This article highlighted the recent development in the prevention and management of child abuse in Malaysia. There is now a willingness to recognise the conlplex social, moral, medical, educational, legal and economic problems related to child abuse. Multidisciplinary research, comprehensive and longitudinal targeted services to prevent child abuse and neglect are needed.
MeSH terms: Child; Child Abuse; Malaysia; Primary Health Care
A quality assurance exercise for non-insulin dependent diabetes mellitus in the Family Practice Clinic, University Hospital Kuala Lumpur, was conducted using HbA1c as an indicator. We found that about 60% of the 163 patients with non-insulin dependent diabetes mellitus had fair to optimal control. The HbA1c correlated well with fasting and post-prandial blood glucose level (r=0.79 and r=0.54, respectively, p<0.001). The mean HbA1c was significantly higher in Malay compared to the other races, in those with longer duration of diabetes and in patients on two types of oral hypoglycaemic agent.
MeSH terms: Ambulatory Care Facilities; China/ethnology; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Family Practice; Hemoglobin A, Glycosylated; Hospitals, University; Humans; India/ethnology; Malaysia/ethnology; Medical Audit; Outpatient Clinics, Hospital; Primary Health Care; Quality of Health Care
This article chronicles the popular health beliefs of the Malays and Chinese regarding chickenpox, as seen through the eyes of a doctor. The interplay of several factors, namely, a marriage of two major cultures, chickenpox in pregnancy, concurrence of two major festivals make this a unique study in medical socio-anthropology.
MeSH terms: Case Reports; Chickenpox; Culture; Humans; Malaysia; Pregnancy
A prospective case controlled study was conducted to determine the incidence of asymptomatic bacteriuria in pregnancy (ASB), causative organisms and fetal outcome. Out of 510 antenatal mothers screened, 46 (9%) had ASB. The main organisms isolated were E. coli (16%), Staphylococcus aureus (15%) and Beta-Haemolytic Streptococcus (11%). Oral Nitrofurantoin and Cefuroxime axetil achieved sensitivity levels of 96%. There was no significant difference in period of gestation at birth and birthweight between the control and study groups. The reasons for routine antimicrobial therapy for ASB are discussed.
In the evaluation of the infertile couple, male factors account for up to 50% of causes. These factors may occur alone or in combination with female causes. Transrectal ultrasound has allowed imaging of the urogenital tract to be less invasive. New assisted reproductive techniques (ART) have revolutionised management. Many previously "hopeless" cases now have a good chance of fathering a child. Such ART include microscopic epididymal sperm aspiration (MESA) and intracytoplasmic sperm injection (ICSI).
985 medical certificates issued by primary care doctors at the Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia were analysed. Most common diagnoses were URTls, conjunctivitis, and gastro-enteritis. Mean duration of absence ranged from 1.3 to 3.4 days. HUSM staff with skin infections were given certificates nearly twice more often than the public. Backache earned more time off for the staff compared to the public. There is a need to formulate guidelines for medical certificates.
MeSH terms: Ambulatory Care Facilities; Conjunctivitis; Cross-Sectional Studies; Gastroenteritis; Hospitals; Humans; Infection; Malaysia; Outpatients; Primary Health Care; Sick Leave
Bicycle fatalities constituted 5% of road fatalities in 1995. A helmet, properly worn, is the most effective measure to prevent head injury to a cyclist in the event of a crash. We studied the knowledge, attitude and practice of children in two secondary schools (Ipoh and Kulim) with respect to bicycle helmet use before instituting a program for helmet use. Although there were no major differences in knowledge, attitude and practice of students in the two groups, children in the Ipoh program failed to wear helmets while the children in the Kulim program complied over a one year period. The main reason for failure of the helmet progranl in Ipoh were negative peer influence. The Kulim helmet program was integrated with a bicycle safety course conducted by dedicated teachers. The quasi experimental study resulted in increased awareness of the importance of bicycle helmets among school children in Kulim Keywords: Bicycle helmet, road traffic injury, prevention.
MeSH terms: Accidents, Traffic; Adolescent; Attitude; Bicycling; Child; Head Protective Devices; Malaysia; Primary Health Care; Knowledge
A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.
Comment in: Hee HW. Differences in public and private health services in a rural district of Malaysia. Med J Malaysia. 1997 Sep;52(3):296-8
MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Health Services*; Humans; Malaysia; National Health Programs*; Private Practice; Rural Health*
In Peninsular Malaysia ten species of lycaenid butterflies use leaf flushes or inflorescences of the legume tree Saraca thaipingensis as larval hostplant. Resource partitioning among these species is regulated by a complex mixture of patterns of interaction with ants. Females of obligately myrmecophilous species lay their eggs exclusively on trees colonized by their specific host ants. On trees colonized by weaver ants, only specialist mutualists adapted to these territorial ants are able to survive, while larvae of other species are killed. The formicine ant Cladomyrma petalae, which inhabits hollow twigs of the myrmecophytic hostplant, likewise precludes oviposition by female butterflies. Lycaenid larvae confronted with this ant species never survive, but one concealed feeding species (Jamides caeruleus) escapes removal due to the cryptic life-habits of the larvae. Two facultative myrmecophiles associate in a mutualistic way with a wide and largely overlapping range of ant genera which forage at the extrafloral nectaries of leaf flushes. One species (Cheritra freja) is not myrmecophilous, but is tolerated by all but the most territorial ants. Ant-dependent hostplant selection and egg-clustering characterize the obligate mutualists, whereas facultative myrmecophiles and the non-myrmecophile distribute their eggs singly over appropriate hostplants. Signals mediating caterpillar-ant communication are highly specialized in one obligate myrmecophile (Drupadia theda), but rather unspecific in four other species tested. Altogether our observations indicate that colonization and establishment of lycaenid butterflies on S. thaipingensis trees are governed by specializations as well as opportunistic use of resources (ants and hostplant parts). Therefore, the diversity of this species assemblage is maintained by deterministic as well as stochastic factors.