS), as a result of the severe symptoms that they cause in the im-munosuppressed patients and also due to the better screening techniques which have been developed resulting in the detection of cases.3 To date 20 species of Cryptosporidium have been reported but these cannot be differentiated morphologically. The differences are based mainly on the host from which the parasites were recovered. The species responsible for causing infection in man is Cryptosporidium parvum.4 Of the 20 species reported several are invalid because the oocysts of some of them were found to be the same as the sporocyst of Sarcocystis. It is now concluded that there are only two species that infect mammals (C. Muris and C. parvum). (Copied from article).
Reported is the first case of syringomyelia and syringobulbia associated with Arnold Chiari I malformation in a Malaysian child. The initial complaint was that of unilateral anhidrosis of the face. The chief presenting features were dissociated sensory loss, asymmetrical weakness of the left upper limb associated with subluxation of left shoulder and signs of upper motor neurone lesion in the left lower limb. One unusual feature was the presence of vesiculation followed by ulceration of the pinnae of both ears. Magnetic resonance imaging (MRI) of the posterior fossa and cervical and thoracic cord facilitated the diagnosis and was the most useful diagnostic procedure in this child.
A survey of 308,101 schoolchildren conducted in 10 of 11 states in Peninsular Malaysia revealed that 10.7% have Pediculus humanus capitis infestation. The results of treatment with 1%, 2% and 5% DDT in coconut oil in 374 cases reveal cure rates of 3.5%, 15.8% and 51.3%, respectively, suggesting that the head louse has probably developed resistance to this insecticide in Malaysia.
A survey of 4.112 primary school children living in and around Kuala Lumpur, Malaysia, revealed that 12.9% of the children were infested with Pediculus humanus capitis. Indians (28.3%) and Malays (18.9%) have a higher prevalence than Chinese (4.6%). The higher prevalence among Indians and Malays correlates well with their lower socio-economic status in the community; long hair also contributes to the higher rates of pediculosis among them. The prevalence rate was found to be related to socio-economic status, length of hair, family size, age, crowding and personal hygiene. Treatment with 0.2% and 0.5% malathion in coconut oil gave cure rates of 93% and 100%. Treatment with gammexane and actellic at 0.5% concentration gave a cure rate of 100% against adults and nymphs of Pediculus humanus capitis.
Vomiting, drowsiness, metabolic acidosis, polymorphonuclear leucocytosis, and encephalopathy developed in thirteen infants within hours of ingestion of margosa oil. Liver biopsy of one infant and necropsy examination of ICR strain mice after experimentally induced margosa-oil poisoning demonstrated pronounced fatty infiltration of the liver and proximal renal tubules as well as cerebral oedema. Electron microscopy demonstrated mitochondrial damage. These findings indicate that margosa oil may be involved in the aetiology of Reye's syndrome among Indians in Malaysia.
A survey of 308,101 primary school children in Peninsular Malaysia conducted in 1979 by the School Health Services, Ministry of Health, Malaysia, revealed that 10.7% of children were infested with Pediculus humanus capitis. The prevalence rate was higher in the economically less advanced states of Terenganu (34%), Kelantan (23%), and Perlis (21%) than in the other states (4-13%). Of 14,233 school children examined in the State of Melaka, 26% of Indians, 18.7% of Malays, 6.1% of Europeans, and 0.7% of Chinese had pediculosis. The prevalence rate, which has remained unchanged over the past 5 years, does not appear to vary with age but is higher in children with long hair and those from the lower socioeconomic groups. Boys have a lower infestation rate than do girls. The higher incidence in Indians and Malays correlates well with their lower socioeconomic status in the community, and their cultural habit of maintaining longer hair than do the Chinese. The difference become less apparent in the higher socioeconomic groups.
A questionnaire survey of student nurses and nurses at a premier hospital in Malaysia reveals that the majority of nurses support the use of corporal punishment on schoolchil-dren. Malay nurses who had received corporal punishment were more likely to endorse corporal punishment than those who had not received it. The number of non-Malay nurses was too small for comment. These findings reveal that nurses need to re-examine their attitudes and their training with respect to child discipline and child rearing practices. Nurses need to be educated on the cycle of violence and the root causes of child abuse in the community. Nurses need to change their attitudes to violence on children and to condemn any such acts, whether it be in the home or at school.
A ten-year review revealed a similarity in the incidence of teratoma in relation to other childhood tumors in Malaysian as compared with Caucasian children. The most common sites of origin were the sacropcoccygeal, gonadal, and retroperitoneal areas. The reason for the high incidence of retroperitoneal tumor in our series as compared with other countries is not clear. Late presentation and poor followup are associated with poor prognosis.
A total of 346 paediatric in-patients in the University Hospital in Kuala Lumpur was examined for infection with Enterobius vermicularis using two anal swabs taken on two consecutive days. 24% of these children. whose mean age was 6 years [range 2-14 years] were infected. The infection was more prevalent among children between the ages of 5-11 years. There is only a slight difference in the distribution of infection among Malay. Chinese and Indian children. There is no significant difference in the prevalance of infection between boys and girls.
Twenty children with retinoblastoma are reviewed who were treated at the University Hospital, Kuala Lumpur over a 10-year-period. They constitute 6.6% of childhood malignancies and without exception all presented with advanced disease. Hereditary cases were notably absent in the the series probably because past cases have almost invariably succumbed without an opportunity to transmit the gene. With enucleation and radiotherapy six of the patients have survived from 2 to 12 years. The addition of vincristine and cyclophosphamide has not been associated with improved survival.
The sale of tobacco-based cigarettes has declined in western countries, and ‘Big Tobacco’ is trying to make up the deficit in profits from the developing world. The recent introduction of e-cigarette, in which they have invested both their hopes and their finances, has been a boon to them as it serves to confuse smokers and non-smokers about the real issues relating to the toxicity, dangers, and the promotion of nicotine addiction especially among youths who have not previously smoked cigarettes. E-cigarettes cause inflammation and damage to epithelial cells in human airways and increased risk of infection. E-cigarette vapour contains more carcinogens like formaldehyde and acetaldehyde compared to a regular cigarette. Longterm vaping is associated with an incremental lifetime cancer risk. E-cigarettes are neither safe nor effective in helping smokers quit; there is enough evidence to caution children, adolescents, pregnant women, and women of reproductive age about e-cigarette’s potential for long term consequences to foetal and adolescent brain development that sub-serve emotional and cognitive functions. The nicotine effects that cause modification of late CNS development constitute a hazard of adolescent nicotine use. The American Heart Association (AHA), Food and Drug Administration (FDA), World Health Organisation (WHO) and two-thirds of the major nations in the world discourage the promotion of e-cigarettes as an alternative to proven nicotine-addiction treatments. Doctors, health care workers, and medical students should be armed with the facts about e-cigarettes, its dangers, and the legal status concerning its use, in order to be able to offer proper counselling to patients and adolescents, in particular, with special reference to the Malaysian context.