Rajakumar MK, Suleiman AB, Lee CH, Cheah M, Yeoh PH
Citation: Rajakumar MK, Abu Bakar Suleiman, Lee CH, Cheah M, Yeoh PH. The Future of The Health Services in Malaysia. A Report of a Committee of Council of the Malaysian Medical Association. Kuala Lumpur: Malaysian Medical Association, 1980
Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 11-15
The macrofauna of the soils on the west ridge of Gunung Mulu in 4th Division, Sarawak, were sampled during February and March 1978. The eleven sampling sites ranged from near the base of the mountain at 130 m a.s.1. to the summit at 2.376 m.Altitudinal changes from lowland rain forest (mixed dipterocarp forest) to lower montane and upper montane rain forests are concomitant with changes in soil from red yellow podzolics and regosols to peaty gley podzolics and organic peats.The abundance of the total macrofauna declined from 2,579 individuals m(-2) at 130 m to 145 m(-2) at 2,376 m. Declining population densities of ants and termites correlated significantly with increasing altitude but the effect on other groups was variable. Changes in total biomass were erratic and varied from 4.1-6.2 g m(-2) (alc. w.w.) in the dipterocarp forest soils to 5.8 g m(-2) in the lower montane, 9.3-20.2 g m(-2) in the upper montane (tall facies) and 1.9-9.5 g m(-2) in the upper montane (short and summit facies). Only the decline in the biomass of termites and ants correlated significantly with altitude. Other groups remained fairly constant, varied erratically or increased in the middle altitudes.The dipterocarp forest soil macrofaunal biomass was dominated by termites, beetles and earthworms (Megascolecidae and Moniligastridae), with ants the dominant predators. The lower montane forest was a transitional and ill-defined zone on the mountain and the soil macrofauna was also transitional to some extent. Termite biomass fell substantially and earthworms replaced them as the dominant detritivores, with beetles in a secondary role. Formicidae remained as the major predators. With the inception of peats in the upper montane forest (tall facies), the macrofauna was dominated by Coleoptera with earthworms, Diptera larvae and Blattodea in lesser roles. With increasing exposure in the upper montane forests (short and summit facies), several major groups disappeared altogether. The soils were dominated by Blattodea with Coleoptera and Megascolecidae of lesser importance. Chilopoda and Arachnida replaced Formicidae as the dominant predators.
7.8% (8/102) of paired sera sent for dengue investigation turned out to be positive for rubella Instead. Dual infection of dengue with rubella was observed in 3.8% (4/104) cases. The clinical features and the serious implications of misdiagnosis of rubella were discussed.
Serological surveillance for up to two years of 114 patients with laboratory confirmed scrub typhus showed that antibody to Rickettsia tsutsugamushi as demonstrated by the indirect fluorescent antibody test is short-lived. The mean reversion time from mean peak titre (1:499) was 48.9 weeks and the calculated annual reversion rate to a titre less than 1:50 was 61%. This can be used to estimate attack rates based on point prevalence of antibody. The relationship between antibody prevalence and attack rates observed by other workers was confirmed using this model. The possible uses of the finding and its implications in Malaysia are briefly discussed.
Congenital malaria from Malaysia is reported here for the first time. It occurred in a baby boy born to a 16-year-old primigravida who contracted Plasmodium falciparum infection during pregnancy. She suffered malaria during the later stages of pregnancy and at parturition. The placenta was heavily infested with various asexual stages of P. falciparum. Gametocytes were not seen. Extensive search did not show other species. Cord blood showed very light infection with young trophozoites of P. falciparum. Serological studies using IFA technique showed specific IgG and IgM antibodies to P. falciparum in maternal cord and two early neonatal sera. These serum samples showed lower levels of IgG antibodies against P. vivax and P. malariae, but there were no specific IgM antibodies against these species. The value of specific IgM antibody in the diagnosis of congenital malaria is discussed.
