MeSH terms: Age Factors; Asia; Asia, Southeastern; Demography*; Developing Countries; Economics; Fertility*; Forecasting*; Malaysia; Marriage*; Mortality*; Population; Population Characteristics; Population Dynamics*; Population Growth*; Public Policy*; Research; Socioeconomic Factors*; Statistics as Topic; Family Planning Policy*; Age Distribution*
We report a retrospective study of all cases of toxic epidermal necrolysis admitted to the adult medical wards of the University Hospital in Kuala Lumpur over a 16 year period from 1967 to 1983. Over this period of time only 7 cases were encountered, suggesting the condition is rare in adults in our country. All the cases were females and the age ranged from 21 to 41 years. Four cases were due to drugs, 2 were idiopathic and one was attributed to Staphylococcal infection. One patient died. The other patients recovered completely with no sequelae.
A patient with a solitary intracranial cryptococcoma of the occipital lobe of the brain and a concomitant granuloma of similar aetiology in the breast is reported. Despite resistance of the causative fungus to 5-fluorocytosine in vitro, the patient responded well to radical excisional surgery and therapy with 5-fluorocytosine.
MeSH terms: Adolescent; Brain Diseases/complications*; Brain Diseases/etiology; Brain Diseases/therapy; Breast Diseases/complications*; Breast Diseases/etiology; Breast Diseases/therapy; Female; Granuloma/complications*; Granuloma/etiology; Granuloma/therapy; Humans; Malaysia
Nonhuman primates can be used as models for the study of immune-complex-associated diseases. Recognizing that very little is known about the levels of circulating immune complexes (CICs) in normal monkeys, we have used three assays to measure the levels in serum collected from 313 adult and 106 juvenile cynomolgus macaques (Macaca fascicularis). The prevalence was higher than expected. There was a strong statistical association between CIC levels and country of origin. Monkeys from Indonesia were more likely to have elevated CICs than those from Malaya or the Philippines. This relationship was observed with all three assays. Furthermore, juvenile macaques tended to have lower levels than did adults. This study indicates that it may be important to consider genetic factors, the country of origin, or both when selecting cynomolgus macaques for research on immune-complex-associated diseases.
The W.H.O. self reporting questionnaires were distributed to 50 psychiatric outpatients with neurotic disorders and 50 medical staff as controls. This pilot study shows that it can differentiate between normal and neurotic patients and that if a cut off point of 3 is taken, there Is a very good chance that no psychiatric case in any epidemiological study will be missed. This study also picked up the 10 most sensitive items in the S.R.Q. which will be validated In future studies.
Study site: Psychiatric clinic, Hospital Kuala Lumpur, Malaysia
PIP:
The NADI program (pulse in Malay) was initially launched as a pilot project in 1980 in Kuala Lumpur, Malaysia. It utilized an integrated approach involving both the government and the private sectors. By sharing resources and expertise, and by working together, the government and the people can achieve national development faster and with better results. The agencies work through a multi-level supportive structure, at the head of which is the steering committee. The NADI teams at the field level are the focal points of services from the various agencies. Members of NADI teams also work with urban poor families as well as health groups, parents-teachers associations, and other similar groups. The policy and planning functions are carried out by the steering committee, the 5 area action committees and the community action committees, while the implementation function is carried out by the area program managers and NADI teams. The chairman of each area action committee is the head of the branch office of city hall. Using intestinal parasite control as the entry point, the NADI Integrated Family Development Program has greatly helped in expanding inter-agency cooperation and exchange of experiences by a coordinated, effective and efficient resource-mobilization. The program was later expanded to other parts of the country including the industrial and estate sectors. Services provided by NADI include: comprehensive health services to promote maternal and child health; adequate water supply, proper waste disposal, construction of latrines and providing electricity; and initiating community and family development such as community education, preschool education, vocational training, family counseling and building special facilities for recreational and educational purposes.
MeSH terms: Asia; Asia, Southeastern; Communicable Disease Control*; Community Health Services*; Conservation of Natural Resources; Consumer Participation; Counseling; Delivery of Health Care*; Developing Countries; Economics; Education; Environment; Government Programs*; Health; Health Facilities, Proprietary*; Health Planning*; Health Services*; Health Services Administration*; Humans; Industry; Malaysia; Maternal-Child Health Centers*; Organization and Administration*; Primary Health Care*; Public Health*; Research*; Sanitation*; Social Change*; Water Supply*
Data from 100 Chinese, 50 Malay, and 50 Indian adults resident in 1980 in the greater urban area of Kuala Lumpur, Malaysia, indicate a heavy use of cigarettes among males of all ethnic groups, light use among female Chinese, and none among female Malay and Indian. Consumption of other tobacco products was important only among Indian males; chewing betal quid among Indian males and also among Malay and Indian females. Alcohol use is increasing among both sexes and all ethnic groups, but Chinese and Indian groups use alcoholic drinks more frequently and in larger quantity than Malay. Beer and liquor are the most common drinks.
