A pig-borne virus causing viral encephalitis amongst human beings in Malaysia was detected in 1997 by the Ministry of Health. Initially, the disease was considered to be Japanese encephalitis. Subsequently, it was thought to be a Hendra-like viral encephalitis, but on 10th April, 1999 the Minister of Health announced this mysterious and deadly virus to be a new virus named Nipah virus. The virus was characterized at CDC, Atlanta, Georgia. The gene sequencing of the enveloped virus revealed that one of the genes had 21% difference in the nucleotide sequence with about 8% difference in the amino acid sequence from Hendra virus isolated from horses in Australia in 1994. The virus was named after the village Nipah. In all, the Ministry of Health declared 101 human casualties, and 900,000 pigs were culled by April, 1999. The worst affected area in Malaysia was Negri Sembilan. The symptoms, incubation period in human being and pigs, animal to human transmission, threat of disease to other livestock, and control program adopted in Malaysia is described.
A rare case of complex partial seizure (psychomotor epilepsy) with varying shades of psychiatric manifestations is presented. The highlights are multiplicity of its manifestation in the same case, its interchanging pattern and the variable durations. This gray area of psychiatry and neurology is discussed with special reference to diagnosis and management.
We report a pulmonary artery (PA) aneurysm associated with severe aortic stenosis and an aortic root dilatation occurring in a 59-year-old woman who presented with dyspnoea and chest pain. PA aneurysms are rare, and there are no definitive guidelines on its management. There are contentious opinions on whether such aneurysms should be managed conservatively or surgically. Our patient had associated aortic stenosis and underwent a successful aortic valve replacement and PA aneurysm repair. This case illustrates that concomitant PA repair with other cardiothoracic surgery can be performed safely, even in patients with moderate surgical risks. We also discuss the natural history, prognosis and management of PA aneurysms.
Insomnia and depression are frequently encountered in patients during withdrawal from substances. While there are no approved medications for treating them, off-label attempts to address these phenomena with mirtazapine have shown some promising results. This case describes the use of mirtazapine as an aid in benzodiazepine withdrawal and its potential benefits in alleviating insomnia and depression in a 32-year-old man. It was found to ameliorate sleep myoclonus that was thought to be associated with his withdrawal syndrome. It is hoped this report will generate interest and stimulate further research in this area of psychopharmacology.
Clozapine is an atypical antipsychotic with superior efficacy in the treatment of refractory schizophrenia. But it can cause agranulocytosis, which occurs in one to two percent of patients. This paper was prepared to discuss the condoned and controversial issues of therapy with this drug, but only within a haematological context. The feasibility of attempting therapeutically controversial blood monitoring regimes, as opposed to following standardised Western guidelines, given the differences in terms of accessibility, convenience and financial considerations between the public and private sector medical care will also be discussed. The proposal of adopting a structured pro forma, with a risk-benefit assessment, in the event of unavoidable veering from the guidelines may allay medicolegal implications, especially in countries where blood monitoring is not mandatory. It is hoped that this article will stimulate further research in our region, bearing in mind the increasing awareness and focus on genetic polymorphism, and the possibility of drawing up our own monitoring guidelines in the near future.
Accurate diagnosis of human filarial infections still remains a problem for clinicians and co-ordinators of filariasis control programs. Diagnosis of filariasis is based on parasitological, histopathological, clinical and immunological approaches. No significant advances have been made for the first three approaches although some refinements in their use and interpretation of results have occurred. For the immunological approach, intradermal tests and antibody detection assays using crude parasite extracts generally lack specificity and/or sensitivity to discriminate between past and present filarial infections in humans. Antigen detection assays would therefore provide a more accurate indication of active filarial infections. Several monoclonal antibodies to various stages of lymphatic filarial parasites have been developed and appear potentially useful for filarial antigen detection.
The evolution of nursing profession and education has taken its pace over the past years. Therefore, with the changes in nursing education over the years, the level of professional socialization among the students has become an area of interest. The objectives of this pilot study were to explore and compare the level of professional socialization between the diploma and degree nursing students (first year and final year) using the measuring tool of NPVS-R as well as to identify the demographic variables related to the level of professional socialization among the nursing students. From this pilot study, it was found that there was no significant difference in the level of professional socialization between the diploma and degree nursing students (p = 0.133). With regards to the demographic variables related to the level of professional socialization, significant difference was found only for the variable of father's educational level (p = 0 .035).
Keywords: Professional Socialization, Diploma and Degree Nursing Students, Nursing Education
Ramelteon is a novel MT1 and MT2 melatonin receptor selective agonist recently approved for the treatment of insomnia characterized by difficulty in sleep onset. It is a nonscheduled drug since it lacks the potential for abuse and does not interact with neurotransmitter receptors most associated with these phenomena. Although the effects of ramelteon use > 5 weeks are unknown, the available data confirms its safety and efficacy for short-term use. Clinical use and future research should uncover more information about ramelteon's properties.
Healthy adult male albino rats were subjected to inhalation of increasing doses of detergent (dioctyl sodium sulfo-succinate) aerosol ranging from 100 mg to 500 mg. Administration of 500 mg of detergent aerosol resulted in peribronchial and focal alveolar oedema in 3 out of 5 animals. The lungs of control animals which were subjected to inhalation of vehicle aerosol (ethanol and saline) did not show any abnormality. It is possible that pulmonary oedema observed in detergent aerosol inhalation may be due to the action of detergents on the surfactant system of the lung.
This study was conducted to evaluate the significance of genotype by environment (G x E) interactions for tropical poultry breeding. Three environmental conditions were considered: controlled normal-temperature (20 +/- 2 C, CN) and controlled high-temperature (32 C, CH) housing in Germany as well as natural open tropical housing in Malaysia (22 to 34 C, TO). Eighty-four sires were considered as genotypes. Their 5,352 progeny were tested simultaneously over three environments. For each sire, its part breeding value (BV) was estimated within each environment for each performance trait. Correlations between these BV for a pair of environments were used to estimate the magnitude of G x E interactions and the degree of relationship between them to demonstrate their implications on breeding strategies. Differences between observed and expected genetic correlations of BV for body weight, egg weight, egg number, egg mass, feed intake, and production efficiency as a fraction of the expected correlation were 5.1, 4.0, 36.7, 36.5, 17.7, and 31.6%, respectively, suggesting greater significance of G x E interactions for reproduction and production efficiency. The relationships between BV over the three environments were linear for most of the traits studied, but the coefficients of determination were dependent upon the magnitude of interactions involved. Relative efficiencies of indirect selection in CN or CH for performance in TO were also very low.
Data for the ABO blood groups and for handclasping, arm folding, handedness, ear lobe types and camptodactyly are presented for 104 Malay and 57 Chinese males in the city of Alor Star, Kedah, Malaysia. The two groups exhibit marked differences in the frequencies of most of these attributes.
A total of 89 histopathologically proven ocular tumours and tumour-like lesions treated in Hospital University Sains Malaysia, Kubang Kerian, Kelantan over a period of nine years were reviewed for their age distribution, site of lesion and histological type. The tumours were observed in all age groups with a maximum prevalence in the first decade. Twenty lesions were malignant and 69 were benign. The eyelid was the most frequent location (51%), followed by the conjunctiva (32%). Retinoblastoma was the most common malignant tumour (10 cases) and dermoid cyst was the most common tumour-like lesion (16 cases).