1. Seven types of water-insoluble adhesives were evaluated in sticky traps for collecting adults of Musca domestica L. and Chrysomya megacephala (Fabricius) or mosquito larvae (Aedes aegypti (L.) and Culex quinquefasciatus Say). 2. Adhesive viscosity affected the tackiness of the glues and this determined their trapping efficiency in air or water. 3. From the 'Hyvis' range of adhesives tested, 'Hyvis 200' was most effective for trapping adult flies. 4. With 24 h exposure to fourth instar Ae.aegypti larvae in tapwater, submerged plates coated with 'Hyvis 10', 'Hyvis 30' or 'Hyvis 200' formulations trapped the majority of larvae. In polluted water the highest rates of trapping were 17.3% of Ae.aegypti and 18.7% of Cx quinquefasciatus with 'Hyvis 200'. Floating traps were consistently less productive than submerged traps under laboratory conditions. 5. In a heavily polluted natural breeding-site of Cx quinquefasciatus, floating traps were more productive than submerged sticky traps with four of seven adhesives tested, the most efficient being 'Hyvis 200' (4.2 mosquitoes per hour) and Hyvis:polyethylene 90:10 (4.5/h). Despite the relative inefficiency of aquatic traps, emergent adults, pupae and second to fourth instars of larvae were collected quickly from the habitat.
MeSH terms: Adhesives*; Animals; Evaluation Studies as Topic; Malaysia
1. Anthropometric variables, resting heart rate and respiratory gas exchange were measured in twelve male and nine female Asiatic adult Moslems during the month of Ramadan, the week before and the month after Ramadan. 2. Energy intakes were estimated from dietary recall during fasting and non-fasting conditions. 3. Both male and female subjects experienced a decrease in body mass with the reduction in energy intake during fasting. Males experienced a greater reduction than females in resting heart rate; females lost more body-weight and subcutaneous fat than males. 4. Urine output and fluid intake were measured in twelve male subjects for 1 d during each week of fasting and 1 d during the pre-fasting control period. Among the subjects examined, the Ramadan regimen did not result in changes in the pattern of fluid exchange.
Required learning of the basic medical sciences based on five clinical problems was compiled by teachers and subsequently derived as 'learning needs' by students during the problem-solving process. These lists of topics were compared in terms of number of lecture-hours and when these were taught in the traditional curriculum. The findings indicate that learning from problems is not entirely free-rein and can be largely determined by teachers; topics taught earlier in the course appeared more frequently than latter topics and there was a tremendous overlap of topics in both the traditional and problem-based list. Regardless of whether lectures have been given or not, students recalled facts better if they had encountered the related clinical problem. This study also reveals that problem-based learning can be as efficient as lectures in content coverage and concludes that the lecture method be retained provided the topics are selective and are derived and sequenced appropriately with clinical problems. Problem-solving should be adopted as a teaching strategy.
The knowledge and clinical and minor surgical skills acquired by 257 medical students in three universities in Sri Lanka and Malaysia were assessed by a questionnaire after they had completed their training period in ophthalmology. This study showed that many medical students graduating from these universities lacked the basic clinical and minor surgical skills essential for a doctor practising in a community in south-east Asia. The responses also indicated that teaching by consultants in all three universities was inadequate and due to these inadequacies the students requested that the duration of their training period be doubled. Ophthalmology is an important component of clinical practice and proper education in this subject is important. An urgent revision of the aims and objectives of the curriculum in ophthalmology is essential to place greater emphasis on this important and much neglected subject, for which very little curricular time is allotted.
MeSH terms: Attitude of Health Personnel; Clinical Competence; Education, Medical, Undergraduate*; Evaluation Studies as Topic; Humans; Malaysia; Ophthalmology/education*; Sri Lanka
Analyses previously reported, based on data from the World Fertility Survey (WFS), are replicated here with data from the Malaysian Family Life Survey. Comparison of results, when data limitations inherent in the World Fertility Surveys are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. Most significantly, these include the greater importance of both breastfeeding and birth spacing under generally unfavorable conditions, the variability of durations to which some benefit of continued breastfeeding persists, and the observation that the great majority of birth-spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths.
