A survey on mosquito breeding in septic tanks in several residential areas was carried out on 211 septic tanks in the Ipoh Municipality. The septic tanks inspected comprised two types; the contact filter-bed with pump sump and pump motor type (Type A) and the subsoil [ilter trench type (Type B). Mosquito breeding occurred in. both types of septic tanks, with Type A septic tanks showing heavier breeding, Seventy-two (55.4 percent) of the 130 Type A septic tanks inspected had Aedes albopictus breeding. Besides being a nuisance, mosquito breeding is a potential threat to public health, as Ae. albopictus is a vector of dengue fever. Prolific breeding by Ae. albopictus was encountered in areas where Type A septic tanks were used. Other mosquitoes encountered in the survey were Culex qusnquefasciatus, Armigeres subabaltus and Uranotaenia spp. Analysis of effluent samples from Type A and Type B septic tanks revealed that of the 4 parameters measured (PH, chloride, BOD5 and Free Ammonia}, only pH was not significantly different at the 95 percent level of confidence. Chloride, BOD5 and Free Ammonia levels in. the Type B septic tanks were significantly higher than that in Type A septic tanks. Turbidity of the effluent in Type B septic tanks probably deters Ae. albopictusfrom breeding. Several methods to prevent breeding of mosquitoes in septic tanks were discussed. The easiest method is to mosquito-proof the septic tanks but this has been tried not too successfully. A method using expanded polystyrene balls is suggested. Other methods include the use of parasitic nematodes and the use of insecticides but these are not favourable.
Comparative laboratory bioassays of three formulations of Bacillus thuringiensis H-14 (IPS-78, San 402-I and Bactimos) were conducted against late 3rd/early 4th instar larvae of four species of mosquito, viz., Aedes aegypti, Culex quinquefasciatus, Anopheles balabacensis and Mansonia (Mansonioides) indiana, in Malaysia. From the average response of the mosquito larvae to the three formulations of B. thuringiensis H-14, Ae. aegypti was found to be most susceptible, followed by Cx. quinquefasciatus, An. balabacensis and M. (M.) indiana in decreasing order. The LC50 values for Ae. aegypti, Cx. quinquefasciatus, An. balabacensis and M. (M.) indiana after a 48-hour exposure to IPS-78 formulation were 50.9, 129.3, 117.8 and 169.6 International Toxic Unit (ITU) Ae. ae./l; to San 402-I formulation were 54.6, 223.1, 405.1 and 177.6 ITU Ae. ae/l and to Bactimos formulation were 57.2, 175.7, 35.6 and 514.5 ITU Ae. ae./l respectively. The efficacy of the bacterial product was also found to be determined by its formulation in relation to the feeding and resting habits of the mosquito larvae. No delayed pupation or emergence was observed on the larvae exposed to B. thuringiensis H-14 at sub-lethal concentrations.
A study of race-related distribution of hepatitis B markers was conducted in 458 children admitted consecutively to Singapore General Hospital. The positive rates for hepatitis B surface antigen (HBsAg) in Chinese, Malays and Indians were 11.2, 8.0 and 12.2% respectively and the corresponding figures for anti-HBs were 30.2, 12.0 and 14.6%. In Chinese children HBsAg prevalence was shown to be sex-related, being higher in males than females. The percentages of Chinese children positive for anti-HBs and anti-HBc were also higher than those of the Indians. This study confirmed that Singapore children were exposed to hepatitis B infection from early life. All three races were equally susceptible to this infection.
