Browse publications by year: 2001

Factor V inhibitor in neonatal intracranial hemorrhage secondary to severe congenital factor V deficiency

Lee WS, Chong LA, Begum S, Abdullah WA, Koh MT, Lim EJ

J Pediatr Hematol Oncol, 2001 May;23(4):244-6.
PMID: 11846304

We report a newborn infant girl, born to consanguineous parents, with recurrent intracranial hemorrhage secondary to congenital factor V deficiency with factor V inhibitor. Repeated transfusions of fresh-frozen plasma (FFP) and platelet concentrates, administrations of immunosuppressive therapy (prednisolone and cyclophosphamide), and intravenous immunoglobulin failed to normalize the coagulation profiles. Exchange transfusion followed-up by administrations of activated prothrombin complex and transfusions of FFP and platelet concentrates caused a temporary normalization of coagulation profile, enabling an insertion of ventriculoperitoneal (VP) shunt for progressive hydrocephalus. The treatment was complicated by thrombosis of left brachial artery and ischemia of left middle finger. The child finally died from another episode of intracranial hemorrhage 10 days after insertion of the VP shunt.

MeSH terms: Brachial Artery; Cerebral Hemorrhage/etiology*; Combined Modality Therapy; Consanguinity; Cyclophosphamide/therapeutic use; Exchange Transfusion, Whole Blood; Factor V/immunology*; Factor V Deficiency/complications*; Factor V Deficiency/immunology; Factor V Deficiency/therapy; Female; Humans; Hydrocephalus/etiology; Hydrocephalus/surgery; Immunization; Immunosuppressive Agents/therapeutic use; Infant, Newborn; Isoantibodies/biosynthesis*; Isoantibodies/immunology; Plasma; Prednisolone/therapeutic use; Recurrence; Thrombosis/etiology; Immunoglobulins, Intravenous/therapeutic use; Ventriculoperitoneal Shunt; Platelet Transfusion; Fatal Outcome
Distribution of alpha1-antitrypsin PI S and PI Z frequencies in countries outside Europe: a meta-analysis

Blanco I, Bustillo EF, Rodriguez MC

Clin Genet, 2001 Dec;60(6):431-41.
PMID: 11846735

The objective of the present study was to review published surveys on allelic frequencies S and Z in countries outside Europe to evaluate the validity of the reported data. Studies on the topic, published from 1965 to May 2001, were retrieved using MEDLINE and bibliographic reference consultations. The criteria for the selection of the studies were the following: 1) sample size >or=250 individuals; 2) alpha1-antitrypsin phenotype determination performed by means of crossed antigen-antibody, isoelectric focusing in polyacrylamide gels, or polymerase chain reaction (PCR); 3) PI type determination performed without any previous screening procedure; 4) S and Z 95% CI of the reported outcomes within the limits of a calculated coefficient of variation. Forty-three out of 85 studies comply with the established criteria for being analysed. Worldwide maps of geographical distributions of PI S and PI Z frequencies have been designed by the authors by adding the data provided by these 43 selected studies to the 70 reported in a recent European meta-analysis.

MeSH terms: Afghanistan; Africa; alpha 1-Antitrypsin/genetics*; Australia; Canada; China; Gene Frequency*; Humans; Japan; Jordan; Korea; Malaysia; New Zealand; United States
Comparison of parenting stress between Malaysian mothers of four-year-old very low birthweight and normal birthweight children

Ong LC, Chandran V, Boo NY

Acta Paediatr, 2001 Dec;90(12):1464-9.
PMID: 11853347 DOI: 10.1080/08035250152708905

A study was carried out to compare parenting stress between 116 mothers of very low birthweight (VLBW) children and 96 mothers of normal birthweight (NBW) children at 4 y of age, using the Parenting Stress Index (PSI). Multiple regression analysis was used to determine factors associated with child-domain stress (CDS) and parent-domain stress (PDS). There was a significantly higher proportion (39.7%) of mothers of VLBW children with high CDS scores >90th percentile than mothers of NBW children (20.8%). No significant differences were observed for PDS scores. Lower intelligence quotient (IQ) scores and adverse child behaviour, as evidenced by higher Child Behavior Checklist (CBCL) scores, were significantly associated with higher CDS scores (p < 0.001). Factors associated with higher PDS scores were higher CBCL scores (p < 0.001), mothers who were the primary caregivers (p < 0.001), male sex (p = 0.018) and lower level of maternal education (p = 0.048). These factors remained statistically significant even when physically and cognitively impaired children were excluded from the analysis.

