Field tests were conducted to compare the degree of protection from bites of Mansonia species and Anopheles maculatus by applying two repellent/insecticidal bars, MOSBAR and MOSKIL, to exposed arms and legs. Human test subjects were exposed to natural populations of mosquitos for an 8-hour night time period while using the repellent/insecticidal bars. MOSBAR gave good protection against the bites of Mansonia and An. maculatus. MOSKIL was effective against An. maculatus but not against Mansonia. High mortality was observed among the mosquitos collected from human test subjects treated with the repellent/insecticidal bars. Use of MOSBAR in terms of cost-effectiveness and safety by field and health workers entering into malaria and filariasis endemic areas is discussed.
An experiment was carried out with Mansonia mosquitos in an area endemic for subperiodic Brugia malayi to assess the applicability of the mark-release-recapture method to these mosquitos. An estimated 17,880 individuals of six species of Mansonia were marked with fluorescent dust and released: 453 Ma. annulata, 305 Ma. annulifera, 6,200 Ma. bonneae, 516 Ma. dives, 3,998 Ma. indiana and 6,408 Ma. uniformis. Twenty-three marked individuals were recaptured. Most recaptures were made one or two nights after their release, but one Ma. annulifera was recaptured five nights later and one Ma. bonneae had been marked and released 6-11 nights previously. The recaptured mosquitos were collected between 0.5 and 2.4 km from their release points.
MeSH terms: Animals; Brugia; Insect Vectors; Malaysia
The measurement of the ultimate effects of the microbial insecticides on mosquito density is best obtained by assessment of adult populations. The main aims of this study are: (1) to assess the effect of Bacillus thuringiensis israelensis (Bti) FC Skeetal and Bactimos briquettes on the emergence rate of Mansonia bonneae developed from the introduced first-instar stage larvae and (2) to measure the effect of these two formulations of insecticides on Mansonia adult populations emerging from the natural breeding plots. Bti Skeetal and Bactimos briquettes at the lower applied dosages of 2.3 kg/ha and 1 briquette case/20 m2 respectively achieved 39-40% pupation rates and 31.5-34.2% adult emergence rates. At these low applied dosages, there was little or no direct effect on pupation from the surviving larvae and thereafter on the emergence of adults from the pupae. A two-fold increase in dosage, however, produced a drastic decline in the pupation rate and adult emergence rate. The rates dropped to 6.5% (pupation) and 4.3% (adult emergence) of the total larvae for Bactimos briquettes and to merely 1.5% (pupation) and 1.3% (adult emergence) of the total larvae for Skeetal. In studying the effect of Bti on the field populations of Mansonia mosquitos, two plots each were treated with Bactimos at 1 briquette case/10 m2 and Skeetal at 4.6 kg/ha. A wooden pyramid-shaped screened cage was placed on a cluster of host plants for a period of 2 weeks to trap the emerging adult mosquitoes. There were a total of 24 clusters of host plants in each plot.(ABSTRACT TRUNCATED AT 250 WORDS)
Peripheral fibroma/fibrous epulis accounts for the great majority of localised gingival swellings as was substantiated by various reports in the literature. A study was undertaken to investigate the clinical features of a series of 204 localised fibrous gingival swellings received by the Histopathology Laboratory, Department of Oral Surgery, National University of Singapore. The female patients were more affected than the male patients and the lesions occurred predominantly among the Chinese. The lesions were mainly pedunculated and most commonly occurred in anterior maxilla. The recurrence rate was about 10.3%. In conclusion the results obtained in this study were overall in agreement with those of other authors.
A survey was carried out in a Malay-speaking Muslim community in southern Thailand to obtain baseline data for planning of long term multidisciplinary research and development. By using a 30-cluster sampling technique, 210 households of 1,308 subjects were studied in the post-Ramadan period. It was found that the community was in a social transition. The crude birth rate was 4% and 37.6% of the households had at least one migrant. About half of these migrants had been to Malaysia and mainly worked in rubber plantations. Ninety-five per cent of the households had electricity whereas only 23.8% had a latrine. Boiled or rain water was regularly drunk in only 13.3 per cent of the households. Home-grown agricultural products were not sufficient to provide adequate food. Twenty-six per cent of the adults were unemployed and 24.6% were illiterate. Of the pregnancies 26.7% had no antenatal care and complete tetanus toxoid was given to only 27.8%. Traditional birth attendants conducted 81.1% of the deliveries and only 28.9 and 24.4% of the umbilical cords were correctly cut and correctly dressed, respectively. Breast feeding was still a common (87.8%) practice. However, complete immunization was given to only 10.8%, and 37.8% of the infants had at least one diarrheal episode in the previous month. It was concluded that high birth rate, high migration, low education, low income and bad health of infants are major problems. These problems were interlinked and needed a special multidisciplinary approach. In addition to common obstacles for routine health delivery, migration may create international complications, particularly related to maternal and child care.
MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Culture; Female; Health Services/utilization; Health Status*; Humans; Infant; Islam*; Male; Middle Aged; Prenatal Care; Surveys and Questionnaires; Rural Health; Social Change*; Social Class; Thailand; Transients and Migrants*
A rare case of squamous cell carcinoma diagnosed in early pregnancy in a 28-year-old woman is described. At the time of radical surgery, which was carried out in the puerperium, the growth had already advanced to Stage IV disease. The rapid growth of the tumor seen in this patient suggests that although treatment needs to be individualised, the definitive radical surgery should not be delayed.
Scrub typhus is a major cause of febrile illness throughout the Asia-Pacific region. It is commonly undiagnosed, partly because of the lack of a simple, reliable diagnostic test which can be used in clinical laboratories. The indirect immunoperoxidase technique, configured into a test kit, was provided to technicians who were trained in its use. They used the kit during a 2 year field trial in their respective clinical hospital laboratories throughout Malaysia. In an evaluation using 1,722 consecutive sera tested in those laboratories, the kit was found to have a median sensitivity for IgG detection of 0.85 (range 0.33-0.95), a median specificity of 0.94 (range 0.88-1.00), reproducibility of 0.86, and efficiency of 0.92 when compared to the reference laboratory. In a proficiency survey in which 10 laboratories received 3 coded test samples, all but 2 laboratories had results within 1 dilution of the reference laboratory in quantitating specific IgG, whereas 7 laboratories were within 1 dilution in quantitating IgM. The shelf life of the kit was at least 1 year at 4 degrees C.
MeSH terms: Antibodies, Bacterial/blood*; Evaluation Studies as Topic; Humans; Immunoglobulin G/analysis; Immunoglobulin M/analysis; Immunoenzyme Techniques/standards*; Predictive Value of Tests; Preservation, Biological; Reagent Kits, Diagnostic/standards*; Orientia tsutsugamushi/immunology*; Scrub Typhus/diagnosis*; Reproducibility of Results
Randomly selected samples from different animal colonies from two laboratory animal houses and from the wild-caught monkeys were tested for the presence of anti-rotavirus antibodies to estimate the rates of infection with group A rotavirus. Antibodies to the common group A rotaviral antigen were detected by a competitive enzyme-linked immunosorbent assay (ELISA) using reagents of WHO ELISA rotavirus detection kit. The results of the study showed that white mice, albino rats, and guinea pigs from long-established breeding colonies and resident house rats and house shrews from the animal house had no serological evidence of rotaviral infection. In contrast, one mousedeer from a colony of 19 animals and most of the rabbits from two separate breeding colonies at the same animal house were serologically positive for the infection. Also a significant number of the same species of monkey kept in captivity were found to acquire the infection. Leaf monkeys had no serological evidence of rotaviral infection. The infection rate in wild cynomolgus monkeys did not seem to be influenced by the different ecological environments of their respective habitats. The rate of infection in adults and juveniles was similar.
Two episodes of El Tor cholera outbreak occurred in Tumpat, Kelantan between the 13th of January and the 16th of May 1990. Every case and carrier reported were investigated to determine the source and mode of transmission and to identify specific preventive measures to break the chain of transmission. There were 109 cases and 85 carriers involved in this study. The first episode of one case only was of Inaba serotype while the second episode was caused by the imported Ogawa serotype. Two foci of spread were identified from cluster occurrence but the majority of infection had no discernible link between them. The outbreak became both explosive and protracted indicating poor basic sanitation and personal hygiene. Person-to-person transmission via food and water was the main mode of spread. The Kelantan river water and river clams were confirmed sources of reservoir during the outbreak. Recommendations for prevention are intensified surveillance throughout the year,urgent upgrading of potable water supply and concerted effort in public health education especially against the use of river water and the consumption of raw food.
Cholera has been in existence in Sarawak for many years and since 1873 many major epidemics have occurred. The epidemics usually occur during the dry months of May, June and July and the population affected are those in coastal areas. As in other outbreaks the areas affected were those which had poor environmental sanitation, poor water supply, poor refuse disposal and indiscriminate disposal of faeces. Malays are more affected as in Peninsular Malaysia outbreaks. The classical biotype was common prior to 1961. In later years the El Tor (biotype) has been responsible for most outbreaks.
The following factors influencing vocational success or failure were selected and studied for their predictive value in a Rehabilitation Centre, age, family background, educational level, work history and work level, motivation, mental ability and physical disability. Graded numerical scores from 1 to 3 were assigned to these factors according to Lane et al. A cut-off score was tested and found to distinguish the successful from the unsuccessful groups. The individual factors found to differ significantly in the two groups were work history and skill, motivation, and physical disability. Mental ability, however, could not be tested adequately.