MeSH terms: Antibodies, Viral/analysis*; Child; Child, Preschool; China/ethnology; Cross-Sectional Studies; Female; Hepatitis B/epidemiology*; Hepatitis B Antibodies/analysis*; Hepatitis B Surface Antigens/analysis*; Humans; India/ethnology; Infant; Malaysia/ethnology; Male; Sex Factors; Singapore
Patients attending a referral Skin Clinic were studied to identify the spectrum of drug eruptions and the offending drugs. There were 51 patients with an incidence of five per thousand and equal sex incidence. Though the pattern of eruption was broadly similar to other reports, unusual reactions were observed. In addition to the skin manifestation, fever and lymphadenopathy were present in most patients. Raised erythrocyte sedimentation rate and eosinopoenia were commonly observed. Clinical acumen and the list of drugs ingested are still the best clues to the diagnosis ofdrug eruption.
Study site: Skin clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
This paper presents four cases of Fournier's gangrene, including one involving a reconstructive procedure using a preputial rotation flap to cover the raw area, to reduce the period of wound healing. Since Fournier's description of Idiopathic scrotal gangrene in 1884, there have been a number of reports on this relatively rare disease but the problem of achieving early healing and epithelialisation remains.
Health, including nuirition is not independent but is closely associated with the social and economic environment. Malnutrition itself can cause death, but more commonly, it can cause considerable ill-health, physical retardation, impaired mental performance, loss in productivity and a decline in the quality of life. The effects of malnutrition as obstacles to socio-economic development are now well recognised. In a rapidly developing country like Malaysia, the nutritional and nutritionally-related problems present themselves with contrasting features. While population indicators such as toddler mortality, incidence of low birthweight and food balance sheet studies suggest an improving nutritional situation, methods of direct assessment have shown that chronic protein-energy malnutrition and anaemia are sWI common amongst pre-school children in both the rural and urban disadvantaged sectors. Moderate anaemia also affects a significant proportion of older children and women of childbearing age. Intestinal parasites, another indicator of under development at the local level, are ubiquitous in the rural setting and urban slums owing to unsatisfactory waste disposal. In striking contrast, diseases associated with dietary excesses and increasing affluence have now emerged as the major killers. This changing pattern of mortality and morbidity along the lines encountered by the industrialised societies is now dramatised by the fact that road accidents are now claiming a large number of victims. It is clear that while continued efforts should be given to the improvement of the nutritional health of both rural and urban poverty communities, little time should be wasted in considering the adoption of public health measures aimed at stemming the rising number of deaths associated with our increasing affluence, particularly those diseases that are nutritionally linked, such as coronary heart disease, hypertension and diabetes mellitus, not forgetting the increasing road toll afflicted by the motor vehicle.
To our knowledge, meningitis due to Listeria monocytogenes has not previously been reported in Malaysia. We describe here two infants with meningitis due to Listeria monocytogenes occurring within a month of each other in the Universiti Kebangsaan Malaysia Paediatric Unit. The incidence of listeriosis in Malaysia is unknown and it is possible that this infection may have been missed in the past.
Folate and vitamin B 12 status in pregnancy was studied in a group of 190 Malaysian mothers belonging to the three major ethnic origins. Cord blood was also analysed for the same vitamins. Ethnic variations with regard to deficiency in these two vitamins was determined. About 58.5 percent of the pregnant mothers suffered from lowered serum folate levels and 32.4 percent had lowered RBC folate levels. In contrast vitamin B 12 levels were within normal limits. Cord blood levels of these vitamins were significantly higher than. the corresponding levels in the maternal blood, suggesting the possible involvement of an active process in the transfer of folates and vitamin B 12 to the fetus.
A pragmatic and rational approach to the management of five child psychiatric cases in Malaysia is briefly reviewed. The significance of sociocultural factors in treating these cases within the context of a rapidly developing plural society is emphasized. The implications of overemphasis on educational and material achievements are noted.
MeSH terms: Adolescent; Mental Disorders/therapy*; Child; Child Abuse/prevention & control; Child Behavior Disorders/therapy; Child, Preschool; Community Mental Health Services/utilization; Conversion Disorder/therapy; Ethnic Groups/psychology*; Family Therapy; Female; Gender Identity; Humans; Malaysia; Male
Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gram-negative infections. However, gentamicin like other aminoglycosides, has a narrow therapeutic index and is potentially ototoxic and nephrotoxic. Blood levels following administration of gentamicin has been shown to be highly unpredictable and monitoring of gentamicin levels is necessary to ensure effective therapeutic levels as well as to avoid toxicity. The Department of Microbiology, Universiti Kebangsaan Malaysia offers such a monitoring service. This paper analyses the results of 135 such estimations performed between August 1979 and May 1981. It is shown that a significant proportion of patients were receiving either too much or too little gentamicin. Empirical determinations of dosages is unsatisfactory and as the microbiological assay method of determining gentamicin levels is both easy to perform and inexpensive, such a service should be offered by all general hospitals in Malaysia.
A local anaesthetic agent with adrenalin meant for infiltration block was inadvertently given into spinal canal without any serious sequelae. The consequences of adrenalin in the subarachnoid space are discussed. Measures to prevent such accidents are suggested.
Two hundred strains of Klebsiella species isolated from clinical specimens over a four-month period were biotyped as Klebsiella aerogenes (173 strains), Klebsiella ozaenae (15 strains), Klebsiella edwardsii (5 strains), Klebsiella atlantae (2 strains) and Klebsiella oxytoca (1 strain). Klebsiella aerogenes and Klebsiella ozaenae were more resistant towards antibiotics when compared with other species. Colonial morphology on eosin methylene blue agar (Oxoid) was not found useful for differentiations of Klebsiella biotypes.
This report describes a case of Behcet's syndrome in which there was involvement of both the intracranial and systemic veins. The pathogenesis of Behcet's syndrome is discussed.
A country-wide diabetic survey of the population (age 15 years and above) of Singapore shows that the prevalence of diabetes mellitus in Singapore is 1.99 percent. It is commoner in males (2.36 percent) than in females (1.64 percent). The prevalence of diabetes in the age group 15-39 years is only 0.40 percent and in the age group 40 years and older it is 5.08 percent. The prevalence of diabetes in Indians (6.07 percent) is significantly higher than that in Malays (2.43 percent) and Chinese (1.55 percent). Indian diabetics have an insignifi"cantly higher incidence of positive family of diabetes (12.7 percent) than Malays (10.9 percent) and Chinese (6.5 percent). Obesity was commoner in Malay diabetics (67.4 percent) than in Chinese diabetics (41.6 percent) and Indian diabetics (35.7 percent). The survey shows that 40.4 percent of the diabetics are known while 59.6 percent of the diabetics are newly diagnosed. The majority of the diabetics are treated with oral hypoglycaemic drugs (71.5 percent) and only 4.8 percent are receiving insulin injections. A mong the female diabetics, 63.0 percent have 4 or more pregnancies and large babies at birth are recorded in 12.3 percent. In the newly diagnosed diabetics, 64.3 percent have no symptoms. The complications of the diabetics are hypertension (26.8 percent), nephropathy (9.8 percent), retinopathy (8.5 percent), coronary heart disease (6.1 percent), skin infection (4.6 percent) and neuropathy (3.3 percent). The high prevalence of diabetes among the Indians is likely to be due to a genetic predisposition coupled with an environmental factor (obesity), although this hypothesis is not conclusively demonstrated by the present study.
The results of a 10-year study of intussusception seen in the General Hospital Kuala Lumpur is presented. Incidence among Indians was found to be the lowest in comparison to the other two major racial groups. In 63.5 percent of infants there was no pain. A large number of patients presented with diarrhoea (21.8 percent), constipation (31 percent) and abdominal distension. (43.7 percent). Overall mortality rate was high (14.4 percent). This could be attributed to late presentation (only 30.8 percent) of cases were seen within 24 hours of onset of symptoms) which also accounted for a higher resection rate. A high incidence of lead points (28.7 percent) was also seen. The usefulness of barium enema reduction in this country is discussed. Mainstay of management in the majority of cases is operation with adequate pre and postoperative care.