CONCLUSION: Specific child characteristics and the social environment appear to have a greater impact on parenting stress than the biological risk of VLBW birth per se.

MeSH terms: Adult; Birth Weight*; Child Behavior Disorders/complications*; Child Behavior Disorders/psychology*; Child, Preschool; Educational Status; Female; Humans; Infant, Newborn; Malaysia; Male; Risk Factors; Stress, Psychological/etiology*; Stress, Psychological/psychology*; Parenting/psychology*; Infant, Very Low Birth Weight/psychology*
Primary torsion of the greater omentum

Gul YA, Jabbar MF, Moissinac K

Acta Chir. Belg., 2001 Nov-Dec;101(6):312-4.
PMID: 11868511

Primary or idiopathic greater omental torsion remains a rare cause of acute surgical abdomen in adults and children. The aetiology is as yet unknown and the treatment of choice, once diagnosis is established, is resection of the torted omentum. We report our experience with three such cases encountered over the last five years, two of which were diagnosed and subsequently managed laparoscopically. The performance of diagnostic laparoscopy for acute abdominal pain of an undetermined origin may lead to an increased detection of this condition and subsequent therapeutic intervention.

MeSH terms: Adolescent; Adult; Female; Humans; Infarction/diagnosis; Infarction/surgery*; Male; Omentum/blood supply*; Peritoneal Diseases/diagnosis; Peritoneal Diseases/surgery*; Laparoscopy; Torsion Abnormality
Mary Jane Cardosa--bringing local solutions to Sarawak, Malaysia

Cardosa MJ

Lancet Infect Dis, 2001 Sep;1(2):128-32.
PMID: 11871464
MeSH terms: Academies and Institutes/organization & administration*; Child; Communicable Diseases/epidemiology; Communicable Diseases/therapy*; Community Medicine/organization & administration*; Disease Outbreaks*; Humans; Malaysia/epidemiology
Leptospira brings fresh challenge to adventure sports

Trubo R

Lancet Infect Dis, 2001 Sep;1(2):73.
PMID: 11871475
MeSH terms: Disease Outbreaks*; Humans; Leptospirosis/epidemiology*; Leptospirosis/physiopathology; Malaysia/epidemiology; Sports*; Travel
Fulltext A ten-year review of ruptured sinus of valsalva: clinico-pathological and echo-Doppler features

Shah RP, Ding ZP, Ng AS, Quek SS

Singapore Med J, 2001 Oct;42(10):473-6.
PMID: 11874151

Rupture of the sinus of valsalva (RSOV) is an uncommon condition with a variety of manifestations ranging from an asymptomatic murmur to cardiogenic shock. This retrospective 10-year review (1985-1995) of 18 patients from a single institution revealed that 6 (33%) were female and 12 (67%) were male with a mean age of 37.6 +/- 13.4 years and that 72% were Chinese by ethnic descent with the remaining 28% being Malay. Eight patients (44.4%) presented with an asymptomatic murmur, 4 (22.2%) with acute chest pain, 4 (22.2%) with mild heart failure, 2 (11.1%) with severe heart failure, and 2 (11.1%) with cardiogenic shock. Rupture of the right aneurysmal coronary cusp (RCC) made up 15 (83.3%) while those of the non-coronary cusp (NCC) made up the remaining. Most of the RCC ruptures were directed into the right ventricle and all of the NCC ruptures were into the right atrium. Ventricular septal defects (VSDs) were found in 9 (50%) of the patients, (although detected by echocardiography in only one third of those patients), aortic regurgitation in 6 (33.3%) and aortic valve vegetations in 2 (11.1%). Echocardiography was found to be accurate in diagnosing RSOVs with 100% diagnostic accuracy after 1990 with four misdiagnoses before 1990. Of these four patients, two were misdiagnosed as having VSDs, one as having a coronary arteriovenous fistula and one as having a patent ductus arteriosus. The anatomical structure of the "windsock" was seen in 64% of the patients who were correctly diagnosed. The pattern of colour flow and spectral Doppler was seen in all patients and helped to localise the site of rupture and the direction of flow. In summary, echocardiography is a simple and accurate way of diagnosing and defining RSOVs and is the imaging modality of choice.