Stevens-Johnson syndrome is relatively rare. The authors report a retrospective study of 34 patients seen at the University Hospital in Malaysia over 16 years and discuss the epidemiology, clinical features, complications, investigations, etiologic association, mortality, sequelae, course of the disease, and the use of steroid.
This paper examines the effect of age at first calving and milking system on the overall lactation performance and incidence of lactation failure of 442 F1 Bos indicus/Bos taurus dairy crossbreds in Sabah. The two types of crossbred used in the study were imported F1 Sahiwal x Friesian and locally bred Friesian x Local Indian Dairy. Heifers which did not lactate for at least 120 days or produced less than 20 kg of milk during the fourteenth week of lactation were considered to have failed to establish a lactation. The imported and locally bred heifers recorded failure rates of 23.4 and 21.4% respectively. Three milking systems were examined namely machine milking without calf, machine milking with calf and hand milking. They produced failure rates of 30, 12 and 5.6% respectively. The cows that passed recorded 120 day milk production figures of 878, 1,134 and 1,054 kg respectively. The three age groups of less than 30 months, 30 to 34 months and greater than 34 months recorded failure rates of 37, 22 and 10% respectively. The heifers machine milked without their calf which calved at less than 30 months of age recorded a failure rate of 44% while those which calved at greater than 34 months recorded a failure rate of only 17%.
Study site: Tawau and Sebrang Livestock Breeding Centres, Sabah, Malaysia
PIP: Resolutions adopted by the 12th Annual Asian Parasite Control/Family Planning (APCO/FP) Conference held in Colombo, Sri Lanka urge the incorporation of quality of life issues of all dimensions in projects of all participating countries. 1 study discussed during the conference concerned health volunteers of the integrated project in Sri Lanka, which analyzes motivating factors which make community young people work on a voluntary basis. Another topic covered was the role of women in the achievement of primary health care. Video reports were presented by Bangladesh on family planning and parasite control activities, Brazil on utilization of existing organizations to improve successful integrated projects, China on making twin concerns of family planning and primary health care, Indonesia on strengthening urban FP/MCH clinics, Korea on health promotion through the integrated project, Malaysia on the NADI program, the Philippines on the Cebu model of integrated health care, and Thailand on fee charging urban programs.
MeSH terms: Americas; Asia; Asia, Southeastern; Bangladesh; Brazil; China; Communicable Disease Control*; Congresses as Topic*; Delivery of Health Care; Demography; Developing Countries*; Family Planning Services; Far East; Health; Health Personnel; Health Planning*; Health Services; Humans; Indonesia; Korea; Latin America; Malaysia; Maternal-Child Health Centers*; Motivation; Organization and Administration; Philippines; Population; Population Characteristics; Primary Health Care*; Public Health; Quality of Life; Research*; South America; Sri Lanka; Thailand; Urban Population*; Videotape Recording; Volunteers; Women's Rights; Developed Countries
Serological markers were used to determine the infective agents causing acute viral hepatitis in 246 patients. The frequencies of the five viral infections investigated were: non-A, non-B hepatitis - 99 patients (40.2%); hepatitis A - 98 patients (39.8%); hepatitis B - 43 patients (17.5%); cytomegalovirus - 4 patients (1.6%); and Epstein-Barr virus - 2 patients (0.8%). The log mean ages of presentation for the three predominant infections were: hepatitis A - 18 years; hepatitis B - 25 years; and non-A, non-B hepatitis - 30 years (F = 18.8, p =< 0.001). 52% of all cases were Malays (expected 32. 7%); 32% Chinese (expected 54.6%); and 16% Indians (expected 1l.5%) (X2 = 53, p = < 0.001). Hepatitis A virus infection was more common amongst Malays whilst non-A, non-B hepatitis was more frequent amongst Chinese and Indians. 28% of children <16 years) and 50% of adults had serological markers of previous hepatitis B infection. The variation in frequency for the different forms of hepatitis amongst the three main ethnic groups would suggest that socioeconomic and/or cultural factors are important in the propagation of acute viral hepatitis in Malaysia. HBsAg-negative chronic liver disease in our community may be a product of the high incidence of non-A, non-B hepatitis.
We conducted 2 case-control studies with Malaysian and Hong Kong Chinese and investigated the association between salted fish intake and nasopharyngeal carcinoma (NPC). Both studies show a highly significant association between salted fish intake, especially during childhood, and NPC. Furthermore, from our results we estimate that the majority of NPC cases occurring in the southern Chinese can be attributed to their consumption of this food early in life.
