The efficacy and safety of mivacurium in children in Singapore.

AIM: The aim of this study was to evaluate the clinical use of mivacurium, a short-acting, non-depolarising muscle relaxant, in the paediatric population in Singapore. METHODS: Twenty children between the ages of 2 and 12 years were given mivacurium to maintain neuromuscular blockade during nitrous oxide-halothane anaesthesia. Reversal from neuromuscular blockade was spontaneous. The onset, ease of intubation after different doses of mivacurium, and the ease of reversal were evaluated. RESULTS: Different intubating doses of mivacurium did not result in significantly different times of onset. The mean recovery index (25% to 75% recovery) was 4.1 minutes. There were no adverse reactions. CONCLUSIONS: Mivacurium provided rapid and efficacious onset of neuromuscular blockade in the local paediatric population. Rapid spontaneous recovery obviated the need for reversal agents.

Prevalence of malnutrition among children in an urban squatter settlement in Petaling Jaya.

In a study of mild to significant malnutrition in an urban squatter settlement, the weights for age of 297 children between birth and ten years, and the heights for age and weights for height of 197 children between two to ten years were analysed. Using NCHS standards, the overall prevalence of underweight was found to be 18.9%, stunting 15.2%, and wasting 11.2%. Age and ethnicity were significantly associated with the prevalence of underweight and stunting. The growth achievement of children below the age of two years were significantly better off than the older children, and Chinese children significantly better off than Malay and Indian children.

PIP: Industrialization and urbanization attract in-migrant. Unable to afford conventional housing, many newcomers settle as squatters. These squatter settlements are generally polluted, overcrowded, and ridden with infectious diseases. Child malnutrition is widespread in urban and rural areas of Malaysia. This study explores the extent of mild to significant malnutrition in the squatter settlement of Kampung Baiduri located adjacent to an industrial area in Petaling Jaya. Weights for age of 297 children between birth and ten years, and heights for age and weights for height of 197 children between 2-10 years were collected over a 3-month period in 1988, and subsequently analyzed. On the basis of US National Center for Health Statistics standards, the overall prevalence of underweight was 18.9%, stunting 15.2%, and wasting 11.2%. Age and ethnicity were significantly associated with the prevalence of underweight and stunting. Moreover, the growth achievement of children under age 2 years was significantly better than that of older children, and Chinese children fared significantly better than Malay and Indian children. These findings indicate a need to make these children primary targets of nutrition intervention programs.

Relationship between selected health problems and exposures among women semiconductor workers in Malaysia.

A study conducted between 1998-2001 on the semiconductor industry in Penang and Selangor found that irregular menstruation, dysmenorrhea and stress were identified as the three leading health problems by women workers from a checklist of 16 health problems. After adjusting for confounding factors, including age, working duration in current factory, and marital status, in a multiple logistic regression model, wafer polishing workers were found to experience significantly higher odds of experiencing irregular menstruation. Dysmenorrhea was found to be significantly associated with chemical usage and poor ventilation, while stress was found to be related to poor ventilation, noise and low temperatures.

The prevalence of musculoskeletal problems and risk factors among women assembly workers in the semiconductor industry.

A cross-sectional study to determine work-related musculoskeletal problems and ergonomic risk factors was conducted among 529 women semiconductor workers. Overall, 83.4% had musculoskeletal symptoms in the last one year. Pain in the back (57.8%), lower leg (48.4%) and shoulder (44.8%) were the three most common musculoskeletal problems. Significant associations were found between prolonged standing and upper and lower leg pain, between prolonged sitting and neck and shoulder pain and between prolonged bending and shoulder arm, back and upper leg pain. The study therefore showed a clear association between work-related musculoskeletal pain and prolonged hours spent in particular postures and movements.

Knowledge and practice of breast self examination and Pap smear screening among a group of electronics women workers.

A total of 486 Malaysian women electronics workers participated in a study of reproductive health knowledge and cancer screening. The practice of Breast Self Examination (BSE) was found to be related to educational attainment; while ever having had a Pap smear was found to be related to being older than 30 years old, being ever married, living with family or relatives, and not staying in hostels. Knowledge on reproductive health was found to be higher for older women, married women, living with family or relatives, not staying in hostels, ever having done BSE and ever having had a Pap smear.

Hypersensitivity pneumonitis due to high-dose colistin aerosol therapy.

We report a case of hypersensitivity pneumonitis, possibly due to aerosolized colistin therapy for severe multi-resistant Gram-negative pneumonia. Microbiological eradication was achieved with colistin therapy, which was stopped after 12 days in view of rising eosinophilia and possible lung fibrosis. The eosinophil count started to normalize 3 days after stopping colistin therapy and the patient was eventually weaned to minimal ventilatory support.

Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia.

AIMS: To determine the relation between sick leave and selected exposure variables among women semiconductor workers. METHODS: This was a cross sectional survey of production workers from 18 semiconductor factories. Those selected had to be women, direct production operators up to the level of line leader, and Malaysian citizens. Sick leave and exposure to physical and chemical hazards were determined by self reporting. Three sick leave variables were used; number of sick leave days taken in the past year was the variable of interest in logistic regression models where the effects of age, marital status, work task, work schedule, work section, and duration of work in factory and work section were also explored. RESULTS: Marital status was strongly linked to the taking of sick leave. Age, work schedule, and duration of work in the factory were significant confounders only in certain cases. After adjusting for these confounders, chemical and physical exposures, with the exception of poor ventilation and smelling chemicals, showed no significant relation to the taking of sick leave within the past year. Work section was a good predictor for taking sick leave, as wafer polishing workers faced higher odds of taking sick leave for each of the three cut off points of seven days, three days, and not at all, while parts assembly workers also faced significantly higher odds of taking sick leave. CONCLUSION: In Malaysia, the wafer fabrication factories only carry out a limited portion of the work processes, in particular, wafer polishing and the processes immediately prior to and following it. This study, in showing higher illness rates for workers in wafer polishing compared to semiconductor assembly, has implications for the governmental policy of encouraging the setting up of wafer fabrication plants with the full range of work processes.

Arginine catabolism in Aphanocapsa 6308.

The catabolic products of arginine metabolism were observed in Aphanocapsa 6308, a unicellular cyanobacterium, by thin layer chromatography of growth media, by limiting growth conditions, and by enzymatic analysis. Of the organic, nitrogenous compounds examined, only arginine supported growth in CO2-free media. The excretion of ornithine at a concentration level greater than citrulline suggested the existence in Aphanocapsa 6308 of the arginine dihydrolase pathway which produced ornithine, CO2,NH4,+ adenosine 5'-triphosphate. Its existence was confirmed by enzymatic analysis. Although cells could not grow on urea as a sole carbon source a very active urease and subsequently an arginase were also demonstrated, indicating that Aphanocapsa can metabolize arginine via the arginase pathway. The level of enzymes for both pathways indicates a lack of genetic control. It is suggested that the arginase pathway provides only nitrogen for the cells wheras the arginine dihydrolase pathway provides not only nitrogen, but also CO2 and adenosine 5'-triphosphate.

Differential presentation of post tracheostomy bleeding: a case series.

The relief of upper airway obstruction is one of the indications for tracheostomy. However, this procedure is not without its complications. We present a case series where post tracheostomy bleeding results in life-threatening sequelae in the form of torrential haemorrhage and sudden airway obstruction from clot. The latter presentation can present a diagnostic conundrum that could prove fatal if not rapidly identified.