MeSH terms: Adult; Aged; Aortic Aneurysm/pathology*; Aortic Aneurysm/ultrasonography*; Aortic Rupture/pathology*; Aortic Rupture/ultrasonography*; Female; Humans; Male; Middle Aged; Retrospective Studies; Sinus of Valsalva*; Echocardiography, Doppler, Color*
Fulltext Acquired immunodeficiency syndrome presenting as childhood non-Hodgkin's lymphoma

Lee WS, Chan TL, Koh MT, Ariffin WA, Lin HP

Singapore Med J, 2001 Nov;42(11):530-3.
PMID: 11876380

Two children with non-Hodgkin's lymphoma (NHL) as the presenting illness of acquired immunodeficiency syndrome (AIDS) are described. There was a delay in diagnosing the underlying AIDS in both cases. In the first case, an 18-month-old boy with stage IV, high-grade,T-cell NHL, the diagnosis of underlying AIDS was suspected only when he developed recurrent and profound opportunistic infection during chemotherapy. The second case, an eight-month-old female infant presented initially with hepatosplenomegaly and thrombocytopenia of undetermined cause. She had progressive abdominal distension and swelling of her right eye one year later due to high grade B-cell NHL. She was later found to be sero-positive for HIV during pre-chemotherapy screening. As the prevalence of HIV infection continues to increase, HIV infection should be considered in the differential diagnoses of childhood hepatosplenomegaly and thrombocytopenia, and as a possible underlying cause of childhood cancer, especially NHL.

MeSH terms: Female; Humans; Infant; Lymphoma, Non-Hodgkin/etiology*; Male; Lymphoma, B-Cell/etiology*; Lymphoma, T-Cell/etiology*; Lymphoma, AIDS-Related/etiology*; Fatal Outcome
Phylogeography of Kandelia candel in East Asiatic mangroves based on nucleotide variation of chloroplast and mitochondrial DNAs

Chiang TY, Chiang YC, Chen YJ, Chou CH, Havanond S, Hong TN, et al.

Mol Ecol, 2001 Nov;10(11):2697-710.
PMID: 11883883

Vivipary with precocious seedlings in mangrove plants was thought to be a hindrance to long-range dispersal. To examine the extent of seedling dispersal across oceans, we investigated the phylogeny and genetic structure among East Asiatic populations of Kandelia candel based on organelle DNAs. In total, three, 28 and seven haplotypes of the chloroplast DNA (cpDNA) atpB-rbcL spacer, cpDNA trnL-trnF spacer, and mitochondrial DNA (mtDNA) internal transcribed spacer (ITS) were identified, respectively, from 202 individuals. Three data sets suggested consistent phylogenies recovering two differentiated lineages corresponding to geographical regions, i.e. northern South-China-Sea + East-China-Sea region and southern South-China-Sea region (Sarawak). Phylogenetically, the Sarawak population was closely related to the Ranong population of western Peninsula Malaysia instead of other South-China-Sea populations, indicating its possible origin from the Indian Ocean Rim. No geographical subdivision was detected within the northern geographical region. An analysis of molecular variance (AMOVA) revealed low levels of genetic differentiation between and within mainland and island populations (phiCT = 0.015, phiSC = 0.037), indicating conspicuous long-distance seedling dispersal across oceans. Significant linkage disequilibrium excluded the possibility of recurrent homoplasious mutations as the major force causing phylogenetic discrepancy between mtDNA and the trnL-trnF spacer within the northern region. Instead, relative ages of alleles contributed to non-random chlorotype-mitotype associations and tree inconsistency. Widespread distribution and random associations (chi2 = 0.822, P = 0.189) of eight hypothetical ancestral cytotypes indicated the panmixis of populations of the northern geographical region as a whole. In contrast, rare and recently evolved alleles were restricted to marginal populations, revealing some preferential directional migration.