Anopheles donaldi Reid, a member of the A. barbirostris species group, is a vector of human filariasis and probably malaria. The discovery of some old specimens of this species, collected in Kuala Lumpur town where it no longer occurs, together with evidence from the literature about past malaria in the town, suggest that donaldi may have played a part in transmitting that malaria.
In 1973, 2610 sera were collected from adults living in 22 localities in four states in Peninsular Malaysia and tested by IFAT for Plasmodium falciparum antibodies. A larger number of thin films were examined. The attack phase of the Malaria Eradication Programme (MEP) in these areas was started between 1968 and 1973. The results showed that the highest prevalence rates and geometrical mean reciprocal titres (CMRT) were among adults from Kelantan where the antibody prevalence varied greatly among the adults and there was active transmission in at least three areas. The values were lowest for Kedah. The P. falciparum antibody prevalence rates were higher than the parasite rates as revealed in single thin film examinations but a number of the positive sera were reactive only at low titres. The low concentration probably indicated the residual antibody from cured cases or past infections and cross reactions to P. vivax and P. malariae infections. The strong reactions probably indicated current P. falciparum transmission as shown by positive thin films. The present study showed that the antibody profile of adults, as shown by IFAT, is of considerable value in assessing the malaria situation in a given area and that it would be useful as a malariometric tool in epidemiological studies to evaluate the progress of malaria eradication/control programmes.
Serum samples from Sinhalese subjects, from Punjab and from Singapore have been studied. The Gm phenotypes found are very numerous and we can observe some similarities concerning the Gm gene frequencies between the Singapore Indians with the Indians of North India, and with the Sinhalese. In contrast, Gm gene frequencies found among Chinese and Malays from Singapore are quite different from those found among Indians of Singapore. Our results here are very similar to those obtained in Malaya studies.
The ultrastructure of the pinealocytes of the Malaysian rat (Rattus sabanus), a mammal inhabiting a zone near the equator where the annual variations of daylength are inconspicuous, was examined and compared with that of pinealocytes of other mammals. On the basis of the presence of granular vesicles, only one population of pinealocytes was found. A large number of granular vesicles and vesicle-crowned rodlets is characteristic of the pinealocytes of this equatorial species. Vesicle-crowned rodlets are especially numerous in the endings of the pinealocyte processes and; they most often found in direct topographical connection with the perivascular spaces. The physiological significance of the presence of such large amounts of vesicle-crowned rodlets and of the secretory process characterized by the formation of granular vesicles is discussed.
A helminthological examination of 367 wood rats, Rattus tiomanicus, in an oil-palm. estate 24 miles north of Kuala Lumpur conducted during 1973 revealed 8 species of helminths: 5 nematodes. Angiostrongylus malaysiensis (54.2% of the rats infected), Hepatojarakus malayae (48.5%), Nippostrongylus braziliensis (48.0%), Gongylonema neoplasticum (0.3%), Syphacia muris (17.7%); 3 cestodes, Hymenolepis diminuta (6.0%), Hymenolepis nana (7.6%), Hydatigera taeniaeformis (cysticercus) (12.0%) and 1 pentastomid, Armillifer sp. (nymph) (0.8%). Overall helminthic infection rates seemed to be higher than those previously reported in this host species.
Sympatric gibbon species Hylobates lar and H. syndactylus were censused on a mountain in Malaya (West Malaysia). Habitat quality was assessed between 380- and 1,525-m altitudes. H. syndactylus was found to occur up to altitudes higher than does H. lar, and this is discussed with reference to the two species' divergent foraging strategies indicated by previous research. It is suggested that gibbons are restricted in their altitudinal range by an increasingly unfavourable ratio of food consumed to energy expended in its location, caused by a reduced food-source density and more difficult terrain at higher elevations.
MeSH terms: Altitude; Animals; Cercopithecidae; Environment*; Feeding Behavior; Female; Hylobates*; Malaysia; Male; Population Density*; Species Specificity; Temperature; Trees; Hominidae*
Two hundred and nineteen patients with skeletal tuberculosis have been reviewed analysing the site of the lesion and the treatment given. Operative management is advocated since the results of this approach are encouraging.