Our previous study showed vitamin E deficiency in newborns (69.7%) and mothers at term (85.9%) when the ratio between serum vitamin E in mg/dl and total lipids in g/dl was used as an indicator of vitamin E status. This study was conducted to determine the human milk content of vitamin E. During the first 12 days of lactation milk vitamin E levels remained almost constant (day 1, 0.68 mg/dl; day 12, 0.65 mg/dl), milk total lipid levels increased daily (day 1, 1.11 g/dl; day 12, 3.60 g/dl), and the ratio between milk vitamin E and total lipids dropped steadily (day 1, 1.3; day 12, 0.2). In spite of this drop in vitamin E status, it is unlikely that vitamin E availability will be affected in neonates, because normal neonates absorb milk fats well and this ability increases with age.
Sera from 200 Malaysian male drug abusers were tested for markers of Hepatitis B virus (HBV) infection, viz. HBsAg, HBeAg, anti-HBs and anti-HBc using commercially available enzyme immunoassay (EIA) kits supplied by Abbot Laboratories, Chicago. Of these, 103 (51.5%) were positive for at least one HBV marker, 11 (5.5%) were positive for HBsAg; 4 (2%) for HBeAg, 74 (37%) for anti-HBs and 85 (42.5%) for anti-HBc. The HBsAg carrier rate was roughly the same as the carrier rate in the general population of Malaysia. The majority of drug abusers (95%) have had subclinical, asymptomatic HBV infection. Racially the Malay drug abusers had the highest exposure rate (54.2%). The HBsAg carrier rate was highest in the Chinese drug abusers (15.3%) and lowest in the Indians (0%). The mean age for the HBsAg carriers was found to be 26 years with a mean duration of drug abuse of 72 months. The Malaysian Anti-Narcotics Task Force of the National Security Council reported in the Malay Mail (July 13, 1985) that there were about 106,000 identified drug abusers in Malaysia and that 63% of these were in the 20-29 age groups. It appears from our study that this age group also coincides with the period of high HBsAg carrier rate. Age wise, those less than 21 years old had the highest HBsAg (11%) and HBeAg (5.6%) prevalence rates indicating high infectivity. After the age of 30 years, nearly 50% of the drug abusers appear to be immune with the HBe prevalence of 0%.(ABSTRACT TRUNCATED AT 250 WORDS)
MeSH terms: Adolescent; Adult; Age Factors; Hepatitis B/epidemiology*; Hepatitis B Antibodies/analysis*; Hepatitis B e Antigens/analysis*; Hepatitis B Surface Antigens/analysis*; Humans; Malaysia; Male; Middle Aged; Substance-Related Disorders/complications*
Sera from one hundred and fifty nine Malaysian individuals were screened for the prevalence of delta markers. These included 15 HBsAg positive homosexuals, 16 acute hepatitis B cases, 9 chronic hepatitis B patients, 13 healthy HBsAg carriers and 106 intravenous (i.v.) drug abusers, of whom 27 were positive for HBsAg only and the rest were anti-HBc IgG positive but HBsAg negative. The prevalence of delta markers in the homosexuals was found to be 6.7%, in the HBsAg positive drug abusers 17.8%, in acute hepatitis B cases 12.5%. No evidence of delta infection was detected in healthy HBsAg carriers, chronic hepatitis B cases and HBsAg negative i.v. drug abusers. With reference to i.v. drug abusers, the prevalence of delta markers was higher in Malays (23%) than in Chinese (7%) although the latter had a higher HBsAg carrier rate. Although the HBsAg carrier rate in the homosexuals was high, their delta prevalence rate was low as compared to drug abusers. In Malaysia, as in other non-endemic regions, hepatitis delta virus transmission appeared to occur mainly via the parenteral and sexual routes. This is the first time in Malaysia that a reservoir of delta infection has been demonstrated in certain groups of the population at high risk for hepatitis B.
