Review of Cases of Fractures of the Spine at the University Hospital
J Francis Silva, Professor and Head, Departments of Orthopaedic Surgery & Rehabilitation, University of Malaya, Kuala Lumpur

Summary
This Paper evaluates 94 patients with dorso-lumbar fractures with 27 patients with cervical spine fractures which have been treated at the University Hospital, Kuala Lumpur. These cases have been analysed as to age, sex, the number of vertebrae involved, and their ethnic groups as well as causative factors. In discussing the management of this series, the need for a conservative approach has been highlighted. The results of treatment in the two groups have been analyzed to justify such conservatism.

Management of Congenital Right Coronary Artery to Right Atrial Fistula
K T Singham, H S Saw, R O Johnson, A Ganendran, Cardiothoracic Service, University Hospital, Kuala Lumpur

Summary
The management of congenital right coronary artery to right atrial fistula in a 4-year-old child initially diagnosed at 8 months of age is discussed. The effect of chronic circulatory overload from a large left to right shunt required surgical interruption of the fistula at the age of 4 years. The most consistent clinical clue is a continuous murmur at an atypical site. Cardiac catheterization and aortography are essential for a definitive diagnosis. Surgical correction can be successfully carried out with low risks in the majority of the patients and hence should be performed in all symptomatic patients and electively in symptomless children to avoid circulatory problems associated with a long standing cardiac shunt.

An Evaluation of B-Mode Grey Scale Real Time Ultrasonography
Loh Chi Loong, Lecturer, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Summary
We have found that ultrasonic imaging to be extremely useful in resolving diagnostic problems in our hospital, particularly for obstetrical patients because of its safety and also for very ill patients who would not be able to tolerate any invasive investigative procedures. The additional real time facility of our machine allowed more rapid studies and easier orientation even by relatively inexperienced staff.

What does the future hold? As far as machines are concerned, we can expect even better resolutions and more compact devices. As far as its application in this country is concerned, it is expected that many hospitals will eventually acquire ultrasonic scanners. Their initial costs is not too expensive (around $100,000 to $200,000) and running costs are relatively negligible, and technicians can be readily trained to operate the machines.

Serological Evidence of Group B Arbovirus Infection in Sabah
Spencer K P Kan*, R W W Kay**, T W Lim**, V Chew**, *Central Laboratory, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, **Institute for Medical Research, Jalan Pahang, Kuala Lumpur

Summary
Paired sera from 20 patients admitted to the various hospitals in Sabah with a clinical diagnosis of pyrexia of unknown origin were serologically tested against Group A and B arboviruses by the haemagglutination inhibition test. Two of the patients were serologically positive for Group B arbovirus infection.

Detection of Pericardial Effusion by Echocardiography
K T Singham, M Anuar, M Ariffin, Department of Medicine, University Hospital, Kuala Lumpur

Summary
Investigatory confirmation of pericardial effusion has been a problem in clinical practice for several years. Our clinical experience with echocardiography for the detection of pericardial fluid has shown that it is a relatively easy, rapid and accurate method of diagnosing pericardial effusions with complete safety to the patient.

The Prevalence of Silicosis Among Chinese Tombstone Makers in Malaysia
Amar Singh*, Harold S Jorgensen**, *Asst. Director of Health, Occupational Health Unit, Ministry of Health, Malaysia, **WHO Adviser to the Government (Occupational Health)

Summary
A pilot study of 119 tombstone workers showed that 36% of them had silicosis. 80% of the workers with more than 15 years of exposure and 11% with less than 5 years of exposure had silicosis. 17% of these workers had suffered from tuberculosis. This is evidently a very dangerous trade, from the occupational health point of view, and efforts should be made to improve the working conditions. These would include regular inspections of the workplaces, health education of the workers and an X-ray of the chest for each worker, every 3 years.

Early Experience with the Copper 7, Copper T220C and Multiload 250 Intrauterine Devices
T H Goh*, C H Tan*, S M Lim**, S C Chew**, H Hutapea***, J Iskandar***, *University of Malaya, Kuala Lumpur, **University of Singapore, ***University of North Sumtra, North Sumatra

Summary
The results of this preliminary study so far may be considered satisfactory but they do not warrant any firm conclusions as the data is small. However, certain trends are noted and possible explanations offered. If the present trends continue, the TCu 220C may prove to be the most effective device of the three : its potential in large family planning programmes would then be tremendous.

A Preliminary Study of Plasma Estriol Levels in Malaysian Pregnancies
Viji Thambyrajah*, Khairuddin Yusof**, Fong Chee Kin**, *Department of Biochemistry, Faculty of Medicine, University of Malaya, Kuala Lumpur, **Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur

Summary
Serial levels of total plasma estriol from 60 normal pregnant patients were measured by a simple radio-immunological method. It was found that the mean estriol values increased from about 80 ng/ml. at 30 weeks gestation to about 240 ng/ml. at term. A significant relationship was found between the mean estriol levels at term in mothers of the different ethnic groups under study, matched for age, socio-economic group and birth weight.

Human Chromosomal Studies in Kuala Lumpur
Moh-Ying Yip, H S Yong, S S Dhaliwal, Department of Genetics & Cellular Biology, University of Malaya, Kuala Lumpur

Summary
233 individuals were analyzed for a cytogenetic evaluation of some marked congenital abomalies and mental retardation. 65 abnormal karyotypes were detected. These include 48 cases of standard trisomy G21+ Down's Syndrom, 3 cases of Dq/Gq translocation Down's Syndrome, 3 cases of trisomy D13+ Patau's Syndrome, 4 cases of trisomy E18+ Edwards' Syndrome and 4 cases of XO, Turner's Syndrome, 3 phenotypically normal, balanced Dq/Gq translocation heterozygotes were observed in one family. An attempt to initiate fibroblast cultures from spontaneous abortuses material provided 3 successful karyotypes, 2 normal and an XO/XX mosaic. This study provides us with an insight to the extent of 'chromosomal syndromes' present and is an useful groundwork for future such studies locally.

Parasitic Disease Among Fishermen Living on Penang Islan I. Helminthiases
Khairul Anuar A, C P Ramachandran, T P Paran, School of Biological Sciences, Universiti Sains Malaysia, Penang

Summary
An investigation into the helminth parasites of fishermen population revealed high infection rates for Ascaris lumbricoides, Trichuris trichura and Necator americanus. The prevalence rates were Ascaris lumbricoides 67.21, Trichuris trichura 55.43, Necator americanus 12.24, Strongyloides 1.15 and Hymenolepis diminuta 0.23. The Malay fishermen had higher infection rate compared to the Chinese fishermen. The prevalence of Ascaris lumbricoides and Trichuris trichura was highest in 1-20 age group and then the infection rate declined with increasing age. Ascaris is highest among the females but for Trichuris the Malay female and Chinese male had higher infection. Also here is probably the first case report of hymenopelis diminuta in adult female Malay women in the Peninsular Malaysia.