During a 6 yr period, 105 (69%) of 153 patients in whom a histological diagnosis of minimal change glomerular disease was made had renal biopsy tissue suitable for immunofluorescence examination. Thirty seven (35%) patients showed glomerular mesangial deposits of IgM. All the patients presented with the nephrotic syndrome. We found no significant difference in age and sex prevalence, presentation, response to therapy and glomerular morphology between IgM positive and IgM negative groups. This study suggests that there is no necessity to categorize IgM positive minimal change glomerular disease as a separate entity.
Seven villages in Banggi Island, Sabah, Malaysia, were surveyed four times to evaluate the roles of local mosquitoes as vectors of malaria and Bancroftian filariasis. 11 species of Anopheles were found biting man. 53.9% of the anophelines caught were An. flavirostris, 27.1% An. balabacensis, 6% An. donaldi and 4.2% An. subpictus. Infective malaria sporozoites, probably of human origin, were found in two of 336 An. flavirostris and 12 of 308 An. balabacensis. Sporozoites, probably of a non-human Plasmodium, were found in An. umbrosus. Nine of 1001 An. flavirostris and four of 365 An. balabacensis harboured L2 or L3 filarial larvae identified as those of Wuchereria bancrofti. This is the first record of An. flavirostris as a natural vector of malaria and W. bancrofti in Sabah.
The problem of dental decay was studied in a sample of 495 Chinese preschool children in Petaling Jaya. The children; 253 males and 242 females ranged in age from 3-6 years. 18.6% of the children was observed to suffer from rampant caries. Only 18.8% were caries free. The dft values ranged from 2.9 +/- 3.12 at 3 years to 5.85 +/- 3.41 at 6 years. The overall mean dft for this group was 4.99 +/- 3.81. Dental treatment was very inadequate. The decayed filled tooth ratio was 6.5:1.
Modern dentistry is a relatively young profession in Malaysia. The development of dentistry in Britain has a major influence on dentistry in Malaysia. Not only does it offer a historical perspective, it serves as a crystal ball to provide an insight into what dentistry will be like in the future. A brief review of dentistry in Britain follows.
MeSH terms: Great Britain; History of Dentistry*; History, 19th Century; History, 20th Century
In 3 urban areas in Selangor, Peninsular Malaysia between 1973 and 1981, blood from 4084 dogs was examined for haematozoa. The following frequencies were found: Babesia gibsoni 17.7%; microfilariae of Dirofilaria immitis 9.6%; Hepatozoon canis 1.2%; B. canis 1.1%; Ehrlichia canis 0.2%; Trypanosoma evansi 0.1%. A detailed examination of B. gibsoni infections and microfilariasis due to D. immitis with regards to monthly distribution, breed frequency, sex and age, revealed that pedigree and non-pedigree dogs were equally susceptible to Babesia and microfilariae infections.
MeSH terms: Age Factors; Animals; Babesiosis/epidemiology*; Dirofilariasis/epidemiology; Dog Diseases/epidemiology*; Dogs; Ehrlichia; Female; Malaysia; Male; Protozoan Infections/epidemiology; Protozoan Infections, Animal*; Rickettsiaceae Infections/epidemiology; Rickettsiaceae Infections/veterinary; Sex Factors; Species Specificity; Trypanosomiasis/epidemiology; Trypanosomiasis/veterinary; Apicomplexa
The plasmid profiles of 160 strains of Neisseria gonorrhoeae isolated in Peninsular Malaysia, comprising 80 penicillinase-producing (PPNG) and 80 non-penicillinase-producing (non-PPNG) isolates, were determined. The 80 PPNG isolates were divided into two plasmid groups. All of them harbored two common plasmid species, a 4.4 megadalton (Md) R plasmid previously associated with beta-lactamase production in PPNG strains from the Far East and a 2.6 Md multicopy plasmid of unknown function. In addition to these two plasmids, 60 (75%) PPNG isolates also carried a large 24.5 Md conjugative plasmid. In contrast, the 80 non-PPNG strains were divided into three plasmid groups. All of them possessed the 2.6 Md cryptic plasmid, and 35 (44%) isolates also harbored the 24.5 Md transfer plasmid. Besides these two plasmids, one non-PPNG isolate carried an additional 7.8 Md cryptic plasmid.
Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.
