The presence of supernumerary teeth in the premaxillary region may cause a variety of pathological effects. This study was carried out to determine the various aspects of supernumerary teeth in the premaxillary region, particularly the effects of the supernumerary teeth on the permanent incisors and surrounding tissues. Approximately 20 percent of the patients (n = 49) with supernumerary teeth did not present with any abnormality. A high proportion of patients (37.9 percent) had delayed or failure of eruption of permanent teeth and 24.1 percent had rotation or displacement of permanent teeth. Other effects observed were median diastema and cystic changes around the unerupted supernumerary tooth. The high proportion of pathological effects seen showed that early diagnosis of the anomaly is important to intercept damage to the adjacent normal teeth and surrounding tissues. However, no cases of root resorption of the permanent teeth due to the presence of supernumeraries were observed.
Brachiaria decumbens toxicity resulted in an altered reticulorumen environment in the sheep. This adversely affected the growth and activity of microorganisms in the rumen as reflected by greatly decreased concentrations of the volatile fatty acids (acetic, propionic and butyric) in B decumbens-intoxicated sheep.
The prevalence of sexually transmitted diseases was determined among 370 prostitutes in Kuala Lumpur, Malaysia. Chlamydial cervicitis (26.5%) was detected more frequently than gonorrhoea (14.25%) and was associated more often with pelvic inflammatory disease. Concurrent infections and asymptomatic infections were common. Seropositivity to hepatitis B and syphilis were 66.3% and 13.6% respectively. Women under 20 years of age had significantly higher rates of infection with Chlamydia trachomatis and hepatitis B virus than older women.
Study site: private clinic, Kuala Lumpur, Malaysia
505 primary school children in Singapore aged 10-14 were surveyed regarding fear of the dentist. Sixty-eight children were classified as having high fear, giving a sex and race adjusted population prevalence rate of 177 fearful children per 1000 population. Females were 2.64 times more fearful than males. There were no significant racial differences in the prevalence rate. Children with high state anxiety are almost three times as likely to report dental fear as those with low state anxiety. Children with trait anxiety scores above the population mean were just as likely as those reporting below the mean to be fearful. Access to dental care is an important intervening variable in dental fear.
About 10% of 3887 ever-married women included in the 1984-85 Malaysian Population and Family Survey revealed that they were influenced by the new population policy to desire more children than they had originally wanted. These women were more likely to be rural Malays from the lower socioeconomic class. Ideal family size was more than four children. Children are desired for economic benefits and emotional support. The natality of the Malays has risen since 1980: their total fertility rate has increased while their contraceptive prevalence rate has dropped sharply. Coupled with a decline in the crude death rate, the present fertility preferences and behaviour of the Malays will render the target of the population policy more attainable than is reflected by the survey data.
MeSH terms: Adult; Age Factors; Contraception/trends; Family Characteristics*; Female; Fertility*; Humans; Infant; Infant Mortality; Malaysia/epidemiology; Rural Population; Socioeconomic Factors
A validated study of the Self-Reporting Questionnaire (SRQ-20) of the World Health Organization against ICD-9 was found to have good validation indices at the cut-off point of 5/6. The sensitivity was 84.8% and specificity 83.7%. However, SRQ-24 had poor validation indices and are too sensitive to detect psychotic illness. Twenty-three per cent of 264 schizophrenic relatives who had been staying together with them and or actively involved in their care for at least one year had neurotic disorders compared with 1% who had latent schizophrenia. The prevalence of psychiatric morbidity was higher in the first-degree relatives compared with non-first degree relatives.
MeSH terms: Adolescent; Adult; Aged; Family Health*; Humans; Middle Aged; Neurotic Disorders/diagnosis; Personality Inventory*; Predictive Value of Tests; Surveys and Questionnaires; Schizophrenia/genetics*; Schizotypal Personality Disorder/diagnosis; Sensitivity and Specificity
Margosa Oil is an extract of the seed of the Neem tree and is widely used as a traditional medicine by Indians in India, Sri Lanka, Burma, Thailand, Malaysia and Indonesia. Used mainly for external applications, it is often administered orally to neonates and infants regularly in small amounts. Margosa Oil causes toxic encephalopathy particularly in infants and young children. The usual features are vomiting, drowsiness, tachypnea and recurrent generalised seizures. Leucocytosis and metabolic acidosis are significant laboratory findings. Management is aimed primarily towards the control of convulsions although supportive management is equally important. Prognosis is usually good but fatalities and neurological deficits have been reported. We report here two infants with Margosa Oil poisoning presenting with encephalopathy.
The anti-phospholipid antibody (aPL) in 26 heat-inactivated normal human sera (NHS) was tested for IgG subclass in ELISA. The specific antibody in NHS included all four IgG antibody subclasses, as well as IgA. The incidence of IgG subclasses ranged from 50% (13/26) for IgG1 to 92% (24/26) for IgG2. Specific IgA anti-phospholipid antibody (aPL) was detected by ELISA in 38% (28/73) of normal human saliva. The salivary IgA aPL bound preferentially to anionic phospholipids including cardiolipin, phosphatidylserine and phosphatidic acid but not to phosphatidylcholine or sphingomyelin. Unlike aPL in normal human sera, aPL in saliva was predominantly not associated with the previously described heat-labile inhibitor of aPL. This may indicate a role of salivary IgA aPL in local immunity by binding to cross-reactive bacterial cell surface components including phospholipids.