MeSH terms: Alleles; Asia; DNA, Mitochondrial/genetics; Genetics, Population; Haplotypes; Mutation; Phylogeny; Genetic Variation; Ecosystem; DNA, Chloroplast/genetics; DNA, Plant/genetics*; Angiosperms/genetics*
Successful clot lysis using low dose of streptokinase in 22 neonates with aortic thromboses

Cheah FC, Boo NY, Rohana J, Yong SC

J Paediatr Child Health, 2001 Oct;37(5):479-82.
PMID: 11885713

OBJECTIVE: To determine whether intravenous infusion of low dose of streptokinase was effective in lysing umbilical arterial catheter (UAC)-associated aortic thrombi.
METHOD: A prospective cohort study of 31 consecutive newborn infants with UAC-associated aortic thrombi which were detected by abdominal ultrasonography after removal of UAC. Twenty-two infants were treated with intravenous infusion of low dose (1000 U/h) streptokinase, while nine others were not treated due to various contra-indications. Thrombolysis occurred after a mean interval of 2.2 days (standard deviation (SD) = 1.8) in the treated infants. In the untreated infants, spontaneous thrombolysis occurred significantly later, after a mean interval of 16.9 days (SD = 14.7) (95% confidence intervals of difference between mean intervals - 26.0, - 3.4; P = 0.02). Only one treated infant developed mild bleeding directly attributed to streptokinase therapy.
CONCLUSION: Low dose streptokinase infusion was effective and safe in thrombolysing UAC-associated aortic thrombi.

MeSH terms: Aortic Diseases/drug therapy*; Aortic Diseases/etiology; Catheterization/adverse effects; Female; Fibrinolytic Agents/administration & dosage; Fibrinolytic Agents/therapeutic use*; Humans; Infant, Newborn; Infusions, Intravenous; Male; Plasminogen Activators/administration & dosage; Plasminogen Activators/therapeutic use*; Prospective Studies; Streptokinase/administration & dosage; Streptokinase/therapeutic use*; Thrombosis/drug therapy*; Thrombosis/etiology; Ultrasonography; Umbilical Arteries; Cohort Studies; Thrombolytic Therapy/methods*; Treatment Outcome
Nucleotide sequence and phylogenetic analysis of a segment of a highly virulent strain of infectious bursal disease virus

Chong LK, Omar AR, Yusoff K, Hair-Bejo M, Aini I

Acta Virol., 2001;45(4):217-26.
PMID: 11885928

The complete nucleotide sequences encoding precursor polyprotein (VP2-VP3-VP4) and VP5 of a highly virulent (hv) infectious bursal disease virus (IBDV), UPM97/61 was determined. Comparison of the deduced amino acid sequences with the published ones revealed 8 common amino acid substitutions, which were found only in the hv IBDV including the UPM97/61 strain. Three of the amino acid substitutions (222 Ala, 256 Ile and 294 Ile) were used as a marker for determining hv IBDV strains. The other five substitutions (685 Asn, 715 Ser, 751 Asp, 990 Val and 1005 Ala) were also conserved in hv IBDV strains isolated in various countries. UPM97/61 strain demonstrated also 8 unique amino acid substitutions of which 3 were in VP2, 4 in VP3 and 1 in VP4. There was 1 unique amino acid substitution in VP5 at position 19 (Asp-->Gly) not found in other strains. However, all the strains have a conserved 49 Arg. The amino acid sequence of UPM97/61 strain differed by 1.09% from the Japanese (OKYM) and Hong Kong (HK46) strains, and by 1.48% from the Israeli (IBDVKS) and European (UK661) strains. Hence, UPM97/61 is more closely related to the hv strains from Asia. However, phylogenetic analysis indicated that the origin of UPM97/61 might be the same as that of other hv strains isolated from other parts of the world.

