225 women with diabetes in pregnancy were managed by a team of obstetricians, physicians (endocrinologists) and paediatricians from the National University of Singapore. A protocol of management was formulated and followed. The incidence of 1.1% or 1 in 90 pregnancies was found, with significantly higher incidence in Indians and lower in Malays. There were 37 established diabetics and 188 diagnosed during pregnancy. Of these (188), 74 were gestational diabetics. All the women were treated with Insulin and Diet or Diet alone. 177 (79%) were treated with Insulin and Diet. Blood sugar profiles were done for monitoring diabetic control. 72.8% of the women were between para 0 and 1 and 85.2% between the ages of 20 and 34. 72.5% of the women delivered at 38 weeks gestation or later. 48.9% went into spontaneous labour, 32.4% were induced and 18.7% had elective caesarean section. 62.2% of the women had labour of less than 12 hours. The overall caesarean section rate was 41.7%. There were 3 stillbirths and 2 neonatal deaths. The perinatal mortality rate was 2.2%. Thirteen babies had congenital malformations (5.8%). 77.8% of the babies had Apgar score of 7 or more at 5 minutes after delivery. 79.1% of the babies weighed between 2.5 kgm and 3.9 kgm. Pre-eclamptic toxaemia was the commonest complication in pregnancy followed by Urinary Tract Infection and Polyhydramnios. Postpartum complications in the mother were confined to 14 women (6.2%), and wound infection or breakdown was the commonest cause.
Circadian variations have been observed in the onset of acute coronary syndromes including acute myocardial infarction. We studied 422 acute myocardial infarction patients who presented to the coronary care unit of General Hospital Kuala Lumpur. Of the 318 (75.4%) patients whose data was complete, a circadian rhythm with bimodal peak was demonstrated. The second quarter of the day i.e. 6.00 a.m. to 12 noon was shown to have a significantly increased frequency of onset of acute myocardial infarction (p less than 0.05). Time delay in presenting to the hospital was also determined. This showed that 56.8% of acute myocardial infarction patients presented early, within four hours of the onset of symptoms. By six hours, more than 71% had sought hospital care. This early presentation to the hospital may offer a realistic opportunity for optimal thrombolytic therapy should this treatment modality be offered as routine to infarct patients.
In a prospective case-control study over a two-year period involving 1006 women, 264 women with acute myocardial infarction (AMI), 305 with non-infarct acute coronary syndromes (CAD) were compared with 437 women with no coronary heart disease (Controls), to determine the relationship between cigarette smoking and other risks factors with coronary heart disease. A history of current cigarette smoking was strongly associated with the risk of coronary events for both AMI And CAD (p less than 0.001). 23.9% of patients with acute coronary syndromes were current smokers, compared with only 12.8% among controls. Overall, women smokers had about a two-fold increase in risk for all coronary events. Younger women smokers (less than 40 years) and those between 61-70 years had particularly higher risks (10.3 and 2.7 times respectively (p less than 0.01, p less than 0.02). A dose-response pattern of increased AMI risks (from 2.0 to 2.9 times) among women smokers was also found, corresponding to the number of cigarettes smoked per day (p less than 0.05). Other significant coronary risk factors established were: postmenopausal status (OR 6.5), diabetes mellitus (OR 5.1), hypertension (OR 1.6), family history of premature coronary heart disease less than 50 years (OR 1.3) and use of oral contraceptive pills (OR 1.4). Our results thus emphasize that cigarette smoking is an important determinant of acute coronary events even among Malaysian women.
The 'Dextran' and the 'Buffy-coat' methods for isolation of human leucocytes for DNA extraction were compared on the basis of DNA yield from the same amounts (10 ml) of blood. Human leucocytes from a total of 11 samples were isolated using both methods for each sample after which DNA was extracted. Extracted DNA samples were treated with ribonucleases and proteinase K after which the yields were quantitated by measuring absorbance at 260 nm. The 'Buffy-coat' method yielded a mean concentration of DNA of 476.7 micrograms/ml (range: 212 to 700 micrograms/ml) while the 'Dextran' method yielded 188.4 micrograms/ml (range: 64 to 340 micrograms/ml). The difference was confirmed by subjecting the extracted DNA samples to agarose gel electrophoresis.
HIV-1 antibody patterns in two groups, those infected by the intravenous route (IV drug users) and those infected by the sexual route (prostitutes, male homosexuals and sexually transmitted disease patients) were compared using the Western blot technique. A total of 160 cases were studied. The intravenous drug user (IVDU) group appeared to respond to fewer antibody markers than the sexually infected group, the difference being significant for markers p31, p51, p55, p66, gp41 and gp120. Furthermore, a higher proportion (63%) of the sexually infected group carried antibodies to all Western blot markers as compared to the IVDU group (49%).
