Republished in: Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 23-26
MeSH terms: Developing Countries; Family Practice; Malaysia; Physicians; Primary Health Care; Singapore; General Practitioners
Declines in density of one natural, three artificially-seeded and eight experimental populations of Anadara granosa were monitored over periods ranging from seven to twelve months. For three of four large populations the decline in density has been adequately described by a model of the form N t=N 0·e zt where N t is density at time t, N o is initial density and z is the instantaneous mortality coefficient. The mean value of the latter was found to be-1.88·yr-1 with 95% confidence limits-1.54 to-2.25. The data obtained from the experimental populations demonstrated that mortality is unaffected by initial densities upto 2,500·m-2, but increases as shore elevation decreases due at least partly to greater access by predators at the lower levels.The data on mortality rates have been combined with previously-published information on growth rates in order to arrive at estimates of production. At one of the artificially-seeded sites the 95% confidence limits of estimates of mean production are 24 and 62 g dry tissue·m-2·yr-1 with an average value of 42 g·m-2·yr-1. Examination of the effects of shore elevation on production revealed that the latter is greatest at the uppermost shore level studied because down-shore increases in growth rate are more than offset by increases in mortality. Production per individual has been shown to decrease with increasing density. This latter fact has been used to estimate the maximum possible production which, for one site 250 cm above chart datum, lies between 49 and 72 g·m-2·yr-1 (95% confidence intervals). It has been demonstrated that for one of the culture sites variation about an estimate of mean mortality rate does not contribute as much to the variation of the final estimate of production as does the variation about the estimates of the mean values of the constants in a growth equation.As far as possible production of Anadara granosa has been compared with values reported for other marine and estuarine bivalve molluscs and it is concluded that A. granosa may be considered moderately to highly productive.
The practice of continuing ventilation into the post·operatlve period in certain poor risk patients resulted in a reduction in morbidity and mortality. So much more surgery can be performed on many patients which otherwise would not be justified without this back·up services provided by the intensive therapy unit. From 1970 - 80, 763 patients were electively ventilated following surgery (both elective and emergency) of which 115 died, giving a mortality incidence of 15.01%
A prospective study of 77 consecutive patients with bullous diseases was done to study the pattern and natural history. Pemphigus was the commonest with 45 patients (59%) followed by pemphigoid with 21 patients (27%). Pemphigoid was more common in Indians than in other ethnic groups and its age of onset was a decade later than pemphigus. Unusual immunofluorescent findings in both diseases are discussed. Six of the 7 patients with dermatitis herpetiformis had linear IgA in the dermo-epidermal junction and the classical papillary IgA deposits were absent. Ultrastructural findings of pemphigoid and dermatitis herpetiformis confirmed earlier reports. Chronic bullous dermatoses of childhood was seen in 4 patients, all of whom had total remission within one year of onset disease.
1. A total of 8 samples from three natural populations and a laboratory strain of Aedes albopictus were analysed for glycerol-3-phosphate dehydrogenase phenotypes by means of horizontal starch-gel electrophoresis. 2. The electrophoretic phenotypes were governed by three codominant Gpd alleles. 3. There was low variability, with the heterozygosity in the variable samples ranging from 0.02 to 0.12. 4. The commonest allele in all the population samples was GpdB which encoded an electrophoretic band with intermediate mobility. 5. There was no temporal or spatial variation.
Malaysian, British and New Zealand soldiers were tested for evidence of infection with Rickettsia tsutsugamushi after several weeks' exposure to the infection during field exercises in Malaysia. 39 (5.0%) of 787 British and New Zealand soldiers developed immunofluorescent antibody (IFA) to R. tsutsugamushi to a titre of 1:50 and two (0.3%) to a titre of 1:100. 11 (1.5%) of 751 Malaysian soldiers also developed low titres less than or equal to 1:100. These low antibody levels were not correlated with clinical disease, and their significance is unknown. Seven (0.9%) of the Malaysians showed an IFA rise to greater than or equal to 1:200, and three of these experienced febrile illnesses, one lasting two weeks. An additional eight Malaysian soldiers had an IFA titre of greater than or equal to 1:400 when first tested and six of these also had a Proteus OXK agglutinin titre of greater than or equal to 1:160, indicating infection shortly before the study.
