This paper reviews the literature on human leptospirosis in Malaysia from its first description in 1925 until the present day. Fletcher diagnosed the first case of human leptospirosis in Malaysia in 1925. Following Fletcher, many investigations on human leptospirosis in Malaysia disclosed a high prevalence of infection. These investigations indicated that the disease was endemic in the country. Examination of 1993 suspected human cases of leptospirosis by Tan indicated 28 % of the cases were positive. In a recent survey, 2190 serum samples from patients with different clinical manifestations in the country disclosed 12.6% were positive for antibodies to leptospires. The risk to leptospiral infection with respect to occupation, location, sex, race and age groups was demonstrated. Both civilians and military personnel were affected. Thirty-seven serovars from thirteen serogroups have been identified in the country. Recent studies on animal leptospirosis showed that the disease was highly endemic in the animal population. It is considered that the majority of leptospirosis cases in humans were due to association of man with animals and disease-infected environment.
Leptospirosis ; Human ; Malaysia ; Review [Publication Type] ; seconds

Of the various rickettsial diseases, only scrub typhus has been well documented in Papua New Guinea. A review of the historical literature confirms this. A serological survey was conducted on 113 antenatal patients presenting to a district hospital in Kokopo, East New Britain. Results suggested that a spotted fever rickettsial infection is common in this area with a seroprevalence of about 17% in young women. There was no evidence of scrub typhus or murine (endemic) typhus in the population sampled. Clinical implications of these findings are discussed.
Review [Publication Type] ; rickettsial ; New ; TYPHUS ; Surveys

seconds ; Review [Publication Type] ; Death, Sudden ; Child

Academic dissertations on Kampo medicine have a certain peculiarity about them, when they are drawn up by the rules of western medical writing. Compared to western medicine, oriental medicine tends to employ more subjective terms, because of its many humanistic elements.Study objectives, methods, results and discussions however, need to be stated objectively in a way that makes a paper easy to understand for both referees and readers. Although it would be ideal to use designated terms when making objective statements, there are in fact many terms that have multiple meanings, which need to be clarified in a paper. And when presenting new evidence, one must declare how far any problems have been resolved, as clearly as possible.We have explained the recent changes to our regulations for contributors, regarding Kampo formulae naming conventions, abstract word counts, and contributions by mail. Here we discuss how our editing work proceeds, and our thoughts on how papers are re-reviewed or rejected.
Medicine, Kampo ; Medicine ; Academic Dissertations [Publication Type] ; counts ; Review [Publication Type]

To review the outcome of our vaccination program against influenza, an investigation was made into the incidence of this acute infectious disease in our community from 2002 through 2004.Enrolled for this retrospective study were 1) all vaccinated individuals, 2) those who underwent nasal examinations by use of the swab, and 3) patients diagnosed as contracting influenza.The number of those administered with influenza virus vaccines increased year after year during the period under review. Over 70% of them were those aged 65years or above. The mean age of those who caught influenza was 42.9±21.3 in 2002, 34.9±20.4 in 2003 and 45.4±20.2 in 2004. Compared with unvaccinated old people, many unvaccinated young and middle-aged people contracted influenza, but among the vaccinated old people, there were some who came down with the flu.Morbidity was low for the old people whose vaccination rate was high.Therefore, it can be said that vaccination was effective in achieving adequate immunity. Nonetheless, for all the preventive injection, the fact that people of advanced age could be infected should be taken note of.
Influenza ; Vaccination ; Retrospective Studies ; Review [Publication Type] ; Hospitals

In japan, pesticides have been used increasingly after World War II and pesticide poisoning has been a major issue of rural medicine. In other Asian countries, pesticide poisoning also seems to be a great concern of rural medicine and occupational and environmental medicine as well. We reviewed the results of research on the prevention of pesticide poisoning in Asia with the reports of international organizations and articles which appeared in medical journals.The WHO Glabal Information Network on Chemicals worked out an international protocol to collect and analyze the cases of pesticide poisoning, and is carrying out hospital-based surveys in east and south Asia from 1998. These data were discussed in comparison with the results of our hospital-based survey of pesticide poisoning in 1998-2000.Also, FAO has been exploring the concept of “community integrated pest management (CIPM)” from 1999, in Asian countries. In a project related to this, farmers were asked to report their pesticide use and symptoms, and researchers analyzed the data and gave advice to the farmers, and these practices produced so fruitful findings that the farmers have come to refrain from using hazardous pesticides of their own accord. These research projects are expected to complementarily contribute to the prevention of pesticide poisoning. We resumed the hospital-based survey of pesticide poisoning in 1996, and have collected and analyzed several hundreds cases. In order to reduce pesticide poisoning in Japan and other Asian countries, we are interested in rendering cooperation in those projects.
Pesticides ; Poisoning aspects ; Prevention ; Asia ; Review [Publication Type]

