Acute myoedema: an unusual presenting manifestation of hypothyroid myopathy.

We describe a patient with primary hypothyroidism due to autoimmune thyroiditis, presenting with acute myoedema and spontaneous rhabdomyolysis. During his hospital stay, he developed altered sensorium due to hypo-osmolal hyponatraemia and later developed bilateral foot drop that responded to appropriate treatment.

Stress experienced by mothers of Malaysian children with mental retardation.

Objective: To compare parenting stress among Malaysian mothers of children with mental retardation and a control group, and to determine factors associated with stress.

Methodology: Seventy-five mothers of children with mental retardation aged 4-12 years and 75 controls (those without disabilities who attended the walk-in paediatric clinic) participated in the Parenting Stress Index (PSI). Intelligence quotient (IQ) and Child Behaviour Checklist (CBCL) scores, together with sociodemographic data, were entered into a multiple stepwise regression analysis, using the PSI as the criterion.

Stress experienced by mothers of Malaysian children with mental retardation.

Objective: To compare parenting stress among Malaysian mothers of children with mental retardation and a control group, and to determine factors associated with stress.

Methodology: Seventy-five mothers of children with mental retardation aged 4-12 years and 75 controls (those without disabilities who attended the walk-in paediatric clinic) participated in the Parenting Stress Index (PSI). Intelligence quotient (IQ) and Child Behaviour Checklist (CBCL) scores, together with sociodemographic data, were entered into a multiple stepwise regression analysis, using the PSI as the criterion.

Treatment of pilonidal sinus by primary closure with a transposed rhomboid flap compared with deep suturing: a prospective randomised clinical trial.

Objective: To assess two techniques of primary closure after excision of pilonidal sinus.

Design: Prospective randomised study.

Setting: University department of surgery, United Arab Emirates.

Outcome of closed head injury in Malaysian children: neurocognitive and behavioural sequelae.

Objectives: To compare the neurobehavioural outcome of children aged 6-12 years with severe closed head injury [sCHI] (coma > 24 h), mild-to-moderate head injury [mCHI] (coma < 6 h) and orthopaedic controls.

Methods: Twenty-nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC-III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post-injury. Parental reporting of pre- and post-injury behaviour was documented using the Child Behaviour Checklist (CBCL).

Relationship between head growth and neurodevelopmental outcome of Malaysian very low birthweight infants during the 1st year of life.

A prospective study was carried out to (i) compare head growth patterns of 103 very low birthweight (VLBW, < 1500 g) Malaysian infants and 98 normal birthweight (NBW, 2500- < 4500 g) controls during the 1st year of life; and (ii) examine the relationship between neurodevelopmental outcome at 1 year of age and occipito-frontal head circumferences (OFC) at birth and at 1 year of age in VLBW babies. When compared with those of NBW infants at birth, mid-infancy and 1 year of age, the mean OFC ratios (observed/expected OFC at 50th percentile) of VLBW infants were significantly lower (p < 0.001).

Neurodevelopmental outcome of Malaysian very low birth weight infants: predictive value of cranial ultrasound appearances.

The aim of the study was to determine the predictive value of cranial ultrasound scans done in the neonatal period for neurodevelopmental outcome of the Malaysian very low birthweight (VLBW, < 1500 grams) infants assessed at 12 months of corrected age. Of the 101 infants studied, 68 (67.3%) were neurodevelopmentally normal at one year of age, 18 (17.

Pattern recognition using invariants defined from higher order spectra: 2-D image inputs.

A new algorithm for extracting features from images for object recognition is described. The algorithm uses higher order spectra to provide desirable invariance properties, to provide noise immunity, and to incorporate nonlinearity into the feature extraction procedure thereby allowing the use of simple classifiers. An image can be reduced to a set of 1D functions via the Radon transform, or alternatively, the Fourier transform of each 1D projection can be obtained from a radial slice of the 2D Fourier transform of the image according to the Fourier slice theorem.

