One of the factors on which the incidence of leptospirosis is dependent is the survival time of shed leptospires in surface water or soil water, and this time is in turn affected by the acidity or alkalinity of the water. The authors have therefore studied the survival of four leptospiral serotypes in buffered distilled water at pH's ranging from 5.3 to 8.0. All survived longer in alkaline than in acid water, and significant differences between the serotypes were found in response to pH. Survival at pH's under 7.0 ranged from 10 to 117 days and at pH's over 7.0 from 21 to 152 days. Survival was also studied in aqueous extracts of soil samples from different areas in Malaya; no correlation was found between pH and survival time.It was also noted that in a group of Malayan ricefields a low incidence of leptospirosis in man was accompanied by a high infection rate among rodents, and when it was found that this phenomenon could not be explained by pH or salinity, attention was turned to the soil. Bentonite clay, similar to the montmorrillonite clay of the ricefields, was found to adsorb about half the leptospires in suspension. The authors recommend that field study of this laboratory observation be undertaken.
The concept of specific reading retardation was discussed, and compared with other terms used as synonymous with it viz. dyslexia and minimal brain dysfunction. It was suggested that specific reading retardation may be a more suitable term to use. The feature's of specific reading retardation, the evaluation of reading disability and management in terms of supportive psychotherapy, environmental manipulation and remedial education was described, using a case-report. of a 13-year old boy with such a disorder as an example.
Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Matched MeSH terms: Attention Deficit Disorder with Hyperactivity/physiopathology
Latah is a culture-bound syndrome from Malaysia and Indonesia. Persons exhibiting the Latah syndrome respond to minimal stimuli with exaggerated startles, often exclaimning normally inhibited sexually denotative words. Sometimes Latahs after being startled obey the commands or imitate the actions of persons about them. Most episodes of Latah are intentionally provoked for the amusement of onlookers. Similar sets of interactive behaviors have been reported from genetically and culturally unrelated populations (e.g., Bantu, Ainu, and French Canadians). Since competent anthropological investigators have shown Latah to be intimately tied to specific factors in the cultural systems of the Southeast Asian societies in which it is found, its occurrence elswhere has been considered paradoxical. New data, including films and videotapes of hyperstartling persons from Malaysia, the Philippines, Japan, and the United States, suggest a model capable of resolving the apparent paradox by showing how the various forms of latah are culture-specific exploitations of a neurophysiological potential shared by humans and other mammals. Latah provides an especially revealing example of the complex ways in which neurophysiological, experiential, and cultural variables interact to produce a strongly marked and phenomenon.
As part of a research programme concerned with the need to lighten the load carried by soldiers engaged in long foot patrols, a field experiment was undertaken in West Malaysia. For 12 d a group of 15 men consumed 7.4 MJ/d (1770 kcal/d) whilst a control group of 14 men ate 12.9 MJ/d (3080 kcal/d); both groups expended on average about 15.8 MJ/d (3770 kcal/d). The low-energy group incurred an energy deficit of 98 MJ (23 410 kcal) with a weight loss of 3.9 kg, whereas corresponding figures for the control group were 37 MJ (8840 kcal) and 2.4 kg. Before, during and after the energy deprivation phase, assessment was made of work capacity (estimated VO2 max), vigilance and military skills but no difference was found between the groups.
Cognitive impairment has been reported to occur in minor head injury (concussion). The value of the P300 evoked potential as a measure of cerebral concussion was studied in 20 patients with minor head injury and compared with the data from 20 normal subjects. Significant abnormalities of the P300 latency and amplitude were noted in these patients in the post-concussion period. The abnormalities improved completely on repeat testing. The correlation of the P300 to other parameters of head injury is discussed. The P300 constitutes a simple laboratory test that is sensitive measure of cerebral dysfunction in concussive head injuries.