A KAP study on dengue/dengue haemorrhagic fever (DF/DHF) was carried out in three areas in the Federal Territory. The three areas were selected based on their ethnic group composition and were Jinjang North (Chinese), Kampung Bahru (Malays) and Sentul (Indians). Houses were selected by a systematic sampling method and house-to-house interviews were carried out with a pre-tested, predesigned questionnaire. 546 (87.62%) of the households responded.
MeSH terms: Adult; Aedes/microbiology*; Attitude to Health; Dengue/prevention & control; Dengue/transmission*; Humans; Malaysia
The stress process and events of later life are more irreversible and chronic as compared with those of young adulthood Coping is defined as "things that people do to avoid being harmed by life-strains". This study looks at the coping status of non-institutionalised ill elderly in Holbaek, Denmark. A structured questionnaire was carried out on 500 elderly, aged 70 years and above. Coping status was found to be associated with income, social network, functional capacity and communications ability. The poor copers used more home help and home nursing services. Effective informal social network and functional capacity were found to be important determinants of coping status. The study recommends that besides strengthening the informal social networks of the elderly, they should also be given coping focussed counselling.
From January 1980 to December 1982, there were 222 MEDEVAC patients admitted to Mid Hospital, out of whom 206 had their case notes available for this study. The median age of the 206 patients MEDEVAC was 24.5 years and the male to female ratio was 1.2 : 1. The Kenyah, Iban, Punans, Kelabit, Kayan and Murut ethnic groups contributed most of the cases. There was some seasonal variation in the number of MEDEVAC done, the high months being July and December and the low periods in May/June and October/November. Most of the MEDEVAC were requested by ground staff at the remote rural clinics and also district hospitals. The median duration of stay of the patients was 9.7 days. The top five causes for MEDEVAC were: bronchopneumonia; accidental falls; gastroenteritis; peptic ulcers; and appendicitis. 7.8% of the MEDEVAC died in hospital. The management of cases ranged from conservative management to blood transfusions to surgical interventions. Based on the criteria set, 63.6% of the MEDEVAC were considered justified.
We questioned 180 patients with end-stage renal disease on maintenance haemodialysis, chronic ambulatory peritoneal dialysis and those who had undergone renal transplantation at the Department of Nephrology, General Hospital, Kuala Lumpur. Twelve patients (6.7%) had consumed excessive quantities ofanalgesics prior to the institution of long-term dialysis or transplantation. Primary renal disease was considered to be analgesic nephropathy in seven patients (3.9%); in five patients (2.8%), analgesic abuse could have been a contributory factor to end-stage renal failure. Analgesic nephropathy is hence an uncommon cause of end-stage renal disease in Malaysia. However, it is important to be aware of the problem and to institute preventive measures as the cost of treatment for end-stage renal disease is prohibitive.
A total of 45 patients with IgA nephropathy were seen at the Department of Nephrology, General Hospital, Kuala Lumpur and the Department of Medicine, Universiti Kebangsaan Malaysia (National University ofMalaysia) between January 1982 to June 1985. This represents an incidence of 10.7% of all primary glomerulopathies. There does not appear to be any racial predilection and the clinicopathological features generally conforms with those reported elsewhere. However it seems to be as common in females as in males but the latter have a worse prognosis. The high incidence of renal failure and hypertension in our patients within the short follow-up period is noteworthy.
Skeletal radiographs of 122 patients treated by maintenance haemodialysis were reviewed retrospectively for bone disease. Significant radiological bone changes were very low at commencement of dialysis (2- 9%), as well as at six months of dialysis (6.1%). This figure rose to 19.7% when the total period of dialysis was considered. In the latter group, fractures occurred in seven patients (5.7%), erosions in 12 patients (9.8%), vascular calcification in 13 patients (10.7%) and osteosclerosis in eight patients (6.6%). Osteoporosis was noted to be very common (76.2%). Significant bone changes are hence rare in maintenance haemodialysis patients in Malaysia.
