Ischemic heart disease is a leading cause of morbidity and mortality in Malaysia. Management strategies for this disease have changed dramatically. This article, based on discussions of real cases, reviews current treatment methods for various patient subsets, with acute myocardial ischemia.
This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
Study site: Outpatients Department (OPD), Hospital Ipoh, Perak, Malaysia
MeSH terms: Ambulatory Care Facilities; Asthma; China/ethnology; Chronic Disease; Cross-Sectional Studies; Diabetes Mellitus; Hospitals, General; Humans; Hypertension; India/ethnology; Malaysia/ethnology; Morbidity; Outpatient Clinics, Hospital; Outpatients; Primary Health Care; Respiratory Tract Infections; Public Health Practice
Anaemia still constitutes a public health problem in the world, especially in the developing countries (1). Nutritional deficiency remains a major causative factor (2). During pregnancy, growth of the foetus, placenta and the larger amount of circulating blood in the expectant mother will lead to an increase in the demand for nutrients, especially iron and folic acid. Many women start their lives with insufficient iron stores, but also, because of inadequate child spacing, they have little time to build up their iron levels between pregnancies. In pregnancy, anaemia has been shown to be associated with an increased risk of maternal and fetal morbidity and mortality (3,4,5). Iron and folic acid supplementation is routinely given to pregnant mothers in Malaysia. It is anticipated that pregnant mothers who comply strictly with the prescribed iron supplement will maintain adequate iron stores at parturition. However, the compliance rate among rural mothers in Kelantan is often poor (6). Kelantan is also one of the most socio-economically underdeveloped
MeSH terms: Anemia; Folic Acid; Health Surveys; Humans; Iron; Malaysia; Mothers; Pregnancy; Rural Population; Women
Strasser R, Rourke J, Anwar I, Naidoo N, Rabinowitz H, McLeod J, et al.
ISBN: 0 7326 0961 5
Citation: Strasser R, Rourke J, Anwar I, Naidoo N, Rabinowitz H, McLeod J, Newbery P, Aziz T, Rosenblatt R, Lee SH, Wynn-Jones J, Rajakumar MK, Yuan G, Chater B, Doolan T, Cowley J, Simpson C. Training for rural general practice. Traralgon , Victoria, Australia: Monash University School of Rural Health; World Organization of Family Doctors (WONCA), 1995
The objective of this study was to assess the nutritional status of children in FELDA Sungai Koyan, Pahang. Anthropometric measurements were taken from 105 children comprising of 62 boys and 43 girls aged 12 to 72 months. Food intake records from 84 of these children aged 4-6.9 years were obtained. Socio-economic factors which may influence nutritional status were also studied. The anthropometric assessment showed that 14.3% (n=15) of the children were underweight, 10.5% (n=11) stunted and 2.9% (n=3) wasted when compared with the NCHS Reference. It was also found that 28.6% (n=30) of the children had low mid arm circumference for age according to the Frisancho reference, indicating a low protein calorie reserve. The result of the dietary study showed that the intake of calories, calcium, niacin and thiamine were below the recommended daily allowances (RDA) for Malaysia. However, the intake of protein, iron, vitamin A, riboflavin and vitamin C were above the RDA levels. Foods most frequently taken were rice, fish, milk and meat. Vegetables and fruits were also often consumed by the children. Based on the Pearson correlation test, a significant relationship was shown between the nutritional status of the children (weight for age and height for age) with the mother’s educational level, and the number of children in the family. There was also a significant relationship between mother’s nutrition knowledge and the nutritional status of the children (weight for age). Inadequate calorie intake is one of the important factors involved in the causation of protein energy malnutrition. This problem is influenced by socio-economic factor such as low educational level and nutrition knowledge of mothers and large family size. Parents should be encouraged to participate in activities that enhance nutrition knowledge and promote good nutritional practices. FELDA is encouraged to organize more such activities.
Research performed in four fishing villages in the district of Semporna, Sabah revealed a total 55 species of intertidal marine organisms were being utilized as source of food. Specimens were collected during low tides by accompanying the local people. The villages involved were Kg. Panjl, Kg. Bangau-Bangau (a resettlement area for the Sea Bajaus), Kg. Air and Kg. Kebimbangan. Idenfication of species was based on illustration described in texts as well as comparing with the collections in local muziums. Local name for each species was obtained from the population living within the vicinity of coastal areas. The total number of species collected, however, differed among the villages. Chemical analysis based on A.O.A.C of several species indicated variations in nutritive values and trace metals as well as lead content.
Food consumption of 50 female students in Universiti Kebangsaan Malaysia was recorded for 7 days. Foods and drinks most frequently consumed were selected for analysis of iron, zinc, copper and lead content. The mean daily intakes of energy, protein, carbohydrate and fat among the students are 6.5±1.4 MJ (1550±335 kcal), 59.8±18.5g. 227. 1±54.6 g and 46.0±11.5 g respectively. This diet contributed 19.6±6.4 mg Fe, 7.0±2.0 mg Zn and 1.6±0.6 mg Cu per day which were lower than the Malaysian RDA for Fe and US RDA for Zn, while Cu is within the recommended range. The main sources of these minerals in the student’s diet were rice, rice products, meat and animal products. Lead concentration in the diet (134±77 ug/day) is below the acceptable daily intake (ADI) value suggested by Codex Alimentarius Commission (1984). This study indicated concern regarding the low intake of the essential trace elements on long term basis among the students.
