Biomedical subjects
Publications and source records attributed to D Sinniah.
An extrapyramidal tract syndrome is reported in an 11-year-old boy following treatment of Hodgkin's disease. Results of investigations and the possible pathophysiology of this disorder are discussed.
Unlike post-epileptic paralysis, inhibitory epilepsy is rare and not well known. Differentiation between the two phenomena is usually difficult because both may have associated seizures. A satisfactory physiological explanation has yet to be advanced to account for the paraplysis. The present is a report of such a case together with the results of electroencephalographic, electromyographic and nerve conduction studies both during and after an attack of paralysis. The results suggest that inhibitory impulses originating from higher centres acting on the upper motor neurone itself leaving the anterior horn cell and possibly the upper motor neurone input to the gamma efferents switched off, are probably responsible for the paralysis.
Finger clubbing was quantified from the magnified silhouette of the right index finger in controls and patients with clubbing, using a simple shadowgram technique. There was good correlation between clinical assessment and measurement of both the profile angle and the hyponychial angle. The hyponychial angle appeared to be a more accurate indicator of clubbing than the profile angle.
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A review of acute childhood leukemia in the University Hospital, Kuala Lumpur reveals no significant differences in either the epidemiological or clinical features between Malaysian and Caucasian children. BCG does not appear to have conferred any protection against the occurrence of leukemia. With the introduction of total therapy 4 of 10 patients with good prognostic features and 3 of 15 patients with poor prognostic features have survived 3 years. Prognosis appears to correlate with adopted clinical criteria.
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A survey of workers and families resident in an oil palm estate in Malaysia revealed high incidence of parasitic infections. The commonest parasites are T. trichiura (56%), A. lumbricoides (52%), hookworm (28%), Entamoeba coli (11.3%) and Giardia lamblia (11.3%). Mixed infections by two or more parasites was seen in 46% of the subjects. Anaemia was present in 70% of children with hookworm infection. Eosinophilia was observed in 69% of subjects. One each of Hymenolepis nana and Hymenolepis diminuta infection was detected. This is the first report of Hymenolepis diminuta infection in man in Malaysia.
The cause of growth retardation seen in children with B-thalassaemia major is not fully understood. Neither the one-hour D-xylose absorption test nor jejunal biopsy support the suggestion of small bowel malabsorption as a contributory cause.
Neurological complications in beta-thalassaemia major are uncommon, with cerebral ischaemic episodes related to severe anaemia or convulsions as the most usual manifestations. Two such cases of children of 6 and 8 years are reported. Cerebral venous infarction is advanced as the probable cause of the symptoms. Caution should be exercised in giving rapid, large blood transfusions to thalassaemic patients adapted to long-standing severe anaemia.
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