The results of 2449 investigations of the upper gastrointestinal tract were analysed to determine the incidence of disease. Abnormalities were detected in 53% of patients who had endoscopy, but were found in only 24% of patients who had barium studies (p <= 0.001). Altogether 916 patients had abnormal findings. Duodenal ulcer accounted for 42% of cases, gastric ulcer 16% and gastric cancer 9%. The prevalence of perforated ulcer was 13%. The annual incidence/1000 in males and females (>14 years) were respectively, for duodenal ulcer 1.66 and 0.42, for gastric ulcer 0.57 and 0.25, for perforated ulcer 0.36 and 0.05, and for gastric cancer 0.29 and 0.14. Most types of gastro-duodenal disease were less common in Malays than expected (p = <0.001). However oesophageal cancer and varices were more common in Indians compared to Malays and Chinese (p = <0.001). This study showed that the pallern of perforating ulcers was not the same as that of non-peforating ulcers, suggesting a differing pathogenesis. Identification of the factors causing a different prevalence of disease between the three ethnic groups would help in the understanding of the causes of upper gastrointestinal disease.
Cultures of Staphylococcus aureus from eight food poisoning incidents in Malaysia were examined for their ability to produce enterotoxins. Five of the eight strains were found to be enterotoxigenic, the enterotoxins detected being A and E (three strains), A and C (one strain), and C (one strain). Penicillinase production was observed in four of the five enterotoxigenic strains; the penicillin·sensitive strain was also found to be coagulase-negative. The bacteriological and epidemiological investigations for confirming staphylococcal food poisoning are presented. The preventive measures to be taken in reducing such outbreaks are emphasized.
PIP:
A total of 552 women in 1983 have undergone laparoscopic sterilization under local anesthesia with sedation in the family planning clinic at Maternity Hospital and the Specialist Center at Batu Complex. A review was made to evaluate the risks, benefits, and safety of outpatient surgery in view of the shortage of anesthetic personnel, operating theaters and costs to patients if general anesthesia were to be used instead. Anesthetic complications (0.9%) were found to be of a very minor nature, not requiring hospitalization. Surgical complication was higher at 3.8%. There was a high rate (21%) of difficulties encountered at operation, 15% for medical officers and trainees but only 6% for specialists. In summary, a very low complication rate was encountered with local anesthetics. The use of local anesthesia with sedation is advocated. This cuts down on costs, hospitalization and recovey time and overcomes the perennial problem of shortage of anesthetic staff and operating theaters. The rate of the surgical complications was related to the surgeon's experience.
Study site: family planning clinic at Maternity Hospital and the Specialist Center at Batu Comple
MeSH terms: Ambulatory Care; Anesthesia; Asia; Asia, Southeastern; Delivery of Health Care; Developing Countries; Diagnosis; Endoscopy; Family Planning Services; Health; Health Facilities; Hospitals, Maternity; Humans; Malaysia; Outpatient Clinics, Hospital; Laparoscopy*; Physical Examination; Retrospective Studies; Sterilization, Reproductive*; General Surgery*; Therapeutics
In this retrospective review of 16 children with vulvovaginitis due to Neisseria gonorrhoeae, the authors attempt to estimate the incidence of this infection and to ascertain the routes of transmission. From January 1977 to December 1982, 422 cases of gonococcal vulvovaginitis in women of all age groups were encountered at the University Hospital, Kuala Lumpur, Malaysia. Of these, 406 cases (96.2%) occurred in adults, and 16 cases (3.8%) occurred in children younger than 12 years of age. Penicillinase-producing N. gonorrhoeae (PPNG) strains were isolated from five (31%) of the 16 girls; all five cases were subsequently treated with cefuroxime and probenecid. The rest responded to intramuscular procaine penicillin. Although all patients appeared to be cured, only ten of 11 (two with PPNG) had test-of-cure cultures performed after treatment. Although interviewing the parents revealed no history of sexual contact in these children, nine of the girls were linked to culture-positive adult(s).
Splenic nodules from 38 cynomolgus monkeys (Macaca fascicularis) which were captured in Malaysia and Indonesia were studied histologically. The lesions were characterized by well-circumscribed focal fibrosis, accumulation of eosinophils and histiocytes, hemorrhage or hemosiderosis, and loss of normal splenic architecture. Small arteries in the lesion frequently had intimal thickening and narrowing of the lumen in addition to the presence of microfilariae. Microfilariae were also seen in the extravascular area of the lesion, and were occasionally engulfed by multinucleated giant cells. The splenic lesion was thought to have been initiated by incomplete infarction caused by intimal thickening and microfilarial occupation of the small arteries.
