A case control study of the families of 35 physically abused and neglected children was conducted to examine some of the family characteristics and sociocultural factors which may contribute to physical abuse and neglect. The cases were matched for sex, ethnic group and as far as possible for age with children admitted to the children's hospital for other medical illness. Physically abused children were more likely to come from disrupted, reconstructed or single parent families and these children had separation experiencesfrom their families during early childhoodfor various reasons including periods of family crisis, parental death, financial difficulties, inability to cope with large family size and cultural beliefs and superstition. Social isolation, alcoholism and drug abuse were also shown to be statistically significant amongst these families.
MeSH terms: Physical Abuse; Alcoholism; Child; Child Abuse; Ethnic Groups; Family Characteristics; Hospitals, Pediatric; Humans; Social Isolation; Superstitions; Case-Control Studies; Single-Parent Family; Parental Death
In a retrospective analysis of paediatric referrals to a Neurology outpatients clinic, the largest single category of 47 patients (32%) presented with acute recurrent headache. There were 30 girls and 17 boys. Using conventional criteria 43 of the children could be classified as classical migraine ( 10 ), common migraine (20), basilar migraine (3), opthalmoplegic migraine (1) and tension headache (9). The 9 children with tension headache, all girls, had pain char-acteristics distinct from the rest, but in terms of severity and duration of headache attacks ,were similar to those with classical migraine, which is against the theory that tension headache and migraine are at different ends of the spectrum of the same process. These findings are consis-tent with recent adult data, but have not been noted in paediatric work. (Copied from article).
MeSH terms: Adult; Child; Female; Headache; Hospitals; Humans; Malaysia; Male; Outpatient Clinics, Hospital; Referral and Consultation; Retrospective Studies; Tension-Type Headache; Migraine with Aura; Migraine without Aura
This is a retrospective and descriptive study of 30 children and adolescents with conduct disorders diagnosed for the first time this year (1993) at the Child and Family Consultation Unit, UKM. Eleven of them were diagnosed to have a Socialized Conduct Disorder, 8 had symptoms of Unsocialized Conduct Disorder, whilst 4 had Conduct Disorder confined to the family context. Another 5 had Depressive Conduct Disorders while 2 had features of other mixed disorders of conduct and emotions. Most them were boys and were ten years old and above. The majority presented with at least one year history of illness and school authorities played an important role in being the main referral agency. Prominent abnormal psychosocial situations were inadequate or inconsistent parental control and discordant intro familial relationships. Socio-economic status and geographical differences were associated with the prevalence of the disorder. The main symptomatology found were disobedience and frequent lying, stealing, truancy and fighting or bullying.
Study site: outpatient clinic, Hospital Kuala Lumpur
Primary malignant epithelial liver tumours in childhood are rare tumours and used to be associated with poor survival. A review of the various current modalities of treatment is undertaken.
The earliest report of a dengue epidemic in the Malaysian Peninsula was from Singapore in 1901 (More, 1904). S. Kae' in 1902 described the next epidemic in Penang. In March 1954, an outbreak of febrile illness was reported at the Methodist Girls' School, Kuala Lumpur, from which dengue viruses were first isolated in Malaysia and identified as dengue type 1.2 However, the first report of the sinister dengue fever with haemorrhagic manifestations was made only in 1962 from Penang Island (Rudnick et al, 1965).3Parameswaran4 in 1965 described the clinical features seen in 41 cases admitted into the children's ward in the Penang General Hospital. Several of the early isolates were of dengue type 2. (Copied from article).
The mercury controversy related to dental amalgam is still continuing. In Malaysia, part of, this controversy has been attributed to a recently - introduced dental amalgam claimed to be non-mercury releasing and causing no mercury toxicity. The purpose of this study was to investigate whether this amalgam, Composil, was indeed non-mercury releasing. Six specimens each of Composil and a control (GS-80) were incubated at 3TC in deionised-distilled water. The daily mercury release was determined over a four-week study period using the stationary cold-vapour atomic absorption spectrometric method. The mean mercury release of Composil was 30.9 Ilg/cm2/ 24hr whilst that of GS-80 was 0.9 Ilg/cm2124hr and the difference was found to be highly significant (P < 0.00l). Results of this study therefore did not substantiate the manufacturer's claim. The release of mercury from amalgam restorations and their implications in clinical practice were also discussed.
The clinical severity of the mutations causing beta-thalassaemia in West Malaysia is presented. Thalassaemia clinical scores (Thal CS), a scoring system, has been formulated to predict clinical severity. It is the type of beta-thalassaemia mutation present that decides on the clinical phenotype. The most severe beta-thalassaemia mutation is assigned a score of 4. A score of 8 indicates a severe thalassaemia phenotype. Alpha-thalassaemia, increased synthesis of Hb F, and glucose-6-phosphate deficiency may ameliorate the clinical condition at phenotype level, and the co-inheritance of hereditary ovalocytosis aggravates it.
