Seven infants with birth weights less than lS00g received total parenteral nutrition for seven to 16 days through the peripheral route, commencing within the first 24 hours of life. Excessive weight loss was prevented and the infants showed significant weight gain. The time required to regain the initial birth weight showed an improvement over that expected in conventionally managed infants. Metabolic and septic complications were minimal and easily manageable. The results demonstrate that the technique, when properly used, warrants consideration in feeding low birth weight infants incapable of tolerating enteral feeding.
Serum samples were obtained within 3 days of capture from 106 cynomolgus monkeys (Macaca fascicularis) in peninsular Malaysia. Fifty-two monkeys were trapped on the fringes of palm oil estates and 54 in dense primary jungle. Sera were tested for antibodies to hepatitis A virus (HAV) with a commercial radioimmunoassay. Twenty-four animals had detectable serum anti-HAV activity (6 of 52 from palm oil estate sites and 18 of 54 from primary jungle sites). Among monkeys at both sites, antibody prevalence was strongly correlated with animal weight: overall only four of 69 monkeys (6%) weighing less than 2.0 kg had serum anti-HAV antibodies, while 14 of 29 (48%) weighing 2.0 to 3.9 kg, and 6 of 8 (75%) weighing 4.0 kg or more, had serum anti-HAV antibodies. These data suggest that wild cynomolgus monkeys in Malaysian jungles become infected with HAV or an HAV-like virus at a rate comparable to that of humans in the same region, and raise the possibility of a sylvatic cycle for HAV.
MeSH terms: Animals; Animal Population Groups/immunology*; Animals, Wild/immunology*; Body Weight; Female; Hepatitis Antibodies/analysis*; Hepatitis B Core Antigens/analysis; Immunoglobulin M/analysis; Macaca/immunology*; Macaca fascicularis/immunology*; Malaysia; Male; Hepatitis A Antibodies
Similar HLA association was found in patients with elephantiasis in Sri Lankans and Southern Indians. HLA-B15 was observed in 13/44 (30%) Sri Lankan patients with elephantiasis compared to 1/27 (4%) Sri Lankan controls (p = .0058; RR = 10.9) and in 5/8 (28%) Southern Indian elephantiasis compared to 10/101 (10%) Southern Indian controls (p = 0.04; RR = 3.5). In combining the data, the significance of the difference of the frequency of B15 between patients with elephantiasis and controls was even more marked (p = 0.00045; corrected p = 0.012; RR = 4.4).
Using ELISA and COPT diagnostic tests, serological evidence of Malaysian schistosomiasis was discovered among Orang Asli populations from three areas in Peninsular Malaysia. Serum samples collected in 1975 indicated an ELISA-positive prevalence of 25% and a COPT prevalence of 11% from Pos Iskandar, Pahang and an ELISA prevalence of 13% and a COPT of 4% from Bukit Lanjan, Selangor. Resurveys at these site in 1982-1984 showed a continued presence of serological positive individuals but prevalence rates were markedly lower: 7% and 1% for ELISA and 4% and 2% for COPT at Pos Iskandar and Bukit Lanjan respectively. Snail hosts were not found at either site. The source of infection for persons living in these lowland areas remains unknown. In a third area, Kuala Tahan, Pahang, located in the foothills of the central mountain range, foci of transmission have been found near to Orang Asli settlements. The serological prevalence rate among Negrito Orang Asli in that study area was 9% for ELISA and 4% for COPT. Thirty-three of 36 COPT-positive sera produced vacuolated bleb precipates and in 31 these were the only reactions seen. The high percentage of positives producing only these precipates suggests that among Orang Asli schistosomiasis patients such reactions are not an indication of recently acquired infection as has been reported for schistosomiasis patients in the Philippines.
House shrews (Suncus murinus) and rats (Rattus rattus diardii), trapped during a survey period from July 1978 to December 1979 and thereafter on a random basis, from residences within and outside the Veterinary Research Institute, Ipoh, Malaysia campus, were bacteriologically examined for the presence of salmonellae. Of the 55 shrews and 8 rats examined, 39 (71%) shrews and 2 (25%) rats were found positive. There were 46 Salmonella isolates which included 5 dual infections. These were serotyped as S. weltevreden, S. bareilly, S. stanley, S. augustenborg, S. hvittingfoss, S. emek, S. paratyphi B, S. ohio and S. matopeni in order of frequency of isolation. The significance of these findings especially with regard to salmonellosis in man and animals is discussed.
