A prospective study was undertaken of 10 chronic renal failure patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) complicated by repeated bouts of peritonitis treated with gentamicin. Each 10-day treatment course consisted of a 120 mg loading dose, followed by 16 mg in 21 of peritoneal dialysate, given four times a day. Serum gentamicin analysed by enzyme immunoassay showed a mean level of 5.2 micrograms/ml, (range 3.7 to 6.6 mg/ml) four hours after the loading dose. Similar levels, well within the therapeutic range, were maintained on the 3rd, 5th, 7th and 9th days of intraperitoneal gentamicin therapy, suggesting no accumulation of gentamicin in the serum. Pure tone audiometry, electronystagmography and clinical assessment were performed during each course of treatment. Although no evidence of ototoxicity was found during the first two courses of gentamicin, but disequilibrium and bobbing oscillopsia were present during the third and fourth courses of gentamicin. These findings could be explained by cumulative injury to the vestibular apparatus caused by repeated therapeutic insults.
A prospective study was carried out to determine the incidence, clinical presentation, early outcome, and risk factors associated with periventricular haemorrhage (PVH) in 88 (84 per cent) of the 105 consecutive very low birth weight (VLBW) (< 1500 g) Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. Based on the cranial ultrasound findings, PVH was detected in 86 of the 88 neonates (98 per cent, 95 per cent confidence intervals: 95 to 101). Seventeen (20 per cent) of them had grade I, 52 (61 per cent) had grade II, 7 (8 per cent) had grade III and 10 (12 per cent) had grade IV PVH. PVH was detected in all the affected neonates by the fifth day of life. Sixty-four neonates (74 per cent) were symptomatic when PVH was first detected. Shock (P < 0.01), pallor (P = 0.028), low haematocrit of less than 40 per cent (P < 0.01), convulsion (P < 0.001), and bulging of anterior fontanelle (P = 0.019) were significantly more common in the neonates with severe PVH (grades III or IV). Death occurred in 43/86 (50 per cent, 95 per cent confidence interval: 39-61 per cent) of the neonates with PVH before their first discharge from the hospital. Ventriculomegaly developed in 29/43 (67 per cent, 95 per cent confidence intervals: 54.4-81.4) of the survivors with PVH. Our study suggests that PVH is a common problem in the Malaysian VLBW neonates. To reduce the incidence and severity of this condition, prevention of preterm delivery and improvement in the basic facilities for neonatal care would help.
MeSH terms: Brain Diseases/diagnosis; Brain Diseases/physiopathology; Cerebral Ventricles/physiopathology*; Cerebral Ventricles/ultrasonography; Female; Health Promotion; Hemorrhage/diagnosis*; Hemorrhage/epidemiology; Hemorrhage/physiopathology; Humans; Infant, Low Birth Weight*; Infant, Newborn; Malaysia/epidemiology; Male; Prospective Studies; Risk Factors; Severity of Illness Index; Age of Onset
Zooplankton samples were collected from the indigenous tropical brackish water lagoon during the wet monsoon (January and February 1990) and the dry monsoon (April and May 1990). The dominant copepod species in the zooplankton community comprising of Oithona sp (especially O. nana and O. robusta) accounted for more than 70% of the zooplankton in January and was gradually replaced by other zooplanktonic species later in the dry season. The lipid contents in zooplankton varied from 0.18 to 1.04% wet weight or 1.14 to 5.92% dry weight respectively. The major fatty acid contents of the zooplankton showed high concentration of 14:0, 16:0, 18:1, 20:5 omega 3 and 22:6 omega 3 especially in the wet season. It also contained high omega-3 highly unsaturated fatty acid series necessary for the growth of commercial fish larvae. It has a better food value than the normally use food organism, brine shrimp; thus reflecting its potential use as food organism for fish larval rearing.
