Spirometry was performed on 614 female subjects ranging in age from 13 to 69 years and comprising all the main races in Malaysia. They were divided into six age categories. Mean forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were 2.51 +/- 0.02 and 2.31 +/- 0.02l, respectively. Both FVC and FEV1 correlated negatively with age. Regression analysis revealed an age-related decline in FVC of 220 ml per decade of life. Multiple stepwise regression of the data for the prediction of an individual's FVC above the age of 20 years gave an equation: FVC(l) = 0.0312 (height)-0.022 (age)-1.64. Predicted FVC values derived from equations based on other populations were considerably higher than the observed mean in this study. Our study, therefore, reemphasizes the need to be cautious when applying formulae derived from one population to another. Grossly erroneous conclusions may be reached unless predicted equations for lung-function tests for a given population group are derived from studies based on the same population group.
From 1981 to 1989, 12 patients of the University Hospital, Kuala Lumpur, were diagnosed to have Evans syndrome based on direct antiglobulin test (DAT) positive haemolytic anaemia and immune thrombocytopenia occurring either simultaneously (7 patients) or consecutively (5 patients). Their mean age at presentation was 24.8 years with a marked female preponderance. All 12 patients were given high dose steroid after diagnosis. Subsequently, other modalities including intravenous immunoglobulin (1 patient) and high dose methylprednisolone (1 patient) were given. Three patients died of intracranial haemorrhage during the first admission while 1 patient died of pulmonary embolism six months after diagnosis. Three patients had splenectomy because of thrombocytopenia. Six patients tested positive for antinuclear factor and antibodies to double stranded DNA and four of them died. Positive serology appeared to be associated with a poorer prognosis. Follow up observations indicate that patients who survive the acute attacks fare reasonably well.
MeSH terms: Animals; Bone and Bones/anatomy & histology; Bone and Bones/radiation effects*; Femur/radiation effects; Microwaves*; Rabbits; Histocytological Preparation Techniques*
In Malaysia the steady rise in the proportion of people aged 60 or more, and an awareness of their complex psychosocial, economic and health care needs, have led medical faculties to introduce geriatrics as an essential subject in their curricula. The efforts made in this field by the School of Medical Sciences of the Universiti Sains Malaysia are outlined in the present article.
MeSH terms: Aged; Education, Medical, Undergraduate*; Geriatrics/education*; Health Services Needs and Demand; Humans; Malaysia
The outcome of 109 patients with severe head injury was studied in relation to clinical and computed tomographic (CT) criteria on admission, after resuscitation. Age, Glasgow Coma Score (GCS) and state of pupils strongly correlated with outcome. The presence of hypothalamic disturbances, hypoxia and hypotension were associated with an adverse outcome. The CT indicators associated with poor outcome were perimesencephalic cistern (PMC) obliteration, subarachnoid haemorrhage, diffuse axonal injury and acute subdural haematoma. The prognostic value of midline shift and mass effect were influenced by concomitant presence of diffuse brain injury. For the subset of patients aged < 20 years, with GCS 6-8 and patent PMC (n = 21), 71.4% correct predictions were made for a good outcome. For the subset of patients aged > 20 years, with GCS 3-5 and partial or complete obliteration of PMC (n = 28), 89.3% correct predictions were made for a poor outcome.
MeSH terms: Adolescent; Adult; Age Factors; Aged; Brain Edema/etiology; Cerebral Hemorrhage/etiology; Child; Child, Preschool; Humans; Infant; Malaysia; Middle Aged; Predictive Value of Tests; Prognosis; Subarachnoid Hemorrhage/etiology; Tomography, X-Ray Computed; Glasgow Coma Scale
Sera from 420 military personnel serving in Sabah and Sarawk, Malaysia, were tested for antibodies to Pseudomonas pseudomallei exotoxin and whole cell antigens by enzyme-linked immunosorbent assay procedure (ELISA). Data showed that 54.4% of serum samples were positive for antibodies to P. pseudomallei exotoxin and 65.7% were positive for antibodies to the whole cell antigens. Samples gave much lower titers for anti-exotoxin antibodies compared to titers against crude whole cell antigens. The incidence of antibody to exotoxin was highest in the age groups ranging from 26 to 32 years, where the positive rates were higher than 40% and 30% for military personnel serving in Sarawak and Sabah, respectively.
Four hundred and ninety-eight predominantly pyocin-type 10 clinical strains of Pseudomonas aeruginosa were analyzed for resistance to carbenicillin, cefoperazone, cefotaxime, ceftazidime, gentamicin, amikacin and netilmicin. Based on NCCLS-recommended MIC breakpoints, 245 strains were found to be resistant, of which 41.6% were resistant to carbenicillin, 38% to gentamicin, 37.8% to netilmicin, 26.3% to cefoperazone, 17.9% to cefotaxime, 0.6% to amikacin and none to ceftazidime. Quadruple resistance to carbenicillin, cefoperazone, gentamicin and netilmicin was the most frequent pattern observed. Resistance to older antibiotics (kanamycin, streptomycin and tetracycline) and to mercuric chloride were also common. Conjugation experiments suggested that self-transmissible and non-transmissible plasmids occurred in at least 66 strains.
The frequency of Schneider's first rank symptoms (FRS) was studied in 221 Malay patients with functional psychosis. The prevalence of FRS in schizophrenia was 26.7%. The most common symptoms were voice arguing, passivity phenomena and somatic passivity. In the absence of organic brain dysfunction, the specificity of FRS for schizophrenia was 87.8%, and their positive predictive value was 90.6%. These findings indicate that although FRS is not pathognomonic of schizophrenia, their presence should be regarded as strongly suggestive of schizophrenia in the absence of organic etiology. FRS do not however occur with sufficient frequency to have potential diagnostic in schizophrenia.
