Browse publications by year: 1993

[Asia: front-line country in the HIV epidemic]

J Sykepleien, 1993 Jan 19;81(1):20.
PMID: 8466793
MeSH terms: Asia/epidemiology; Humans; HIV Infections/epidemiology*
Fulltext Dementia in elderly Malays--preliminary findings of a community survey

Kua EH

Singapore Med J, 1993 Feb;34(1):26-8.
PMID: 8266123

This is a study of the prevalence of dementia in elderly Malays living in the Eunos district of Singapore. The subjects included all Malays 65 years and more living in public housing, and they were first interviewed and screened for any cognitive deficit using the Malay version of the Elderly Cognitive Assessment Questionnaire (ECAQ). All those who scored 5 or less in the ECAQ were assessed again with a more detailed questionnaire called the Geriatric Mental State (GMS) schedule. This is the preliminary results of 149 subjects interviewed--77 men and 72 women. Data from the GMS were analysed by a computer diagnostic programme, AGECAT. There were only 6 cases of dementia and the overall prevalence of dementia in the sample was estimated as 4.0%. In the age group 65 to 74 years the rate was 2.5% and this increased to 10.3% in those 75 years and more. The prevalence of dementia in elderly Malays is higher than elderly Chinese in Singapore, but it is similar to the results of studies in New York and Liverpool. All the subjects with dementia were living with their families and they had good social resources.

MeSH terms: Aged; Dementia/ethnology*; Female; Health Surveys; Humans; Malaysia/ethnology; Male; Surveys and Questionnaires; Singapore/epidemiology; Social Support
Fulltext Reliability of computerised electrocardiographic reports

Ong HT, Kuah SH, Chew SP

Singapore Med J, 1993 Feb;34(1):53-4.
PMID: 8266130

The aim of this study is to assess the reliability of computerised reporting of electrocardiograms (ECG). Fifty ECG performed consecutively at the outpatient department of the Penang Adventist Hospital on the Marquette 12SL-SC were studied. Two physicians independently reviewed the ECG and the manual readings were compared with each other and to the computer reports. There was no significant difference in the measurement of rate. The PR and QT intervals measured by the two physicians were similar but each was significantly different from the computer reading. The QRS duration assessed by Physician 1 was similar to the computer reading but each was significantly different from that of Physician 2. The overall diagnosis was the same between the two physicians in 76%, between Physician 1 and the computer in 68%, and between Physician 2 and the computer in 78%. No ECG was reported as normal by the computer and said to be abnormal by either physician. Thus, the computer programme is reasonably reliable in ECG reporting with computer-physician variability being comparable to inter-physician variability.

Study site: outpatient department of the Penang Adventist Hospital

MeSH terms: Cross-Sectional Studies; Diagnosis, Computer-Assisted*; Electrocardiography*; Humans; Malaysia; Outpatient Clinics, Hospital; Reproducibility of Results; Observer Variation; Hospitals, Private
Fulltext Fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis--a Malaysian experience

Jalleh RD, Kuppusamy I, Parameswary V, Yeow CS

Singapore Med J, 1993 Feb;34(1):55-7.
PMID: 8266131

We report our experience on the use of fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis. The case records of 1,274 patients who underwent fibreoptic bronchoscopy at the National Tuberculosis Centre, Kuala Lumpur, Malaysia during a three-year period were reviewed. In 120 of them the final diagnosis was tuberculosis. Bronchoscopy confirmed the diagnosis in 37 patients (30.8%). This was achieved by bronchial aspiration for culture in 26 patients (70.3%) and bronchial biopsy for histopathology in 11 patients (29.7%). It was the exclusive method of confirmation in 16 patients (13.3%). Sputum culture was positive in 62 patients (51.7%) including 41 patients (34.2%) in whom bronchoscopy was unhelpful. Six patients had diagnosis confirmed by other means while in 36 others (30%) it was based on clinical features and supportive basic investigations. There were no complications noted. We conclude that while sputum examination remains the mainstay for diagnosing pulmonary tuberculosis, fibreoptic bronchoscopy serves as a safe and useful adjunct.

MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Bronchoscopy*; Female; Fiber Optic Technology; Humans; Malaysia; Male; Middle Aged; Tuberculosis, Pulmonary/diagnosis*; Bronchoscopes
Fulltext Neonatal melioidosis

Halder D, Abdullah WA, Johari MR, Choo KE

Singapore Med J, 1993 Feb;34(1):85-6.
PMID: 8266140

We report a neonate with melioidosis. The presentation, progress and treatment are described, followed by a discussion on melioidosis.

MeSH terms: Humans; Infant, Newborn; Male; Melioidosis*; Fatal Outcome
A thrombosed saccular posterior cerebral artery aneurysm in an infant

Cheung H, Lee FC

Australas Radiol, 1993 Feb;37(1):90-2.
PMID: 8323524

A case of recurrent hemiplegia due to saccular aneurysm of the left posterior cerebral artery in a female infant is described. The diagnosis was made at angiography, prompted by CT detection of a hyperdense, intra-aneurysmal thrombus, and was confirmed at subsequent surgery.

MeSH terms: Intracranial Aneurysm/complications; Cerebral Angiography; Intracranial Embolism and Thrombosis/complications; Female; Hemiplegia/etiology*; Humans; Infant; Tomography, X-Ray Computed
Eating disorders in Hong Kong

Goh SE, Ong SB, Subramaniam M

Br J Psychiatry, 1993 Feb;162:276-7.
PMID: 8435714
MeSH terms: Anorexia Nervosa/diagnosis; Anorexia Nervosa/epidemiology*; Anorexia Nervosa/psychology; Body Image; Cross-Cultural Comparison*; Developing Countries*; Hong Kong/epidemiology; Humans; Malaysia/epidemiology
Blunt abdominal trauma--injury assessment in relation to early surgery

Visvanathan R, Low HC

J R Coll Surg Edinb, 1993 Feb;38(1):19-22.
PMID: 8437147

One hundred and thirteen patients sustaining blunt abdominal trauma over a 24-month period were retrospectively divided into three groups to assess parameters of three diagnostic methods and the time-lapse before implementing surgical treatment. Diagnosis was based in group A patients (n = 20) on physical findings, plain radiology, and blood and urine examinations. Diagnostic methods in group B patients (n = 35) and in group C patients (n = 58) were as in group A but with the addition of diagnostic peritoneal lavage (DPL) in group B or with the addition of diagnostic abdominal ultrasonography (DAU) in group C. Sixty-five patients underwent abdominal exploration. The time-lag from commencement of examination to surgery was 332.33 +/- 48.90 min, 251.82 +/- 29.08 min and 570.89 +/- 133.80 min respectively in groups A, B and C. It was significantly shorter in group B compared with group C (P = 0.03). DPL had a sensitivity of 95%, a specificity of 81% and an accuracy of 89% whilst DAU had a sensitivity of 79%, a specificity of 85% and an accuracy of 83% in detecting significant injury. The conclusion is that DPL in combination with DAU would facilitate early assessment and treatment of intra-abdominal injuries.

MeSH terms: Abdominal Injuries/diagnosis*; Abdominal Injuries/surgery; Abdominal Injuries/ultrasonography; Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Peritoneal Lavage; Retrospective Studies; Time Factors; Wounds, Nonpenetrating/diagnosis*; Wounds, Nonpenetrating/surgery; Wounds, Nonpenetrating/ultrasonography; Treatment Outcome
A comparative study of the aerobic fitness of 421 healthy adult males in Singapore

Ong TC

J Sports Sci, 1993 Feb;11(1):71-6.
PMID: 8450589 DOI: 10.1080/02640419308729966

The maximum oxygen consumption (VO2 max) of 421 healthy adult males from three ethnic groups (Chinese, Malay and Indian), aged 25-54 years, was assessed from direct analyses of their expired respiratory gases during all-out runs on a treadmill as a measure of aerobic fitness. The subjects were divided into three age groups: group 1, 25-34 years; group 2, 35-44 years; group 3, 45-54 years. Each group was further subdivided into non-exercisers (NE), non-regular exercisers (NRE) and regular exercisers (RE). Consistently within each age group, regular exercisers produced significantly higher VO2 max values compared to non-regular exercisers and non-exercisers. They also met the VO2 max requirements for heavy physical work and compared favourably with the standards of the National Physical Fitness Award of Singapore and Cooper's aerobic fitness classification standards based on North American males. Non-regular exercisers and non-exercisers only met the VO2 max requirements for moderate physical work and compared poorly in both of the aerobic fitness standards.

