An account is given of the first hundred consecutive proven cases of sulphone resistance in leprosy, detected in Malaysia between 1963 and 1974. Proof of resistance was clinical in eighty patients and was obtained by drug-sensitivity testing in mice in ninety-six patients; 76 cases were proved both clinically and experimentally, and there was no discrepancy between the two methods. Sulphone resistance was confined to patients with lepromatous-type leprosy--i.e., patients with a large bacterial population. Clinical evidence of relapse due to drug resistance appeared 5-24 years after the start of sulphone treatment. Low dosage favoured the appearance of resistance; therefore regular treatment of lepromatous leprosy with dapsone in full dosage is recommended. The attainment of "skin smears negative for leprosy bacilli" is no test of cure of lepromatous leprosy.
Spontaneous fatal aspergillosis occurred in several species of parrots imported from Latin America, Australia, Malaya and Ghana for studies on the control of psittacosis. Over a period of 4 years, 655 parrots were imported for use in these studies. All birds that died during these investigations were necropsied, and the internal organs of 45 were found to have macroscopic lesions suggestive of aspergillosis. Of these 45 suspected cases, 32 were confirmed as aspergillosis by both histopathology and culture, and three others by histopathology alone. There was no evidence that the remaining 10 had this disease. Of the 32 culturally confirmed cases, 13 were found to be caused by Aspergillus fumigatus, 16 by A. oryzae, and three by both fungi. In this series, three sets of circumstances appear to have been associated with the development of fatal aspergillosis. Their capture and transport to the United States, the administration of chlortetracycline used in the control of psittacosis, and the administration of cortisone acetate in an attempt to activate existent latent psittacosis infections. The possible causal relationship of these factors are discussed.
One hundred and ninety hepatitis B surface antigen positive (HBsAG+) sera were subtyped, belonging to : blood donors, hepatitis patients, patients and staff in a hemodialysis unit, all from Kuala Lumpur; Malaysian aborigines from three jungle locations in Peninsular Malaysia; and East Malaysians from Sarawak, East Malaysia; Three subtypes adr, adw and ayw were present in Malaysia in the following frequencies: 44%, 29%, and 27%, respectively; In Kuala Lumpur 87% had subdeterminant d and 13 per cent y, whereas in the deep jungle aborigines of Perak and Pahang, the y subdeterminant was present in 87% and the d in 13%. A similar pattern of preponderance of y prevailed in Sarawak, East Malaysia. In Kuala Lumpur the two main ethnic groups, Malays and Chinese, differed in subtype distribution, in that adr predominated in the Malays (61%), while the adw predominated in the Chinese (51%); Subtype distribution was not related to age or sex of carriers of the antigen, or to whether they had hepatitis, or asymptomatic antigenemia.
Twenty-two cases of corrosive oesophageal strictures were reviewed and divided into annular, short segment and long segment lesions. The lower third of the oeseophagus was involved in all the long segment strictures, but with sparing of the extreme distal portion in most. Irregularity of the stricture walls with an appearance similar to reported cases of intramural diverticulosis is a common finding but smooth strictures can also occur.
A dental health survey of 15,197 schoolchildren age 6-18 years was conducted in West Malaysia. The caries experience in the permanent teeth of the three racial groups, namely Malay, Chinese and Indian/Pakistani, showed a distinct variation. The prevalence was highest among the Chinese children, being about twice that of the Malay and Indian/Pakistani children. In the primary dentition, however, the caries experience in the three racial groups was comparable. An analysis of the factors contributing to the racial variation showed that dietary influence was not the only factor responsible. The possibility of a racial variation in caries susceptibility has been postulated. In the primary dentition the similar caries experience observed in the three groups of children was most probably due to the widespread occurrence of rampant caries which would heavily weight the dift score of the children in all three groups. The need to fluoridate the public water supply as an effective preventive measure is emphasized.
MeSH terms: Adolescent; Age Factors; Child; China/ethnology; Dental Caries/epidemiology*; Dental Health Surveys*; DMF Index; Humans; India/ethnology; Malaysia; Pakistan/ethnology; School Dentistry; Continental Population Groups*
A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.
Electrophoretically detectable variation in the fungus Neurospora intermedia has been surveyed among isolates from natural populations in Malaya, Papua, Australia and Florida. The principal result is a pattern of genetic variation within and between populations that is qualitatively no different than the well documented patterns for Drosophila and humans. In particular, there is a high level of genetic variation, the majority of which occurs at the level of local populations. Evidence is presented which argues that N. intermedia has a population structure analogous to that of an annual vascular plant with a high level of vegetative reproduction. Sexual reproduction appears to be a regular feature in the biology of the species. Substantial heterokaryon function seems unlikely in natural populations of N. intermedia. Theoretical considerations concerning the mechanisms underlying the observed pattern of variation most likely should be consistent with haploid selection theory. The implications of this constraint upon the theory are discussed in detail, leading to the presentation of a model based upon the concept of environmental heterogenicity. The essence of the model, which is equally applicable to haploid and diploid situations, is a shifting distribution of multiple adaptive niches among local populations such that a given population has a small net selective pressure in favor of one allele or another, depending upon its particular distribution of niches. Gene flow among neighboring populations with differing net selective pressures is postulated as the principal factor underlying intrapopulational allozyme variation.