A review of 24 children with posterolateral (Bochdalek) diaphragmatic hernia over a five-year period was carried out to highlight the problems of diagnosis and' management. Nine children were delivered in the Maternity Hospital Kuala Lumpur, giving an incidence of 1:10,000 live births which is half the expected incidence. Difficulty in diagnosis is apparent from the large number of initially misdiagnosed cases (29%) and those not detected
soon after birth (71% diagnosed after 24 hours). Less than half the babies had associated anomalies, commonest being malrotation and ipsilateral lung hypoplasia. Mortality (20.8%) appears to be related to the degree of lung hypoplasia and shunting, and the birthweight of the babies. Current evidence indicates that pulmonary hypertension is the main factor in the chain of events beginning with lung hypoplasia, which ultimately leads to their demise. Various methods to overcome this complication have been evolved which appear to give some hope for these high-risk infants.
A clinical study was undertaken to standardize a set of Malay word lists for speech audiometry evaluations. A set of ten word lists is drawn out to test a general Malay-speaking population. A normal discrimination curve is obtained using these materials and some examples of clinical applications are illustrated.
50 cases of anterior chamber intraocular lens implantation at the University Hospital, Kuala Lumpur were studied. 80% of the cases achieved visual acuity of 6/9 or better. The percentage would be higher if cases with pre-existing pathology are excluded and the period of follow-up is longer. Complications, mainly minor and non sight-threatening, are discussed.
Between June 1977 and May 1982, 2,291 samples of raw, cooked and dried foods were examined for the presence of Salmonella. Of these samples, 43 were positive, isolations being made from raw foods (4.8%) and cooked foods (0.4%) but not from dried foods. 14 Salmonella seratypes were isolated, Salmonella anatum being the most predominant. The significance of these isolations is discussed and the need for consumer education to reduce the incidence of human salmonellosis is emphasised.
More than half of 174 patients with end stage renal disease (ESRD) treated by the Department of Nephrology, General Hospital Kuala Lumpur in 1982 presented for the first time in uraemia, with no known renal disease in the past. Although about half of all patients seen in 1982 were treated by dialysis or transplantation, the great majority of the estimated number of patients developing ESRD in Malaysia in 1982 did not receive definitive treatment.
From 1970 to 1984, 100 patients suffering from organophosphate poisoning were treated in the Intensive Care Unit at the University Hospital. These patients developed signs and symptoms of cholinergic over-activity and were treated with continuous intravenous atropine. Many of the patients also developed acute respiratory failure, which necessitated ventilatory support in the form of intermittent positive pressure ventilation. Other measures included the use of inotropes and nutritional support. Daily estimation of serum cholinesterase levels were useful in assessing degree of recovery of the patients from the effects of the organophosphates.
A study was carried out to study lite prevalence of hypertension amongst rural Malays living in two villages in Kuala Selangor district. Simple random sampling of households was carried out and all members 15 years and above were examined. Out of 359 persons examined, 92 (25.6%) had hypertension. A significant increase in prevalence was observed with increasing age and in smokers. Prevalence rates did not differ significantly in the two sexes and with income. Only 38 of the hypertensives were known cases. It was found that 78. 7% of them had been detected within less than five years and 81.6% had undergone medical treatment. It is proposed that preventive programmes in hypertension be introduced in rural health services and a national prevalence survey be conducted.
MeSH terms: Body Weight; Child Nutritional Physiological Phenomena*; Child, Preschool; Evaluation Studies as Topic; Health*; Health Status*; Humans; Malaysia
The paper discusses the results of 24 cases of Millin's prostatectomy in a District Hospital carried out between April and December 1983. The results show that the blood loss in the operation is usually not more than 600ml and therefore would not pose a strain on the blood bank. Postoperative bleeding is very minimal and again does not tax the nursing staff of an overcrowded, large ward in the District Hospital. The results for the patients are excellent.
To our knowledge, sickle cell anaemia in pregnancy has not been reported in Malaysia. We describe here such a case with emphasis on modern methods of management.
"Data from the Malaysian Family Life Survey are used to examine the sensitivity of urban/rural income differentials to the definition and measurement of income. Measured income differentials vary with the extent to which nonmarket activities are included in the scope of income, how the distribution of income is summarized, and whether one adjusts for differences in hours of work, household size and composition, ethnic composition, and other sociodemographic characteristics. For example, depending on the measure chosen, estimates of the amount by which urban income exceeds rural income in Malaysia range from 9 percent to 141 percent."