MeSH terms: China/ethnology; Drug Industry/economics; Drug Industry/education; Drug Industry/history; Drug Industry/legislation & jurisprudence; Income/history; Indonesia/ethnology; Malaysia/ethnology; Local Government; Politics*; Public Health/economics; Public Health/education; Public Health/history; Public Health/legislation & jurisprudence; Social Class; Social Problems/economics; Social Problems/ethnology; Social Problems/history; Social Problems/legislation & jurisprudence; Social Problems/psychology; Socioeconomic Factors*; Street Drugs/economics; Street Drugs/history; Crops, Agricultural/economics; Crops, Agricultural/history; Substance-Related Disorders/economics; Substance-Related Disorders/ethnology; Substance-Related Disorders/history; Substance-Related Disorders/psychology; History, 19th Century; History, 20th Century
MeSH terms: Humans; Japan/ethnology; Malaysia/ethnology; Prejudice; Rape/legislation & jurisprudence; Rape/psychology; Sexual Behavior/ethnology; Sexual Behavior/history; Sexual Behavior/physiology; Sexual Behavior/psychology; War Crimes/economics; War Crimes/ethnology; War Crimes/history; War Crimes/legislation & jurisprudence; War Crimes/psychology; World War II; History, 20th Century
To identify gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of Malaysia, we conducted a 20-item questionnaire interview on storage of pesticide (4 questions), mixing of pesticide (3 questions), use of personal protective equipment and clothing while spraying pesticide (7 questions), activities during and after spraying of pesticide (5 questions), and maintenance of pesticide sprayer (1 question) in 496 tobacco farmers (395 males and 101 females) in Bachok District, Kelantan, Malaysia. Duration of employment was significantly longer in females than those in males (p<0.001). In addition, proportion with no formal education in females was significantly higher than those in males (p<0.05). The following eight common factors were extracted from the 20 questionnaires by principal components factor analysis after varimax rotation in all farmers: (1) use of personal protective equipment, (2) unsafe work habit, (3) reading and following instructions on pesticide label, (4) security, storage and disposal of pesticide container, (5) safe work habit, (6) proper handling of pesticide and maintenance of pesticide sprayer, (7) use of personal protective clothing, and (8) safe handling of pesticide. Results of analysis of covariance for the eight factor scores of all male and female farmers, controlling for educational level and duration of employment, showed that: (1) factor scores for use of personal protective equipment (p<0.001), use of personal protective clothing (p<0.001) and safe work habit (p<0.001) in females were significantly lower than those in males; (2) conversely, factor scores for reading and following instruction on pesticide label (p<0.001) and proper handling of pesticide and maintenance of pesticide sprayer (p<0.01) in males were significantly lower than those in females; and (3) there were no significant differences in other three factor scores (p>0.05). We therefore conclude that: (1) for female tobacco farmers, choice of personal attire tend to result in lower scores on use of personal protective equipment and personal protective clothing while personal hygiene practices result in lower score on safe work habit; and, (2) for male tobacco farmers, the lower scores on reading and following instruction on pesticide label and mixing pesticide and maintenance of pesticide sprayer in good condition suggests that they were not primarily involved in these activities. It is postulated that these differences in safe and unsafe practices of pesticide handling across gender is related to the choice of personal attire, personal hygiene practices and division of labour within farming households which in turn is influenced by prevailing sociocultural norms in the community.
Osteoporosis is recognised as a public health problem the world over. There is increasing awareness about this problem in Malaysia and this is particularly important, as our population gets older. This brief review aims to highlight the important aspects of history taking as well as the investigative approach to the diagnosis of osteoporosis. The modalities of bone mineral density measurements particularly with regards to the diagnosis and the monitoring of the disease are also discussed.
ERCP (Endoscopic Retrograde Cholangiopancreaticography) was introduced in this hospital in late 1995. Since then, a lot of improvement have been achieved in the management of biliary tract diseases. Various general surgeons posted to this hospital have been trained in this procedure. A study was done to include all patients admitted for ERCP from August 1998 to July 1999. A total of 322 new patients with a mean of 26.9 cases a month had underwent this procedure. The duration of cannulation varied from 2 minutes to 45 minutes with a mean of 12 minutes. Cannulation rate by various surgeons differed. Overall success rate was 80%. Mortality was 0.6 % and morbidity was 0.9%. ERCP is safe and it takes at least 6 months of regular duodenoscopy before one can master the technique. Achieving 80% cannulation rate, has definitely reduced unnecessary common bile duct (CBD) explorations. During this study we have trained various surgeons in this procedure and at least 2 surgeons could be credentialled according to the guidelines provided by the Malaysian Society of Gastroenterology and Hepatology. During this study we have identified various reasons for the failure of cannulation which are useful for future training of endoscopists.
