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
A study into the incidence of urinary calculi over a 15-year period from 1962-1976 in the states of mainland Malaysia is presented. Figures from the Ministry of Health Returns are the only source for such information. The incidence from the various states over each five year period from 1962-1972 is tabulated and its significance especially, the pattern of incidence, and its relation to industrialisation is discussed. Malaysia is beginning to show the same pattern of incidence in the upper and lower urinary tract as that of other industrialised countries. A plea is made for the establishment of a central register at the Institute of Urology and Nephrology to carry out a national survey of urinary calculi so that a study into the epidemiology, and if possible, preventive aspects of urolithiasis can be undertaken.
MeSH terms: Adolescent; Adult; Aged; Child; Female; Humans; Industry; Malaysia; Male; Middle Aged; Sex Factors; Urinary Calculi/etiology; Urinary Calculi/epidemiology*; Continental Population Groups
MeSH terms: Adolescent; Adult; Ambulatory Care Facilities; Blood Pressure*; Body Weight*; Community Health Services; Cross-Sectional Studies; Female; Humans; Malaysia; Middle Aged; Continental Population Groups
A cohort of90 infants born in March 1979 in Kedah, Pahang and Malacca were followed up to find out the feeding practices, preventive health care and medical care practices during infancy. A high proportion of infants were breastfed compared to the urban population. However, early introduction of solids was very common. Parents were well aware of the immunisation schedule and attended government clinics for immunisation. However, attendance for health appraisal was not made according to schedule. Cough and cold,fever, diarrhoea, measles and skin conditions were the common ailments. Medical care for cough and cold, fever and diarrhoea was sought from general practitioners, clinics, and hospitals. Practice of buying analgesics and penicillin cream for self treatment for fever and sores was a common practice. Help was soughtfrom traditional healers for measles. Fever and diarrhoea were thought to be signs of health by some and nothing was done. Mothers were well educated on the importance of breast feeding but were not aware that introduction ofearly solids is not satisfactory. Education with regards to introduction of solids by health staff was not done timely. Health staff were mentioned as injluentials for feeding practices and immunisation, but were not mentioned for medical care. Some recommendations for infant care are also mentioned in the paper.
MeSH terms: Breast Feeding; Community Health Services*; Female; Follow-Up Studies; Health Education; Humans; Immunization; Infant; Infant Care*; Infant, Newborn; Malaysia
Squamous cell carcinoma is the commonest malignant tumour of the mouth (91 percent) in people living in Peninsular Malaysia. Since the histological grading of oral carcinoma ·is one of the several important factors to be considered in the long term survival of patients a more detailed study of anaplastic carcinoma of the mouth in 100 patients is made in this study. As reported in an earlier study the Chinese seem to be more prone to develop anaplastic carcinoma of the mouth. In contrast although oral carcinoma occurs most commonly in the Indians, the development of anaplastic carcinoma seems to be the least in them. The Indians seem to have a better host immune response to oral carcinoma than the Chinese and the Malays occupy an intermediary position. The peak age incidence was between 51-70 years (50 percent). In descending order of frequency anaplastic carcinoma involved the gingiva (29 percent), buccal mucosa (22 percent), palate (20 percent), and tongue (16 percent). Further studies may help to formulate a more effective tailor-made regime of treatment for each individual oral carcinoma patient.
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 of lost dental units.
MeSH terms: Glossalgia/etiology*; Glossalgia/therapy; Hematologic Diseases/complications; Humans; Tongue Diseases/complications*; Tongue Neoplasms/complications; Ulcer/complications; Drug-Related Side Effects and Adverse Reactions
Two cases of Syndromes of Ophthalmoplegia , Ataxia and Areflexia were reported. A brief discussion on its clinical feature and differential diagnosis was made.
The content of indole and the pH have been determined post mortem in shrimps (Pandalus borealis) caught in the Barents Sea and in shrimps caught outside Malaysia, India and Taiwan. These two criteria were compared with organoleptic assessment and the contents of volatile nitrogen bases (ammonia, trimethylamine) and living bacteria. For shrimps caught in the Barents Sea, both raw shrimps stored in ice and processed (broiled, peeled and single-frozen) shrimps were investigated. The results showed that only low levels of indole had been formed during ice-storage. Not until an advanced state of spoilage could a distinct increase in the indole content in raw and in boiled, peeled shrimps be discerned. pH increased slowly and varied in the area between acceptable and not acceptable quality. Neither the indole content nor the pH seems therefore to be a useful criterion for quality assessment either of raw shrimps caught in the Barents Sea or of such shrimps after processing (boiling and peeling). Most of the samples of boiled, peeled shrimps from the Far East were assessed organoleptically as less good-spoiled, and bacterial growth was significant. The content of trimethylamine oxide and volatile nitrogen was low, while the content of indole was high and exceeded 25 microgram/100 g in 8 or 14 samples. This is the upper limit for import in USA. The content of indole seems to be an important quality criterion for shrimps caught in warmer countries. The content of indole exceeded 25 microgram/100 g in some samples which were assessed organoleptically as acceptable. The pH was lower in brine-treated shrimps than in the others.
Two hundred and twelve of undescended testes were operated on in the Department of Surgery, Singapore General Hospital between the years 1974 through 1980. There was a 51.9% incidence of right undescended testis, 34.9% left undescended testis and 13.2% were bilateral. The method of treatment was surgical exploration with orchidopexy wherever technically feasible or orchidectomy if the testis was found to be severely hypoplastic. Of the total series, 42% were operated on before the age of 5 years. The oldest patient undergoing orchidopery was aged 40. Failure of orchidopexy to secure the scrotal position for the testis was noted in 14 cases. This was probably due to inadequate mobilisation at the first operation. There was no mortality and no significant morbidity following surgical treatment in this series.
A seroepidemiological study was carried out on Orang Asli (Aborigines) children who lead a semi-nomadic life in the deep jungles of Ulu Kelantan, Malaysia. Out of a total of about 190 children below 14 years, 143 were studied. Blood was collected from finger pricks on standard "strip type" filter papers for indirect fluorescent antibody (IFA) tests with Plasmodium falciparum antigen. A positive reaction at 1:10 dilution in infants and young children was considered positive and the reasons are given. The P. falciparum antibody prevalence rate was 84.6% compared to 81.8% spleen and 43.4% parasite rates. Both P. Falciparum and P. vivax were present in children. The age-specific patterns of antibody, spleen and parasite rates were those of a hyperendemic community. There was a positive correlation between antibody and spleen rates up to the age of 9 years. In older children, the antibody rates increased while the spleen and the parasite rates dropped.
A case of apical hypertrophic cardiomyopathy occurring in a 53 year·old Indian man is described. So far only 39 cases have been reported in the english literature to the best of our knowledge. This case is the first reported in a non·Japanese and outside of Japan, suggesting that this condition may be encountered in future in other parts of the world.
Updated data on permanent cardiac pacing in Malaysia is presented. Over the past 3 1/2 years (1976-1980), 75 patients underwent insertion of pacemakers giving an annual incidence of about 20 cases as compared with a total of 21 cases in the previous 8 years (1968-1977). Many of the features reported in an earlier paper in 1977 viz mode of presentation, age and sex distribution and indications for pacing remain unchanged. Over this period only 4 patients required lead replacement. Since concentrating mainly on the use of epicardial leads implanted via a subxiphoid approach, complications have been remarkably low. The problem of availability of pacemakers has been averted. Cost remains a major consideration when recommending one pacemaker in preference over another. The details concerning clinical features, indications for pacing, complications and other problems encountered in the management of these patients are discussed.