MeSH terms: Bone and Bones/radiography; Renal Dialysis*; Hospitals, General; Humans; Kidney Failure, Chronic/therapy; Malaysia; Renal Osteodystrophy/radiography*; Retrospective Studies; Risk
A study was carried out on 16 cases of leptospirosis with acute renal failure (ARF) detected in adult patients admitted into the Medical and Nephrology wards of the General Hospital, Kuala Lumpur, over a four-year period from 1980 to 1983. Most of the cases were male, Malays and older adults. The predominant infecting serovars were L. celledoni (of the serogroup L. javanica and L. pomona (of the L. pomona serogroup]. All the cases survived, including those who required peritoneal dialysis. The sensitised erythrocyte lysis (SEL) antibody prevalence rate of the chronic renal failure cases (10.4%) was found to be similar to that of the healthy population in West Malaysia (12. 7%), confirming the observation by other workers that leptospirosis is not an important cause of chronic renal failure.
45 patients (50 eyes) were treated for juvenile rhegmatogenous retinal detachments between August 1979 and July 1984. A review of these cases revealed high myopia and trauma to be the main aetiological factors. Eight-six per cent detachments were successfully reattached. Visual acuity of 6/36 or better was present in 16% preoperatively and in 52% postoperatively, some of the characteristics of juvenile rhegmatogenous retinal detachments in Malaysian population are discussed.
The light microscopic features of the dentine in three teeth from two cases of osteogenesis imperfecta (OJ) are presented. Results show that teeth in OJ distinctively have a more uniform and tubular mantle dentine, and a characteristic laminated circumpulpal dentine formed by distorted incremental bands alternating with parallel rows of interglobular dentine and interrupted by comet-shaped vascular canals. The study indicated that in the absence of overt OJ features, the changes in dentine alone are sufficiently characteristic to establish such a diagnosis.
Barium enema hydrostatic reduction was carried out for eight patients with Intussusception over a six-month period. There were five successes (62%) and three failures. There were no mortality or complications arising out of this procedure. The technique is discussed. This procedure offers many advantages over surgical reduction. However, it is not a substitute for surgery which is still indicated in the sick infants and in those where hydrostatic reduction failed.
A case of benign cystic teratoma, sufficiently large to present as an abdominal mass with pressure signs on the right ureter in a two-year old child is presented, the lowest age in this country recorded.
The neuroleptic malignant syndrome is a rare but potentially fatal complication of neuroleptic administration. Many clinicians may not be familiar with this complication. This case report highlights the clinical features of neuroleptic malignant syndrome and its management.
MeSH terms: Aged; Dementia/drug therapy*; Drug Therapy, Combination; Female; Humans; Neuroleptic Malignant Syndrome/diagnosis*; Thioridazine/adverse effects*; Thioridazine/therapeutic use
An unusual case of fibrous epulis in a newborn is presented. The clinical appearance, histological features and method of treatment are described. A short review of the literature is also included.
This study examines the possibility that estimation of the effect of breast-feeding on infant survival is affected by selection bias, in that children who are healthier at birth may be more likely to be breast-fed. Data are from the 1976 Malaysian Family Life Survey. "Ordinary logit models for breast-feeding and survival are estimated, and the results suggest that selection is indeed present. For example, children of higher birth weight appear to be more likely to be breast-fed and likely to survive. In addition, weight at birth and the duration of breast-feeding appear to be linked." Using birth weight as an indicator for the child's health, the authors conclude that "the direct influence of breast-feeding on survival remains of overwhelming importance even after corrections for selection bias are made."
MeSH terms: Asia; Asia, Southeastern; Biology; Birth Weight*; Body Weight; Breast Feeding*; Child Welfare*; Demography; Developing Countries; Health; Infant Mortality*; Infant Nutritional Physiological Phenomena; Malaysia; Models, Theoretical*; Mortality*; Nutritional Physiological Phenomena; Physiology; Population; Population Dynamics; Research; Research Design; Bias (Epidemiology)*
MeSH terms: Ambulatory Care; Asia; Asia, Southeastern; Delivery of Health Care; Developing Countries; Diagnosis; Endoscopy; Evaluation Studies as Topic*; Family Planning Services; Health; Health Facilities; Health Planning; Humans; Malaysia; Organization and Administration; Patient Acceptance of Health Care*; Laparoscopy*; Physical Examination; Sterilization, Reproductive*; Program Evaluation*