The effect of exercise on the venous blood ammonium concentration in man.

Mild muscular exercise did not cause any significant rise in the ammonium concentration of venous blood draining the exercising forearm of control subjects or patients with cirrhosis. However, in both cirrhotic and non-cirrhotic subjects moderate exercise produced significant increases in venous blood ammonium values and these occurred earlier and were more prolonged in cirrhotic patients. Severe exercise caused larger increases in venous blood ammonium concentration in all subjects but there were no significant differences between the mean ammonium concentrations of the cirrhotic and control groups either before or after exercise. All ammonium values returned to their pre-exercise levels within half an hour of resting. The exact mechanism of these phenomena is not fully understood but they are of practical importance in the study of blood ammonium metabolism in normal subjects and in patients with cirrhosis of the liver. The importance of making subjects rest for at least 30 minutes before obtaining blood for ammonium determination is emphasized in order to obviate misleadingly high readings due to muscular activity.

Venous blood ammonium levels in control subjects and in patients with disorders of the liver.

Venous blood ammonium levels were studied in 106 control subjects and 47 patients with varying degrees of liver disorder. The resting venous blood ammonium was normally distributed in both male and female control subjects and was not influenced by either the sex or the fasting state of the subject. In general it was also uninfluenced by age except that the level was found to be a little lower in subjects over 60 years of age probably due to their state of greater muscular inactivity. The mean resting ammonium level in controls was 80.0 mug/100 ml +/- 17.17 mug/100 ml and the range (mean +/- 2 SD) 46-114 mug/100 ml. Raised levels were obtained in 16.7% of patients with subclinical liver disorder, 62.5% with moderate liver disorder, and 85.5% with severe liver disorder, indicating a relationship between the severity of liver disorder and the resting venous blood ammonium level. As the majority of patients with severe liver disorder were known to have varices the raised ammonium levels are likely to have been related to the greater magnitude and incidence of portal systemic shunts in those with severe liver disease.

Epidemiology of Pediculus humanus capitis infestation in Malaysian school children.

A survey of 308,101 primary school children in Peninsular Malaysia conducted in 1979 by the School Health Services, Ministry of Health, Malaysia, revealed that 10.7% of children were infested with Pediculus humanus capitis. The prevalence rate was higher in the economically less advanced states of Terenganu (34%), Kelantan (23%), and Perlis (21%) than in the other states (4-13%). Of 14,233 school children examined in the State of Melaka, 26% of Indians, 18.7% of Malays, 6.1% of Europeans, and 0.7% of Chinese had pediculosis. The prevalence rate, which has remained unchanged over the past 5 years, does not appear to vary with age but is higher in children with long hair and those from the lower socioeconomic groups. Boys have a lower infestation rate than do girls. The higher incidence in Indians and Malays correlates well with their lower socioeconomic status in the community, and their cultural habit of maintaining longer hair than do the Chinese. The difference become less apparent in the higher socioeconomic groups.

Resistance of head louse (Pediculus humanus capitis de Geer) to DDT in Malaysia.

A survey of 308,101 schoolchildren conducted in 10 of 11 states in Peninsular Malaysia revealed that 10.7% have Pediculus humanus capitis infestation. The results of treatment with 1%, 2% and 5% DDT in coconut oil in 374 cases reveal cure rates of 3.5%, 15.8% and 51.3%, respectively, suggesting that the head louse has probably developed resistance to this insecticide in Malaysia.

Acute septicemic melioidosis occurring in a child with acute lymphoblastic leukemia.

A 13-year old boy with acute lymphoblastic leukemia on chemotherapy developed neutropenia and acute cellulitis progressing to fulminating septicemia due to Pseudomonas pseudomallei. Septicemic melioidosis should be considered in the differential diagnosis of a febrile illness in children who are susceptible to infections.

Prevalence of parasitic infections in Malaysian oil palm estate workers.

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.