Beta-thalassemia in West Malaysia is caused by 14 molecular defects with differing clinical severity. In Chinese patients from West Malaysia, the main beta-thalassemia mutations seen were (a) a 4 base pair-TCTT deletion in codon 41-42 [frameshift mutation (FSC 41-42)]; (b) a C to T substitution at the second intervening sequence (IVS2-654); (c) an A to G substitution in the TATA box [-28 (A to G)], and (d) an A to T substitution in codon 17[17 A to T]. In the Malays, the main mutations seen were (a) a G to C in nucleotide 5 at the intervening sequence I [IVS1-5 (G to C)]; (b) G to T substitution in nucleotide I at the intervening sequence I [IVS1-1 (G to T)]; (c) a A to T substitution in codon 17 (17 A to T); (d) removal of C from codon 35 [codon 35 (-C)], and (e) a 4 base pairs-TCTT deletion in codon 41-42 [frameshift mutation (FSC 41-42)]. A scoring system (Tha1 CS) has been formulated to predict clinical severity. It is the type of beta-thalassemia mutation present that decides on the clinical phenotype. The most severe beta-thalassemia mutation is assigned a score of 4. A score of 8 indicates severe thalassemia.
Beta-thalassemia mutations in 282 alleles of 253 unrelated individuals originating from various provinces in the south of Thailand were characterized by dot blot hybridization, specific PCR-amplification and direct DNA sequencing. It was possible to characterize the mutations in 274 (97.2%) of alleles studied. Twelve different point mutations and two different large deletions of the beta-globin gene were identified. Seven common mutations, namely 4 bp deletion at codons 41/42. IVS1 position 5 (G-C), codon 19 (AAC-AGC), codon 17 (AAG-TAG), IVS1 position 1 (G-T), position -28 (A-G) and 3.5 kb deletion, accounted for about 91.5%. The mutations at mRNA cap site + 1 (A-C) and IVS1 position 1 (G-A), previously undescribed in Thailand, were found in 1 and 2 individuals, respectively. A novel mutation of 105 bp deletion at the 5' end of beta-globin gene was detected in a family originating from this area. The knowledge from this study should be useful for planning of genetic counseling and prenatal diagnosis programs for patients with beta-thalassemia in the south of Thailand.
MeSH terms: Alleles; Base Sequence; Myanmar; Codon; Globins/genetics*; Humans; India; Indonesia; Malaysia; Molecular Sequence Data; Mutation*; Thailand; Oligonucleotide Probes; Polymerase Chain Reaction; beta-Thalassemia/genetics*; Point Mutation; Sequence Deletion; DNA Primers
It is known that alpha1-antitrypsin deficiency is associated with emphysema in adults and liver cirrhosis in neonates. The phenotypes PiZZ and PiSZ are considered to be high risk groups. alpha1-antitrypsin deficiency is one of the most common lethal congenital disorders in Europe and the USA, occurring in approximately 1 in 2,000 caucasians of North European descent. Studies in Malaysia have found that the phenotypes PiZ and PiS are present in our population. Out of 950 samples analyzed, it was found that 10 samples were shown to be apparently Z homozygous phenotype. The phenotype is determined by high resolution isoelectrofocusing on an ultra-thin polyacrylamide gel embedded with narrow range Pi phamarlyte. The isoelectrofocused bands are confirmed by immunofixation and the plasma alpha1-antitrypsin levels determined by electroimmunoassay. The abnormal phenotypes are further confirmed by polymerase chain reaction using allele specific oligonucleotides.
The chromosome in situ suppression hybridization or chromosome painting technic was applied to confirm and eliminate the markers involving chromosome 21 segments using a chromosome 21 DNA library. The library ATCCLL21SNO2 was amplified, directly biotinylated using the polymerase chain reaction. The results demonstrated a translocation of chromosome 21 material on chromosome 2 and X and eliminate the origin of the marker. Thus, the technique provides an important tool to complement the conventional G-banding technic.
The nucleotide sequence of the haemagglutinin-neuraminidase (HN) gene of Newcastle disease virus (NDV) viscerotropic-velogenic strain AF2240 was determined by direct RNA sequencing and by sequencing RT-PCR products. It encodes a single open reading frame of 581 amino acids with a calculated Mr of 63.8 kDa. The predicted sequence contains five asparagine glycosylation sites. Comparison of the AF2240 HN protein sequence with 13 other previously published sequences showed 88% homology. This HN protein is unique because it lacked the Arg 403 residue which is present in all of the other strains and cannot be grouped under the proposed three size classes of HN proteins in NDV.
