The primary cause of 68 enucleations in the University Hospital, Kuala Lumpur, are reviewed and compared with those from Uganda and Jerusalem. Trauma 25% especially in the 20 - 29 age group was the most important cause, followed by corneal diseases 22% seen largely over the age of 50. Malignant tumours 16% consisting nearly all of retinoblastoma and a very low incidence of malignant melanoma when compared with the Caucasians. Glaucoma 12% was mainly of the narrow angle type. Males predominate nearly all age groups with an overall ratio of 2:1 and a peak of 5:1 in trauma.
Three consecutive cases of lacrimal gland carcinoma seen at the University Hospital during a twelve-year period are presented. One case was unusual, presenting at the age of sixteen years and developing metastases to the lungs. Adenoid cystic carcinoma is the commonest type of lacrimal malignancy and its clinico-pathological features and surgical management are discussed.
115 cases of enucleated eyes in the University Hospital, Kuala Lumpur, are reviewed. Trauma 36, Glaucoma 28, tumours and suspected tumours 24 and Infection 17 are the main causes. Trauma caused mainly by sticks, stones and sharp Instruments Is largely confined to the age group below 30. Primary narrow angle glaucoma accounts for 5 cases. The main types of secondary glaucomas are due to aphakia (12) and a hypermature lens (7) . Two thirds of the tumours are retinoblastomas and this Is the commonest cause of removal below the age of 5 years. There are 4 cases 01 malignant melanoma, all are Chinese. The average age Incidence Is 43 years, which appears to be a decade earlier than in the Caucasians. Preventive measures especially In regards to trauma and glaucoma are discussed.
Acute dacroadenitis is a rare condition. This case illustrates the acute onset, typical pain and tenderness in the upper outer eye of an enlarged lacrimal gland with purulent discharge. Good response to antibiotics is usual.
Foreign body aspiration is commonly seen in the pediatric age group and can be a life-threatening condition. Typical presentations include coughing, wheezing, and choking and can often masquerade as asthma causing misdiagnosis and treatment delay. Most of the time, the actual aspiration event is unnoticed, and patients may remain asymptomatic until they present with recurrent infections with or without positive radiological findings. Aspirated objects tend to migrate distally, and organic objects may induce edema and inflammation. Diagnosis is crucial as near-total or total obstruction of the airway may cause asphyxia and, subsequently, death if no immediate intervention is taken.
The peel of Hylocereus polyrhizus is often regarded as a waste hence this study was aimed at exploring the feasibility of using the peel as a natural colorant using simple water extraction method. Samples were subjected to a series of temperatures: Room temperature (RT), 50, 80 and 100 degrees C; varied length of heating time from 1, 2, 3, 4, 5 and 10 min and a varied range of pH using 1 M of citric acid solution. The best condition to obtain highest betacyanin content was heating samples at 100 degrees C for 5 min in a pH 5 citric acid solution. The next part of this study involved the stability test of the pigments obtained through the best method determined earlier. The pigments were dried and resuspended in distilled water. The samples were then exposed to light to monitor pigment changes. Initial resuspension of the dried pigments yielded a comparable high content of betacyanins to its juice counterpart. The results showed that resuspended pigments had high pigment retention and were stable up to 7 days. These initial findings must be further studied in more controlled conditions to understand the stability of betacyanin. Nevertheless, the results show that betacyanin obtained from the peel of dragon fruit has a high potential to be used as a natural dye.
13 patients with the amenorrhoea-galactorrhoea syndrome who conceived during treatment with bromocriptine were reported. Mean period of amenorrhoea was 3.0 years. In ten patients galactorrhoea was noted for a mean period of 4.2 years while in three it was discovered during examination. Seven patients presented with primary infertility. Menses returned in all cases after a mean duration of 2 months of treatment with bromocriptine at an average dose of 5. 86 mg daily. Mean serum prolactin was 4344 mUll (range 750 mU/l to 23,000 mU/l) before treatment and this declined to 186 mU/l with treatment. Seven patients became pregnant 5 to 25 months of treatment while six conceived after first menses. 21 pregnancies resulted from the thirteen patients. There was one spontaneous abortion and one premature delivery in which the baby died. Of the 16 live- births, there were twelve girls and four boys and their mean birth-weight was 2932 g. All were normal at birth and during subsequent developments except one with congenital dislocation of hip. It is concluded that bromocriptine is effective in restoring menstrual cycles and fertility by lowering serum prolactin in patients with the amenorrhoea-galactorrhoea syndrome. Bromocriptine may be safe for use during pregnancy, but it is suggested that the medication should be stopped immediately after conception unless tumour growth is apparent.
A case is presented to illustrate the difficulties
encountered in the clinical diagnosis of an intraocular mass. The fundus was not visible ophthalmoscopically because of opaque media. The anterior surface of the iris showed three discrete hyperpigmented nodular patches. Ultrasound showed an intraocular mass occupying half the posterior segment. The eye did not have useful vision and was enucleated after a clinical diagnosis of malignant melanoma of the choroid was made. The eye did not contain a melanoma but an organised blood clot after an extensive vitreous haemorrhage because of systemic hypertension.
'Pai syndrome' (PS) is a rare congenital syndrome. Presented here, a new-born baby-girl who exhibited the characteristic features of having a midline nasal (septal) polyp, an anterior alveolar process polyp, and a pericallosal lipoma associated with corpus callosum dysgenesis of the brain. Both polyps were lined with stratified-squamous epithelium. The overall features were largely consistent with those described by Pai et al., in 1987. A midline cleft-lip (with or without cleft-alveolus) is one of the most common features of the syndrome which was however absent in this case. Instead, an anterior alveolar polyp is present, which is relatively rare.
Background: Complex changes of glycemia that occur in diabetes are not fully captured by any single measure. The Comprehensive Glucose Pentagon (CGP) measures multiple aspects of glycemia to generate the prognostic glycemic risk (PGR), which constitutes the relative risk of hypoglycemia combined with long-term complications. We compare the components of CGP and PGR across type 1 and type 2 diabetes. Methods: Participants: n = 60 type 1 and n = 100 type 2 who underwent continuous glucose monitoring (CGM). Mean glucose, coefficient of variation (%CV), intensity of hypoglycemia (INThypo), intensity of hyperglycemia (INThyper), time out-of-range (TOR <3.9 and >10 mmol/L), and PGR were calculated. PGR (median, interquartile ranges [IQR]) for diabetes types, and HbA1c classes were compared. Results: While HbA1c was lower in type 1 (type 1 vs. type 2: 8.0 ± 1.6 vs. 8.6 ± 1.7, P = 0.02), CGM-derived mean glucoses were similar across both groups (P > 0.05). TOR, %CV, INThypo, and INThyper were all higher in type 1 [type 1 vs. type 2: 665 (500, 863) vs. 535 (284, 823) min/day; 39% (33, 46) vs. 29% (24, 34); 905 (205, 2951) vs. 18 (0, 349) mg/dL × min2; 42,906 (23,482, 82,120) vs. 30,166 (10,276, 57,183) mg/dL × min2, respectively, all P