A report was made of 4 cases of chloroquine resistant Plasmodium falciparum infections. The infections, detected in Jakarta, were imported from Kotabumi, Tanjung Karang, the Island of Pidada in the Lampung Province and from Pangkalpinang on the Island Bangka in the Province of South Sumatra. Treatment with courses of 1500 mg chloroquine base and with increased dosages up to 2250 mg base failed to cure the patients. The chloroquine sensitivity test in vitro was carried out in 3 patients, which showed that the Plasmodium falciparum strains were resistant to chloroquine at the R I level. The strains appeared to be similar to the Malaya Camp strain. In vivo observations revealed that the parasites were resistant at the R I level with a delayed recrudescence. The chloroquine resistant falciparum malaria cases, acquired in South Sumatra, may therefore be regarded as the first reported cases from a focus outside the already known two foci in Indonesia, namely East Kalimantan and Irian Jaya. It may be expected that chloroquine resistant Plasmodium falciparum will be encountered in other parts of Indonesia in the near future. The use of a combination of sulfadoxine and pyrimethamine should not be recommended in Indonesia because chloroquine is still considered the drug of choice against all malaria infections in Indonesia.
MeSH terms: Adult; Chloroquine/therapeutic use*; Drug Resistance; Humans; Indonesia; Malaria/drug therapy*; Malaria/parasitology; Male; Plasmodium falciparum/drug effects*; Pyrimethamine/therapeutic use; Sulfadoxine/therapeutic use
Paradistomoidella cerberi n.g., n.sp. and Paracanthostomum cerberi from Cerberus rhynchops, Xenopharynx pyriformis and Allopharynx mehrai from Ptyas korros, Neopronocephalus orientalis from Geoemyda spinosa, and Duthiersia expansa from Varanus salvator are all reported from the area of Kuala Lumpur, Malaysia. Paradistomoidella cerberi most closely resembles members of Paradistomoides but is characterized by relatively short caeca, a cirrus sac containing a bipartite rather than sinous internal seminal vesicle, and unevenly-sized suckers. Kuala Lumpur is a new locality for Paracanthostomum cerberi, X. pyriformis, A. mehrai, and D. expansa. Ptyas korros is a new host for X. pyriformis and G. spinosa is a new host for N. orientalis.
Malaysia has a large variety of traditional medical systems that are a direct reflection of the wide ethnic diversity of its population. These can be grouped into four basic varieties, namely, traditional “native”. traditional Chinese. traditional Indian, and modem medicine, examples of which are described. In spite of the great inroads made by modem medicine, the traditional systems are firmly established. Patients move from one system to another or use several systems simultaneously. The integration of the traditional Malay birth attendant into the health team is described. The forces influencing the development, acceptance, and integration of the medical systems are discussed.
MeSH terms: Delivery of Health Care*; Health Services, Indigenous/utilization; Malaysia; Medicine, Ayurvedic; Medicine, Chinese Traditional; Medicine, Traditional*; Midwifery; Patient Care Team; Sociology, Medical*
A report is presented of seven patients with acute septicaemic melioidosis seen at the University Hospital, Kuala Lumpur, Malaysia, during 1976-1979. All had associated disorders which rendered them more susceptible to infection. As prognosis depends on early diagnosis it is important that this disease be considered in the differential diagnosis of a septicaemic illness in such patients from endemic areas. The treatment of choice is a combination of tetracyclines and chloramphenicol, initially used in massive doses, and continued for at least six month to prevent relapses.
One hundred and fifty two patients were treated for acute renal failure in 1976-1978. Overall mortality was 46 (30.3 percent) and was highest among the surgical patients 15 (51.7 percent) and lowest in patients with outflow tract obstruction 2 (8.7 percent) uncontrolled sepsis was the commonest cause of death.
The clinical presentation of patients with bilateral stones is discussed. The majority of patients presenting to the Nephrology Unit were in renal failure. Aggressive medical treatment allowed
diagnostic procedures and definitive surgery to be performed in uraemic patients. Most patients presenting in uraemia benefitted from treatment.