MeSH terms: Amino Acid Sequence; Animals; Aspartic Acid/genetics; Chickens/virology*; Cloning, Molecular; Genes, Viral*; Glycine/genetics; Infectious bursal disease virus/classification; Infectious bursal disease virus/genetics*; Infectious bursal disease virus/pathogenicity; Molecular Sequence Data; Phylogeny; Protein Precursors/genetics*; Virulence/genetics; Viral Structural Proteins/genetics*; Consensus Sequence; Sequence Alignment; Sequence Homology, Amino Acid; Amino Acid Substitution
Fulltext Chikungunya infection--an emerging disease in Malaysia

Lam SK, Chua KB, Hooi PS, Rahimah MA, Kumari S, Tharmaratnam M, et al.

Southeast Asian J Trop Med Public Health, 2001 Sep;32(3):447-51.
PMID: 11944696

Many countries neighboring Malaysia have reported human infections by chikungunya virus, a mosquito-borne togavirus belonging to the genus Alphavirus. However, although there is serological evidence of its presence in Malaysia, chikungunya virus has not been known to be associated with clinical illness in the country. An outbreak of chikungunya virus occurred in Klang, Malaysia, between December 1998 and February 1999. The majority of the cases were in adults and the clinical presentation was similar to classical chikungunya infections. Malaysia is heavily dependent on migrant workers from countries where chikungunya is endemic. It is speculated that the virus has been re-introduced into the country through the movement of these workers.

MeSH terms: Antibodies, Viral/blood; Chikungunya virus/immunology; Disease Outbreaks; Humans; Malaysia/epidemiology; Alphavirus Infections/epidemiology*; Alphavirus Infections/physiopathology; Alphavirus Infections/virology; Communicable Diseases, Emerging/epidemiology*; Communicable Diseases, Emerging/physiopathology
Fulltext Short stature and truncal shortening in transfusion dependent thalassemia patients: results from a thalassemia center in Malaysia

Hamidah A, Rahmah R, Azmi T, Aziz J, Jamal R

Southeast Asian J Trop Med Public Health, 2001 Sep;32(3):625-30.
PMID: 11944728

One of the major complications in patients with transfusion dependent thalassemia is growth impairment secondary to iron overload. We studied the growth status in 66 patients with beta-thalassemia major and HbE-beta thalassemia who were transfusion dependent, aged from 2 to 24 years, and 66 controls matched for sex and age. The prevalence of short stature in transfusion-dependent thalassemics was 54.5% compared to 4.5% in control group (p<0.001). Short stature was more prevalent in those above the age of 10 years in this study group (83.3% vs 16.7%). Transfusion dependent thalassemics with short stature were found to have significantly lower mean standing height standard deviation scores (SDS), sitting height SDS and subischial leg length SDS values (p<0.001). There was also a significant difference between the mean sitting height SDS and the mean subischial leg length SDS in our thalassemics with short stature, suggesting that the short stature was due to disproportionate truncal shortening. Serum ferritin levels were significantly higher in transfusion dependent thalassemics who were short compared to those who were of normal height (p = 0.002). However, the mean pre-transfusion hemoglobin levels did not differ significantly between patients with short stature and those with normal height (p = 0.216). The prevalence of short stature also did not differ significantly between those with beta-thalassemia major and those with HbE-beta thalassemia (p = 0.32). This study highlighted the importance of providing optimal treatment in these patients, including monitoring of growth parameters and optimizing iron chelation therapy.

MeSH terms: Adolescent; Blood Transfusion; Body Height*; Child; Child, Preschool; Female; Hospitals, University; Humans; Infant; Infant, Newborn; Malaysia; Malaysia/epidemiology; Male; Thalassemia/epidemiology; Thalassemia/physiopathology*; Thalassemia/therapy; Prevalence; Case-Control Studies
Fulltext The prevalence of, and factors related to, compliance with glove utilization among nurses in Hospital Universiti Sains Malaysia