MeSH terms: Biliary Tract Diseases; Catheterization; Cholangiopancreatography, Endoscopic Retrograde; Common Bile Duct; Duodenoscopy; Gastroenterology; Humans; Surgeons
Helicobacter pylori-associated gastric carcinoma is generally more common in the antrum/body and is of the intestinal type. The aim of this study was to determine the pattern of gastric carcinoma in an area known to have a low prevalence of H. pylori. Pathology records of gastric carcinoma diagnosed at Hospital University Sains Malaysia between 1995 and 1999 were retrieved and studied. There were a total of 23 cases. The median age was 60 years. Eighteen patients were Malay and 5 were Chinese. The most common location of the tumour was the cardia/gastrooesophageal junction (61%, 14/23 patients). The majority was of the intestinal type (69.6%, 16/23). The frequency of gastric carcinoma appears to be exceptionally low in the area of study. The Chinese population was over-represented. The higher frequency of tumour in the cardia/gastro-oesophageal junction as compared to the antrum and body is in sharp contrast to most other studies. This reaffirms the notion that Helicobacter pylori infection is a causative agent for non-cardia gastric carcinomas.
Pulmonary tuberculosis (TB) in the AIDS population has a variable chest radiographic presentation. The association between the chest radiographic presentation of pulmonary TB and CD4 T-lymphocyte count in the HIV-infected patient was investigated in order to provide an empirical approach for early diagnosis, treatment, and isolation of these patients. A retrospective analysis of chest radiographs, CD4 T-lymphocyte counts, and clinical history of 80 patients from Hospital Kota Bharu, was performed. All patients were HIV-seropositive and had culture and /or cytology-proven pulmonary tuberculosis. Radiographs were evaluated for the presence of atypical or typical patterns of pulmonary TB. Thirteen (16.2%) patients had typical postprimary pattern, where opacities were distributed at the upper zones, with or without cavitation. Sixty-seven (83.8%) patients had atypical patterns, consisting of normal chest radiograph, middle and/or lower zones parenchymal opacities, mediastinal lymphadenopathy, pleural effusion and miliary TB. Of these, 18 (22.5%) patients demonstrated normal chest radiographs, 36 (45%) patients showed parenchymal opacities at the middle and/or lower zones of the lungs, 30 (37.5%) had mediastinal lymphadenopathy, 18 (22.5%) revealed pleural effusion and 6 (7.5%) presented with miliary TB. Sixty-two (77.5%) patients had CD4 T-lymphocytes count less than 200 cells/ul. Of these patients, only 1 (1.6%) had typical pattern. Eighteen (22.5%) patients had CD4 T-lymphocyte count more than 200 cells/ul, where 12 (66.7%) of them showed typical pattern. Patients with CD4 T-lymphocytes count of less than 200 cells/ul, were more likely to produce normal chest radiographs, middle and /or lower zones parenchymal opacities and mediastinal lymphadenopathy. The mean CD4 T-lymphocytes count were also found significantly lower. AIDS patients with pulmonary TB can present with both typical and atypical chest radiograph patterns. An AIDS patient who had CD4 T-lymphocytes count less than 200 cells/ul were more likely to present with atypical radiographic appearance of pulmonary TB. They required appropriate treatment and isolation until the diagnosis of pulmonary TB was confirmed.
Milk is a physiological fluid which has high nutritional value and soybean has strong antioxidant characteristics which is believed to inhibit carcinogenesis. The objective of this study was to investigate the effects of administration of soybean and goat's milk on hepatocarcinogenesis in rats (fed with diethylnitrosamine; DEN and acetylaminofluorene; AAF) by determining the activities of plasma gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP). Thirty-six rats from the species Sprague-Dawley were divided into 6 groups : control, DEN/AAF, soybean, DEN/AAF with soybean treatment, goat's milk and DEN/AAF with goat's milk treatment. Soybean and goat's milk administrations were given 5 ml/day. The rats were sacrificed after 8 weeks and the blood was collected. Treatment with DEN/AAF caused an increase in ALP and GGT levels and a decrease in weight significantly (p<0.05). ALP and GGT activities decreased significantly after administration of soybean and goat's milk (p<0.05). Administration of goat's milk and soybean alone did not cause any changes in the enzyme activities. Comparison between the effect of soybean and goat's milk in reducing the enzyme activities (ALP and GGT) did not give significant values (p>0.05). However, a decrease in weight was observed in the rats given soybean as well as goat's milk. The results obtained suggested that soybean and goat's milk may work as anti cancer agents in hepatocarcinogenesis although further studies are required to further elucidate this aspect.
