Congenital mastoid cholesteatoma presenting as a mass obstructing external auditory canal.

We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 - 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck's traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.

Level of knowledge, attitude and practice of night market food outlet operators in Kuala Lumpur regarding the usage of repeatedly heated cooking oil.

Consumption of repeatedly heated oil can be detrimental to health. The objective of this study was to determine the level of knowledge, attitude and practice of night market food outlet operators in Kuala Lumpur regarding the usage of repeatedly heated cooking oil. The quality of cooking oil was also investigated. A cross-sectional study involving pretested questionnaire was undertaken in April 2009. The questionnaire was designed as a tool to collect data from the respondents (n=100) by face-to-face interview. The results showed that majority of respondents had only moderate (53.0%) or low (18.0%) level of knowledge regarding this issue. Most respondents (67.0%) agreed that it is not a good practice. The majority (69.0%) agreed that the usage of repeatedly heated cooking oil is detrimental to health. Despite that, most respondents (63.0%) admitted that they had used cooking oil repeatedly. Most (62.0%) of the cooking oil samples taken from the night market food outlets were considered fit for human consumption. In conclusion, the level of knowledge of night market food outlet operators in Kuala Lumpur regarding this issue needs to be improved in order to ensure the safety of fried food purchased from such establishments.

Sensory attributes of dishes containing shrimp paste with different concentrations of glutamate and 5'-nucleotides.

The shrimp paste called belacan is a traditional umami taste condiment extensively used in Malaysia that is rich in glutamate and 5'-nucleotides. The aim of this study was to determine the concentration of glutamate and 5'-nucleotides of various types of foods prepared with belacan and to measure their sensory attributes. The concentration of free glutamic acid found in different brands of belacan was 180-530mg/100g and in local dishes 601-4207mg/100g. The total amount of 5'-nucleotides in belacan samples ranged from 0.85 to 42.25µg/g. A Quantitative Descriptive Analysis (QDA) using a list of 17 sensory attributes showed a good correlation between belacan concentration in the final food and a range of positive sensory attributes, except for bitter, sweet, sour taste and astringency. Belacan also contains bitter, sweet and sour compounds that change the positive attributes of belacan at higher concentrations. The highest aroma attributes were linked to nasi goreng belacan (belacan fried rice) while the highest flavour attributes were found in sambal belacan. There was a 32 folds significant increase of umami attributes with the addition of belacan to final foods. The optimum amount of belacan was 0.45% for asam pedas (tamarind flavoured dish with belacan), 18% for sambal belacan (chilli belacan), 1.5-2.5% for kangkong goreng belacan (stir fried water convolous with belacan), and 2% for nasi goreng belacan.

Monitoring of free glutamic acid in Malaysian processed foods, dishes and condiments.

A study to quantify the free glutamic acid content of six processed foods, 44 dishes and 26 condiments available in Malaysia was performed using high-performance liquid chromatography with a fluorescence detector (HPLC-FRD). Recovery tests were carried out with spiked samples at levels from 6 to 31 mg g(-1). High recovery in different matrices was achieved ranging from 88% +/- 13% to 102% +/- 5.12%, with an average of 97% +/- 8.92%. Results from the study revealed that the average free glutamic acid content ranged from 0.34 +/- 0.20 to 4.63 +/- 0.41 mg g(-1) in processed foods, while in prepared dishes it was as low as 0.24 +/- 0.15 mg g(-1) in roti canai (puffed bread served with curry or dhal) to 8.16 +/- 1.99 mg g(-1) in dim sum (a small casing of dough, usually filled with minced meat, seafood, and vegetables, either steamed or fried). Relatively, the content of free glutamic acid was found to be higher in condiments at 0.28 +/- 0 mg g(-1) in mayonnaise to 170.90 +/- 6.40 mg g(-1) in chicken stock powder.