Cardiac complications comprise as much as 50% of perioperative vascular surgical morbidity and mortality. Using the Goldman multifactorial index for evaluating cardiac risk pre-operatively, 53 consecutive patients who underwent abdominal aortic aneurysm surgery were prospectively studied. Forty patients (75.5%) were also evaluated with echocardiography for assessment of left ventricular function. There were 14 (23.7%) peri-operative events, of which nine (17.0%) were acute myocardial infarctions--two of whom died (3.8%). The minor complications included three with hypovolaemic renal failure, and one each with acute respiratory failure and cerebrovascular accident. Patients with Goldman cardiac risk index (CRI) classes III and IV were associated with significantly higher risks of peri-operative complications (p less than 0.001), i.e. 77.8% and 66.7% respectively, compared with class II (22.7%) and class I (nil). Echocardiographic left ventricular shortening fraction (LVFS) of less than 28% helped identify high risk groups in all classes, although its positive predictive value was low (42.3%). Combining LVFS less than 28% with Goldman CRI categories II to IV improved the sensitivity to 91.7% and the positive predictive value to 61.1%. Careful pre-operative assessment using the simple Goldman index and echocardiography is helpful in identifying higher risk patients who would benefit from pre-operative stabilisation and more rigorous perioperative hemodynamic monitoring preferably including intensive care (ICU) management, so as to reduce cardiac complications.
MeSH terms: Aged; Aged, 80 and over; Aorta, Abdominal; Aortic Aneurysm/surgery*; Echocardiography; Humans; Middle Aged; Postoperative Complications/mortality; Postoperative Complications/prevention & control*; Predictive Value of Tests; Preoperative Care/methods*; Prospective Studies; Risk; Sensitivity and Specificity
The prescriptions of all patients who attended an urban general practice from September 1987 to December 1987 were studied. Of the 111 patients (60 females and 51 males) who received a psychotropic prescription the commonest presenting complaint was insomnia (56 patients or 50.5%). This was followed by tension, headache and unexplained aches and pains (19 patients or 17.1%), and anxiety (nine patients or 8.1%). Consistent with these presentations a vast majority (92.8%) received a benzodiazepine. The commonest drugs prescribed were Lorazepam and Bromazepam whereas the longer acting benzodiazepines were rarely used. Polypharmacy was rare.
MeSH terms: Ambulatory Care Facilities; China/ethnology; Cross-Sectional Studies; Family Practice; Female; Humans; Malaysia; Malaysia/ethnology; Male; Drug Prescriptions/statistics & numerical data*; Private Practice; Psychotropic Drugs/administration & dosage; Psychotropic Drugs/therapeutic use*
The value of tuberculin skin testing in the diagnosis of active tuberculosis remains uncertain. Interpretation of tuberculin tests would be easier if the tuberculin test profiles in different communities were accurately known. We reviewed 468 Mantoux test reactions in patients coming to Hospital Universiti Sains Malaysia with suspected tuberculosis. Eighty six percent of patients with active tuberculosis had a positive Mantoux test. Forty two percent of the cases of positive Mantoux test did not have evidence of active tuberculosis. Most of these cases had evidence of past infection with tuberculosis. We conclude that Mantoux test is a sensitive but a non-specific test in the diagnosis of active tuberculosis.
Study site: outpatients, inpatients; Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
The use of pressurised metered dose inhalers was assessed among 93 asthmatic patients attending the respiratory out patient clinic between January to October 1989. They were regular users of the inhalers prior to the assessment. 62.4% of the patients were found to use the inhalers incorrectly. Forty three percent made more than one error. The commonest error observed was the failure to actuate and inhale the aerosol together in 41.9%. There was no difference in the occurrence of incorrect performance between different sexes, age groups, duration of inhaler used and previous supervision or no supervision by the doctors.
Study site: Respiratory clinic, Hospital Kuala Lumpur (UKM), Malaysia
Six of 16 patients presenting to the University Hospital Kuala Lumpur with unilateral recurrent laryngeal nerve paralysis were treated with teflon injection of the paralysed vocal cord. The results are presented and the role of surgical therapy, in particular teflon injection is reviewed.
This paper presents a study of cycles with spontaneous luteinizing hormone (LH) surge in superovulatory Malay women during in vitro fertilization and gamete intrafallopian transfer programmes. Sixteen Malay women underwent ovarian stimulation for ovum pick up at the National Population and Family Development Board, Malaysia. Two cycles showed spontaneous LH surge, and comparisons were made between these two cycles and the cycles without surge. Further observations were made in their characteristics and differences in these two cycles as well as the relationship between progesterone and LH at the time and before the surge.
Oral lorazepam is a commonly used premedicant both locally and abroad. We studied its effect on recovery time after minor gynaecological procedures. The results showed a significant prolongation of recovery time.
A seven-month-old female child presenting with a large abdominal mass was found on investigation to have a duplex right kidney with a non-functioning obstructed upper moiety and a right ureterocele. The grossly dilated and tortuous upper moiety ureter presented as a large cystic mass on ultrasound and computed tomographic scans.