Moraxella catarrhalis has gained reputation as a pathogen in the lower respiratory tract especially in patients with underlying chronic lung diseases. It is considered significant when isolated from sputum specimens of adults with respiratory tract infections. A study was carried out to determine the prevalence of Moraxella catarrhalis isolated in sputum specimens and beta-lactamase production of these isolates. Sputum specimens sent to the Bacteriology division, Institute for Medical Research from April 1990 until April 1993 were screened for Moraxella catarrhalis. A total of 1678 sputum specimens were processed and Moraxella catarrhalis was isolated from 15 (0.89%) of the sputum specimens. Six out of 15 (40%) were isolated from patients with chronic lung disease. Eight out of 15 (47%) were beta-lactamase producers. Moraxella catarrhalis isolated in good-quality sputum must not be disregarded and should be looked for especially in patients with chronic obstructive pulmonary disease. Beta-lactamase production should be tested on all isolates so that appropriate treatment can be given. All the isolates in this study were sensitive to cotrimoxazole.
Low birth weight babies are defined as those weighing under 2,500 g. They make 13.5% of all births at the Maternity Hospital, Kuala Lumpur but contribute to 74.8% of all deaths. They are most likely to be Indian babies and least likely to be Chinese. Among all 3 communities, the primigravidae tend to produce smaller babies than multiparae but this is also true for the Indian of parity more than 3. The Malay teenager is more likely to produce small babies than their older counterparts but not so with the Indian and Chinese. There are definite clinical factors associated with or causing the births of small babies and the lighter the baby, the more influential are these factors. Maternal hypertension, antepartum haemorrhage, multiple pregnancy and unexplained intrauterine death are the 4 outstanding associations with both low birth weight and perinatal death. Although the spontaneous (often premature) onset of labour was the commonest preceding factor, it was much less important in the lowest birth weight groups of babies and was a less important contributor to perinatal death.
Transvaginal sonography was performed in 70 patients diagnosed to have placenta praevia by transabdominal sonography. The diagnosis was confirmed either by digital examination in theatre at term or operative finding at delivery. Forty-nine cases (70%) were correctly diagnosed to have placenta praevia by both modes of sonography. Transvaginal sonography ruled out placenta praevia in 12 cases (17%) thought to be placenta praevia by transabdominal ultrasound. Both transabdominal and transvaginal sonography demonstrated 'placental migration' in 4 cases (6%) which were no longer praevia at delivery. Five patients (7%) were erroneously believed to have placenta praevia by both sonographic techniques. Overall, the diagnostic accuracy of transvaginal sonography was 92.8% compared with 75.7% for transabdominal sonography. None of the subjects experienced any exacerbation of bleeding or other complications. The results suggest that transvaginal sonographic localization of the placenta is safe and superior to the transabdominal route.