This is a comparative study of the prevalence of dementia among elderly Chinese and Malay persons living in the community in Singapore. The subjects, aged 65 years and over, were all living in public housing estates. Two hundred elderly Chinese and 149 elderly Malay persons were interviewed. They were first screened for any cognitive deficit with the Elderly Cognitive Assessment Questionnaire (ECAQ). All those who scored 5 or fewer points on the ECAQ were then assessed with the Geriatric Mental State schedule. The results showed an overall dementia prevalence of 4.0% among the Malay elderly and 2.5% among the Chinese elderly. The rate of dementia of the Alzheimer's type was 1.8% for Chinese women and 1.5% for Malay women; for multi-infarct dementia the rate for Malay women was 4.4% and for Chinese women 0.9%. For Chinese and Malay men, the prevalence of Alzheimer's disease and multi-infarct dementia was quite similar (1.1% and 1.2%).
The patterns of health care seeking behavior of 1061 schizophrenics and the factors that affect the determination of the patterns were studied in 6 areas of 5 nations in east Asia: Hunan and Sichuan Provinces in China, Japan, Korea, Malaysia and the Philippines. The information was gathered through a structured questionnaire developed by the authors. The subjects generally favored psychiatry-oriented health care, but with frequent interruptions or combination with other types of managements. Most Japanese subjects sought care in western medicine, while subjects from Hunan, Sichuan and Korea alternated between western medicine and magicoreligious therapies or traditional herbal medicine. In the Philippines and Malaysia, the majority of the subjects sought magicoreligious therapies first, then later sought western psychiatric care. The choice of western psychiatric care was mostly influenced by the decision maker's knowledge and interpretation of the patient's illness. In determining the choice of management among various types of non-psychiatric management, cost, location, and societal attitudes played substantial roles as well as knowledge and interpretation. Suggestions and opinions were discussed to improve health care services for schizophrenic patients in each community.
One hundred and thirteen consecutive infants with a very low birthweight of less than 1500 g were followed prospectively for 6 months to determine the incidence of retinopathy of prematurity (ROP) and associated risk factors. Of this group, 36 (31.9%) infants developed ROP (13 infants had stage 1 ROP, nine had stage 2, six had stage 3, six had stage 4, and two had cicatricial stage ROP). Stepwise logistic regression analysis of various potential risk factors (birthweight, gestation, duration of oxygen therapy, duration of ventilation, highest documented PaO2 and exchange transfusion) showed that only two risk factors were significantly associated with the development of ROP. These risk factors were: the duration of oxygen therapy (p = 0.0005) and exchange transfusion during the neonatal period (odds ratio 5.754, 95% confidence interval 1.002 to 32.997, p = 0.049). The equation of the regression model is: log (odds of developing ROP) = -0.8395 + 0.1447 (OXY)- 0.8750 (ET), where OXY is the duration of oxygen therapy in days, ET = -1 when there was a history of exchange transfusion, and ET = 1 when there was no history of exchange transfusion.
The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the "lost time" percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.
MeSH terms: Absenteeism*; Female; Government*; Humans; Malaysia/epidemiology; Male; Population Surveillance; Surveys and Questionnaires; Retrospective Studies; Severity of Illness Index; Prevalence; Private Sector*; Public Sector*; Sex Distribution; Sick Leave*
Given the magnitude of drug addiction in Malaysia, the government has given top priority to this issue. It is timely that an assessment of knowledge, attitudes and perceptions related to drug abuse and drug dependents among the general public be carried out. Thus, a nationwide survey was undertaken. A representative sample of 2,591 respondents aged 13 years and above from households were surveyed throughout the 11 states and the Federal Territory of Kuala Lumpur in Peninsula Malaysia. The results revealed that the respondents are moderately knowledgeable on drug abuse, especially information pertaining to treatment, rehabilitation and aftercare services, including education to families against drug abuse. The public possess a negative attitude towards drug dependents. Majority felt that drug addicts do not have the will power to rid themselves of drugs and they also lack a supportive family network system. Many believe that the most vulnerable group are the adolescents. Respondents were aware of the type of drugs commonly abused, although they failed to realise their long-term effects. Respondents do not attribute low education, large family and marginal income to the background of drug dependents. The findings showed gaps and misconceptions in terms of knowledge, attitudes and perceptions of the public. Accurate knowledge on, and right attitudes and perceptions towards drug related issues would certainly benefit the public in timely prevention of drug abuse.
With the prognosis of dental implant replacement of missing teeth becoming better each year, practitioners are focusing their attention on the aesthetic aspects of implantology. However, improvement in aesthetics is only possible with the improvement in implant technology, surgical techniques and prosthodontic procedures. This study aimed at evaluating the effects of various physical and chemical agents on the implant surface; with the view of obtaining increased surface area and biocompatibility. The study found that the treatment of air-aluminum oxide blasted implants using a mixture of 30% HNO3-5% HF acids produced a surface which meets the consideration of aesthetics for implants placed in the anterior maxillary region.
