Chest imaging features of patients afflicted with Influenza A (H1N1) in a Malaysian tertiary referral centre

This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis

Clinical features of nipah virus encephalitis among pig farmers in Malaysia

Background: Between September 1998 and June 1999, there was an outbreak of severe viral encephalitis due to Nipah virus, a newly discovered paramyxovirus, in Malaysia. Methods: We studied the clinical features of the patients with Nipah virus encephalitis who were admitted to a medical center in Kuala Lumpur. The case definition was based on epidemiologic, clinical, cerebrospinal fluid, and neuroimaging findings. Results: Ninety-four patients with Nipah virus infection were seen from February to June 1999 (mean age, 37 years; ratio of male patients to female patients, 4.5 to 1). Ninety-three percent had had direct contact with pigs, usually in the two weeks before the onset of illness, suggesting that there was direct viral transmission from pigs to humans and a short incubation period. The main presenting features were fever, headache, dizziness, and vomiting. Fifty-two patients (55 percent) had a reduced level of consciousness and prominent brain-stem dysfunction. Distinctive clinical signs included segmental myoclonus, areflexia and hypotonia, hypertension, and tachycardia and thus suggest the involvement of the brain stem and the upper cervical spinal cord. The initial cerebrospinal fluid findings were abnormal in 75 percent of patients. Antibodies against Hendra virus were detected in serum or cerebrospinal fluid in 76 percent of 83 patients tested. Thirty patients (32 percent) died after rapid deterioration in their condition. An abnormal doll's-eye reflex and tachycardia were factors associated with a poor prognosis. Death was probably due to severe brain-stem involvement. Neurologic relapse occurred after initially mild disease in three patients. Fifty patients (53 percent) recovered fully, and 14 (15 percent) had persistent neurologic deficits. Conclusions: Nipah virus causes a severe, rapidly progressive encephalitis with a high mortality rate and features that suggest involvement of the brain stem. The infection is associated with recent contact with pigs. (N Engl J Med 2000;342:1229-35.) (C) 2000, Massachusetts Medical Society. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down

Ungentlemanly Capitalism: John Hay and Malaya, 1904-1964

John Hay was one of Britain’s leading colonial capitalists, building his career from the 1900s to the 1960s in Malaya’s plantation industry. He became the leading spokesperson for the British rubber growers, and played a major role in the formulation of international restriction schemes during the 1930s. Hay was a remarkable entrepreneurial talent, consolidating his corporate power through the premiere Malayan agency house, Guthrie & Co. This in itself challenges the notion that Britain’s myriad of ‘free-standing’ companies, which were typical of direct investment in the Empire, represented a relatively weak and unsustainable form of multinational enterprise. But Hay’s dominance of the Malayan plantation sector also questions the notion of ‘gentlemanly capitalism’ as the driving force behind the expansion and sustenance of the British imperial system. Hay’s network of colonial corporate influence did not extend into the corridors of ‘gentlemanly capitalist’ power in Whitehall and the City, where he often had frosty relations. Ultimately, it was the financial sector in London that brought about Hay’s forced resignation from Guthrie in 1963. Examining questions of class, ethnicity, personality, ideology and strategy, the article focuses on why Hay did not develop better relations with commercial, financial and official elites, issues that would also engender tensions with the post-colonial political and business leadership of Malaya/Malaysia