"This article describes characteristics of prospective migrants in the Malaysian Family Life Survey and investigates how planning to move affects hours of work. [The authors] use ideas about intertemporal substitution...to discuss the response to temporary and permanent wage expectations on the part of potential migrants. [An] econometric section presents reduced-form estimates for wage rates and planned migration equations and two-stage least squares estimates for hours of work. Men currently planning a move were found to work fewer hours. Those originally planning only a temporary stay at their current location work more hours."
MeSH terms: Asia; Asia, Southeastern; Behavior; Demography; Developing Countries; Economics; Emigration and Immigration*; Employment*; Health Manpower; Income*; Malaysia; Motivation*; Population; Population Characteristics*; Population Dynamics*; Psychology; Salaries and Fringe Benefits*; Social Class; Socioeconomic Factors; Time Factors*; Transients and Migrants*
Hexamermis cathetospiculae n. sp. (Mermithidae: Nematoda), a parasite of the rice stemborer, Tryporyza incertulas (Wlk.), is described. This mermithid was observed to control the stemborer in Malaysia. It is distinguished from other members of the genus by the shape of the vagina, the nearly straight spicules, and the form of the amphids.
The relative viabilities of homozygous and heterozygous karyotypes were measured by making crosses between strains ofD. ananassae homozygous for ST or inverted gene orders in the second and third chromosomes. The strains utilized during the present study originated from widely separated localities in India, Kuala Lumpur and Kota Kinabaru, Malaysia and Chian Mai, Thailand. The presence of heterosis in many interpopulation crosses is evident from the results which show that the inversion heterozygotes formed by chromosomes coming from distant populations exhibit heterosis. On the other hand, heterosis is absent in two intrapopulation crosses. Thus the present results provide evidence that heterozygosis for many genes and gene complexes does produce high fitness without previous selectional coadaptation.
An Indian family with all 3 sons having the fragile X syndrome is reported. The frequency of fragile X cells observed ranged from 4·16%. The phenotypically normal mother, although an obligate carrier, did not express any fragile X chromosomes in her Iymphocyte cultures. The range of mental retardation in affected
hemizygous males and heterozygous females as well as the significance of the fragile X chromosome in prenatal diagnosis are discussed.
MeSH terms: Adolescent; Adult; Case Reports; Child; Female; Fragile X Syndrome/complications; Fragile X Syndrome/genetics*; Humans; India/ethnology; Malaysia; Male; Intellectual Disability/complications; Middle Aged; Phenotype
Cement is a common cause of dermatitis. Workers affected are usually those in cement factories and at building construction sites. Cement dermatitis among port-workers is not so commonly reported. This paper describes an outbreak of dermatitis among stevodores at a port handling cement. The cement was imported in bags, and because of breakage, there was much spillage. It was also hot and dusty inside the hatch of the ship, and some of the stevodores worked bare-bodied. Cases of dermatitis began to appear in January 1983 and reached a peak in April 1983, gradually subsiding over the next few months to August 1983. This coincided with the increased tonnage of cement handled at the port. A total of 33 stevodores were reported as having dermatitis over this period. Of the 15 cases examined, 13 had eczema, and in 19 the hands and wrists were affected. However, most of the cases had multiple site involvement, including the arms, legs and abdomen.
Samples of cement showed the presence of water-soluble chromium, varying from 9.9 to 17.8pg/g. As the stevodores were reluctant to go for skin patch-testing, only four were tested, but two did not return for the reading of the results. The other two were found to have a positive reaction to dichromates. The outbreak of dermatitis was probably due to several factors which are discussed.
In West Malaysia, hepatocellular carcinoma (HCC) is common in the Chinese and in the members of the Senoi aboriginal tribe, two racial groups with diametrically opposite life-styles. Certain fundamental differences exist between the liver tumors in the two races. In the Senoi, the tumor occurs in a younger age group and there is a greater male preponderance than in the Chinese. There is also a very close relationship between hepatitis B virus infection, chronic active hepatitis, cirrhosis, liver cell dysplasia, and HCC in the Senoi and the tumors generally present as multiple nodules studding both lobes of the liver. In the Chinese, although a relationship between hepatitis B virus infection, HCC, and cirrhosis exists, this association is not as strong as in the Senoi and the tumors are generally large and solitary. The data suggest that, although the hepatitis B virus is probably an important oncogenic agent in both racial groups, there may be a difference in the pathogenesis of HCC in the two races.