MeSH terms: Adult; Animals; Diet; Female; Fishes; Food Handling; Hong Kong; Humans; Interviews as Topic; Malaysia; Male; Medical History Taking; Nasopharyngeal Neoplasms/etiology; Nasopharyngeal Neoplasms/epidemiology*; Nasopharyngeal Neoplasms/radiotherapy; Risk; Smoking
Nonfermentative Gram-negative bacilli were commonly isolated from clinical material in a Malaysian hospital over a two year period of study. Pseudomonas aeruginosa, Acinetobacter sp and other Pseudomonas were the most common organisms seen. Although these bacteria occurred regularly in clinical specimens their pathogenetic role could be established in only a small proportion of cases. Most 01 these organism were either contaminants or
commensals 01 the normal bacterial flora. It is important to interpret the isolation of a nonfermentative Gram-negative bacillus with caution, and in the light of clinical findings. Failure to do so may result in the unnecessary use of antibiotics.
An epidemio-meteorotropic analytical study of Selangor, in the Southwest coast of Peninsular Malaysia, examines the monthly incidence of dengue for the period 1973-1982 to assess possible quantitative association with the monthly rainfall. The relationships between rainfall, abundance of A. aegypti and dengue infection during 1982 in Jinjang, a dengue-prone area in Selangor, were also examined. A quantitative association between rainfall and the number of dengue cases was found during the first wet period. The lag time between the onset of heavy rain and dengue outbreak was about two to three months. A 120% increase in the number of dengue cases was observed when the monthly rainfall was 300 mm or more. Positive associations were seen between the incidence of dengue and the Aedes house index and the Breteau index in Jinjang. The relationships between these three variables and rainfall suggest that the latter might have exerted its effect on dengue infection partly through the creation of more breeding sites for A. aegypti. Assessment of the importance of A. aegypti in the transmission of dengue in this locality was not possible because of the lack of adjustment for A. albopictus, the other known vector of dengue in the state, and for social and other environmental factors influencing infection rates. In spite of this and the interpretational problems common in aggregate studies, the present analyses have provided relatively strong statistical evidence of an association between rainfall and dengue outbreaks in Selangor, thereby indicating that it is a factor worthy of careful surveillance and monitoring.
A descriptive epidemiology of cancer in Sarawak, based on histopathology records in the Central Medical Laboratory, Kuching, Sarawsk, in 1981 and 1982 was presented. There were 8,219 patients from whom biopsies were taken and 485 from whom marrow biopsies were taken. Out of these, 1,326 were reported malignant. Most of the cases were from Kuching. There were slightly more males than females. The Chinese formed the majority of cases followed by the Sea Dayaks and Malays. The most common cancer sites among males were lymph nodes, nasopharynx, skin and stomach, while in the females the most common sites were the breast, cervix and lymph nodes. Among the Chinese the most common cancers were those of the nasopharynx in males, and breast in females. Among the Sea Dayaks, the most common cancers were those of the lymph nodes in males and cervix in females. Among the Malays, skin cancers were relatively common, and among the Land Dayaks nasopharyngeal cancers were common. Most of the patients were in the older age groups. The pattern of cancers has not changed much since 1966 and the findings of the present study are very similar to the series from the Institute of Medical Research, Kuala Lumpur, in 1969 to 1971.
Some information on cancer in Malaysia are available, and its epidemiology is described. There is a need for systematic and coordinated collection of cancer statistics which are essential to patient management, cancer control programme formulation, implementation and evaluation. The decision of the Ministry of Health to introduce National Cancer Registry and to encourage epidemiological studies, which will ultimately lead to the utilization of data and introduction of control and preventive activities for cancers are positive steps in the right direction. Meanwhile, curative and palliative treatment is available from the existing hospital facilities, and preventive activities such as actions on smoking and health will be continued until such time when a comprehensive prevention and control programme for cancers in the country is evolved.
MeSH terms: Adult; Age Factors; Aged; China/ethnology; Female; Humans; Malaysia; Male; Middle Aged; Neoplasms/epidemiology*; Neoplasms/therapy; Sex Factors
The prevalence rate of 749 cases of oral squamous cell carcinomas (SCC) recorded between 1978-1984 was studied. Results showed that the Indians formed the dominant group (63.8%) followed by the Malays (19.6%) and Chinese (16.6%). The peak incidences were generally located between the sixth and eighth decades. Only in the Chinese group a male preponderance was noted. In the Indians, the buccal mucosa was the most prevalent site; in the Malays and Chinese males, the gingiva and alveolus; and the Chinese female, the tongue. In all three groups, the well-differentiated SCC was the commonest type and the poorly differentiated least common.