To prevent lifestyle related diseases, it is important to modify lifestyle behavior. The control of mental stress level and prevention of mental stress-related diseases have become one of the most important problems in Japan. To check mental stress level objectively during the early stage of stress-related diseases and determine appropriate coping methods, it is necessary to design a useful index for mental stress. Cortisol is a steroid hormone secreted by the adrenal cortex. This is an essential hormone to human survival, and plays a key role in adaptation to stress. In another review, we concluded that cortisol appears to be an adequate index for mental stress. However, lifestyle factors such as alcohol drinking, smoking, lack of exercise etc., are strongly associated with mental stress. Thus, in this review, we focus on the relationship between cortisol and lifestyle. The present findings suggested that lifestyle factors; smoking, alcohol drinking, exercise, sleep and nutrition are strongly associated with cortisol levels, and it may be impossible to determine whether alterations in cortisol levels are due to mental stress. It was suggested that those lifestyle effects on not only mental stress itself but also cortisol levels should be considered, when assessing mental stress by cortisol levels.
Stress, Psychological ; Life Style ; Hydrocortisone ; Review [Publication Type] ; Hydrocortisone measurement

This is a report on schools of Traditional Chinese Medicine (TCM) and the state of the traditional education system in Singapore. School texts made in the People's Republic of China were used in Singaporean schools. In 1994, however, the Minister of Health appointed a committee to review TCM practices, and recommended measures to safeguard patients' interests and safety. The committee's report published in 1995 recommended that TCM practices in Singapore should be regulated, and recommended steps to upgrade training standards. In compliance with said committee, TCM schools have added basic western medical science to their curricula. And TCM school requirements in Singapore were revised to 3 years full-time curricula or 6 years part-time curricula. In 2000, the TCM Practitioners Act was passed. Singapore is small country with a population of 4.16 million. However, it promotes traditional medical education projects and studies enterprisingly, receiving WHO support and NCCAM grants.
Singapore ; Schools ; Medicine, Chinese Traditional ; seconds ; Review [Publication Type]

Proliferating trichilemmal cyst is a rapidly growing large cutaneous adnexal neoplasm occurring on the head and neck region of elderly women. Malignant transformation has rarely been reported in these lesions. We describe here a 85-year-old lady who presented with a large ulcerated growth over the scalp for one year duration. Incisional biopsy revealed proliferating trichilemmal cyst with malignant transformation. She underwent wide local excision of this growth. She is alive and without evidence of disease after 14 months of follow up. Because of limited number of cases reported in literature, management of malignant proliferating trichilemmal cyst is controversial. Treatment mainly entails wide local surgical excision. Many other adjuvant modalities have been tried. This paper presents the diagnosis and management of one case of malignant proliferating trichilemmal cyst followed by review of the literature.
Cysts ; Literature ; Review [Publication Type] ; Malignant - descriptor ; Malignant Neoplasms

Thyrotoxic periodic paralysis (TPP) is a medical emergency characterised by sudden onset of muscle weakness with hypokalemia that resolves with the treatment of hyperthyroidism. We report three cases of thyrotoxic periodic paralysis seen at the Accident and Emergency Care Department, University of Malaya Medical Centre in a period of four months. We also review the clinical presentation, pathophysiology, biochemical features and management of TPP. All three patients were young Asian males, presenting with muscle weakness of sudden onset. The first patient presented with lower limb weakness and had symptoms of thyrotoxicosis and goitre. He had a previous similar episode which resolved spontaneously. The second patient presented with quadriplegia, respiratory acidosis and had no signs and symptoms of thyrotoxicosis. The electrocardiogram of this patient showed normal sinus rhythm with U wave in V3 and a flat T wave, which are characteristic of hypokalaemia. The third patient, who was a known case of thyrotoxicosis, was admitted thrice for hypokalemic paralysis during the study period. All cases had low serum potassium, suppressed TSH and elevated T4 confirming thyrotoxic periodic paralysis. Potassium therapy was useful during the crisis; however prophylactic potassium has not been shown to prevent attacks as seen in one of our cases. Conclusion: Thyrotoxic periodic paralysis should be considered in the differential diagnosis of sudden onset paralysis in young male patients. Determination of the plasma potassium levels and thyroid hormones help in the diagnosis. The definitive treatment for TPP is the achievement of euthyroid state.
Thyrotoxic periodic paralysis ; Patients ; Paralysis ; Review [Publication Type] ; Thyrotoxicosis