Naing L, Nordin R, Musa R

Southeast Asian J Trop Med Public Health, 2001 Sep;32(3):636-42.
PMID: 11944730

Increasing risk of HIV infections among health care workers has been a continuing concern. The study was designed to identify the compliance of glove utilization, and factors related to non-compliance. A sample of 150 staff nurses were recruited from the study population of 550 nurses in Hospital Universiti Sains Malaysia. Data were collected by using a structured self-administered questionnaires. The response rate was 98.4%. The study revealed a low compliance (13.5%) of glove utilization (for all 9 procedures), which varied among different procedures (27-97%). Younger nurses and those with shorter duration of working experience had better knowledge of Universal Precautions. Nurses in intensive care unit and operation theatre were better in both knowledge and compliance of glove utilization. The three commonest misconceptions were identified as "selective use of gloves for high risk groups and suspected cases", and "tendency to depend on HIV prevalence". Nurses reported practical problems including administrative and personal related such as "stock irregularity" (46%), "glove not available at the emergency sites" (44%), and "reduction of tactile sensation" (39%). It was concluded that poor knowledge and practical problems were possible responsible factors for the low compliance. A good training for nurses comprising principle and practice of Universal Precautions, updated knowledge of blood and body fluid borne infections and risk and its management, will probably improve the compliance.

MeSH terms: Adult; Hospitals, University; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Middle Aged; Nursing Staff, Hospital/psychology*; Nursing Staff, Hospital/statistics & numerical data; Surveys and Questionnaires; HIV Infections/prevention & control; Occupational Exposure/prevention & control; Universal Precautions; Gloves, Protective/utilization*; Guideline Adherence/statistics & numerical data*
Fulltext Endemic typhus in Singapore--a re-emerging infectious disease?

Ong AK, Tambyah PA, Ooi S, Kumarasinghe G, Chow C

Singapore Med J, 2001 Dec;42(12):549-52.
PMID: 11989574

Singapore is a modern urban city and endemic typhus is thought to be a disease of the past. This may be due to lack of specific serological testing as indirect immunoperoxidase testing using specific rickettsial antigens (U.S. Army Medical Research Unit, Institute of Medical Research, Kuala Lumpur, Malaysia) has only recently become available. In the last fourteen months, twenty-one cases of endemic typhus were diagnosed in patients hospitalised for acute febrile illnesses at the National University Hospital. We conducted a case control study to define the clinical and laboratory features of endemic typhus in Singapore.

MeSH terms: Adult; Female; Humans; Immunologic Tests; Male; Middle Aged; Retrospective Studies; Singapore/epidemiology; Transients and Migrants; Typhus, Endemic Flea-Borne/diagnosis*; Typhus, Endemic Flea-Borne/epidemiology*; Prevalence; Case-Control Studies; Communicable Diseases, Emerging/diagnosis*; Communicable Diseases, Emerging/epidemiology*
Fulltext Clinical measurement of longitudinal femoral overgrowth following fracture in children

Nordin S, Ros MD, Faisham WI

Singapore Med J, 2001 Dec;42(12):563-5.
PMID: 11989577

We have studied residual limb length inequality following femoral shaft fractures in 62 children. From 61.2% of the children who had shortening of more than 1 cm at union, 34.21% still maintained the shortening at the completion of study. The longitudinal femoral overgrowth occurred significantly during the first 18 months of the fracture in 77.4% of the children, with an average of 1.17 cm. Children with proximal-third fractures and those who sustained the fractures before eight years of age have higher capability to correct the limb length disparity.

MeSH terms: Child; Child, Preschool; Female; Femoral Fractures/physiopathology*; Femur/growth & development; Femur/injuries*; Humans; Infant; Leg Length Inequality/etiology*; Male; Retrospective Studies; Fracture Healing*
Causes of childhood blindness in Malaysia: results from a national study of blind school students