Hepatitis C virus (HCV) is the chief aetiologic agent for the parenterally transmitted Non-A, Non-B (NANB) hepatitis. This preliminary study was done to determine the prevalence of anti-HCV in the blood donor population. Blood from 3,540 donors who donated blood to the Blood Services Centre, Hospital, Kuala Lumpur, from 25th August 1991 to 13th January 1992, was tested for anti-HCV using both the Ortho and Abbott 2nd Generation ELISA test kits. ELISA positive specimens were repeated twice but no confirmatory test was done. There were 53 out of 3,540 (1.49%) blood donors who were repeatedly reactive to anti-HCV by ELISA. We plan to do further tests to confirm the results, using RIBA-2 or Abbott Neutralising test. Twenty eight out of 1,713 (1.63%) Malays, 22 out of 1,373 (1.60%) Chinese and 2 out of 393 (0.50%) Indians had antibodies to HCV. There was no significant difference in prevalence in the different age groups. The majority of donors tested were males (3,511 out of 3,540) of which 53 (1.50%) were anti-HCV positive. Only 29 females were tested and all were negative. To determine infectivity of the anti-HCV positive cases we would like to introduce testing for RNA by polymerate chain reaction (PCR). Screening all donated blood for anti-HCV will decrease, but not totally eliminate, post-transfusion hepatitis.
The distribution of restriction fragment length polymorphism (RFLP) at the BamH1 site of the beta-globin gene was investigated in the Chinese, Indian, and Malay race in Singapore. The sample comprised of 183 normal individuals and 35 beta-thalassemia carriers in which 13 were couples with at least one beta-major child. The results from this study indicate that BamH1 polymorphism will be informative in 22% of pregnancies at risk for beta-thalassemia major in Chinese, 19% in Malays and 7% in Indians. In prenatal diagnosis using BamH1 polymorphism for one beta-major affected family, the fetus was diagnosed to be normal or beta-carrier. The validity of BamH1 polymorphism in the exclusion of beta-thalassemia major was subsequently confirmed at birth by globin chain biosynthesis.
1. The effect of tocotrienol and tocopherol on glutathione S-transferase (GST) and gamma-glutamyl transpeptidase (GGT) activities in cultured rat hepatocytes were investigated. 2. Tocotrienol and tocopherol significantly decreased GGT activities at 5 days in culture but tocotrienol also significantly decreased GGT activities at 1-2 days. 3. Tocotrienol and tocopherol treatment significantly decreased GST activities at 3 days compared to the control but tocotrienol also decreased GST activities at 1-3 days. 4. Tocotrienol showed a more pronounced effect at a dosage of greater than 50 microM tocotrienol at 1-3 days in culture compared to the control.
The residual effectiveness of 0.005mg/ml of cyhalothrin applied to cattle was determined against three species of mosquitos: Anopheles maculatus Theobald. Anopheles dirus Peyton and Harrison Mansonia uniformis Theobald. Twenty-four hour post exposure mortality and the degree of successful blood engorgement were determined by exposing mosquitos for 10 minutes to cattle. Three replicated assays were conducted and mortality determined at 1, 2, 7, 14 and 21 days after each treatment. An initial mortality of 92-94% for An. dirus and Ma. uniformis and 79% for An. maculatus was obtained. Percentage mortality declined to 10%, 18% and 31% for An. maculatus, An. dirus and Ma. uniformis respectively on day 7 post application. On day 21 post application, percentage mortality was 2-3% for the three species of mosquitos.
MeSH terms: China/ethnology; Great Britain; History of Nursing*; Humans; Malaysia; Red Cross; Refugees*; Warfare*; Transcultural Nursing; History, 20th Century
Eight cases of liver failure and encephalopathy were observed among twenty cases of grade 3 and grade 4 dengue hemorrhagic fever/dengue shock syndrome admitted to the Department of Pediatrics, University Hospital, Kuala Lumpur from January 1990 to December 1991. All patients with deterioriation in mental status showed a marked increase in liver enzymes (aspartate and alanine aminotransaminases) and severe coagulopathy. Six patients needed cerebral protection, including ventilation, intravenous sedation and muscle relaxants. There was one death during the period of study and one case of residual hemiparesis in a boy who had, in addition, intracerebral hemorrhage. All other survivors had complete recovery of liver and neurological function.
A dot enzyme immunoassay for determination of antibodies to Japanese encephalitis virus was designed for use as a field technique for the surveillance of Japanese encephalitis virus activity among domestic pigs. The test was compared with the neutralization test and the hemagglutination inhibition test and found to be more sensitive than the hemagglutination inhibition test and comparable to the neutralization test in sensitivity but more simple to perform than either the neutralization or the hemagglutination inhibition tests. An IgM capture ELISA for the determination of JEV specific porcine IgM was also utilized to determine current infection rates in pigs. The tests which do not involve the determination of specific IgM are better used for testing sentinel animals for providing clues as to the rate of transmission of JEV among pigs. IgM tests determining acute infection are less likely to be useful unless animals are tested very frequently or if a great number of animals are tested at any one time.