The Programme on Prevention and Management of Obesity in Preschool Children, aged three to six years, was implemented in 17 Primary Health Clinics in November 1991. The study sample comprised 1128 preschool children who qualified to enter the obesity register, using the defined criteria for obesity of 2 standard deviations above the normal weight for height and age. This group was divided into three categories, namely, mildly overweight (120% to below 140%), moderately overweight (140% to below 160%), and severely overweight (above 160%). The severely overweight category was referred to dietitians for follow-up management, while the other two categories were managed by the clinic staff through pre-planned nurse-conducted counselling sessions. In this paper, we analysed the first 1128 preschool children aged three to six years on the Programme with respect to their demographic characteristics; medical conditions; family history of obesity, diabetes, hypertension and ischaemic heart disease; number of siblings and parents' educational and occupational status. The Malay children showed significantly more severe grades of obesity compared to the Chinese and Indian children. A family history of obesity and hypertension among the three groups were significant (P < 0.001). After one year of follow-up with the intervention programme, the following were found: 40.4% (456) of the children improved in their obesity status and 20.2% (228) reached normal status. The severe, moderate and mild categories reduced from 6.3% to 5.9%, 29.3% to 23.2% and 64.4% to 50.7% respectively and was found to be statistically significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
"Exploring the unique experience of migration transition in Malaysia, this paper identifies the turning points in relation to the level and nature of economic and labor market developments in Malaysia. Examining the development dynamics that mark the passage from exporting labor to depending on foreign labor, the paper concludes that such dynamics are influenced not only by economic but also sociocultural, demographic and policy factors. Several lessons from the Malaysian experience are drawn at the end to be utilized by other countries that still have to reach the turning points of the migration transition."
Mosquito adults and larvae were collected from dengue high risk areas and transported to the laboratory for identification. Identified mosquitos were pooled according to the species, date and locality and stored at -70 degrees C. A total of 1,385 pools of Aedes albopictus and 267 pools of Ae. Aegypti were collected from major towns in 12 states in Peninsular Malaysia. Virus isolation was carried out using cell culture (C6/36 clone) of Ae. albopictus and detection of dengue virus by the peroxidase anti-peroxidase staining. All positive isolations were further re-confirmed by the reverse transcriptase-polymerase chain reaction (RT-PCR). Most of the pools were negative with PAP staining and RT-PCR. However, 11 mosquito pools were positive with PAP staining. On the other hand, samples from Terengganu, Pulau Pinang and Johor were positive using both methods.
The diversity of monogeneans from Southeast Asia was examined using information from the literature to show their diversity at different taxonomic (subclass, family, genera, species) levels. Knowledge of monogeneans is still incomplete in Southeast Asia and the present numbers of monogeneans are likely an underestimate of what is present on/in aquatic organisms in the region, since so few hosts have been examined. An estimate of the possible numbers of monogeneans that could be present on/in fishes and turtles in Peninsular Malaysia indicates that only 8% of the monogeneans are presently known. Analysis of the available data on monogenean diversity (or species richness) at different taxonomic levels will provide useful information on their distribution patterns. There is an uneven distribution of investigations on this topic and Malayan fauna is considered to be representative of the Southeast Asian fauna. Southeast Asian (Sundaland) monogeneans are related (at the generic level) to the monogenean fauna of South China, India and Africa.
Resistance to activated protein C (APC-R) is the commonest inherited cause of thrombosis among Caucasians. Few studies have been carried out on its prevalence in Asians. We conducted a prospective study on 60 patients with thromboembolism to determine its prevalence in our local population. The Factor V Leiden (VaQ506) mutation associated with this condition was detected by amplification of the Factor V gene by polymerase chain reaction (PCR) and digestion of the fragment with Mnl I. Three patients were found to be heterozygous for this mutation. None of the 3 patients had other concomitant hypercoagulable states. In addition, we studied the prevalence of this condition in Malays which was found to be 0.5%. Our study suggests that the incidence of APC-R is much lower here compared to the West.
Neopolystoma liewi sp. n. is described from the conjunctival cavity of the Malayan box turtle Cuora amboinensis (Daudin, 1802), in Peninsular Malaysia. This is the first record of Neopolystoma in Malaysia and the fourth polystomatid species described from C. amboinensis. Of the 27 Malayan box turtles examined, 8 were found to be infected. A maximum of 2 parasites per eye and 4 individuals per host was recorded. N. liewi sp. n. differs from all other members of the genus by possessing few and short genital spines and small marginal hooks. The oncomiracidium has 64 ciliated cells arranged symmetrically about the sagittal axis.
