A primary health care system is being developed in Baram District, Sarawak, Malaysia, for the benefit of the Penans, who, until recently, were largely nomadic. Many of them are now attempting to adopt a settled mode of existence, and this in itself creates special health problems because the people lack the skills needed for living in one place. Substantial progress has already been achieved in mother and child care and in immunization coverage.
MeSH terms: Community Health Workers/education; Culture; Delivery of Health Care*; Health Promotion; Humans; Malaysia; Primary Health Care*; Rural Population*
The temporal sequence of drug use should reveal which drugs are precursors to heroin and which drugs are used subsequent to the establishment of heroin addiction as adjunctive drugs. This temporal sequence was examined in an epidemiological study. Out of 249 opiate addicts interviewed in the area of Penang, Malaysia, this sequence of drugs could be obtained in 248 cases. The mean (median) age for first use of nicotine is 15.5 (15) years, alcohol 18.4 (18) years, cannabis 17.8 (17) years, heroin 21.8 (21) years, opium 22.8 (22) years, and benzodiazepines 25.8 (25) years. The age of first use of different drug types is presented in some detail. The patterns of sequence of drug use was analyzed for the five major and most frequently reported drugs, i.e. alcohol, cannabis, heroin, opium and benzodiazepines. Nicotine, used as first drug in almost all cases, was omitted in this analysis. A clear trend to multiple drug abuse emerges from this analysis; the biggest number of cases were users of 4 drugs (81 cases), followed by 3 drugs (59 cases) and 5 drugs (58 cases). Thus, nicotine, alcohol and cannabis are precursors of heroin addiction. Other adjunctive drugs become important only after heroin addiction. Among these substances, opium and benzodiazepines are numerically preponderant.
1. The major phospholipase A2 (PLA-DE4) of the venom of Trimeresurus purpureomaculatus (shore pit viper) has been purified to electrophoretic homogeneity. 2. The isoelectric point of the purified enzyme was determined to be 4.20, and the mol. wt was 31,700 as estimated by Sephadex G-75 gel filtration chromatography; and 14,000 as estimated by SDS-polyacrylamide gel electrophoresis. The purified enzyme hydrolyzed phosphatidylcholine (PC) faster than phosphatidylethanolamine (PE), whereas phosphatidylserine (PS) was not hydrolyzed at all (PC greater than PE greater than PS =0). However, in reaction system consisted of mixtures of PC and PS, phosphatidylserine was effectively hydrolyzed by the enzyme. 4. The phospholipase A2 exhibited edema-forming activity but not hemolytic, hemorrhagic or anticoagulant activities. It was not lethal to mice at a dosage of 10 micrograms/g by i.v. route.
Pseudomonas pseudomallei exotoxin was found to be a potent inhibitor of protein and DNA synthesis in cultured macrophages. Inhibition of DNA synthesis occurred at toxin concentrations as low as 1-2 micrograms/ml and inhibition of 3H-thymidine uptake was almost complete at concentrations of 8 micrograms/ml or more. A close correlation between cell damage and inhibition by DNA synthesis was observed. For protein synthesis, inhibition was obtained at much lower doses (0.06-2.0 micrograms/ml) of the toxin. At similar toxin concentrations, DNA synthesis was marginally affected. Further, it was shown that protein synthesis inhibition occurred almost immediately after incubation, reaching its maximal inhibitory effect of 70% after 6 hr. DNA synthesis, however, was minimally affected by a similar toxin concentration even after 10 hr of incubation. The inhibition of macromolecular synthesis in macrophages by P. pseudomallei exotoxin may be relevant to its modulatory effect on the host defense mechanism.
This study compares the knowledge, attitudes and practice of mothers in two ethnic groups with regard to acute respiratory infections (ARI) in their child. Most had traditional beliefs as to the cause of ARI with only a minority knowing the causes. Most mothers were aware of the effect of frequent attacks of ARI on the health status of their child and of the importance of early treatment. Reasons for their becoming worried during an episode of ARI in their child indicated that problems of distance, transportation and arrangements for care of their other children predominate. A large proportion of the respondents felt that their present knowledge of ARI was inadequate and were thus interested in obtaining more information.
MeSH terms: Adolescent; Adult; Ambulatory Care Facilities; Child Health Services; Cross-Sectional Studies; Ethnic Groups; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Maternal-Child Health Centers; Middle Aged; Mothers*; Respiratory Tract Infections/etiology*; Respiratory Tract Infections/therapy
Although Brachiaria decumbens was not toxic when fed to cattle, the infusion of rumen liquor from B. decumbens intoxicated sheep into the rumen of cattle produced evidence suggesting hepatic and renal dysfunction. Several biochemical changes were observed including increases in serum aspartate amino transferase, serum creatinine and blood urea nitrogen and a marked reduction in the plasma bromosulphthalein clearance.
The reasons underlying the need for extraction of 2765 permanent teeth carried out over a 6 month period in the Out-patient Clinic in the Dental Faculty, University of Malaya, was investigated. The present study showed that dental caries (67.4%) is the leading cause for extraction followed by periodontal disease (19.6%). Caries accounted for the highest proportion of extractions up to the age of 50 whereas periodontal disease becomes the major factor beyond this age. The highest frequency of extractions carried out was between the ages of 21-30.
The fluoride content of several brands of infant milk formulas were determined to approximate that available in the water used in its preparation. It was also found that the public water supply contains a mean fluoride content of 0.379 ppm. The daily fluoride intake derived from infant milk formulas in a fluoridated community is discussed in relation to the recommended dosage.