The occurrence of adult Gnathostoma malaysiae in Rattus surifer and R. tiomanicus in Malaysia has been reported but there are no known reports on the host tissue reactions. This paper reports on the gross pathology caused by G. malaysiae in a red spiny forest rat, R. surifer and the tissue reactions caused. A tumor-like growth was located on the mid-stomach wall in a female rat captured in Gunung Bachock, Kelantan, Malaysia. This growth consisted of four tunnel-like structures containing sanguinopurulent fluid and leukocytes and this structure led into a central canal. The tissue surrounding the tumor was greatly inflamed and there was localized gastritis. The tunnel-like structure was surrounded by dense fibrotic tissue. The stomach wall was devoid of superficial epithelium and smooth muscle but mucinous glands were present. The midregion of the fibrotic scar contained eggs of G. malaysiae which had evoked a strong tissue reaction and were surrounded by pus. Blood vessels were empty, dilated and had undergone vasculitis and thrombosis.
Collections of anopheline mosquitos were made twice monthly for 13 months from a cow-baited trap in two villages, Kampung Permatang Rawa and Sungai Udang Kecil, on mainland coastal Penang, Malaysia. Each collection period was six hours from sunset. Unquantified larval collections were made regularly in each area. Although the villages were only about 50km apart, and each had extensive, irrigated rice-fields in its vicinity, the species abundance and the seasonal fluctuations differed significantly. In Kampung Permatang Rawa Anopheles sinensis and An. peditaeniatus were dominant in prevalence, whereas in Sungai Udang Kecil An. indefinitus and An. lesteri paraliae were most common and An. peditaeniatus was relatively rare. The rice growing schedules in the two areas differed, but there was a moderate correlation between the abundance of several species and the rice-growing pattern. There was no correlation at either site with rainfall.
MeSH terms: Agriculture; Animals; Breeding; Ecology*; Larva/growth & development; Malaysia; Oryza; Seasons*; Time Factors; Water Microbiology*
The host preferences of eight species of anophelines were studied in two coastal Malaysian villages, Kampung Permatang Rawa and Sungai Udang Kecil, by seven 12-hour catches in each village. Collections were made concurrently from a human-baited net trap, a cow-baited net trap and by human-bait landing catches. Anopheles campestris was attracted almost equally to man and cow, but An. lesteri paraliae, An. nigerrimus, An. peditaeniatus, An. sinensis, An. indefinitus, An. subpictus and An. vagus showed a strong preference for the cow bait. The human-bait landing catches were more productive than the human-baited net trap, which attracted very few mosquitos. Seven more all-night catches were made at each village employing only the cow-baited trap, and the combined data were used to plot the biting-cycles of each species at each site. Although the biting-cycles at the two localities were in general agreement, there were notable differences. At Sungai Udang Kecil, where the collection site was relatively sheltered, several species showed a steady decline in numbers from sunset to sunrise. At Kampung Permatang Rawa, on the other hand, where the site was more exposed and close to the sea, the same species showed a bimodal pattern of activity with an early evening peak followed by a decline then a period of increased activity before sunrise rising to a second, lesser peak at 0500-0600 hours.
A survey was conducted to document the blood pressures of two indigenous groups (Kadazans and Bajaus) who reside in rural Sabah in East Malaysia. Their health knowledge status is also recorded. Fifty percent of those surveyed were unable to associate high blood pressure with a risk factor and as high as 38% were unaware of the consequences of high blood pressure. A total of 16.2% had blood pressures > or = 140/or 90mm Hg while 3.9% had blood pressures > or = 160/or 95mm Hg. While these figures are low compared to those of developed countries, lifestyle changes associated with rapid urbanization in Malaysia may be expected to increase hypertension prevalence. The strengthening of health education programs is timely as health knowledge is limited and many hypertensives default treatment.
MeSH terms: Adult; Aged; Blood Pressure; Borneo/epidemiology; Developing Countries*; Ethnic Groups*; Female; Health Planning; Health Services Needs and Demand; Humans; Hypertension/diagnosis; Hypertension/ethnology*; Hypertension/prevention & control; Hypertension/psychology; Health Knowledge, Attitudes, Practice*; Life Style; Male; Middle Aged; Population Surveillance*; Risk Factors; Rural Population*; Urbanization; Prevalence