An examination of the fat composition of the diet of a Malaysian urban hostel population obtained by chemical analysis of representative meals prepared by a 7-day rotation menu, revealed both nutritional attributes and limitations when compared against the dietary messages contained in the American Heart Association (AHA) and World Health Organisation (WHO) models. The Malaysian diet supplies 26% kcal i.e. 66 g total fat (51 g vegetable fats, 15 g animal fats) and contains
MeSH terms: American Heart Association; Animals; Diet; Food Habits; Rotation; United States; Vegetables; Meals
The objective of this paper is to assess the perception of bodyweight status among the office workers in two government departments in Kuala Lumpur. A total of 385 Malay workers aged between 18 to 55 years were randomly selected from the Prime Minister’s Department and the Ministry of National Unity and Community Development. The weights and heights of all subjects were measured and their Body Mass Index (BMI) determined. In this study, obesity is defined as individuals having ï‚³ï€ 25 kg/rn 2 . A questionnaire was prepared to obtained information on socioeconomic status, health aspects, dietary intakes, activity levels and perception on bodyweight status. The study revealed a high prevalence of obesity (38.1 %) and among the obese subjects, 21.7 % perceived themselves as having normal weight. The normal weight and underweight subjects perceived themselves as obese (33.5 % and 6.3 % respectively). A small percentage (5.7 %) of the obese individuals who perceived themselves as obese did not wish to lose weight. In contrast, 9.7 % of the normal weight subjects who perceived themselves as having normal weight wanted to lose weight. A third person’s perception on the subjects’ bodyweight status is significantly associated with the subjects’ bodyweight status (P
MeSH terms: Adult; Body Weight; Cross-Sectional Studies; Female; Humans; Malaysia; Malaysia/ethnology; Male; Obesity; Perception; Surveys and Questionnaires; Body Mass Index; Prevalence
A study was carried out to investigate whether smoking had any effect on the Langerhans cells in the oral mucosa, which might throw light onto the mechanism of malignant transformation of some keratotic lesions in the oral cavity. Thirty-two cases of keratotic lesions from biopsy specimens of smokers and non-smokers were studied. Langerhans cells were identified by immuno cytochemical staining for 5100 proteins and their densities quantified. Smokers were associated with a significant reduction in the Langerhans cell population compared to non-smokers. The mean values of Langellans cell density in light smokers and heavy smokers were 2 2 2 28.64/mm and 33.421mm respectively compared to 66.51/mm in non- smokers. There was a dose-response relation between the number of cigarettes smoked daily and the effect on cell counts. These findings of a local immunological effect of smoking on oral epithelium may explain the means by which cigarette smoking contributes to the development of oral cancer.
A 73.1 percent response rate was obtained in a postal questionnaire survey conducted among Malaysian dentists to assess their attitudes and needs for continuing dental education. It appeared that on an average the Malaysian dentist spent very little time on continuing education,reading journals and participation in professional dental meetings.The need for continuing education was strongly evident as almost all dentists indicated that such activities be further developed in Malaysia. Crown and Bridgework, Oral Surgery and Orthodontic appeared to be areas in which more continuing education were required.
A postal questionnaire concerning the Malaysian dentists' attitudes towards their patients yielded a 73.1% response rate. The results of this study indicated that a majority of dentists felt that patients had more negative than positive attributes. Private practitioners attributed more negative traits to their patients than their public sector colleaques. About 88% of dentists indicated that the most negative patient attribute was fear of pain. Fear of pain was perceived to be stronger than fear of the dentist (62.2%). likewise the patients' inability to seek treatment soon enough (78.4%), to come for regular check-up (72.7%) and to follow advice on personal oral hygiene(70.1%) were worrisome.
MeSH terms: Attitude; Dentists; Emotions; Fear; Humans; Oral Hygiene; Pain; Surveys and Questionnaires; Public Sector
The aim of the article is to report on the perception of utilizers of government dental services towards the preservation of natural teeth for life and relate it to their past utilization pattern and the associated demographic factors. All patients aged 15 years and over attending ten randomly selected government dental clinics in Selangor, Wilayah Persekutuan and Negri Sembilan during the study period of thirty non consecutive outpatients days were interviewed and examined clinically. Five-hundred and fifty subjects were included in the survey. It was found that the majority of respondents (63%)have a.rather pessimistic perception of their ability to preserve natural teeth for life and most have a very poor past utilization behaviour (90%).The most pessimistic and worst utilization behaviour was reported by the Malay ethnic group, the least formally educated and the lowest income group (p O.O1).It is postulated that one of the main reason for this trend among Malay respondents could be due to their lower educational and income status, rather than cultural influences. Further research into the influence of culture on the utilization pattern of the Malays is therefore recommended.
The mangement of vascular lesions such as haemangiomas frequently present difficult choices between various treatment modalities. Circumstances may limit the,number of options available for the surgeon. This article describes the circumstances, investigations, difficult choices, and eventual treatment of a case of a mandibular haemangioma. It is concluded that for a medium sized haemangioma such as in this case,in the absence of facilities to embolize it, surgical excision may be safely carned out provided that proper investigations and precautions have been conducted. An angiogram is of utmost important in determining the feeding vessels and is very important before any surgical procedure is attempted.
The ability of a pathologist to accurately interpret a lesion is largely dependent on a good biopsy performed by the surgeon. This article describes the common pittfalls in biopsy techniques and offers ways to minimize them. It also discusses the difficulties encountered by the pathologist in attempting to interpret artefactually damaged tissues.
An apartment complex collapsed in Malaysia killing 48 people trapped inside.The dental disaster victim identification team comprising of officers from the Kuala Lumpur General Hospital, Armed Forces and the Dental
Faculty, University of Malaya played a very active role in the identification process. Most of the bodies were badly decomposed and some grossly disfigured. Problems were encountered due to inadequate facilities and
equipments at the mortuary.Difficulties were also encountered during the procurement and deciphering of information from dental records. Suggestions have been made to improve facilities, expertise and also to create awareness amongst dentists to ensure proper recording of their patients' dental status.