MeSH terms: Adult; Bone Diseases/diagnosis; Bone Diseases/etiology*; Bone Diseases/radiography; Contracture/etiology; Diagnosis, Differential; Female; Humans; Joint Diseases/etiology*; Male; Middle Aged; Muscular Diseases/etiology*; Osteitis/etiology; Osteomyelitis/etiology; Periostitis/etiology; Syphilis/diagnosis; Ulcer/etiology; Yaws/complications*; Yaws/diagnosis; Yaws/radiography
The decade of the 1980s is declared as a time to solve global domestic water supply problems. By 1990 international goals include the provision of adequate quantities of clean water to every person on earth. Such goals are justified on the basis of human health, economic well being, political development and equity and public safety. Drawing upon observations from Ethiopia, Malaysia and Liberia, cases where attempts to provide domestic water to villagers and rural town dwellers are presented. In all cited cases attempts to provide safe water have failed or are in jeopardy. Conclusions drawn from these cases include acknowledgement that global goals will best be achieved by approaching local problems one-by-one and recognizing the technical, environmental and human constraints upon safe water provision interact differently from one site to another. To properly plan, implement and maintain safe water systems the current technical solutions must be combined with the contributions of social and environmental scientists on a case-by-case basis.
MeSH terms: Communicable Disease Control/trends; Developing Countries*; Ethiopia; Humans; Liberia; Malaysia; Rural Health/trends*; Sanitation/trends; Water Microbiology; Water Pollution/prevention & control*; Water Supply/standards*
We examined the gross and microscopic anatomy of placental tissues and umbilical cords from six species representing the three living families of the Suina. These species included, of the Suidae, the wart hog (Phacochoerus aethiopicus), the giant forest hog (Hylochoerus meinertzhageni), the domestic pig (Sus scrofa), and the banded pig of Malaysia (Sus scrofa vittatus); of the Tayassuidae, the white-lipped peccary (Tayassu pecari); of the Hippopotamidae, the hippopotamus (Hippopotamus amphibius) and the pigmy hippopotamus (Choeropsis liberiensis). All these species have a diffuse epitheliochorial placenta. The chorion is folded, and has on its surface rows of shallow ripples or villi, interrupted by round, oval or irregularly shaped areolae. Placental capillaries indent the epithelial layer covering the tops and sides of the interareolar villi, but not the columnar cell layer lying in the troughs between these villi or covering the areolae. Cuboidal cells cover the crests of the villi in the Suidae and Hippopotamidae, whereas in the Tayassuidae the epithelium is syncytial in appearance. The similarities in placental structure between the six species are more apparent than the differences. Suidae and Tayassuidae have smooth umbilical cords containing two arteries and one vein; those of the Hippopotamidae are pustule-encrusted and contain two arteries and two veins.
The Reason for Encounter Classification (RFEC) was designed by a WHO Working Party to classify the reasons why patients seek care at the primary care level. It is designed along two axes: Chapters and Components. Each chapter carries an alpha-code which is the first character of the basic 3-character alphanumeric code. Each chapter is subdivided into seven "components" carrying 2-digit numeric codes. The field trial was undertaken by family physicians and nurses in: Australia, Barbados, Brazil, Hungary, Malaysia, the Netherlands, Norway and the US. 90497 RFE's were analysed. Their distribution over the chapters and components characterize the content of international primary care. Listings with the most common RFE's in the participating countries reflect the cultural differences. It is concluded that the RFEC is not only feasible to classify reasons why patients seek care but also to classify the diagnosis and the process of primary care. As a result of this, the International Classification of Primary Care (ICPC) succeeds the RFEC.