MeSH terms: Adult; Age Factors; Body Constitution; China/ethnology; Exercise Test; Humans; India/ethnology; Malaysia/ethnology; Male; Middle Aged; Oxygen Consumption*; Physical Fitness*; Singapore; Exercise/physiology*
Aberrant behaviour in a bitch with a granulosa-theca cell tumour

Cheng NA

Aust. Vet. J., 1993 Feb;70(2):71-2.
PMID: 8457180
MeSH terms: Animals; Behavior, Animal; Dog Diseases/psychology*; Dogs; Female; Granulosa Cell Tumor/complications; Granulosa Cell Tumor/veterinary*; Ovarian Neoplasms/complications; Ovarian Neoplasms/veterinary*
Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas

Choo KE, Razif AR, Oppenheimer SJ, Ariffin WA, Lau J, Abraham T

J Paediatr Child Health, 1993 Feb;29(1):36-9.
PMID: 8461177

Data are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP-CP) for Salmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP-CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positive S. typhi culture in a febrile child (culture positive vs the rest) showed the best model to be an O- and/or H-titre of > or = 1 in 40 (sensitivity 89%; specificity 89%). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of O and H (> 1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP-CN patients really were typhoid but were missed by culture. The TYP-CN patients showed a very similar clinical and age profile to TYP-CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific 'fever screen' for typhoid although it will not identify all cases. In children, lower cut-off points for O- and H-titres should be used than are generally recommended.

MeSH terms: Agglutinins/blood*; Antigens, Bacterial/blood*; Child; Child, Preschool; Female; Humans; Infant; Malaysia/epidemiology; Male; Predictive Value of Tests; Salmonella typhi/immunology; Salmonella typhi/isolation & purification*; Sensitivity and Specificity; Typhoid Fever/blood; Typhoid Fever/diagnosis*; Typhoid Fever/immunology; Typhoid Fever/microbiology; Typhoid Fever/epidemiology
Polymorphism of two closely linked hexokinase loci in the grasshopper Oxya japonica japonica (Orthoptera: Acrididae: Oxyinae)

Chan KL, Yushayati Y

Biochem Genet, 1993 Feb;31(1-2):1-6.
PMID: 8471020
MeSH terms: Alleles; Animals; Crosses, Genetic; Female; Grasshoppers/enzymology; Grasshoppers/genetics*; Hexokinase/genetics*; Isoenzymes/genetics; Genetic Linkage; Male; Mutation; Phenotype; Polymorphism, Genetic*
Estimation of population pharmacokinetics for carbamazepine in Malaysian patients using the OPT computer program

Ismail R, Rahman AF

J Clin Pharm Ther, 1993 Feb;18(1):55-8.
PMID: 8473361

We used OPT to estimate individual and population pharmacokinetics for carbamazepine (CBZ) in Malaysian epileptic patients attending our Neurology Clinic. We noted that plasma CBZ concentrations and clearances correlated poorly with daily doses and body weights respectively but we found the values for clearance, volumes of distribution, elimination rate constants and half lives to be in good agreement with earlier reports. We conclude that OPT is a simple yet useful program to derive individual and population pharmacokinetic parameters for CBZ for use in dosage adjustments. We also conclude that although the Malaysian population do not differ substantially in handling CBZ, available data for the pharmacokinetic parameters must be used cautiously in applying it to the therapeutic drug monitoring for CBZ in our patients.

