In mid-January 2000, the reappearance of Japanese encephalitis (JE) virus activity in the Australasian region was first demonstrated by the isolation of JE virus from 3 sentinel pigs on Badu Island in the Torres Strait. Further evidence of JE virus activity was revealed through the isolation of JE virus from Culex gelidus mosquitoes collected on Badu Island and the detection of specific JE virus neutralizing antibodies in 3 pigs from Saint Pauls community on Moa Island. Nucleotide sequencing and phylogenetic analyses of the premembrane and envelope genes were performed which showed that both the pig and mosquito JE virus isolates (TS00 and TS4152, respectively) clustered in genotype I, along with northern Thai, Cambodian, and Korean isolates. All previous Australasian JE virus isolates belong to genotype II, along with Malaysian and Indonesian isolates. Therefore, for the first time, the appearance and transmission of a second genotype of JE virus in the Australasian region has been demonstrated.
Citation: Prevalence survey of sexually transmitted diseases among sex workers and women attending antenatal clinics: Malaysia (1999-2000). Manila: World Health Organization, Regional Office for the Western Pacific; 2001
MeSH terms: Adult; Ambulatory Care Facilities; Chlamydia Infections; Cross-Sectional Studies; Gonorrhea; Humans; Malaysia; Maternal-Child Health Centers; Mothers; Sexually Transmitted Diseases; Syphilis; Trichomonas Infections; Women; HIV Infections; Sex Workers
Production of tomato (Lycopersicon esculentum) in Bangladesh, Malaysia, Myanmar, Vietnam, and Laos has been severely affected by yellow leaf curl disease. Tomato leaf samples were collected from symptomatic tomato plants from farmers' fields in the five countries from 1997 to 1999. DNA was extracted from all samples, four from Vietnam, two each from Malaysia, Laos, and Myanmar, and seven from Bangladesh. Virus DNA was amplified by polymerase chain reaction (PCR) using the begomovirus-specific degenerate primer pair PAL1v 1978/PAR1c 715(1), which amplifies the top part of DNA A. All samples gave the expected 1.4-kb PCR product. The PCR product of one sample per country was cloned and sequenced. Based on the sequences of the 1.4-kb DNA products amplified by the first primer pair, specific primers were designed to complete each of the DNA A sequences. Computer-assisted sequence comparisons were performed with begomovirus sequences available in the laboratory at the Asian Vegetable Research and Development Center, Shanhua, Tainan, and in the GenBank sequence database. The five DNA species resembled DNA A of begomoviruses. For the detection of DNA B two degenerate primer pairs were used, DNABLC1/DNABLV2 and DNABLC2/DNABLV2 (DNABLC1: 5'-GTVAATGGRGTDCACTTCTG-3', DNABLC2: 5'-RGTDCACTT CTGYARGATGC-3', DNABLV2: 5'-GAGTAGTAGTGBAKGTTGCA-3'), which were specifically designed to amplify DNA B of Asian tomato geminiviruses. Only the virus associated with yellow leaf curl of tomato in Bangladesh was found to contain a DNA B component, which was detected with the DNABLC1/DNABLV2 primer pair. The DNA A sequence derived from the virus associated with tomato yellow leaf curl from Myanmar (GenBank Accession No. AF206674) showed highest sequence identity (94%) with tomato yellow leaf curl virus from Thailand (GenBank Accession No. X63015), suggesting that it is a closely related strain of this virus. The other four viruses were distinct begomoviruses, because their sequences shared less than 90% identity with known begomoviruses of tomato or other crops. The sequence derived from the virus associated with tomato yellow leaf curl from Vietnam (GenBank Accession No. AF264063) showed highest sequence identity (82%) with the virus associated with chili leaf curl from Malaysia (GenBank Accession No. AF414287), whereas the virus associated with yellow leaf curl symptoms in tomato in Bangladesh (GenBank Accession No. AF188481) had the highest sequence identity (88%) with a tobacco geminivirus from Yunnan, China (GenBank Accession No. AF240675). The sequence derived from the virus associated with tomato yellow leaf curl from Laos (GenBank Accession No. AF195782) had the highest sequence identity (88%) with the tomato begomovirus from Malaysia (GenBank Accession No. AF327436). This report provides further evidence of the great genetic diversity of tomato-infecting begomoviruses in Asia. Reference: M. R. Rojas et al. Plant Dis. 77:340, 1993.