126 Malay children from higher income families were followed-up regularly from birth to six years of age in the University Hospital, Kuala Lumpur. Their developmental performance was compared to that of Denver children. Generally, Malaysian and Denver children appear to be similar in their development during the first six years of life except for some minor differences in the personal-social, language and gross motor sectors. Malaysians appear to be slower in self-care but more advanced in "helping around the house", "playing interactive games" and in "separating from mother". They were slightly slower in gross motor function during the first year of life but more advanced during the second year of life. However, they were slightly more advanced in language development. The differences in development between the two groups of children are discussed and it is concluded that the differences can partly be explained by differences in socio-economic or cultural differences between the two groups of children. However, the influence of genetic factors cannot be dismissed.
1,256 malnourished children, aged seven to ten years, were selected for study, 575 from Kuala Langat, 416 from Wilayah Persekutuan and 265 from Ulu Selangor. Ninety-three percent of the children were from low socioeconomic groups with large family size, and most of their parents had only primary or no formal education. During the study period, children in Kuala Langat received daily milk supplementation for five days per week, those in Wilayah Persekutuan for two days per week, while those in Ulu Selangor did not receive any milk supplementation. The study shows that a majority of the malnourished primary school children liked to drink milk and that milk intolerance was not a problem among them.
The BIOSELF 110 is a hand-held, non-invasive electronic instrument that measures basal body temperature and cycle length, and automatically identifies the fertile and infertile phases of the menstrual cycle with flashing red light and green light signals, respectively. The device was evaluated in 77 cycles from 33 ovulatory women in Kuala Lumpur, Malaysia. Ultrasound monitoring of maximum follicular diameter (MFD) and urinary LH measurements with Ovustick were used as reference methods to estimate the time of ovulation and the fertile period. Based on the MFD day, the BIOSELF correctly identified the entire fertile period, and at least four fertile days, in 89% and 94% of the cycles studied, respectively. The mean duration of the fertile period as determined by the number of flashing red light days was 11.0 days (SD 2.9). The device correctly identified the onset of the postovulatory infertile phase in 94% of cycles, with a mean duration of about 10 (green light) days. The results were similar using the LH peak day as the reference method. The mean interval from the onset of the fertile period (first flashing red light day) to the MFD day was 6.9 days (SD 2.6), and from the MFD day to the end of the fertile period, 3.1 days (SD 2.2). The BIOSELF 110 showed itself to be a reliable device for identifying the fertile and infertile phases of the menstrual cycle and, thus, should be a useful aid for couples seeking pregnancy. Prospective clinical trials are underway to assess the contraceptive effectiveness of the device.
MeSH terms: Adult; Body Temperature*; Female; Fertility*; Ovarian Follicle/physiology; Humans; Luteinizing Hormone/urine; Menstrual Cycle*; Ovulation Detection/methods; Time Factors; Ultrasonography
A case is described of subdural spinal lipoma with posterior fossa extension and the world literature is reviewed. A high proportion of high cervical lipomas extend into the posterior cranial fossa. Many cases were probably missed in the pre-computed tomography era. Those cases with posterior fossa growth are more likely to be found in infants or those cases with symptoms dating from birth; most present with quadriparesis. All cases of high cervical lipoma demonstrated by myelography should be submitted to brain computed tomography in order to exclude posterior fossa extension and demonstrate the presence of hydrocephalus.
Gonadectomized male mice aged 5 weeks were given 5 mg testosterone propionate daily for 14 days. The treatment significantly decreased the number of blood leukocytes. The number of all individual types of leukocytes except basophils in vehicle-treated gonadectomized mice was increased. Testosterone-treated mice consistently had a lower number of leukocytes after being infected with Plasmodium berghei than did vehicle-treated mice. The results suggest that testosterone suppresses the production of leukocytes and that testosterone-treated mice become more susceptible to parasite infection.
DNA samples from numerous subjects of different racial and ethnic backgrounds, with or without various hemoglobinopathies (classical beta-thalassemia; silent beta-thalassemia, Hb E, sickle cell anemia), were studied for a rearrangement (+ATA; -T) at nucleotide -530 in the 5' flanking region of the beta-globin gene using amplified DNA and 32P-labeled synthetic oligonucleotide probes. The data show that this unusual sequence is a common feature among East-Asians and Blacks (particularly SS patients), and is not associated with mild thalassemic features typical for the silent form of beta-thalassemia, as has been suggested (5).
One hundred years ago cervical cancer was rapidly fatal, regardless of therapy rendered. Today with cytological screening, early diagnosis is possible and ablative therapy can be instituted in appropriate cases. The advent of coloscopy has helped reduce unnecessary cone biopsy for diagnosis. However, the same cannot be said of the use of cytology for screening endometrial cancer, and often endometrial tissue biopsy is necessary. Ovarian cancer is notoriously silent in its early stages and symptoms if present are generally non-specific. To date there is no other useful and reliable method for its early detection than routine pelvic examination. An annual cytological screening test for cervical cancer will give an opportunity for examination of the breasts, abdomen and pelvis. Screening techniques for female genital tract malignancies are discussed.
MeSH terms: Adenocarcinoma/epidemiology; Canada; Carcinoma/epidemiology; Carcinoma, Squamous Cell/epidemiology; Uterine Cervical Neoplasms/epidemiology*; Colposcopy; Female; Humans; Mass Screening*; Ovarian Neoplasms/epidemiology*; Predictive Value of Tests; Risk Factors; Uterine Neoplasms/epidemiology*; Vaginal Smears