The last confirmed case of poliomyelitis in West Malaysia was in 1986', and over the past few years, we have condescendingly associated polio with other developing countries. Recently, 2 children with acute flaccid paralysis (AFP) were confirmed as cases of poliomyelitis due to a wild strain of the virus. This implies a failure of the immunisation programme to contain the spread of the wild virus (Hall). However, if we look at the WHO standard case definition of polio virus infection (appendix 1) it is possible that we could have missed a few cases over the last 6 years. At this juncture a brief clinical summary of the 2 cases and a discussion of the differential diagnosis may be useful. (Copied from article).
Familial Paroxysmal Rhabdomyolysis of the non-exertional variety is a rare but treatable disorder previously not described in Malaysia. We report 3 Malay siblings of a consanguinous marriage who developed myoglobulinuria during a febrile illness. The first 2 died without being investigated, but the last had creatinine kinase levels of 24,800 UIL suggesting acute rhabdomyolysis. Fasting appears to be a major precipitating factor, and glucose infusions combined with alkaline diuresis may be life-saving.