Overweight and obese adults are at increased risk of both mortality and morbidity, principally from cardiovascular disease and diabetes mellitus. Intentional weight loss of 5-1 0% is associated with substantial benefits. Weight reduction should be encouraged by dietary and behavioural modification initially, with realistic targets set over an initial 6-month period. It must be emphasised that these measures should continue indefinitely. This can be complemented by pharmacological intervention with orlistat, or perhaps sibutramine when available in the near future. Given the important impact environmental and social factors have on the aetiology of obesity, the community at large should effect programmes to encourage healthy lifestyles among the populace. Town and city planners should include readily available recreational and sporting facilities in residential districts, especially in the urban and sub-urban areas. Physical education sessions in schools in both primary and secondary levels should receive more emphasis to encourage the young to make sports and physical exercise a part of life, rather than being seen as a non examinable appendage of the school curriculum. The key to defeating obesity is prevention, and an effort to lose weight once it accumulates, can often be too little, too late.
Otitis media is a common disease presenting to family practitioners all over the world. There have been many changes in the way these patients were managed over the years. This article attempts to provide an overview to family physicians regarding the latest approach in managing this common condition. Keywords: Otitis, otitis media, otoscopy, eardrops.
Despite time, mobility, knowledge and other constraints, it is still possible for General Practitioners to play an active role in Palliative Care. This article offers various roles where GP can play. Differences between hospice, palliative medicine, palliative care are discussed. Suggestions are made on where to seek formal or informal education on palliative care. Key Words: role, hospice, palliative medicine, palliative care, illness, sickness
MeSH terms: Malaysia; Palliative Care; Physicians; Physicians, Family; General Practitioners
Adolescent pregnancy is associated with long term medical and sociological problems. For intervention, it is important to have information on their profile and obstetric outcome. A study was conducted in 1999 on teenage mothers compared to mothers in the 20-34 year age group. Antenatal records of all these mothers registered in a Malaysian semi-rural Health Clinic in 1998 were reviewed and the relevant information was analysed using descriptive statistics and chi-square for comparison in SPSS 7.5. Only 402 (80.9%) of the 497 antenatal records could be included. There were 40 (9.95%) adolescent pregnancies and 362 (90.05%) pregnancies in mothers aged 20-34 years. Pregnant adolescents were more likely to be Malays (85% versus 66%), unmarried (65% versus 5.5%) and less educated (32.5% versus 12.1%). They have a significantly lower rate of contraceptive usage (2.5% versus 20.2%) and tend to come late for their first antenatal visit (55% versus 18.5%). Their pregnancy complications of anaemia and pregnancy induced hypertension were no worse. But they had a significantly higher preterm delivery rate (37.5% versus 21.8%) and their babies were more likely to have low birth weight (32.5% versus 9.9%). Based on this preliminary finding, further investigations should be carried out and polices should include programmes targeted for this group.
Asthma is a chronic reversible respiratory problem commonly seen by Family Physicians. Pregnancy can produce physiological and physical changes that can affect the severity of asthma and its management. Conversely poorly controlled asthmatic attacks can result in adverse obstetric outcome: prematurity, low birth weight babies, foetal hypoxia and increased maternal and foetal morbidity and mortality. It is important that Family Physicians should be able to manage competently and provide appropriate counseling for women with asthma in pregnancy, labour and lactation. Assessment of asthma control using a peak flow meter is recommended. The use of the usual inhaled and oral corticosteroids, beta 2 agonists, cromones and anticholinergics are generally safe in pregnancy, labour and lactation. But methylxanthines should be used with caution. Women should be advised that asthma medication would not adversely affect their unborn babies and the birth outcome of well-controlled asthmatic women approaches that of the normal population but uncontrolled asthma would be detrimental to the health of mother and child.
Epistaxis is a common clinical condition and perhaps the most common ENT cause for emergency hospital admission. Commonly epistaxis originates from the anterior septum and is easily controlled with caurterization and packing. Posterior epistaxis is less common, but more difficult to treat. It usually occurs in the elderly and is frequently associated with hypertension, artherosclerosis and conditions that decrease platelets and clotting function. In the elderly and hypertensive patient the source of bleeding is likely from the sphenopalatine area in lateral posterior nasal wall. Intractable posterior epistaxis that persists despite repeated use of nasal packing has been treated in many different ways. Conventional methods of arterial ligation in intractable epistaxis often involve surgical morbidity as well as failure due to arterial anastomosis. Embolization is most effective in hands of an experience radiologist, in patients with epistaxis refractory to arterial ligation, bleeding site difficult to reach surgically or epistaxis due to general bleeding disorder. Endoscopic ligation or clipping of sphenopalatine artery is a relatively simple and effective procedure for control of intractable posterior epistaxis.