The Median Time to Develop Recurrent Tuberculosis at a Tertiary Hospital in Kota Bharu, Kelantan, Malaysia.

This study has the intention to determine the median time to develop recurrent tuberculosis [TB] in TB patients attending the Chest Clinic at Hospital Raja Perempuan Zainab II [HRPZ II], Kelantan, Malaysia. Records of 114 recurrent TB patients from 1/1/2003-31/12/2009 were analyzed. Kaplan-Meier analysis was used to examine the median time for recurrence of TB. The overall median time to develop TB recurrence in registered TB recurrent patients was six months [95%CI: 4.58, 7.42] after the previous episode. It was found that recipients of Streptomycin (S), Isoniazid (H) and Rifampicin (R) twice weekly (S2H2R2) drug regimen [p=0.026] or daily HR drug regimen [p=0.049] during the continuation phase took a longer duration to develop recurrent TB than non-recipients of these medicines by Kaplan-Meier analysis. Moreover, there also existed a significant time difference [P = 0.006] between the defaulters and non-defaulters of treatment to develop recurrent TB. Patients should take the complete course of therapy, to reduce recurrent TB infection. The drug regimens must contain the two most potent first line drugs Isoniazid [H] and Rifampicin [R] during the continuation phase.

Role of intramuscular anti-snake venom administration as a first-aid measure in the field

Effectiveness of intramuscular (i.m) anti-snake venom (ASV) administration immediately after bite as a first-aid measure in the field followed by standard hospital treatment in the management of Russell's viper bite patients was studied in 12 victims and was compared with that of standard hospital management alone in 82 victims. there was a marked reduction in the number of patients with systemic envenomation ie. disseminated intravascular coagulation (DIC), clinical proteinuria, oliguric acute renal failure (ARF), systemic bleeding, hypotension and fatality rate of Russell's viper bite victims who received initial i.m ASV prior to the hospitalization compared with those who did not. It is recommended that i.m ASV could be administered to the Russell's viper bite patients at the site of incident as a first-aid method in places where no facility for giving intravenous ASV therapy prior to hospitalization.

Shigellosis among children attending the paediatric wards of hospitals in suburban areas

A total of 55 cases of children with dysentery admitted to the Defence Services Obstetric, Gynaecology and Children Hospital and North Okkalapa General Hospital were included in this study. It was found that 49.1 per cent of the children were suffering from shigella bacillary dysentery. The Shigella spp. isolated were: Shigella flexneri (44.4 per cent), Shigella dysenteriae (29.6 per cent), Shigella boydii (22.2 per cent) and Shigella sonnei (3.7 per cent). the distribution of Shigella spp. among the different age groups were 42.9 per cent in the age group of less than 6 months, 40 per cent in 6 to 12 months, 55 per cent in 13 to 24 months and 66.7 per cent in 25 to 60 months. Antibiotic susceptibility test revealed that these shigellae were resistant to ampicillin (84 per cent), chloramphenicol (76 per cent), streptomycin (84 per cent), tetracycline (64 per cent) and septrin (72 per cent); were fully sensitive to amikacin, gentamycin, netilmicin, norfloxacin and were less sensitive to cephalothin (76 per cent) and furazolidone (72 per cent).

The prevalence of Xenopsylla cheopis in rodents in relation to the weather

A survey was carried out in Mandalay in 1968 to investigate the prevalence of Xenopsylla cheopis of rodents in relation to the weather. The study was done contemporaneously with the plague survey and control work of that year. Fleas found were either X. cheopis or X. astia but the ratio of the former to the latter was found to be 80 per cent to 93 per cent during the period January to early April, gradually decreasing to 28 per cent to 58 per cent during the hot months. X. cheopis index and proportion to X. astia were also found to rise with the fall in atmospheric temperature. It was also observed that the plague season began and ended with the high proportion of X. cheopis to other species (the index reaching 0.9) and the falling of the index to 0.5 or less.

Plague epidemic in Mandalay, 1966-67

(1) Epidemic (and epizootic) of plague in Mandalay during winter months of 1966-67 was presented. (2) Mandalay City is situated in plague endemic zone of the country ; plague infection could be present in or around the city. (3) The present epidemic was due to "carry-over" of rodent plague of 1966, which spread through out the city. Growth of susceptibles among rodents created a situation ready to explode into severest epizootic. (4) Possibility of natural foci infection round about the city as discussed.