MeSH terms: Adolescent; Adult; Carbamazepine/administration & dosage; Carbamazepine/blood; Carbamazepine/pharmacokinetics*; Child; Epilepsy, Tonic-Clonic/metabolism*; Female; Half-Life; Humans; Malaysia; Male; Metabolic Clearance Rate; Software
Fetal cerebral Doppler in the recognition of fetal compromise

Chandran R, Serra-Serra V, Sellers SM, Redman CW

Br J Obstet Gynaecol, 1993 Feb;100(2):139-44.
PMID: 8476805

OBJECTIVE: To establish reference ranges for the human fetal middle cerebral artery pulsatility index (MCA PI) for the local obstetric population, and to compare computerised antenatal fetal heart rate (FHR) analysis with the MCA PI as indicators of fetal compromise.
DESIGN: Prospective data collection for selected patients.
SETTING: High risk pregnancy unit of a teaching hospital.
SUBJECTS: Group 1 consisted of 18 healthy women with uncomplicated singleton pregnancies. Group 2 consisted of 27 women admitted to the high risk pregnancy unit over a 9 month period with intrauterine growth retardation and other related problems; all these women were delivered by prelabour caesarean section.
INTERVENTION: Serial Duplex sonography to determine fetal MCA PI in Groups 1 and 2. Serial FHR analysis using computerised numerical techniques in Group 2 only.
MAIN OUTCOME MEASURES: Serial MCA PI values from 24 to 39 completed weeks of gestation in Group 1. Comparison of serial MCA PI values with FHR analysis in relation to fetal outcome in Group 2.
RESULTS: In Group 1 the MCA PI diminished significantly as gestation advanced from 1.73 (SD 0.25) at 24 weeks to 1.38 (SD 0.26) at 39 weeks (P < 0.01). In Group 2 eleven babies were hypoxaemic at delivery: all had low MCA PI values while only nine had an abnormal FHR prior to delivery.
CONCLUSION: In normal pregnancy, there is a fall in the fetal MCA PI with advancing gestation which probably reflects a decreasing vascular resistance to fetal cerebral blood flow. Hypoxaemia at delivery appeared to be better recognised by the fetal MCA flow velocity waveform than the FHR analysis. This increased sensitivity, however, was achieved at the expense of a reduced specificity. Larger studies are needed to confirm the findings of this preliminary investigation.

MeSH terms: Adult; Female; Gestational Age; Heart Rate, Fetal/physiology*; Humans; Pregnancy; Prospective Studies; Pulse; Reference Values; Risk Factors; Observer Variation; Ultrasonography, Prenatal*
The distribution of urban population and income: explorations using six Asian cases

Chakravorty S

GeoJournal, 1993 Feb;29(2):115-24.
PMID: 12318386

"Urban concentration (or primacy) and inequality (in size distribution of income) are expected to follow bell shaped curves through the development process. Spatial convergence (through investments in transportation etc.) is expected to precede income convergence. Using longitudinal data from six Asian countries (Japan, Taiwan, Malaysia, the Philippines, Sri Lanka and India) this paper shows that (i) the bell shapes for urban concentration and income inequality generally hold, and (ii) the temporal relationship between the curve peaks is determined by geographical factors (for urban concentration); income inequality is seen to be more policy amenable."

MeSH terms: Asia; Asia, Southeastern; China; Demography; Developing Countries; Economics*; Far East; Geography*; Income*; India; Japan; Malaysia; Philippines; Population; Population Density*; Population Dynamics; Socioeconomic Factors*; Sri Lanka; Taiwan; Time Factors*; Urban Population*; Urbanization*; Developed Countries
Microminutinin: A Novel Coumarin from Micromelum minutum

Rahmani M, Hin TY, Ismail HB, Sukari MA, Manas AR

Planta Med, 1993 Feb;59(1):93-4.
PMID: 17230343
Trace monitoring of water-borne phenolics in the Klang River Basin

Tan GH, Chong CL

Environ Monit Assess, 1993 Feb;24(3):267-77.
PMID: 24227384 DOI: 10.1007/BF00545983

The Klang River Basin is located in the most densely populated region in Malaysia, with its heavy concentration of industries and population. A systematic study of the pollution to this river system caused by phenolic compounds have been carried out under this project. Analyses of water samples from the Klang River by high performance liquid chromatography (HPLC) with an ultraviolet (UV) detector at 280 nm have shown the presence of some priority phenolic pollutants.

