Concerned by the alarming decline in breast feeding in the urban and rural areas of Malaysia, we conducted a critical review of infant feeding practices among nursing personnel from representative centres using questionnaires. It was found that although 75% of mothers breast-fed their babies at birth only 19% did so at 2 months and 5% at 6 months respectively. Chinese mothers initiated breast feeding less frequently compared with Indian or Malay mothers. The prevalence of breast feeding was higher among lower category nurses, lower income groups and those from health centres. Decision for breast feeding was based in most instances on conviction derived from reading, lectures or advice from relatives. The vast majority of mothers listed "work' as the main reason for termination of breast feeding followed by "insufficient breast milk' and satisfactory past experience with bottle feeding. The ramifications of these findings and measures to improve the prevalence and duration of breast feeding are discussed.
Summary Median age at marriage for women has risen sharply for each of the three major ethnic groups - Malays, Chinese and Indians, in Peninsular Malaysia since 1957. The sharpest rise has been recorded for Malays and Indians, whose median age at marriage was barely over 17 in 1957. A shortage of potential husbands in the traditionally sanctioned ages contributed to the rise for Malays and Indians, but was probably not the paramount reason; average age differences between the spouses narrowed, but median age at marriage for men actually rose. During the same period, the previously extremely high divorce rates amongst Malays have fallen sharply, though wide inter-state differences remain. The sharp changes in marriage patterns reflect, and in turn are partly responsible for, far-reaching social and economic changes. They have profoundly affected fertility levels and patterns, as well as intra-familial relationships.
A severe epizootic of bovine malignant catarrh occurred from November 1976 until June 1977 in cattle at an agricultural institute in peninsular Malaysia. In a group of 82 Kedah-Kelantan cattle the morbidity rate was 47.6 per cent with a fatality rate of 89.7 per cent. In a group of 43 local Indian dairy cattle the morbidity rate was 23.3 per cent with a fatality rate of 100 per cent. Although evidence suggested that sheep acted as a common source of infection, the disease occurred in one animal which had no contact with sheep but had contact with infected cattle and carcases.
Fifty-one Rickettsia tsutsugamushi isolates from small mammals collected in central Peninsular Malaysia serologically characterized by direct immunofluorescence using eight prototype strains. Karp-related (TA763, TA686, TA716) antigens were found in 90.2% of the isolates.
A ten-year review revealed a similarity in the incidence of teratoma in relation to other childhood tumors in Malaysian as compared with Caucasian children. The most common sites of origin were the sacropcoccygeal, gonadal, and retroperitoneal areas. The reason for the high incidence of retroperitoneal tumor in our series as compared with other countries is not clear. Late presentation and poor followup are associated with poor prognosis.
An epizootic of measles occurred in a group of 31 silvered leaf-monkeys (Presbytis cristatus) that had been in captivity for 4-12 months. Twenty-four of the monkeys exhibited a maculopapular rash that persisted for 6-9 days. A serous to mucopurulent nasal discharge and conjunctivitis were seen in some animals. Eight monkeys died during the epizootic; however, their deaths could not be directly attributed to measles. Serum samples from the surviving monkeys collected 1-2 months prior to, and 5 weeks after, the epizootic were examined by the complement-fixation and hemagglutination-inhibition tests for antibodies to measles virus. The preepizootic complement-fixation titers were all less than 1:4 and hemagglutination-inhibition titers, less than 1:10. The postepizootic complement-fixation titers in 21 of 23 surviving monkeys ranged from 1:8 to 1:128, and hemagglutination-inhibition titers in 22 of 23 monkeys ranged from 1:40 to 1:80 or greater.
Coagulation, fibrinolytic activity and platelet function were studied in 104 Asian women volunteers who received 150 mg of depot medroxyprogesterone acetate intramuscularly every three months for two years or more. The results were compared with those in matched controls. There was a paucity of change in coagulation factors. The fibrinogen levels were increased and prothrombin time was shortened. The fibrinolytic activity, as shown by the euglobulin clot lysis time, was significantly increased. This latter change contrasts with the many reports concerning Caucasian women and may reflect an increase in fibrinolytic potential in Asian women.