The clinical and histological features of the peripheral odontogenic fibroma are briefly outlined. A case arising from the attached lingual gingiva between the mandibular right permanent first molar and the second molar in a 67 year old Indian female is reported here. The unusual occurrence of marked clear cell differentiation within the odontogenic epithelial component, and histogenetic link to the clear cell rests of the dental lamina and surface epithelium are discussed.
Suicide statistics are generally recognised to be unreliable. This study of the reported rates of suicide in West Malaysia between 1966-1990 shows that the mean crude suicide rate between 1966-1974 was 6.1 per 100,000, but had dropped drastically between 1975-1990 to a mean of 1.6 per 100,000. Three lines of evidence are presented to show that this reduction in the suicide rate is due to a systematic misclassification of medically certified suicides as deaths due to undetermined violent deaths (which refers to violent deaths not known to be accidentally or deliberately inflicted). Firstly, the large drop in reported suicide rates corresponds closely to an increase in the rate of deaths due to undetermined violent deaths. There is a highly positive negative correlation between the two rates (coefficient of correlation, r = -0.9). Secondly, the misclassification appears to be mainly a problem with the medically certified deaths which follow the ICD classification. The mean ratio of uncertified to certified suicides before 1975 was 0.8, but from 1975 onwards the mean was 3.1. This is in contrast to the corresponding ratio for deaths due to all accidents which has remained fairly constant throughout these years. Thirdly, the race and sex differences for the rates of undetermined violent deaths are identical to those of suicide. Taking the misclassification into account the corrected suicide rate for West Malaysia is estimated to be between 8-13 per 100,000 since 1982.
MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Cause of Death*; Child; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Population Surveillance/methods*; Registries; Suicide/classification*; Suicide/trends; Suicide/statistics & numerical data*; Violence/trends; Violence/statistics & numerical data*; Bias (Epidemiology); Age Distribution; Sex Distribution
PIP: The great deal of documentation which was prepared for the recent TSS/CST Population IEC (information, education, and communication) meeting from research, field experiments, and action projects will be useful to TSS/CST advisors and individual countries undertaking IEC and population education work. This article summarizes the 12 sessions held during the open forum. To illustrate some of the latest trends in population and health communication, the "enter-educate" approach and use of the interactive computer software called SCOPE (Strategic Communication Planning and Evaluation) were discussed. Next, ways in which to apply research effectively in IEC and population education were considered. Examples were provided of 1) a workshop methodology used to help a multidisciplinary group design a problem-solving communication strategy in Malaysia and Dominica; 2) the counseling training evaluation technique based on the GATHER (greet, ask, tell, help, explain, and return for follow-up) model; and 3) four types of evaluation of population education in schools. The third session was concerned with the program approach used in IEC and population education. Session 4 dealt with the implication of UNFPA support to family planning (FP) IEC. Counseling skills training and interpersonal communication were next on the agenda, followed by a consideration of how knowledge and policies are applied in the area of youth. The seventh session concentrated on ways to involve men in FP and reproductive health and included a discussion of a case study on the attitude and behavior of men with regard to FP which had IEC implications. The next session described the need to reconceptualize population education and what such a reconceptualization would entail. Session 9 was devoted to a consideration of gender issues and the education of girls. The tenth session covered the use of participatory approaches and community involvement in population communication programs. Innovative methodologies for school-based population education were described next, and the last session was concerned with new information technologies such as navigating the Internet and using new software for establishing databases.
MeSH terms: Adolescent*; Age Factors; Automatic Data Processing; Behavior; Child; Communication*; Congresses as Topic*; Consumer Participation*; Counseling*; Demography; Economics; Education*; Health; Health Planning; Information Services*; International Agencies; Interpersonal Relations*; Organizations; Population; Population Characteristics; Research*; School Health Services*; Sex Education*; Software*; Technology; United Nations*; Reproductive Medicine*
"This paper examines how and to what extent the three demographic components of urban change, urban reclassification, natural increase and net migration, operated in Malaysia between 1980 and 1991.... Since there is a spatial dimension to urban demographic changes, another emphasis of the paper is to differentiate the areal patterns of such changes. The analysis is conducted at both the national level and sub-national levels." Data are from the Malaysian Department of Statistics. The author finds that "the important role of natural increase in urban population change is remarkable considering that a rapid fertility transition had been unfolding in Malaysia up to the mid-1970s."
MeSH terms: Asia; Asia, Southeastern; Demography; Developing Countries; Emigration and Immigration; Geography; Malaysia; Population; Population Characteristics; Population Dynamics*; Population Growth*; Urban Population*; Urbanization*
MeSH terms: Adolescent*; Age Factors; Asia; Asia, Southeastern; Demography; Developing Countries; Economics; Education; Health Services Needs and Demand*; Malaysia; Organization and Administration; Population; Population Characteristics; School Health Services*; Sex Education*; Program Development*