MeSH terms: Diagnosis; Disease/classification*; Humans; International Cooperation; Morbidity; Primary Health Care
The concentrations of non-haem iron, ferritin and ferritin-iron were measured in the livers of 137 adults and children collected at necropsy. The concentrations of non-haem and ferritin iron were found to be 146.6 +/- 95.2 micrograms/g and 61.6 +/- 32.4 micrograms/g, respectively, in males and 108.0 +/- 61.7 micrograms/g and 60.6 +/- 26.4 micrograms/g, respectively, in females. The values for males in Singapore were lower than those reported in developed Western countries. No correlation was observed between storage iron and age, or ferritin concentration and age. Concentrations of non-haem iron and ferritin were similar for persons dying from accident and coronary heart disease. The non-haem iron concentration in Chinese (187.9 +/- 101.0 micrograms/g) was significantly greater than that in Indians (103.1 +/- 65.8 micrograms/g), while the ferritin concentration in Chinese (6.18 +/- 2.37 mg/g) was significantly greater than either Malays (3.81 +/- 1.8 mg/g) or Indians (3.52 +/- 1.6 mg/g). A significant positive correlation was observed between the non-haem iron and ferritin and also ferritin-iron in Chinese males (r values of 0.678 and 0.598, respectively) and Indian males (r values of 0.576 and 0.612, respectively). However, the correlation between these indices was not significant in the case of Malay males. In premenopausal women the non-haem iron correlated well with ferritin (r = 0.737) and ferritin iron (r = 0.826) while the correlation was lacking in postmenopausal women.
The authors selected 38 thin-layer-chromatography (TLC) systems described in the available literature published over the last 10 years and evaluated those systems with respect to their suitability for detection and identification of opiates in urine, opium and heroin, as well as adulterants in heroin. A total of 14 substances: 8 opiates (morphine, 6-monoacetylmorphine, diacetylmorphine, codeine, acetylcodeine, noscapine, papaverine and thebaine) and 6 adulterants (ephedrine, quinine, methadone, caffeine, cocaine and strychnine) were used as test samples for this research. Using laboratory-coated plates and pre-coated plates, 15 and 13 TLC systems, respectively, were found to be able to detect and identify morphine and codeine in urine without interference from the remaining 12 substances. For the detection of opiates in opium samples as well as opiates and adulterants in illicit heroin samples the TLC system: chloroform-n-hexane-triethylamine (9:9:4) which was developed by the National Drug Research Centre, Penang, Malaysia, was found to be most suitable on both laboratory-coated and pre-coated plates. In addition, the following two systems, one on laboratory-coated plates--hexane-chloroform-diethylamine (50:30:7)--and the other on pre-coated plates--benzene-dioxane-ethanol-ammonia (50:40:5:5; T-7)--were also found to be among most suitable TLC systems for the analysis of opiates in opium samples. The article also presents the relative cost of each of the 38 evaluated TLC systems.
MeSH terms: Chromatography, Thin Layer; Costs and Cost Analysis; Heroin/analysis; Humans; Narcotics/analysis*; Narcotics/urine; Opium/analysis; Street Drugs/analysis
A questionnaire on smoking habits was administered to 4106 Form IV school children in Kuala Lumpur. The period of survey was from 9 to 20 April 1984. 2099 boys and 2007 girls were studied and their mean age was 16.1 years. 32.8% of the students had been initiated to smoking and the mean age of initiation was 13.3 years. The prevalence of smoking was found to be 9.8% and the mean duration of smoking was 2.5 years. Most of the smokers and occasional smokers were boys. About 42% of the smokers wished to stop smoking and only 1% of the non-smokers intended to smoke in the future. The study recommended that health education programmes should be started earlier in school.
MeSH terms: Adolescent; Age Factors; Female; Humans; Malaysia; Male; Motivation; Schools; Sex Factors; Smoking*; Social Environment; Urban Population*
This paper examines four drug rehabilitation systems in Malaysia from an organizational perspective. It focuses on authority structures in rehabilitation centres and their impact on rehabilitees' identities. The findings show that there are important differences between government-run and private centres in terms of administration and approach to therapy. Some policy implications are derived from a comparison of these systems.
MeSH terms: Combined Modality Therapy; Community Mental Health Services/organization & administration; Heroin Dependence/rehabilitation*; Humans; Malaysia; Medicine, Traditional; Social Environment; Social Support
MeSH terms: Asia; Asia, Southeastern; Demography*; Developing Countries; Economics*; Emigration and Immigration*; Malaysia; Population*; Population Characteristics*; Population Dynamics*; Social Planning*
MeSH terms: Abortion, Induced; Age Factors*; Asia; Asia, Southeastern; Birth Rate*; Contraception Behavior; Demography*; Developing Countries; Economics*; Emigration and Immigration*; Ethnic Groups; Family Characteristics*; Family Planning Services; Fertility; Income; Malaysia; Marriage; Population*; Population Characteristics*; Population Dynamics*; Research; Research Design*; Sexual Behavior; Social Change*; Social Planning*; Socioeconomic Factors*; Marital Status; Age Distribution*