PIP: Analyses previously reported, based on data from the World Fertility Survey (WFS) are replicated with data from the Malaysian Family Life Survey, based on a stratified probability sample for 1,262 ever-married women 50 years of age in Peninsular Malaysia. Comparison of the results, when data limitations inherent in the WFS are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. The greater importance of both breastfeeding and birth spacing under generally unfavorable conditions becomes clear. The relationship between breastfeeding and survival for all births, as well as for the last 2 births, emphasized in this model, has a logit coefficint significant at the .01 level for the 1st month of life as well as the period from birth to 1 year. The durations to which some benefit of continued breastfeeding persists, are variable. In countries where the situation generally is more favorable to child survival, as indicated by rates of infant mortality, breastfeeding's positive effects on child survival are less significant. Breastfeeding promotion and continuation should be the goal especially for programs operating among very poor groups. The great majority of birth spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths, as indicated by the fact that significant survival advantages are often associated with birth spacing after controlling for breastfeeding
MeSH terms: Adult; Birth Intervals*; Birth Weight*; Breast Feeding*; Female; Health Status; Humans; Infant; Infant Mortality*; Infant, Newborn; Malaysia; Maternal Age
We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics.
The distribution of serum transferrin subtypes was determined by PAG electrophoresis and isoelectric focussing in a group of 2288 individuals from 10 Mongoloid populations of East Asia. The sample comprised 857 Chinese from different localities: Singapore (239), Malaysia (228), Taiwan (265), Hong Kong (65), Fouzhou (60); Koreans (332), Filipinos (281), Thais (455), Malays (335) and Indonesians (28). The frequencies of TfC1 varied from 0.73 to 0.79 in the Chinese and from 0.76 to 0.83 in the other Mongoloid populations. TfC3 was observed at a frequency of 0.02 in the Koreans and Chinese from Fouzhou. TfDChi was present in a low frequency (0.01 to 0.03) in all the populations. A low frequency of TfB was also present in all the populations. The phenotypic distribution of transferrin subtypes was at Hardy-Weinberg equilibrium in all the populations.
MeSH terms: Adult; Alleles; Far East; Gene Frequency; Humans; Male; Polymorphism, Genetic; Transferrin/classification; Transferrin/genetics*; Transferrin/isolation & purification; Asian Continental Ancestry Group
Computed tomography of the brain was performed in thirty schizophrenic patients in the age group of 19-45 years and thirty controls matched for age and sex The size of lateral ventricles, the width of the third ventricle and the sylvian fissure were measured in the CT scans. On group comparison, we found that the size of lateral ventricles expressed as ventricular brain ratio, and the width of the third ventricle and sylvian fissure were significantly greater in the schizophrenic patients (P< 0.001) as compared to the control group. No correlation was observed between the duration of illness and the cerebral findings. There was no significant difference between the group of schizophrenic patients with a history of having been treated with electro-convulsive therapy and the group without such a history.
Patients at high risk of recurrence or metastases following radical surgery for Stage 1B and 2A cervical carcinoma include those with pelvic node metastases, lymphatic or vascular space permeation in the cervix by tumour cells, large size of the primary tumour, involvement of the full thickness of the cervix and parametrial spread. We report the initial results of adjuvant chemotherapy using a combination of cisplatinum, bleomycin and vinblastine in 22 patients who had undergone Wertheim radical hysterectomy and were thought to be at high risk of developing recurrence. The mean duration of follow-up was 23 months. All are alive after follow-up ranging from 13 to 43 months. Three patients developed recurrences--one in the pelvis, another at the posterior aspect of the urethral meatus and the third developed pulmonary secondaries at 20 to 23 months after surgery. Toxicity from the chemotherapy was acceptable.
A total of 350 strains of group B streptococci (308 from adults and 42 from neonates) were serotyped. The majority of the isolates from adult patients were from the genito-urinary tract and most of the neonatal isolates were from babies less than 10 days old. Serotype III was the predominant type among all groups of patients and accounted for 50.9% of all serotypes. The second and third most frequently occurring serotypes were II and Ic respectively. Together with type III they made up 87% of the isolates.