Twenty-eight isolates of E. faecalis and 5 isolates of E. hirae were isolated from chicken samples obtained from markets in Sri Serdang, Selangor. They were tested for susceptibility to vancomycin and other antimicrobial agents. All of the isolates showed multiple resistance to the antibiotic tested. All Enterococcus spp. were resistant (100%) to ceftaxidime, cephalothin, erythromycin, gentamicin, kanamycin, nalidixic acid and streptomycin. Resistance was also observed to norfloxacin (97%), tetracycline (91%), penicillin (85%), bacitracin (82%), chloramphenicol (61%) and the least resistance was to ampicillin (27%). High prevalence to vancomycin resistance was detected among the E. faecalis (27of 28) and E. hirae (4 of 5) isolates. The multiple antibiotic resistance index ranging between 0.64 to 1.0 showed that all strains tested originated from high-risk contamination. Plasmid profile analysis of Enterococcus spp. revealed plasmid DNA bands ranging in size from 1.3 to 35.8 megadalton but some isolates were plasmidless. No correlation could be made between plasmid patterns and antibiotic resistance.
Hepatoblastoma is the most common primary liver tumour of childhood. This is a case report of a one-year-old boy who presented with a one-month history of progressive abdominal distension and weight loss. He was cachexic, anaemic, had gross hepatomegaly and ascites. He had been born prematurely with a birth weight of 1.23 kg, and his developmental milestones were delayed. Ultrasound and CT scan demonstrated a large solid tumour in the left lobe of the liver with a smaller superficial nodule in the right lobe. Serum alpha fetoprotein was significantly raised. A left lobe hepatectomy and complete excision of the right sided nodule was performed. There was no evidence of metastatic disease. Histopathological examination confirmed hepatoblastoma of the fetal type. The patient developed features of intestinal obstruction a few days after surgery and he succumbed ten days after re-laparotomy. The clinical presentation and investigation results in this case are characteristic. Recent reports have suggested a strong relationship between very low birth weight (< 1500gm)/prematurity and hepatoblastoma as is present in this case. Surgery is the mainstay of therapy in hepatoblastoma. A brief review of the literature on this tumour is presented.
72 subjects reporting symptoms indicating Type I hypersensitivity reactions to natural rubber latex (NRL) gloves were included in this study. 44 of them had a positive prick test to NRL. They underwent wearing tests using 2 types of NRL gloves with high (n=63) and low (n=70) allergen contents. Unigloves Malaysia with a high allergen content caused positive skin reactions in 47% of SPT-positive and no IgE-negative subjects. After application of Hand Sense skin protection cream, the frequency of positive skin responses in wearing tests decreased to 30% in prick-test-positive subjects. The Biogel Diagnostic gloves with low allergen caused hypersensitivity with and without Hand Sense in 2 cases (5%) of the prick-test-positive. 60% of all test participants had a positive prick test to NRL. No prick-test-negative subjects showed any urticaria during the glove-wearing test. Our study demonstrates that high allergen contents in latex gloves frequently elicit skin responses in NRL-sensitized subjects. Since other skin protection creams have shown to increase allergic symptoms, it is encouraging to report that Hand Sense skin cream may hamper the uptake of allergens from gloves, thus decreasing allergic reactions.
This is a study to describe the health beliefs related to oral cancer (OC) in a high-risk group in Malaysia, a predominantly Indian community living in an agricultural setting called an estate. The study population was a convenient sample of 112 adults, above 20 years of age, attending oral cancer screening in two estates. The subjects consisted of 106 (94.6%) Indians and six (5.4%) Malays. Using the Health Belief Model, the perceptions of susceptibility to OC, its severity, and the benefits of and barriers to preventive actions, as well as beliefs underlying OC aetiology were investigated. About half of the subjects (n=57, 50.9%) felt susceptible to oral cancer. A majority of subjects (n=93, 83.0%) felt that oral cancer is a severe disease. Thirty four people (30.4%) perceived OC as a preventable disease, while 56 (50%) did not, and the remaining 22 (19.6%) did not know if OC was preventable or not. The majority of subjects (84.8%) believed that modifications to the betel quid habit could be beneficial. The information solicited can be used as a starting point to design health-education activities aimed at this group in particular and the population in general.
MeSH terms: Adult; Aged; Aged, 80 and over; Areca/adverse effects; Culture*; Female; Follow-Up Studies; Health Education*; Humans; India/ethnology; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Middle Aged; Mouth Neoplasms/prevention & control*
The pathogenesis of pre-eclampsia is still unclear. Placental hypoperfusion, which precedes the maternal manifestations of pre-eclampsia, could be due to some vasoconstrictor factor/s like endothelin-1. The aim of the study therefore was to estimate the levels of endothelin-1 in feto-placental tissue homogenates from normotensive pregnant women and women with pre-eclampsia.
Empirical antibiotic treatment for febrile neutropenic patients has been the mainstay of treatment for many years. Beta-lactam antibiotics and aminoglycosides have been the most frequently used drug combination. The purpose of this study was to evaluate the efficacy, safety, tolerance and costs of single-daily ceftriaxone plus amikacin versus thrice-daily dose of ceftazidime plus amikacin.