Reddy SC, Tan BC

Int Ophthalmol, 2001;24(1):53-9.
PMID: 11998890

A national study was conducted in children attending six schools for the blind in Malaysia to identify the anatomical site and underlying causes of blindness (BL) and severe visual impairment (SVI), with a view to determine the potentially preventable and treatable causes so that appropriate control measures can be implemented in the future. The standardized clinical examination of eyes was performed and the findings were recorded on the WHO Prevention of Blindness Programme eye examination record form for children with blindness and low vision. A total of 358 children aged between 7 and 17 years were examined, of whom 332 (92.7%) were blind or severely visually impaired. The results relate to these 332 children. Lens was the major anatomical site (22.3%) of visual loss followed by retina (20.8%), whole globe (17.2%), cornea (15.1%), optic nerve (8.7%) and uvea (5.1%). Glaucoma was responsible for BL/SVI in 7.2% and others in 3.6% of cases. Hereditary diseases were responsible for visual loss in 29.5%, intrauterine factors in 4.5%, perinatal factors in 9% and childhood factors in 7.8% of cases. However, the aetiology was unknown in 49.1% of cases which included congenital anomalies of the globe. Childhood cataract and corneal scarring are major treatable causes of BL/SVI that can benefit from future intervention strategies. Perinatal screening for intrauterine factors and hereditary eye diseases, and appropriate interventional therapy will help in reducing the prevalence of childhood blindness.

MeSH terms: Adolescent; Blindness/etiology*; Blindness/epidemiology*; Blindness/prevention & control; Child; Eye Diseases/complications; Eye Diseases/prevention & control; Female; Humans; Malaysia/epidemiology; Male; Schools; Visually Impaired Persons/statistics & numerical data
Fulltext Beta-thalassemia major in Malaysia, an ongoing public health problem

George E

Med J Malaysia, 2001 Dec;56(4):397-400.
PMID: 12014756
MeSH terms: Humans; Malaysia/epidemiology; Public Health*; beta-Thalassemia/genetics*; beta-Thalassemia/epidemiology*; beta-Thalassemia/therapy
Fulltext A dental-anthropological study of health and illness behaviour among Orang Asli of the Semai Tribe: the perspective of traditional healers

Saub R, Jaafar N

Med J Malaysia, 2001 Dec;56(4):401-7.
PMID: 12014757

This observational study investigates and describes the oral health beliefs and illness behaviour in the Semai tribe of Orang Asli community. Data was obtained from a "Key informant interview" method i.e. the village Tok Halaq (Traditional healer). Information about common oral diseases and conditions were illustrated with enlarged pictures of dental caries, periodontal disease, oral cancer and cleft. The most common oral problem was toothache. This is treated by self-medication. However if the pain still persist, the Tok Halaq was consulted to start traditional methods. He will identify the cause. If "germs" were thought to be the cause, he will ask the person to see a doctor. Otherwise, he attempts traditional treatment. If the effort failed after a few days, the person will be advised to see a doctor. It appears that the Tok Halaq plays an influential role in prevention, promotion and the healing process in this community. Hence any effort to promote oral health and prevent oral disease must seek their cooperation. Their beliefs on causes of common oral diseases are described in the text.

MeSH terms: Anthropology, Cultural*; Humans; Malaysia; Medicine, Traditional*; Oral Health*; Sick Role*; Health Behavior/ethnology*
Fulltext Inhaled nedocromil sodium for persistent cough in children

Chan PWK, Debruyne JA

Med J Malaysia, 2001 Dec;56(4):408-13.
PMID: 12014758

The efficacy of inhaled nedocromil sodium (NS) for children with a persistent cough was studied. Children aged 4-12 years with a persistent cough for >1 month were recruited and entered a 2-week baseline period during which an asthma diary was kept. Children with a cough score of >20 received inhaled NS via a spacer, 4mg qid for 2 weeks followed by 4mg bd for another 4 weeks. Twenty-two (42%) of 52 children recruited fulfilled treatment criteria. Four children were withdrawn from the study (2 developed wheezing and 2 were not compliant). The baseline cough score (29.1 +/- 13.6) improved after 2 weeks of treatment (15.2 +/- 9.3, p < 0.01) and improvement was sustained after 6 weeks (14.2 +/- 13.0, p = 0.01). Parents and patients had a more favourable perception of its efficacy compared to physicians (72% vs 50%, p = 0.01) Inhaled NS may be considered for treatment of persistent cough in children.
Study site: Paediatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

MeSH terms: Administration, Inhalation; Anti-Inflammatory Agents/administration & dosage*; Anti-Inflammatory Agents/therapeutic use*; Child; Child, Preschool; Cough/drug therapy*; Female; Hospitals, University; Humans; Malaysia; Male; Outpatient Clinics, Hospital; Clinical Trial; Nedocromil/administration & dosage*; Nedocromil/therapeutic use*

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