We determined the prevalence of cholelithiasis, by ultrasound in 728 Asian subjects and calculated the annual incidence of disease amongst the gallstone carriers. The prevalence of asymptomatic cholelithiasis in the age group> 29 years, was 11.8% (95% confidence interval: 7.2-16.4%) in males and 13.7% (8.4-19.0%) in females. The median diameter of the stones 10mm (range 4-17) did not differ from that of symptomatic stones - 12.5mm (3·21). The odds of having cholelithiasis increased by 5% each year of life (p 29 years) developing symptoms leading to a hospltal-based investigation was estimated as only 1/1000, whilst the annual cholecystectomy rate was 6/100,000. The chance of a carrier having a cholecystectomy in Malaysia was approximately 5 times less than the chance in the United Kingdom. We conclude that asymptomatic gallstones are common In Malaysians, but the risk of disease is low. The low cholecystectomy rate may be the result of a conservative approach to cholelithiasis due to limited surgical resources.
MeSH terms: Adult; Age Factors; Cholecystectomy; Cholelithiasis/epidemiology*; Cholelithiasis/surgery; Female; Humans; Malaysia; Male; Probability; Sex Factors
The motoneurons, dorsal root ganglion (DRG) and sympathetic ganglion (SG) cells forming the common peroneal (CPN) and tibial (TN) nerves of young and semiadult monkeys (Macaca fascicularis) were localised by the horseradish peroxidase method of tracing neuronal connections. The motoneurons forming the CPN occur in the L4-L6 segments, appearing as 1-3 groups and occupying the retroposterolateral (rpl), posterolateral (pl) and central (c) groups of motor nuclei. The motoneurons forming the TN occur in the L4-L7 segments, appearing as 1-4 groups and occupying the rpl, pl, c and anterolateral (al) groups. The motoneurons and DRG cells forming the CPN show peak frequencies at the L5 level, and the SG cells forming the same nerve, at the L6 level in most cases. The motoneurons and DRG cells forming the TN show peak frequencies at the L6 level and the SG cells forming the same nerve, also at the L6 level in most cases. The bulk of motoneurons, DRG and SG cells forming the CPN and TN are concentrated in two segmental levels. For CPN the motoneurons measure between 14-76 micron in their average somal diameters and for TN, 16-70 micron. The majority of them (65.5% for CPN motoneurons and 72% for TN motoneurons) have average somal diameters greater than 38 micron. The size spectrum of the DRG cells forming the CPN is similar to that of DRG cells forming the TN, being 12-78 micron for CPN and 10-76 micron for TN. The sympathetic neurons forming the CPN (measuring 10-44 micron) have a larger size spectrum than those forming the TN (measuring 6-33 micron). The diameter spectrum (3-20 micron for TN and 2-19 micron for CPN) and peak frequency distributions (10 micron for both TN and CPN) of the myelinated fibres present in the CPN and TN are also similar, with the CPN fibres skewing towards a slightly larger size. Many of the fibres in the young and semi-adult monkeys are not yet myelinated.
Our experience from 1968 to 1985 in 12 women requiring closed mitral valvotomy during pregnancy is reviewed. All patients had severe mitral stenosis and were in functional class 3 (2 patients) or class 4 (10 patients). Mitral valvotomy was performed between the 18th and the 30th week of pregnancy using a transventricular dilator. Improvement in functional class was noted in all patients postoperatively. One patient had postvalvotomy mitral regurgitation and heart failure, which responded to diuretics; the subsequent course was uneventful. Eleven patients had normal deliveries; whilst one patient had a Caesarean section for an obstetric indication. All babies were normal and there was no maternal death. This series confirms that closed mitral valvotomy can be performed with an acceptable degree of safety during pregnancy, when indicated.