Sundapolystoma chalconotae. n. g., n. sp. (Polystomatidae, Polystomatinae) is proposed for a new polystomatid from the urinary bladder of Rana chalconota (Schlegel) in Peninsular Malaysia. This is the first species of polystomatid to be described from the amphibians of Peninsular Malaysia and the second for the Southeast Asian region. This new genus, as exemplified by S. chalconotae, differs from other polystomatids, and in particular Parapolystoma Ozaki, 1935 (P. bulliense (Johnston, 1912) Ozaki, 1935 and P. johnstoni Pichelin, 1995), in having a tubular uterus and a single diffuse testis. P. crooki Vande Vusse, 1976 is similar to S. chalconotae in having a similar type of uterus and testis, and is re-assigned as Sundapolystoma crooki (Vande Vusse, 1976) n. comb. S. chalconotae differs from S. crooki in having anchors with a longer outer root rather than a longer inner root and 7-8 genital spines compared to 9-13 in S. crooki.
This is a catalogue and discussion of the known dactylogyridean monogenean genera of siluriform fishes of the Old World. Of a total of 38 nominal genera, only 19 are considered valid. Seventeen of these 19 genera are currently in the Ancyrocephalidae (containing the Ancyrocephalinae and Ancylodiscoidinae), whilst the other two (Neocalceostoma and Neocalceostomoides) are in the Neocalceostomatidae. The 17 genera are Anchylodiscus, Ancylodiscoides, Bagrobdella, Bifurcohaptor, Bychowskyella, Chauhanellus, Cornudiscoides, Hamatopeduncularia, Mizelleus, Paraquadriacanthus, Pseudancylodiscoides, Protoancylodiscoides, Quadriacanthus, Schilbetrema, Schilbetrematoides, Synodontella and Thaparocleidus. Clariotrema Long, 1981 and Neobychowskyella Ma, Wang & Li, 1983 are considered synonyms of Bychowskyella Akhmerov, 1952, Anacornuatus Dubey, Gupta & Agarwal, 1992 is considered a synonym of Quadriacanthus Paperna, 1961, Mizellebychowskia Gupta & Sachdeva, 1990 is considered a synonym of Neocalceostoma Tripathi, 1959 and Hargitrema Tripathi, 1959 is treated as a synonym of Hamatopeduncularia Yamaguti, 1953. It is proposed that the Ancylodiscoidinae be raised to family status within the order Dactylogyridea to accommodate these 17 'ancyrocephalid' genera from siluriforms, together with Malayanodiscoides and Notopterodiscoides from notopterids. A key and the diagnostic characteristics of the 19 recognised dactylogyridean genera from catfishes plus two from notopterids, together with a list of species and synonyms, are included. New combinations made in this work are Thaparocleidus avicularia (Chen, 1987) n. comb., T. calyciflorus (Chen, 1987) n. comb., T. choanovagina (Luo & Lang, 1981) n. comb., T. dissimilis (Chen, 1988) n. comb., T. leiocassis (Reichenbach-Klinke, 1959) n. comb., T. meticulosa (Chen, 1987) n. comb., T. parasoti (Zhao & Ma, 1999) n. comb., T. persculpus (Chen, 1987) n. comb., T. valga (Chen, 1987) n. comb. and T. wulingensis (Yao & Wang, 1997) n. comb. [all from Silurodiscoides] and Bychowskyella glyptothoraci (Ma, Wang & Li, 1983) n. comb. [from Neobychowskyella].
Intestinal parasitic infection among five interior communities at Bakun Valley, upper Rejang River, Sarawak, Malaysia, was investigated as part of a public health impact assessment of the proposed US$ 3 billion Bakun Hydroelectric Project. Coproparasitological examination of 355 stool samples from 7 of 16 villages representing 5 of 7 tribes in the area revealed infection rate of 41%. A higher infection rate was found among the settled Kayans (56%) than the seminomadic Penans (29%). Infection rate was high (68%) among children less than 14 years old. Trichuris trichiura accounted for more than 90% of all infections; less common were Ascaris lumbricoides, hookworms and Strongyloides stercoralis. Polyparasitism was found in 8% of the individuals surveyed with dual infection due to T. trichiura and A. lumbricoides being more common than dual infection with T. trichiura and hookworm. Women had higher infection rates (57%) than men (33%).
Four new species of Calydiscoides Young, 1969 are described from three species of nemipterids caught off Kemaman, Terengganu, on the eastern coast of Peninsular Malaysia: C. monogrammae n. sp. from Scolopsis monogramma; C. conus n. sp. from S. magaritifer; C. scolopsidis n. sp. from S. margaritifer and S. monogramma; and C. kemamanensis n. sp. from Pentapodus setosus. The present investigation reveals that the squamodiscs (lamellodiscs) are composed of 10-12 short, complete, interlocking and concentric tubular lamellae. The innermost lamella is attached to a pair of adductor muscles.