The outcome in 148 inborn meconium-stained neonates was studied prospectively over a 5-month period. Fifty-three infants (38.5%) developed meconium aspiration syndrome (MAS). There was a significantly higher rate of MAS (p < 0.001), mechanical ventilation (p < 0.016) and hospital stay (p < 0.016) in neonates with meconium in the trachea than in neonates with no meconium in the oropharynx. The incidence of MAS was significantly higher and the duration of hospital stay longer in outborn than in inborn infants (p < 0.022).
The prevalence of ocular abnormalities was studied in 165 children from a Malaysian school for the deaf. Ninety-five children (57.6%) had one or more ocular abnormalities. Rubella retinopathy was the commonest form of ocular abnormality (35.2%). Refractive errors were found in 23 children (13.9%). Refractive errors in the rubella group were significantly more common than in the non-rubella group of deaf children (p < 0.001) (chi 2 test). Thirteen children had congenital anomalies causing significantly impaired vision. Ophthalmological examination of deaf children helps in the detection of cases with rubella eye signs and thus helps to identify the cause of deafness. Since deaf children are at greater risk of visual and ocular abnormalities, periodical ophthalmological examination should be carried out in these children.
By a combination of PCR and direct-cycle sequencing using consensus primers, we analyzed approximately 400-bp fragments within the NS3 genes of twenty-one dengue virus type 3 strains isolated from five neighboring Southeast Asian countries at different time intervals from 1956 to 1992. The majority of base disparities were silent mutations, with few predicted amino acid substitutions, thus emphasizing the strict conservation of the NS3 gene. Phylogenetic trees constructed on the basis of these nucleotide differences revealed distinct but related clusters of strains from the Philippines, Indonesia, and strains from Singapore and Malaysia of the 1970s and early 1980s, while the Thai cluster was relatively more distant. This genetic relationship was compatible with that proposed by other workers who have studied other dengue 3 virus genes such as E, M and prM. However, we observed that the more recent, epidemic-associated dengue 3 strains from Singapore and Malaysia of the late 1980s and early 1990s were more closely related to the Thai cluster, implying their evolution from the latter, and emphasizing the importance of viral spread via increasing travel within the Southeast Asian area and elsewhere. Nucleotide sequence analysis of the NS3 genes of dengue viruses can serve to advance the understanding of the epidemiology and evolution of these viruses.
Trace elements, such as As, Co, Cr, Hg, Sb, and Zn, were determined by neutron activation analysis (NAA), whereas Cd, Cu, and Pb were determined by graphite furnace atomic absorption spectroscopy (GFAAS) in clam, crab, prawn, swamp cerith, and mussel samples after digestion by microwave heating under controlled conditions before eluting the solutions through a column of a chelating resin, Chelex-100. The standard used in the determination of percentage volatile elements retained by microwave digestion and also in the activation process was Lobster Hepatopancreas TORT-1, whereas known mixed standards were prepared from nitrate salts to determine the efficiency of the separation procedure at a controlled pH. Mercury and lead detected in crabs exceeded the maximum permissible level. Some species also showed a high affinity toward certain elements, and their levels of accumulation in the tissues of these species corresponded with the concentration of these elements in sediments, especially at sites in the vicinity of an industrial zone.
MeSH terms: Animals; Chromatography, Ion Exchange; Crustacea/chemistry*; Hydrogen-Ion Concentration; Ion Exchange Resins; Liver/chemistry; Nephropidae; Malaysia; Mollusca/chemistry*; Neutron Activation Analysis; Pancreas/chemistry; Spectrophotometry, Atomic; Trace Elements/analysis*; Water Pollutants, Chemical/analysis*
Fish has been known as a source of nonoccupational mercury exposure to fish-consuming population groups. In this study, hair samples collected from fishermen and their families residing in an industrialized area in Penang and a nonindustrialized area in Terengganu were analyzed for mercury by neutron activation. The range, arithmetic mean, geometric mean, and median of the mercury concentrations for the groups in Penang and in Terengganu were 0.45-16.68, 3.61, 3.49, and 2.96 and 6.79-18.31, 12.08, 11.69, and 12.05 mg/kg, respectively. Somewhat lower values than from the Penang group were found in a group from Selangor consisting mainly of office workers. The group in Penang took about 40-100 g of fish/d, whereas the group in Terengganu consumed twice as much. This shows that hair mercury levels depend on a fish consumption pattern, and not on the location of the population. The levels of mercury found in this study were similar to those reported by other workers for fish-consuming population groups worldwide.
Aspergillus flavus produced approximately 50 U/mL of amylolytic activity when grown in liquid medium with raw low-grade tapioca starch as substrate. Electrophoretic analysis of the culture filtrate showed the presence of only one amylolytic enzyme, identified as an alpha-amylase as evidenced by (i) rapid loss of color in iodine-stained starch and (ii) production of a mixture of glucose, maltose, maltotriose and maltotetraose as starch digestion products. The enzyme was purified by ammonium sulfate precipitation and ion-exchange chromatography and was found to be homogeneous on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The purified enzyme had a molar mass of 52.5 +/- 2.5 kDa with an isoelectric point at pH 3.5. The enzyme was found to have maximum activity at pH 6.0 and was stable in a pH range from 5.0 to 8.5. The optimum temperature for the enzyme was 55 degrees C and it was stable for 1 h up to 50 degrees C. The Km and V for gelatinized tapioca starch were 0.5 g/L and 108.67 mumol reducing sugars per mg protein per min, respectively.
A simple and effective method of lipase immobilization is described. Lipase from Candida rugosa was first modified with several hydrophobic modifiers before being adsorbed on to organic polymer beads. The soluble hydrophobic lipase derivatives adsorbed more strongly on to the various polymers as compared with the native lipase. The optimal adsorption temperature of the native and modified lipases on all the polymers was 40 degrees C. The optimal pH of adsorption was between 6 and 7. Lipase immobilized in this manner produced high catalytic recoveries which are affected by the type of modifiers, degree of modification and type of supports used. Monomethoxypolyethylene glycol (1900) activated with p-nitrophenyl chloroformate was found to be the best modifier of the enzyme at 95% modification, for adsorption to the polymers. Increasing the degree of modification of the enzyme increased the activity which was immobilized. Generally, both native and hydrophobic lipase derivatives showed higher specific activities when immobilized on polar polymers compared with non-polar polymers.
MeSH terms: Candida/enzymology; Ion Exchange Resins; Microspheres; Polymers
This paper describes selected maternal and child health indicators based on a cross-sectional study of citizens and migrants in Sabah, Malaysia. A total of 1,515 women were interviewed from a multi-stage random sample of households in eight urban centers. Among the 1,411 women in the sample who had experienced a pregnancy before, 76% were local citizens and 24% were migrants. There were statistically significant differences between citizens and migrants in ethnicity, religion, education, household income, and access to treated water supply and sanitary toilet facilities. Significantly fewer migrants practiced any form of contraception and obtained any antenatal care during any pregnancy. Furthermore, citizens tended to initiate care as early as three months but migrants as late as seven months. Despite these differences, only the infant mortality rate, and not pregnancy wastage, was statistically significantly higher among migrants. Pregnancy interval was also similar between the two groups. The influence of several socioeconomic factors on pregnancy wastage and infant mortality was explored.
MeSH terms: Adolescent; Adult; Child Welfare*; Contraception/utilization; Female; Health Status Indicators*; Humans; Infant Mortality*; Infant, Newborn; Malaysia/epidemiology; Maternal Health Services/utilization; Maternal Welfare*; Middle Aged; Pregnancy; Pregnancy Outcome; Transients and Migrants*; Urban Health*; Odds Ratio
The present study was undertaken to see if there was any variability in the power output of Piezon-Master 400 ultrasonic files when driven using different generators, tranducers and file holders. The displacement amplitude of the oscillating tip of the file in air was used as a measure of the power output. The results showed that there was considerable variability in the power output of Piezon-Master 400 ultrasonic files of similar size and length when driven using different generators, transducers and file holders. In consideration of this, it is recommended that a calibration device be incorporated in the ultrasonic unit so that the operator will have some knowledge of when the unit is working at its maximum efficiency.
MeSH terms: Electric Conductivity; Electric Power Supplies; Root Canal Therapy/instrumentation*; Transducers; Ultrasonic Therapy/instrumentation*
A case of non-vital infected dens invaginatus of the maxillary right lateral incisor with open apex, which presented with pain and swelling is presented. Although root growth and apical closure was achieved using calcium hydroxide, the periapical infection persisted and resolution was only achieved after apical curettage and apicectomy.
MeSH terms: Apicoectomy; Bacterial Infections/etiology; Bacterial Infections/surgery; Child; Dens in Dente/complications*; Dens in Dente/therapy; Dental Pulp Necrosis/complications*; Female; Humans; Periapical Abscess/etiology*; Periapical Abscess/surgery; Root Canal Therapy
A questionnaire survey was conducted to examine the attitudes of Malaysian dentists toward patient education and preventive dentistry and the level of preventive care adopted in Malaysian dental practice. An adjusted response rate of 73.1% was obtained. Generally the Malaysian dentists had positive attitudes towards patient education and preventive dentistry including fluoridation. However, a sizable proportion of them considered that preventive measures were no challenge for the dentist. The common preventive measures given to patients were scaling, dental health education, prophylaxis and instruction in correct brushing and flossing in as much as 40 to 50 percent of the queried dentist claimed that these preventive items were provided to most or all of their new patients. In spite of the fact that the majority of the dentists had good knowledge about the application and effects of sealants only about 41 percent of the dentists claimed to have used sealants. More dentists in the private sector reportedly having done so. Also many Malaysian dentists (18.5%) did not use leaded protection for any of their new patients when taking radiographs.
MeSH terms: Adult; Attitude of Health Personnel*; Dentists/psychology; Developing Countries*; Female; Health Education, Dental*; Humans; Malaysia; Male; Middle Aged; Patient Education as Topic; Pit and Fissure Sealants; Preventive Dentistry/statistics & numerical data*; Professional Practice/statistics & numerical data*; Surveys and Questionnaires; Chi-Square Distribution