This paper discusses the prevalence and characteristics of epidemic hysteria among predominantly rural Malay schools in Malaysia. An illustrative episode in a Malay residential girls' school is described, and contributory factors to this outbreak are elaborated. An attempt is made to analyze the complex interweaving of psychological, religious, cultural, and sociological factors in the precipitation of the outbreak.
Alpha-Fetoprotein (AFP) levels of 1,335 males (15 years and older) of seven ethnic groups (Chinese, Indians, and Malays from Singapore, Caucasians from Lyon, and Blacks from Nairobi, forest, and the savanna region of the Ivory Coast) were determined by radioimmunoassay. A few elevated levels (up to 30 nanounits/ml) were detected in some normal individuals, especially in the older age-groups. In addition, there was a systematic age-dependency of AFP levels particularly evident in the groups from Singapore-Lyon, in which there was a 50% AFP increase between the ages of 20 and 40. Comparison between Africans on the one hand and people from Singapore-Lyon on the other hand revealed highly significant differences (p less than 0.001), especially in the younger groups, whereas Chinese, Malays, and Indians from Singapore had very similar AFP pattern; this suggests an important role for environmental factors in the regulation of AFP levels. The age dependency of the presumed effect of environmental factors is in keeping with experimental data showing that young animals respond more vigorously to AFP-stimulating factors. Although the incidence of hepatocellular carcinoma (HCC) differs in the three Singapore groups (the highest in Chinese and the lowest in Indians), no relationship was observed in this study between mean AFP level and HCC incidence in Singapore.
MeSH terms: Adult; Age Factors; Aged; alpha-Fetoproteins/metabolism*; Epitopes; China/ethnology; Dose-Response Relationship, Drug; Fetal Proteins/metabolism*; France; Hepatitis B Antigens; Humans; India/ethnology; Cote d'Ivoire; Kenya; Liver Neoplasms/blood*; Malaysia/ethnology; Male; Middle Aged; Precipitin Tests; Singapore; African Continental Ancestry Group; European Continental Ancestry Group; Asian Continental Ancestry Group; Continental Population Groups*
A study of 300 Malaysian women who were fitted with the Copper-7 intrauterine device is presented. Two per cent of the acceptors were nulliparous. Insertion was easy in 97-7% of the cases and the side effects were minimal. In a study of over 4,634 women-months a low cumulative expulsion rate, at 12 and 24 months of use, of 3-1 and 3-6 respectively, was observed. However, relatively high cumulative rates of pregnancy of 4-3 and 9-2 occurred at 12 and 24 months of use respectively. Out of a total of 19 pregnancies, in 12 cases the device was found to have descended, a finding not commonly reported. One woman experienced translocation of the device five months after insertion, and in this instance, the device was removed by laparotomy. The findings in this study and their implications are discussed.
Neodiplostomum (Conodiplostomum) Brachylaima, Ectosiphonus and Euparadistomum are reported for the first time from small mammals in Malaysia. New host and locality records are given for Echinostoma, Achillurbainia, Beaveria, Odeningotrema, Leipertrema, Athesmia, Skrjabinus and Zonorchis. Possible-life-cycles of the parasites are discussed in relation to the ecology and feeding habits of the hosts.
The second case of Sarcocystis infection in man is reported from an aborigine girl. It was an incidental finding at autopsy and two cysts were seen in the muscle of the oropharyngeal region. The cysts and zoites were similar to those in the previous case reported from Malaysia.
Analysis of histories and genealogies from seven relatively unacculturated, swidden-farming Semai settlements shows that the composition of local groups fluctuates through time. This instability is similar to a pattern which Neel and his colleagues have suggested is typical of primitive society, the fission-fusion model. In addition, the individuals comprising Semai fission groups are kinsmen which implies that the number of independent genomes represented is markedly less than the number of individual migrants (the lineal effect). Fission groups may form new villages or fuse with an established settlement. In either case, the genetic effects of such migration are more pronounced than would be expected on the basis of founder effect or random migration. Despite several conspicuous differences in social organization between the Semai and the South American Indians (e.g., bilateral vs. unilineal descent) whose population structure provided the empirical basis for the fission-fusion, lineal effect model, the basic similarities are striking. The Semai case thus lends support to the proposition that this pattern may be of some generality in technologically primitive populations.