In the outbreak of cholera in Perak in 1978, a study on 179 cholera patients (cases) from 8 health districts in the state indicated that those afflicted with the disease were from the rural areas, belonged to the lower socio-economic class and had little or no formal education. Under such conditions, it is expected that personal hygiene may not be satisfactory and person to person contact could play an important role in the transmission of the disease especially among those living in close contact. 34.2 percent of the 164 households of the cholera patients contained injected household contacts. From 1 to 6 infected household contacts per household were found for household size ranging from 2 to 18. Ninetyjive (8.6 percent) of the total 1101 household contacts were injected. Only 8 of these 95 infected household contacts developed clinical symptoms giving a ratio of 1:12 symptomatic to inapparent injections. While most of the contacts probably acquired their infection from the patient who constitutes the index case, the role of the asymptomatic carrier in the transmission ofinjection cannot be underestimated.
Fifty patients with temporomandibular pain dysfunction syndrome were examined. Seventy-eight percent and 32 percent were female and male respectively. The white collar workers were more frequently affected. Emotional stress, dental malocclusion and a history of trauma were the main causes. Treatment consists of reassurance, relaxed jaw movements and exercises, anxiolytic drugs, thermotherapy, biting appliance, occlusal adjustments and restoration oflost dental units.
The first culture-proven case zn Malaysia of fungal keratitis, due to Fusarium solani, is presented, followed by a brief discussion of mycotic keratitis.
An immunofluorescence test (IFT) using platelet suspensions was used to detect the presence of serum anti-platelet antibodies (APA) in the sera of Malaysian patients with idiopathic thrombocytopenic purpura. Of the 28 patients tested, 19 (or 68%) had detectable APA with percentage platelet fluorescence ranging from 34% - 80% (mean 51% +/- 10). Normal sera gave fluorescence values of 6 - 15% (mean 9% +/- 5). Sera from patients with SLE, thyrotoxicosis and dengue haemorrhagic fever gave mean values of 29%, 8% and 9% respectively. Additionally, no apparent correlation was observed between percentage platelet fluorescence and the severity of thrombocytopenia. The importance and significance of these findings are discussed.
Demographic characteristics of all patients with a diagnosis of alcoholism or alcoholic psychoses admitted between 1975 and 1978 to the Psychiatry Department, General Hospital, Kuala Lumpur, were examined. The diagnosis of alcoholism or alcoholic psychoses accounted for 2% of the total psychiatric admissions. Males greatly predominated over females and Indians greatly predominated over Malays and Chinese. Reasons for these differences are discussed.
A total of 12 severely hypertensive patients were treated with a once daily dose ofNadolol. There was a drop in diastolic pressure to a mean of 105 mm Hg standing within two weeks and this was well maintained up to 12 months of therapy, the lowest diastolic pressure being 94 mm Hg standing at six months of therapy. Nadolol produced no significant side effects and bradycardia was not a problem during treatment. Of the eleven patients who were resistant to previous therapy because of various reasons all except two responded excellently. One of the non responders has real resistance to therapy and the other is non compliant. Nadolol is found to be an effective once daily treatment for severe and resistant hypertension.
The 1980 malaria notifications in Malaysian soldiers are analysed. The number of new cases notified was 964, giving an annual incidence of11.81/1000 soldiers. Sixty-three percent were falciparum and 36 percent were vivax infections. There were 48 relapses and recrudescences. Twenty-three carriers were detected on mass screening. The yield from mass screening was very low - 5.09/1000 screened. The current practice of chemotherapy, though generally acceptable, was unsuitable for a number of patients. Recommended regimens are not being adhered to. There were two cases ofcerebral malaria, one of whom died.
MeSH terms: Adult; Carrier State/epidemiology; Humans; Malaria/epidemiology*; Malaysia; Male; Mass Screening; Military Medicine*; Plasmodium falciparum; Plasmodium vivax
Radioimmunoassay technique has been used to investigate the variation in the serum human prolactin (hPRL) levels at different stages of menstrual cycle and during a 24-hours period in Malay women. The results showed that the serum hPRL concentrations during menstrual (24.5 ± 4.3 ng/ml), preovulatory (36.6 ± 7.4 ng/ml), ovulatory (29 ± 5.3 ng/ml) and postovulatory (26.6 ± 5.2 ng/ml) periods were not significantly different among each other. The hPRL level was highest during night-sleeping, at 0200hr and was significantly different from the values obtained at 1400, 2000, 0800 and 1400 (last sampling) hours (P < 0.01).
Turner's concepts of structure and anti-structure are applied to the culture-bound syndromes to demonstrate that they are dialectical aspects of cultural reality, The Malay cases of amok, latah and possession hysteria are discussed as instances of anti-structural behaviors that dramatize role-reversals and role-enhancement. The performers of these behaviors are not subjected to the Malay code of moral conduct. The supernatural ethos in Malay culture plays an important role in shaping tolerance towards them. Although this tolerance has been gradually eroded as a result of the introduction of Western psychiatry, the anti-structural status of these syndromes has not faded away but has assumed new meanings in terms of psychopathology.
MeSH terms: Mental Disorders/psychology*; Cultural Characteristics*; Cultural Evolution; Culture*; Female; Humans; Malaysia; Male; Morals; Motivation; Psychological Theory; Sex Factors; Social Control, Informal; Syndrome
The findings of a cholera epidemic in Krian district is reported. There were 77 cases and 92 carriers in the epidemic. Although the three main ethnic groups of Malays, Chinese and Indians were involved in the epidemic, the Malays constituted majority of the cases and carriers. The overall infection rate and case attack rate was higher among the younger population. The case: carrier ratio was also higher among the younger population especially among Indians. Various reasons and probable causes of the epidemic have been described briefly.
MeSH terms: Adolescent; Adult; Age Factors; Carrier State/epidemiology; Child; Child, Preschool; Cholera/epidemiology*; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Middle Aged; Occupations; Continental Population Groups