Comparison of morbidities in very low birthweight and normal birthweight infants during the first year of life in a developing country.

Objective: To compare the morbidities in the very low birthweight (VLBW; < 1500 g) and normal birthweight (NBW; > or = 2500 g) Malaysian infants during the first year of life.

Methodology: Prospective observational cohort study of consecutive surviving VLBW infants and randomly sampled NBW infants born in the Kuala Lumpur Maternity Hospital between 1 December 1989 and 31 December 1992. Infants were followed up regularly during the first year of life, after correction for prematurity.

Early patient discharge following appendicectomy: safety and feasibility.

One hundred and twenty patients with non-perforated acute appendicitis were discharged within 72 h of operation; 50 left hospital within 48 h of surgery. Criteria adopted for early discharge were: stable vital signs, active bowel sounds, ambulation and ability to tolerate fluid and food without discomfort. The patient's contact address was taken and every patient was requested to report to the out-patient department on the 7th post-operative day to remove stitches and assess the wound.

Helicobacter pylori infection in perforated peptic ulcer disease.

This study examined a possible aetiological agent, namely, Helicobacter pylori, in perforated peptic ulcer disease and its relationship to persisting ulcer. Twenty-nine patients with perforated peptic ulcer underwent simple closure of the perforation at laparotomy. A 13C urea breath test carried out on the eighth day after operation was positive in 24 patients.

A randomized prospective study of cefoxitin versus piperacillin in appendicectomy.

A randomized prospective study of antibiotic prophylaxis using a single dose of either cefoxitin or piperacillin is presented. The trial was carried out in Al Ain Hospital in the period 1989-1992 on 250 adult patients with non-perforated appendicitis. One group (124 patients) received 2 g cefoxitin, the other group (126 patients) 2 g piperacillin.

Simple surgical audit: an aid to undergraduate curriculum development.

This study investigates the usefulness of a simple surgical audit in designing the undergraduate surgical curriculum in the newly established medical school of the United Arab Emirates. The audit system was designed for use by people previously unaccustomed to this activity. The pattern of disease is found to be biased towards a young male expatriate population.

Altered regulation of atrial natriuretic peptide in essential hypernatremia.

Hypothalamic osmoreceptor dysfunction resulting in hypodipsia and altered regulation of vasopressin secretion is well established as the pathogenetic mechanism in the syndrome of 'essential hypernatremia'. However, little is known about the secretory pattern of atrial natriuretic peptide (ANP) in this syndrome. Therefore, we assessed ANP regulation by determining ANP concentrations in a patient manifesting this syndrome of essential hypernatremia during several well-established experimental protocols.

Pharmacokinetics of morphine and its surrogates. X: Analyses and pharmacokinetics of buprenorphine in dogs.

Specific and sensitive reverse-phase HPLC assays of buprenorphine and its metabolite in biological fluids were developed with sensitivities of 2-6 ng ml-1 using fluorimetric detection. Pharmacokinetics were monitored on acute bolus administration of buprenorphine in 6 dogs within the 0.7-2.

Pharmacokinetics of morphine and its surrogates. IX: Discrepancies among infused buprenorphine plasma concentrations sampled from different veins.

When blood was drawn from the brachial vein of the dog upon infusion of buprenorphine hydrochloride in saline through a plastic catheter into the jugular vein, the post-infusion jugular vein plasma concentrations observed during the first 15 min of the post-infusion distributive phase were significantly higher than the highest observed brachial vein plasma concentrations at the time of cessation of infusion. When blood was drawn from the jugular vein following infusion of buprenorphine hydrochloride into the left brachial vein, the post-infusion left brachial plasma concentrations during the first 15 min of the post-infusion distributive phase were significantly higher than the highest jugular and contralateral brachial vein concentrations observed just before and after the cessation of infusion. Dependent on whether the plasma concentrations sampled from the infused catheter or another catheter were used, the apparent calculated total body clearances differed by 25-39%.

Child abuse and neglect as seen in General Hospital, Kuala Lumpur--a two year study.

Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls.