MeSH terms: Asia; Asia, Southeastern; Attitude; Behavior; Consumer Participation*; Contraception Behavior; Developing Countries; Economics*; Education; Family Planning Services; Health Personnel; Health Planning*; Malaysia; Organization and Administration; Research Design; Sexual Behavior; Social Change; Social Planning; Program Evaluation*
MeSH terms: Asia; Asia, Southeastern; Delivery of Health Care*; Developing Countries; Family Planning Services; Health; Health Planning*; Health Services; Health Services, Indigenous*; Malaysia; Medicine; Medicine, Traditional*
MeSH terms: Asia; Asia, Southeastern; Delivery of Health Care*; Developing Countries; Family Planning Services; Health; Health Planning*; Health Services; Health Services, Indigenous*; Malaysia; Medicine; Medicine, Traditional*
MeSH terms: Asia; Asia, Southeastern; Delivery of Health Care*; Developing Countries; Family Planning Services; Health; Health Planning*; Health Services; Health Services, Indigenous*; Malaysia; Medicine; Medicine, Traditional*
PIP:
This paper presents data on contraceptive prevalence from 26 national sample surveys conducted in the Asian and Pacific region during the 1966-84 period. The basic data presented are: contraceptive prevalence rates, cross-classified by age where possible; the percentage of couples using each contraceptive method, also cross-classified by age where possible. To facilitate comparison between countries and across time, the data are presented in a standardized form, both numerically and graphically. Contraceptive prevalence rates range from 1-85% (the highest and lowest ever reported). In the Asian and Pacific region as a whole, the prevalence rate was around 40%, which was about the same level as in the Latin American region. In Africa the prevalence rate was around 12%, and in developed countries around 70%. In the late 1960s, prevalence rates in the Asian and Pacific region were less than 20%. By the early 1980s, contraception had spread throughout all parts of society so that the rates in many countries were over 50%, and in some over 60%. Most of the countries with high prevalence rates were in East and Southeast Asia, and most of those with low prevalence in South Asia. Displayed graphically with the age of wife (from 15-49 years) on the x axis, contraceptive prevalence rates appear as an inverted U, low at both ends of the age range and high in the middle. Curves skewed to the left generally have stronger effects on fertility than those skewed to the right. This is due to the fact that most births occur among younger couples and contraception used by younger couples prevents more births than contraception used by older couples. The curves of countries relying primarily on sterilization are generally skewed to the right. The data show a wide variation in the mix of contraceptives used in each country. The use of various contraceptives by age is similar throughout the region. Young couples generally use oral contraceptives (OCs), those in the middle of the reproductive ages the IUD, and those near the end of the childbearing ages sterilization. Rhythm and withdrawal methods appear to be preferred both by couples in the youngest and oldest age groups. Contraceptive needs change as couples progress through the life cycle. Consequently, family planning programs must work to provide a broad mix of contraceptives. The tables show that Thailand and the Republic of Korea, 2 countries which are thought to have excellent family planning programs, have provided well-balanced mixes of contraceptives. Other countries in the region have depended on only 1 or 2 methods.
MeSH terms: Age Factors; Asia; Asia, Southeastern; Bangladesh; China; Contraception; Contraception Behavior*; Data Collection*; Developing Countries; Family Planning Services; Far East; Fiji; Health Planning; India; Indonesia; Intrauterine Devices; Korea; Malaysia; Nepal; Pacific Islands; Pakistan; Patient Acceptance of Health Care*; Philippines; Polynesia; Population; Population Characteristics; Research Design; Sri Lanka; Thailand
Tetrahymena of the T. pyriformis complex collected from varied habitats in Malaysia, Thailand, and The People's Republic of China include strains of the micronucleate species T. americanis and T. canadensis and the amicronucleate T. pyriformis and T. elliotti. Two new breeding species are described-T. malaccensis from Malaysia and T. asiatica from China and Thailand. Two wild selfers from China and some of the amicronucleate strains from all three countries fall into isozymic groups similar to named micronucleate and amicronucleate species. The T. patula complex is represented by two groups of clones from Malaysia that fit the morphological description of T. vorax. They, however, have radically different isozymic electrophoretic patterns and both groups differ from those of previously described T. vorax. As their molecules indicate relationships to other "T. vorax" strains as distant as that between T. vorax and T. leucophrys, they are considered to be new species, T. caudata and T. silvana. A third new breeding species, T. nanneyi, was identified among strains previously collected in North America. Viable immature progeny were obtained from the new strains of the five breeding species. Maximum temperature tolerances were determined for the new strains of four of the breeding species.
Field surveillance of Cq. crassipes was conducted in an open housing estate near Kuala Lumpur using IMR traps baited with chicken and gerbils. Chicken bait attracted more Cq. crassipes. There was significant difference between chicken and gerbil as bait. The mosquitoes preferred to feed at canopy level. The parous rate was 20.41% and the infection rate for Cardiofilaria nilesi was 2.04%. None of the 120 chicken and 5 ducks, in a village close to the open housing estate, examined for microfilariae were positive. Ar. durhami and Ar. subalbatus did not support development of C. nilesi. However, Cq. crassipes is an extremely efficient vector of C. nilesi.
Of the five diseases generally recognised as causing congenital defects, viz., toxoplasmosis, rubella, cy tomegaloviral infection, herpes simplex and syphilis (TORCHES) studied in Malaysia, rubella was found to be the most important. A total of 574 children with features of congenital rubella syndrome (CRS) were examined for rubella-specific IgM (in infants four months and below), and for rubella HAl antibodies (in children six months to four-years-old), and compared with 374 normal children of the same age groups. Whereas the prevalence rate of rubella in normal children was only 1.3%, in children with CRS (multiple defects) it was 87.3%; with congenital heart disease 71.0%; with congenital cataract 64.0%; with deafness 60.1%; with rash 30.8%; with hepatomegaly 17.1%; with mental retardation 4.1 %. Congenital rubella was not important as a cause of neonatal jaundice (0.9%)
and CNS defects (0%).
19 cases of Kawasaki Syndrome were seen at the University Hospital, Kuala Lumpur between June 1979 and August 1984. The clinical features of the cases are reviewed in this paper. Kawasaki Syndrome is not an uncommon disease in Malaysia and clinicians should be aware of its presentation.
The complications of temporary transvenous endocardial pacing as performed in the University Hospital Kuala Lumpur, from 1971 to 1979 were reviewed. 125 temporary pacings were performed in 111 patients. Different routes of temporary pacing
were used: namely percutaneous subclavian vein and femoral vein puncture and acutecubital vein cutdown. The latter route was associated with a higher incidence of dislodgement and infection. Other common complications encountered were ventricular arrhythymia and generator failure.
This paper is based on the beta-thalassaemia programme at the Duchess of Kent Hospital, Sandakan, Sabah. It seeks to show that a hypertransfusion regimen which improves the quality of life of children with thalassaemia major can be practised in district and general hospitals if there is an organised blood recruitment programme, at least at departmental level. Such a programme reduces the demand on the hardpressed hospitals' blood banks. Frequent and regular transfusions can be given with minimal interference with the school and family life of affected children and reduces immeasurably the social, emotional and financial strain on the affected families. There is also an urgent need to define the magnitude of the problem of beta-thalassaemia through population studies so that genetic counselling can be given and adequate resources can be allocated to improve the quality of life of affected patients.
Four cases of puffer fish poisoning with one death in a family are described. Acute respiratory cessation probably resulted from both depression of the medullary centres and muscular paralysis by the neurotoxin. Artificial ventilation is the single most effective therapeutic measure and should be considered in all severe cases. Delay in treatment may result in death. Anticholinesterases are not known to confer any benefit. Medical staff in coastal hospitals should familiarise themselves with the management of puffer fish poisoning.
This paper deals with our experience of two cases of retropharyngeal abscess due to foreign body. A briefaccount ofthe anatomy. pathology, complications and treatment ofthis condition is given
A case of Aeromonas hydrophila infection complicating an open Rolando's fracture of the hand is reported. Only two cases, both complicating open tibial fractures have been reported in the literature previously.' ,2 The organism was resistant to the usual antimicrobial (ampicillin and cloxacillin) used in the management of open fractures at University Hospital, Kuala Lumpur. The severity of the infection is largely dependent on the resistance of the host, and could vary from a locally spreading necrotizing cellulitis without systemic signs to a frank septicaemia with serious consequences. Early diagnosis with adequate debridement of the wound and appropriate antimicrobial to which the organisms are sensitive, are essential for effective control.
Neonatal epiphyseal separatton of the head of femur is a rare obstetrical injury. This is confused with the more common proximal femoral metaphysical fracture, dislocation of hip or even an infection. Such a case is reported in this paper. Management was conservative, with abduction splint for three weeks and the outcome was satisfactory.
A retained Graefenberg , ring intrauterine. contraceptive device which looked like a fractured Lippes loop on pelvic radiography is presented, and its management outlined.