In the 12-year period between 1974 and 1985, 19 children aged between 8 and 12 years with systemic lupus erythematosus (SLE) were seen in the Department of Paediatrics, University Hospital, Kuala Lumpur. A preponderance of females (M:F = 1:2.8) and ethnic Chinese was evident. Renal biopsies revealed a wide Iange of renal morphology, including minimal change glomerulonephritis, focal proliferative glomerulonephritis, diffuse proliferative glomerulonephritis with varying degrees of severity and membranous glomerulonephritis. The majority (15) of patients had clinical SLE at the time of renal biopsy, of whom 4 were also grossly nephrotic. In the remaining 4 patients a diagnosis of SLE was made after further investigation for nephrotic syndrome (2) and acute nephritis (2). The pattern of renal pathology in childhood lupus nephritis appears not to differ significantly from adults.
Key words: Systemic lupus erythematosus, glomerulonephritis
The dental needs, demands and patterns of service utilization were assessed in a randomly selected sample of 750 subjects attending the Dental Faculty, University of Malaya, Kuala Lumpur. Toothache accounted for the most frequent overall dental complaint. However, the most common motives for seeking dental care varied among children (2-12 yr), adolescents (13-18 yr) and adults (19 + yr). The attendance behavior of women is more preventively orientated and more inclined towards rehabilitation compared to that of men. The proportion of normative needs of the patients varies from 7.5% for dentures to 66% for dental caries. About 50% of service utilization for the first visit consisted primarily of extractions in the oral surgery department.
MeSH terms: Adolescent; Adult; Child; Child, Preschool; Dental Caries/therapy; Female; Health Services Needs and Demand*; Health Services Research*; Humans; Malaysia; Male; Oral Health; Patient Acceptance of Health Care*; Toothache/therapy; Urban Population
Margosa oil (MO), a fatty acid-rich extract of the seeds of the neem tree and a reported cause of Reye's syndrome, has been used in the induction of an experimental model of Reye's syndrome in rats. It has been reported that MO causes a decrease in in vivo mitochondrial enzyme activity similar to that seen in Reye's syndrome. We have attempted to uncover some of the biochemical mechanisms of MO's toxicity by examining its effect in vitro on isolated rat liver mitochondria. Male rat liver mitochondria were isolated by centrifugation; oxygen uptake, reduced forms of cytochrome b, c + c1, a + a3, and flavoprotein, intramitochondrial concentrations of acetyl coA, acid-soluble coA, acid-insoluble coA, and ATP content were measured after incubation with and without MO. Our results reveal that MO is a mitochondrial uncoupler. State 4 respiration was increased while the respiratory control ratio was decreased. The intramitochondrial content of ATP was also decreased. There were substantial changes in the reduction of the respiratory chain components after incubation of mitochondria with MO. This decelerative effect on mitochondrial electron transport was alleviated by the addition of coenzyme Q and/or carnitine. These effects of MO on mitochondrial respiration may be due to changes in fatty acid metabolism caused by MO as MO caused a shift in the proportion of acid-soluble or acid-insoluble coA esters. Supplementary therapy with L-carnitine and coenzyme Q may be useful in the management of MO-induced Reye's syndrome.
An investigation into the seasonal changes in the population structure of Haemonchus and Trichostrongylus in tracer goats was conducted over 12 months at Serdang, an area in southern West Malaysia with year-round tropical rainfall. Successive groups of parasite-free tracer goats were grazed for a month alongside naturally infected adult goats and necropsied for worm counts 14 days after their removal from pasture. No hypobiotic larvae of Trichostrongylus were recovered. Hypobiotic larvae of Haemonchus were evident during each month of the year but accounted for only a very small proportion of the total Haemonchus burden. Very low levels were encountered from December through to June. Comparatively higher levels of hypobiosis were observed thereafter with a peak of 7.4% in September. The factors responsible for hypobiosis were not clearly defined but the phenomenon was associated with increasing levels of soil moisture storage. Host resistance, adult worm population of tracers and population of ingested L3 were ruled out as possible inducing factors.
Ciliary-block glaucoma occurred in one eye of a 65-year-old-male, following a combined trabeculectomy and extracapsular lens extraction for long-standing angle-closure glaucoma. After pupillary block was excluded as a cause, a posterior capsulotomy resolved the condition. This procedure was repeated successfully when a flat anterior chamber recurred on spontaneous closure of the initial capsulotomy. The ciliary block appeared to be caused by the residual zonule and lens capsule.