MeSH terms: Adolescent; Adult; Aged; Cross-Cultural Comparison; Female; Great Britain; Humans; Malaysia; Male; Middle Aged; Pakistan; Psychiatric Status Rating Scales; Saudi Arabia; Schizophrenia/diagnosis*
Gonadectomized male albino rats aged 7 weeks were given 1.5 mg/kg testosterone propionate daily and inoculated with 50 third-stage larvae of Angiostrongylus malaysiensis. The treatment significantly increased the number of larvae and adult worms recovered from the brain and pulmonary arteries, respectively, and the rats exhibited smaller thymus glands. The total numbers of leukocytes, monocytes, neutrophils, and especially eosinophils increased significantly post-infection, but the counts were higher in the untreated infected controls. Presumably, immunosuppressive effects of testosterone may at least partly be responsible for the higher loads of A. malaysiensis worms found in male rats as compared with females in the field.
Three cases of muscular sarcocystosis from West Malaysia are reported. The morphological features of the parasites from these three cases are similar to the eight cases previously reported from this country. A review of this total of eleven cases of muscular sarcocystosis showed that they were all incidental findings, where man acted as intermediate hosts of as yet unknown Sarcocystis spp. These cases of muscular sarcocystosis were probably zoonotic in origin and associated with close contact with definitive hosts (both domestic and wild animals) thus permitting the contamination of food and drink with sporocysts shed by these definitive hosts. These infections were probably acquired locally as most of the subjects were born in Malaysia and none had ever left the country to stay elsewhere. Eight of the eleven cases reported were associated with malignancies, especially of the tongue and nasopharynx.
Pulpal tissue changes following pulpotomies with 2% w/v buffered glutaraldehyde in primary teeth were observed. A 3 minute single application of 2% w/v buffered glutaraldehyde was able to produce effective surface fixation. Limited penetration of the medicament left the remaining pulp tissue unaffected. The zone of fixation did not proceed apically. With time, macrophages and fibroblasts appear apical to the zone of fixation indicating the onset of replacement resorption.
A case report showing the eruption of the left maxillary and mandibular permanent cuspids in a six-year-old boy, is presented. In addition, the dental age of all the permanent cuspids as seen by the eruption and tooth development suggested that the cuspids are comparable to those seen in a 13 to 14 year-old-boy. A search of the literature has not revealed any such reports.
The prevalence, possible etiological factors and management of hypodontia was briefly reviewed. A report of a case of hypodontia affecting the primary and permanent lower incisors was described.
A survey on oral hygiene practices was conducted on 537 dentate adult patients aged 15 years and over. The aim of this study was to investigate the variation in dental behavior with regards to socio-demographic factors, namely age, sex, ethnicity, income, education and occupational status. Patients attending nine randomly selected government dental clinics were interviewed on their daily oral hygiene practices. The majority (89.7%) of the subjects reported that they brushed their teeth, 68% used toothpaste containing fluoride, but only 8.4% flossed their teeth. Generally the younger group had better oral hygiene habits. The higher the socioeconomic status of the adults, the better their toothcleaning practices. Awareness concerning dental floss was low regardless of all the socio-demographic variables. It was concluded that there is a need to improve the dental health practices of adults in Malaysia.
Genetic variation among Malaysian isolates of Salmonella typhi was determined by analysis of ribosomal RNA gene restriction patterns. Of the 20 isolates analyzed, eight different pattern combinations were detected. The amount of variation observed was also dependent upon the restriction endonuclease used; PstI produced more different patterns than did SmaI. The results suggested that disease activity was due to a number of different clones circulating simultaneously rather than a single strain. Further implications of the data are discussed.
We conducted a prospective longitudinal study to determine the nature and prevalence of cardiac abnormalities in systemic lupus erythematosus and to study their natural history and relationship with disease activity. Forty consecutive inpatients with systemic lupus erythematosus were studied during their admission and subsequently 6 to 12 months later. On each occasion a clinical cardiovascular examination was carried out, disease activity was scored using the "Lupus Activity Criteria Count" and a Doppler echocardiographic examination was carried out. 72.5% of patients had an abnormal echocardiogram in the first study while 51.7% were abnormal during the follow-up study. Valvar disease occurred in 37.5% of patients. The mitral valve was most commonly affected. Libman-Sacks endocarditis was rare (2.5%). Pericardial effusions were seen in 36.2% of echocardiograms. The majority (76.0%) of these were associated with hypoalbuminaemia. 80.0% of patients had active disease during the first examination and 41.4% at follow-up. There was no correlation between activity of disease and prevalence of cardiac abnormalities at either examination. We conclude that cardiac disease is common in systemic lupus erythematosus. Prevalence of cardiac abnormality did not correlate with disease activity.
The susceptibility of three strains of Aedes aegypti (L.) to four strains of Ascogregarina culicis were studied under laboratory conditions. The parasite was found to be pathogenic to the mosquito; although pathogenicity varied among geographical strains of A. culicis and susceptibility varied among geographical strains of Ae. aegypti. In addition to affecting the survival of the mosquito larvae, infection with the parasite was found to shorten larval development time. Selected strains of A. culicis may be useful as a biological control agent against Ae. aegypti.
MeSH terms: Aedes/parasitology*; Animals; Female; Male; Pest Control, Biological*; Apicomplexa/physiology*