exudates and Beriberi

In February 2012, a district health authority received three inmates with bilateral leg swelling and difficulty in breathing from a detention camp for unauthorized immigrants. A case control study was conducted. Fasting blood samples of case and control groups were collected according to instructions of the laboratory for determining thiamine level, and their 1 week dietary intake was analyzed. 9% (21/226) of inmates had bilateral leg swelling, and 75% (6/8) of them had low thiamine level (< 66 mmol/L). Their diet contained mainly polished rice and other items with low thiamine contents. Bilateral leg swelling was associated with history of no meat consumption during past 3 months (OR 8.4; CI 2.2-32.1). Patients were treated with 100 mg thiamine intravenously and 5 mg orally per day for 6 weeks. All patients responded well. The management was advised to provide vitamin B complex daily, and encouraged to provide thiamine rich foods.

Topics: Adult; Beriberi; Diet; Disease Outbreaks; Humans; Malaysia; Male; Thiamine; Undocumented Immigrants

A possible outbreak of beriberi occurred at a drug detention and rehabilitation centre, Pusat Serenti Bukit Cabang, Perlis, Malaysia in February 2004. This outbreak was identified following the presentation of a large number of inmates at a health centre with signs and symptoms of ankle oedema and shortness of breath. Further investigations revealed the death of three inmates at the General Hospital with similar clinical presentations during the period from October 2003 till February 2004. A cross sectional comparative study was carried out at the rehabilitation centre to find out the prevalence of thiamine deficiency among the inmates both symptomatic and asymptomatic. A total of 154 inmates were examined (57 symptomatic and 97 asymptomatic cases). It was found that 74% from the sample study (114 cases) had thiamine deficiency (44 symptomatic and 70 asymptomatic). Further statistical analysis showed that ankle oedema is consistent with the diagnosis of thiamine deficiency but lack sensitivity (p < 0.05, sensitivity 24.6%, specificity 95%). This outbreak could have been triggered by poor diet intake of thiamine by the inmates coupled with possible intake of certain thiamine antagonists in their diet.

Topics: Adult; Beriberi; Cross-Sectional Studies; Humans; Malaysia; Male; Middle Aged; Substance Abuse Treatment Centers; Thiamine Deficiency

Topics: Beriberi; History, 19th Century; History, 20th Century; Humans; Malaysia; Military Medicine; Netherlands; Nobel Prize; Thiamine Deficiency

William Fletcher's 1905-1906 beriberi experiment with residents of the Kuala Lumpur Lunatic Asylum is the focus of Vollrath's essay on the moral obligations of the scientist. If an experiment harms some subjects (several of Fletcher's patients died), is the scientific integrity of the research consistent with the scientist's moral obligations to those subjects? Do the subjects have the moral right not to be harmed? What are the subjects' moral rights in this context? The author argues that, aside from the issue of using nonconsenting institutionalized subjects, Fletcher's experiment did not violate a moral right of the subjects; moral right is determined prospectively by anticipating risks, not retrospectively by calculating known harms.

Topics: Beriberi; Control Groups; Ethics, Professional; History; History, 20th Century; Hospitals, Psychiatric; Human Experimentation; Human Rights; Humans; Informed Consent; Malaysia; Mentally Ill Persons; Moral Obligations; Mortality; Nutritional Physiological Phenomena; Patient Selection; Physicians; Random Allocation; Research; Research Design; Research Personnel; Research Subjects; Risk; Risk Assessment; Social Responsibility; Therapeutic Human Experimentation; Wounds and Injuries

Topics: Beriberi; Diet; History, Modern 1601-; Malaysia; Nutritional Physiological Phenomena

Topics: Aldehydes; Beriberi; Blood Preservation; Erythrocytes; Ethnicity; Female; Humans; Malaysia; Male; Occupations; Pregnancy; Prisons; Stimulation, Chemical; Temperature; Thiamine; Thiamine Deficiency; Thiamine Pyrophosphate; Time Factors; Transferases