The chemoprophylactic use of diethylcarbamazine citrate at total oral doses of 15--180 mg/kg body weight was tested against subperiodic Brugia malayi infection in the leaf monkey (Presbytis melalophos). A total dose of 45 mg/kg body weight given over 9 days killed all developing infective larvae. Similarly, a total dose of 35 mg/kg body weight given over 7 days killed all fourth stage larvae. The minimum effective dose that prevents infection would be 5 mg/kg body weight daily for 7 days every month.
One hundred four children with acute lymphoblastic leukaemia were diagnosed at the University Hospital, Kuala Lumpur, Malaysia, between 1976 and 1982; 87 were evaluable with respect to treatment. They were divided into good prognosis (GP) and bad prognosis (BP) groups based on their initial total white cell count, their treatment differing only during the maintenance phase. Remission was achieved in 82 patients (94%) of whom ten (12%) subsequently died in remission from infection. Twenty-eight (34%) relapsed while on treatment and three while off therapy. Eleven patients ceased treatment after 3 yr of continuous complete remission (CCR). Three of these later relapsed, two within the first year. Survival in CCR was significantly better in the GP group up to 30 months, after which the difference diminished. There was no difference in survival between boys and girls. The overall disease-free survival at 3 yr and 5 yr was 40% and 25%, respectively, with a median follow-up period of 20 months (range 4-69 months). The reasons for the relatively low survival rates as compared with those in developed countries are discussed.
The relationship between the timing of maternal tetanus toxoid immunization and the presence of protective antitoxin in placental cord blood was investigated among women admitted to the obstetrical service of the University Hospital in Kuala Lumpur, Malaysia. The 1st dose was given between 13-39 weeks of gestation, with a median of 29 weeks. The 2nd dose was given an average of 4 weeks later. Protection was conferred on 80% or more of newborns whose mothers received their 1st tetanus toxoid injection 60 days or more before delivery. Protective levels were seen in all cord blood samples from infants whose mothers had received their 1st injection 90 days before delivery. Similarly,protective titers were found in 100% of cord blood samples when the 2nd maternal injection was give 60 days or more before delivery. There was no significant degree of protection when immunization was carried out less than 20 days before delivery. A single-dose schedule provided no protection when less than 70 days before delivery. Cord and maternal antiotoxin titers differed by no more than 1 2-fold dilution for almost all of the individual paired sera. A cord: maternal antitoxin ratio of 2 was more likely to occur with increasing time between the 2nd injection and delivery. Overall, these findings indicate that the 1st injection of a 2-dose maternal tetanus toxoid schedule should be given at least 60 days and preferably 90 days before delivery.
Edesonfilaria cynocephali n. sp., a parasite of Cynocephalus variegatus taylori (Thomas) in Malaysia, is described. Makifilaria Krishnasamy et coll., 1981 is placed in synonymy with Edesonfilaria and the new combination E. inderi (Krishnasamy et coll., 1981) n. comb. is proposed. Edesonfilaria and the closely related genus Macacanema constitute a small evolutionary line of Filariae with a hyperspecialized oesophagus (the glandular portion lacks lumen); the line is restricted to the Indo-Malaysian region and occurs in arboreal Dermopterans, Chiropterans and Primates.
The evidence for a hypothesis that eating salted fish is associated with nasopharyngeal carcinoma (NPC) is reviewed. The hypothesis was tested among Malaysian Chinese using a matched case-control design. The kinds of salted fish and patterns of use were also investigated in a control group comprising 100 Chinese, 50 Malay and 50 Indian households. During 1980, in Selangor, Malaysia, interviews with 100 Chinese cases of NPC and 100 non-disease controls indicated that salted fish consumption during childhood was a significant risk (relative risk = 3.0, P = 0.04), with an elevated risk for daily as opposed to less frequent consumption. Salted fish consumption during adolescence was a less significant risk, and current consumption not at all. There were 19 kinds of fishes reported as being eaten as salted fish by the 200 control households. There were marked differences between ethnic groups in preference for different kinds: Chinese preferred red snapper (74% of households), Malay jewfish (54%) and Indian red snapper (28%). Salted fish was hardly ever eaten daily by any household; weekly was a moderate frequency in all ethnic groups; less than weekly most common. There were no statistically significant differences between Chinese NPC case and non-disease control participants in kind of salted fish eaten. Results were the same when the data were analyzed by sex, subethnic group and income.