MeSH terms: Chromatography, High Pressure Liquid; Environmental Pollutants; Environmental Pollution; Industry; Malaysia; Phenols; Rivers
Fulltext Haemopoietic growth factors--from discovery to clinical application

Begley CG

Med J Malaysia, 1993 Mar;48(1):3-8.
PMID: 7688062

The Colony Stimulating Factors (CSFs) are a family of haemopoietic hormones that likely share a common ancestral origin and stimulate white blood cell development. They display unique but overlapping biological functions and stimulate the survival, proliferation, differentiation and functional activation of granulocytes and monocytes/macrophages and their precursor cells in vitro and in vivo. Each hormone has been purified and produced in active recombinant form. Recombinant G-CSF and GM-CSF are now being used around the world in a variety of clinical situations (e.g., in conjunction with chemotherapy and bone marrow transplantation) to promote the formation and function of these leukocytes. These molecules are among the first of a new generation of biological agents that will impact enormously on clinical medicine.

MeSH terms: Bone Marrow Diseases/therapy; Colony-Stimulating Factors/physiology; Humans; Recombinant Proteins/therapeutic use; Bone Marrow Transplantation; Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use; Granulocyte Colony-Stimulating Factor/therapeutic use
Fulltext Hydatidiform mole and post-evacuation regression patterns of serum beta human chorionic gonadotrophin

Kamariah K, Satgunasingam N, Nasri NM, Ng KY

Med J Malaysia, 1993 Mar;48(1):40-5.
PMID: 7688063

Eighty-nine patients who had hydatidiform moles evacuated at the General Hospital, Kuala Lumpur, were followed with serum beta hCG determinations from October 1988 to June 1991. A regression curve for serum beta hCG, as measured by RIA, was derived from the results of 47 of the patients who demonstrated spontaneous regression of serum beta hCG titres. All 47 patients had normal serum titres at 135 days after evacuation. The mean time taken to reach normal level was 82.6 days, while the range was 39 to 135 days (5 to 19 weeks).

MeSH terms: Adult; Female; Chorionic Gonadotropin/blood*; Humans; Hydatidiform Mole/blood*; Hydatidiform Mole/therapy; Middle Aged; Peptide Fragments/blood*; Pregnancy; Radioimmunoassay; Regression Analysis; Time Factors; Biomarkers, Tumor/blood*; Uterine Neoplasms/blood*; Uterine Neoplasms/therapy; Chorionic Gonadotropin, beta Subunit, Human
The vibratory pattern of ultrasonic files driven piezoelectrically

Ahmad M, Roy RA, Kamarudin AG, Safar M

Int Endod J, 1993 Mar;26(2):120-4.
PMID: 8330934

The pattern of oscillation of a Piezon-Master 400 ultrasonic file driven by a piezoelectric transducer was studied in air and on water. In addition, the displacement amplitudes of the files were measured. The findings were compared with those observed with the Cavi-Endo unit reported in another study (Ahmad 1969). It was observed that the file vibrated such that a standing wave was formed on the file and it exhibited points of maximum deflection (antinode) and points of minimum deflection (node) with the largest deflection occurring at the apical end. This pattern of oscillation was similar to that exhibited by the Cavi-Endo file which employed a magnetostrictive transducer. However, the displacement amplitudes were very much higher than those exhibited by the Cavi-Endo. It is considered that the 120 degrees angle of the file holder inherent in the Piezon-Master 400 unit and the more effective power transmission with the piezoelectric transducer may have contributed to the large amplitudes.

MeSH terms: Dental Cavity Preparation/instrumentation*; Root Canal Therapy/instrumentation*; Transducers; Ultrasonic Therapy/instrumentation*; Vibration

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