Study Site: Urology Unit, General Hospital, Kuala Lumpur, Malaysia
38 episodes of peritonitis in 28 patients were recorded among 97 patients undergoing a total of 159 peritoneal dialysis at the Nephrology Unit, General Hospital, Kuala Lumpur between November 1979 to June 1980. Of these only 14 episodes were associated with a positive bacterial culture. Organism of the Moraxella-Acinetobacter group were responsible in 8 episodes. There were 16 positive cultures in patients who had no clinical evidence of peritonitis. The interpretation of bacterial peritonitis in patients undergoing peritoneal dialysis must be made on the basis of clinical findings and bacteriological reports.
Hypoxic cells in tumors are proposed to consist of at least 2 types, depending on whether they remain hypoxic for long (chronic hypoxia) or short (acute hypoxia) periods. Experimental evidence of the possible presence ofacutely-hypoxic cells in one type of murine tumour is presented. Finally, the possible implications for radiotherapy and chemotherapy of the presence of acutely-hypoxic cells in human tumors is discussed briefly.
This paper reviews the pattern of glomeruler disease from 163 renal biopsies performed at the Institute of Urology and Nephrology. Nephrotic syndrome formed the largest group of patients. There is a high prevalence of SLE nephritis in our community. The histopathologic findings in our series were comparable to those from Western countries except for the lower incidence of membranous and membranoproliferative glomerulonephritis.
The characteristics of 74 patients who attempted suicide in Penang are described. Differences in the incidence and reasons for and methods of attempting were observed among the ethnic groups. There was a higher incidence in females and patients of single status. The majority of patients did not suffer from severe psychiatric disorders, but did encounter chronic inter-personal and intra-familial conflicts. Conflicts with elders were more frequent among female patients, and this finding suggested that young females were faced with a greater degree of role conflicts. Rural to urban shift among the Chinese patients was observed to be associated with a high incidence of attempts. Dwellers of high-rise flat complexes were not over-represented. In view of antecedent social factors, professionals and others besides psychiatrists have a role in the prevention and management of para-suicidal behaviours.
MeSH terms: Adolescent; Adult; Age Factors; Ethnic Groups; Female; Humans; Malaysia; Male; Middle Aged; Sex Factors; Socioeconomic Factors
We report this 21 years old Indian male with the nephrotic syndrome due to membranous nephropathy who later developed numerous epithelial crescents leading to a rapid loss of renal function. The pathogenesis of the crescentic transformation in this type of glomerulopathy is discussed.
A Population Oratorical Competition between upper secondary pupils aimed at getting students interested in population problems will be held in Johore from May to June. The competition will be launched on 20th May 1981 in Segamat by En. Nordin bin Nazir the Deputy Director of Education, Johore. 81 secondary schools will be sending 184 students to participate at this oratorical competition. The Districts of Kluang, Segamat, Batu Pahat, Muar and Johore Bahru will send students who will face an elimination round during the 1st stage of the competition. The competition is jointly organized by the State Education Department and the National Family Planning Board with a funding support of $3500 from the National Family Planning Board. The Director-General, National Family Planning Board Malaysia, Datin Dr. Hajjah Nor Laily Aziz is scheduled to officiate at the opening ceremony and to give away the prizes on 27th June 1981.
MeSH terms: Asia; Asia, Southeastern; Developing Countries; Education; Government Programs*; Malaysia; Organization and Administration; Population Control*; Public Policy; Schools*; Students*
Screening by culture of endocervical specimens revealed four cases of gonorrhea among 744 pregnant women attending the prenatal clinic at the University Hospital in Kuala Lumpur, Malaysia. The observed prevalence of gonorrhea (0.54%) in pregnant women is similar to that in Great Britain (0.2-0.7%), but lower than the prevalences reported for North America (2.5-7.5%) and Thailand (11.9%). The results indicate that routine screening of pregnant women attending prenatal clinics in Malaysia would aid in the control of gonorrhea in that country.
This is a report of 9 cases of Pilomatrixoma (Calcifying Epithelioma) recorded in 188 benign tumours of the skin and adnexa in Sarawak during 1976 and 1977, with an incidence of 4.7 per cent. Out of the seven Chinese patients four were females. One more female was a Kayan and the race of another female patient was not recorded. Except one, all were below the age of 20 years; the youngest being only 6 months old. In one lesion ossification was also detected.
MeSH terms: Adolescent; Adult; Child; Female; Humans; Infant; Malaysia; Male; Skin Neoplasms/epidemiology*; Skin Neoplasms/pathology; Continental Population Groups