Cryptococcosis is a known opportunistic infection in immunosuppressed hosts. We report our experience of all cases presenting to our Department between December 1975 and September 1988. Eight post-renal transplant patients and three systemic lupus erythematosus (SLE) patients were affected. All were receiving treatment with steroids, in association with either azathioprine or cyclosporin. The diagnosis of cryptococcal meningitis was initially based on a positive cerebrospinal fluid (CSF) cryptococcal antigen, by latex agglutination test, and subsequently confirmed by cultures. Common clinical presentations, in descending order of frequency, included headaches, fever, mental confusion, epilepsy and papilloedema. Meningism was not a prominent feature. CT brain scans were obtained in eight patients and one showed a focal lesion and one showed cerebral atrophy. Four patients also had an abnormal chest X-ray (CXR) and one had disseminated cryptococcosis. Amphotericin and 5-fluorocytosine were the mainstay of therapy, although ketoconazole alone was subsequently used in three selected patients with cure. Four early deaths occurred in patients with delayed diagnosis and treatment, usually in association with other severe concurrent infections. We conclude that awareness of cryptococcosis is essential in immunocompromised hosts presenting with headache with, or without, mental confusion or fever.
A young primigravida had idiopathic warm antibody (IgG) autoimmune haemolytic anaemia (AIHA) occurring in the third trimester of pregnancy. Her haemolytic process was responsive to steroid therapy and no transfusion was needed. She delivered a healthy baby with no evidence to haemolysis, though his red cells were coated with IgG which was probably of maternal origin.
Twenty-three cases of ovarian fibroma, comprising 3% of all benign tumors seen over a 20-year period, were analyzed. It was unilateral in all cases affecting more commonly the left ovary (70%). Whilst a majority of cases (77%) were encountered in the reproductive age group, the tumor was rare before the second decade. Only in 13% of cases was ascitis clinically detectable. This was not influenced by the size and weight (average of 9.3 x 10.8 x 11.1 cm and 959 g, respectively) of the tumors; a smooth-surfaced tumor was, however, associated with a greater amount of peritoneal fluid. Varying degrees of calcification in some tumors are detectable on ultrasonography and occasionally on abdominal radiography. The classical Meig's Syndrome was seldom encountered. The histopathological features, diagnostic problems and management are discussed.
In this retrospective study, 81 patients were diagnosed to have deep vein thrombosis (DVT) at the University Hospital, Kuala Lumpur over a ten year period from 1977 to 1986. Fifty-six patients had their DVT confirmed by venograms. The left side was affected in 79.5% of venographically proven cases of DVT of the lower limbs above the popliteal vein. The incidence of clinically apparent DVT following surgery was 0.21 per 1,000 operations. The incidence of pregnancy-related DVT was 0.039%. DVT was 3 times more frequent in the puerperium than in the antenatal period. The overall incidence of symptomatic pulmonary embolism was 13.6% of the cases of DVT.
Vocal fold sulcus is a cause of dysphonia which has not been recognized until recently. Awareness of its existence combined with use of laryngostroboscopy would enhance the management of this group of patients. Five such cases were treated initially by voice therapy and subsequently combined with microlaryngeal Teflon injections of the vocal cord. Representative photomicrographs and the end results of treatment are presented. A good voice, subjectively and objectively, was obtained in three patients, with satisfactory improvement in the other two.
A 27 year old housewife developed thrombotic thrombocytopenic purpura during the twelfth week of pregnancy. She had partial response to initial plasma infusion and subsequent plasmapheresis. However, her clinical course was complicated by the development of severe pancytopenia the consequence of a hypocellular marrow. She succumbed to septicaemic shock one month after diagnosis. The development of hypocellular marrow in thrombotic thrombocytopenic purpura has not been reported before.
Two groups of goats were dosed with 10,000 and 20,000 sheep-derived strain (SDS) larvae of Haemonchus contortus respectively. Over a period of 42 days goats dosed with 20,000 larvae lost more weight than those dosed with 10,000 larvae. Infected goats showed anaemia from about 2 weeks after infection as well as reduced levels of total serum proteins and albumins.
The phoretic association between Macrocheles muscaedomesticae and flies that inhabited poultry manure in a poultry farm in Sungai Buloh, Selangor, Malaysia was studied. The effects of temperature, relative humidity and fly abundance on phoretic rates also were investigated. The most abundant fly species found was Musca domestica; Musca sorbens, Chrysomyia megacephala and Ophyra chalcogaster were present in relatively large numbers. Representatives of ten families of mites were found on collected Mu. domestica. The most common mite was Ma. muscaedomesticae (Macrochelidae), found on all four species of flies mentioned above. The highest infestation (2.0%) occurred on O. chalcogaster but Mu. domestica had the highest average number infested (5.7). The ventral part of the housefly's abdomen was the most common site of mite attachment. Usually only one mite was found attached per fly. The highest phoretic rate recorded was 64.4 Ma. muscaedomesticae per 1000 Mu. domestica. There was no correlation between phoretic rates and Ma. muscaedomesticae abundance, nor was relative humidity a factor. However, a positive correlation was recorded in this host species between phoretic rates and temperature.
MeSH terms: Animals; Feces/parasitology; Houseflies/parasitology*; Humidity; Malaysia; Mites/physiology*; Poultry; Temperature
The aims of this study were to determine the dental and periodontal status and the associated treatment needs, other than that for prosthetic care, in patients who requested removable partial dentures. Forty-six patients who had never worn removable partial dentures before were examined for plaque index, tooth status, gingival index, loss of periodontal attachment and tooth mobility. Prior to prosthetic treatment, 15% of the teeth needed conservative treatment and 1% needed extractions. From the periodontal point of view, 65% of the teeth needed some form of related therapy, and 2% of the teeth were at risk of extraction due to advanced mobility.