A study was carried out in theJengka Triangle in Pahang to find out the prevalence and a practical cum effective method of treatment and control of scabies. Scabies was the commonest skin lesion among the 5590 people examined. its prevalence being 11.6%. Both sexes were equally affected. Prevalence was high among children and teenagers, the worst affected being the 10 to 14. 2 to 4, 15 to 19 and 5 to 9 year olds. The problem of scabies in Jengka could be due to inadequate and irregular water supply, plus lack of mothers' supervision of the personal hygiene of their children aged > 2 years. The persistence of scabies since 1976 is very likely due to the people's non-compliance with standing instructions on treatment with Benzyl benzoate emulsion A comparative study of treatment of scabies with Gamma Benzene Hexachloride [GBH] and with Benzyl benzoate emulsion [BBE] showed GBH to be the medication of choice. It was more effective and convenient, giving 97.9% cure rate with one application. A hot bath was not necessary. The patients preferred GBH to BBE since it was painless and without side-effects. The cost of treatment with GBH [1 application] was also much less than that with BBE [2 applications]. Only 28.7% of the cases and contacts complied with instructions to do 2nd application of the medication on their own, making it imperative that application be done by the health Staff or under their direct supervision. The majority [87.2%] complied with instructions to place their used clothes in large polythene bags and air these in the sun for two days. This procedure should replace the instructions to boil personal clothes as it is just as effective. yet more convenient and economical. A regular, biannual screening of all kindergarten and primary school children is recommended. Application of GBH to all scabies cases and all close contacts should be done by the health worker. The whole body from neck to soles of feet should have the application, and the people should be instructed to bathe only after 24 hours. They are to go to the nearest clinic or hospital on the 7th day for second application of GBH, if the itchness or lesions persist or reappear. Such supervised medication is possible and will minimise misuse of GBH.
Cefotaxime [HR 756], a third generation cephalosporin with pronounced antibacterial activity
against the Enterobacteriaceae, was assessed in serious and problem antibiotic resistant infection. Good clinical success was achieved without observed untoward effects. The study suggests that due to its properties, cefotaxime could be used as a first-line antibiotic provided that the clinical situation warrants the use of a cephalosporin or aminoglycoside.
Key words - cefotaxime [HR 756], serious surgical infection, antibiotic resistant infection.
Seven non-anthletes [21-26 yrs] and five athletes [23-29 yrs] have participated in the study of cardiovascular and metabolic responses to 15 minutes isometric leg exercise at 15% of each of their maximal voluntary contraction force [MVC]. Oxygen consumption [V02 ]. heart rate [HR] and blood pressure (BP]. were measured during resting. exercise and recovery! periods. The results show that there were a significant increase in V02. HR and BP of the two groups studied during exercise, but no significant difference between groups has been found. This study indicates that although cardiovascular response between the rwo groups was not significantly different, 15 minutes isometric leg exercise at 15% MVC has challenged this system in a such a way to fulfill the metabolic requirement of the
working muscle ill both groups. This finding was
discussed in light of the available literatures.
Filarial infections in 447 cats and 68 dogs from six endemic areas of human filariasis in Peninsular Malaysia were studied as part of the study on the zoonotic transmission of subperiodic Brugia malayi infection. 20.6% of cats and 57.4% of dogs had filarial infections. Cats were infected with subperiodic B. malayi, B. pahangi, Dirofilaria repens and D. immitis. Dogs were infected with B. pahangi and D. immitis. 6.9% of the cats had subperiodic B. malayi infection. The zoonotic implications of these infections and their impact on the filariasis control programme in Peninsular Malaysia were discussed.
Thirteen bats, Tadarida mops de Blainville, collected from the Ampang district in Kuala Lumpur, Malaysia, were found positive for the trematodes Castroia kamariae sp. nov. and Limatulum kuziai sp. nov. Two distinct but morphologically similar forms of Castroia kamariae were recovered. The morphological type is apparently determined by its location in the host intestine.
This is a study of 110 married men as to their attitudes to family planning. Most of the respondents approved of family planning. There is a reluctance to plan families before the first child. more among the Malays than among the Indians. Majority of the respondents [81%] have discussed family planning with their wives, and are also willing to allow their wives to practise family planning. Induced abortion is not favoured by the respondents especially the Malays. Only half the respondents are practising family planning and it appears that the better educated approve as well as practise family planning more than those with less education. A large proportion [89%] of respondents are interested in learning more about family planning.
Study site: Army Garrison Hospital, Port Dickson, Negeri Sembilan, Malaysia
Two outbreaks of mushrooms poisoning involving 3 and 9 soldiers respectively with one death on 9 March 1980 in Perak are described. The symptoms were compatible with muscarine [a neurotoxin] poisoning which was detected in the stomach contents of the dead soldier and the mushrooms consumed by one group.