HBeAg and anti-HBe were determined in the blood of 189 male blood donors. The incidence of HBsAg was 6.9% while that for HBeAg and anti-HBe was 1.6 and 18%, respectively. Of the 13 samples positive for HBsAg, two (15.4%) were positive for HBe while six (46.2%) were positive for anti-HBe. One specimen was negative for HBsAg but was positive for HBeAg and anti-HBe. The observations are discussed.
MeSH terms: Adult; Blood Donors*; Carrier State/diagnosis*; Hepatitis B/transmission*; Hepatitis B Antibodies/analysis; Hepatitis B e Antigens/analysis; Hepatitis B Surface Antigens/analysis; Humans; Malaysia; Male; Middle Aged; Radioimmunoassay
Three taxa of the malaria mosquito Anopheles balabacensis complex representing three geographical regions (Thailand, Peninsular Malaysia and Sabah) in Southeast Asia, were analysed for genetic variation at 15 gene-enzyme systems. The Sabah taxon was monomorphic for all the 15 gene-enzyme systems. Only two gene-enzyme systems (esterase and glucose phosphate isomerase) were variable in the Thailand and Peninsular Malaysia taxa. The average heterozygosity or gene diversity was 0.007 for the Thailand taxon and 0.028 for the Peninsular Malaysia (Perlis) taxon. There were no unique gene-enzyme markers in the three taxa studied. The average values of genetic identities (0.933-0.997) and genetic distances (0.003-0.069) indicate that these three taxa are of subspecific status.
Many trichostrongyloid species parasitizing rodents in Malaysia were described in 1967 in a thesis that was never published. Some of these species have since been redescribed sometimes with, sometimes without reference to the thesis. The remaining species are redescribed using information given in the thesis and certain additional morphological data (in particular, the synlophe) taken from study of the paratypes. The species are reclassified according to criteria established in the most recent classification. The following genera are proposed: Brevistriatinae: - Macrostrongylus n. gen. characterized by a caudal bursa of Calypsostrongylus type and absence of synlophe. Nippostrongylinae: - Malaistrongylus n. gen. characterized by a synlophe of Heligmonoides type but with a larger number of ridges and by the fusion of rays 4 and 5 in the caudal bursa. - Rattus strongylus n. gen. characterized by small, subequal dorsal left ridges and a total number of ridges less than 20. - Sabanema n. gen. characterized by small subequal dorsal left ridges and a total number of ridges greater than 30. The species under consideration are the following: Hepatojarakus malayae Yeh, 1955; Pithecostrongylus bicapitatus n. sp. (= P. bicapitatus Ow Yang, 1967, in litt); Macrostrongylus ratti n. gen., n. sp. (= Macrostrongylus ratti Ow Yang, 1967, in litt.); Calypsostrongylus malayensis Durette-Desset, 1976 (= Brevistriata malayensis Ow Yang, 1967, in litt); Fissicauda callosciuri (Supperer et Kutzer, 1964); Fissicauda brevispicula n. sp. (= Brevistriata brevispicula Ow Yang, 1967, in litt.); Nippostrongylus brasiliensis (Travassos, 1914); Orientostrongylus tenorai Durette-Desset, 1970 (= Longistriata selangora Ow Yang, 1967, in litt.); O. krishnansamyi Durette-Desset et Lim-Boo-Liat, 1974 (= Longistriata malaccae Ow Yang, 1967, in litt.); Heligmonoides bulbosus n. sp. (= Heligmonina (Heligmonoides) bulbosa Ow Yang, 1967, in litt.); Heligmonoides lanceolatus n. sp. (= Heligmonina (Heligmonoides) lanceolata Ow Yang 1967, in litt.); Malaistrongylus odontospicularis n. gen., n. sp. (= Malaistrongylus odontospicularis Ow Yang, 1967, in litt.); Paraheligmonelloides triangulus n. sp. (= Longistriata triangulum Ow Yang, 1967, in litt.); P. annandalei n. sp. (= Longistriata annandalei Ow Yang, 1967, in litt.); P. rajah n. sp. (= Heligmonina (Heligmonoides) rajah Ow Yang, 1967, in litt.); Rattustrongylus odontoconus n. gen., n. sp. (= Longistriata odontocona Ow Yang, 1967, in litt.); R. rotundoconus n. sp. (= Longistriata rotundocona Ow Yang, 1967, in litt.); Sabanema sabana n. gen., n. sp. (= Longistriata sabana Ow Yang, 1967, in litt.); S. kepongi n. sp. (= Longistriata kepongi Ow Yang,