There is an increasing prevalence of diabetes mellitus around the world associated with rapid sociocultural development and changing lifestyles. Increased prevalence of obesity, with a higher consumption of animal products and lower consumption of fruits and vegetables, increases the risk of diabetes mellitus and other chronic degenerative diseases. Insulin-dependent diabetes (IDD) is caused by insulin deficiency, whereas the main feature of non-insulin-dependent diabetes (NIDD) which accounts for more than 90% of diabetics, is hyperinsulinemia and insulin resistance, which may eventually lead to actual insulin deficiency. Hyperinsulinemia is undesirable because it increases the risk of developing vascular disease. In Malaysia, the prevalence of NIDD in some communities now exceeds 5%, and of impaired glucose tolerance 10%. Along with these increases in prevalence of hyperglycemia are increases in prevalence of overweight (BMI>25) and almost certainly abdominal fatness. In terms of management, nutrition is given priority. Insulin and hypoglycemic drugs (sulphonylureas or biguanides), where required, may adversely affect body composition if overused. Newer therapeutic strategies require greater attention to the underlying problem in NIDD of abdominal fatness by attention to the relevant nutritional factors, physical activity and other lifestyle factors like cigarette smoking and alcohol. The greater impact of obesity and diabetes on Malaysian women as opposed to men also needs to be addressed.
This study was conducted to determine the health status of aboriginal ("Orang Asli') children aged 0-12 years in Post Brooke, Gua Musang, Kelantan. This is done by appraising the environmental status, patterns of illnesses including communicable diseases and usage of health resources. Six villages were selected randomly from 12 villages in the area; 179 families were interviewed, 200 under-12-year-olds were examined and their blood samples taken for haemoglobin (HB) estimation as well as malarial screening. Water supply through Gravity Feed System (GFS) was used by 134 families (70.2%) whilst the rest obtained water direct from the river for the purpose. Only 63.6% of families boiled their drinking water 56.4% families threw rubbish indiscriminately, while 82.1% used the river as their toilets. Eighty-seven percent of the families saw the village medicine man first when ill. Forty (22.2%) children had had serious illnesses including malaria and 24 were admitted to hospitals. 15% of the children had never been immunized. A total of 102 (51%) children were pale and 90 (45%) had brown hair. Eighty nine (44.5%) of the children were anaemic (Hb < 10 gm/di). Sixty-nine children (34%) had dental caries. Forty-two (21%) had distended abdomen and 37 (18.5%) had hepatomegaly. Out of 84 stool samples examined, 67 (79.8%) had helminthic ova. Of all families, 47.1% gave a past history of at least one baby among their children who had died due to one reason or another. The health status of this community (especially children) was low that it warrants special attention.
A sample of 204 handicapped children below 12 years of age consisting of 121(59.3%) males and 83 (40.7%) females who were classified into various types of mental and physical handicaps, were surveyed in April and May 1996. The majority of those with mental handicaps were Down Syndrome while those with cerebral palsy were the mostfrequent cause of physical handicaps. A structured questionnaire was used for interviewing the children parents to evaluate their attitude towards their handicapped children. The majority of the parents expressed their opinions that having handicapped children was not a burden to them although these children had to be given more attention. However, a significant minority felt that the child would be afinancial burden to the family and that he/she would restrict the social life of the family. The majority of the children were sent to school, as parents felt it was their duty to do so. For those children not attending school, the majority of parents felt that the children would not benefit by going. The others could not do so because offinancial constraints or because of the distance between home and school. For these children, provid-ing hostel facilities in a boarding school could be the answer. This study shows that parental love and support plays a major role in ensuring optimal growth and development of a handicapped child
Thinking is something that we do all through our lives - an activity thcit possibly antedates our very birth itself Yet our children and we are not told about thinking or taught about the thinking process that dominates our lives, possibly, because of our own limited under-standing. Consequently, children are told to be logical and are discouraged from thinking differently, because it is the only type of think-ing we know and can understand. Methods of assessing their performance based on logical thinking underestimate their true potentials. The creative potentials of these children, 40% of who are right-brained need to be harnessed by approaches to learning that utilize methods of teaching and assessment, appropriate for their style of thinking. Another group of children, who need special attention, are those with learning disabilities that have been ignored, but can be corrected with appropriate programmes that provide a comprehensive approach to regular and special education.
Oral recurrent aphthous stomatitis is the most common oral mucosal disease. Despite much clinical and research attention, the causes remain incompletely understood. Treatment options include no treatment, treatment of associated systemic diseases, topical medications, systemic treatment and palliative treatments. The most effective treatments involve agents that suppress or modulate the immune function. Topical agents are preferred due to its limited side-effects. Adjunct pain control and prevention of secondary infections is sometimes necessary.
Significant advances in perinatology and neonatology in the last decade have resulted in increased survival of extremely premature infants.' Survival rates at 25 and 26 weeks of gestation age ranging from 60% to 82% and from 75% to 93%, respectively, have been reported.' In Malaysia, the survival rates among premature very low birth weight infants (< 1500 g) were reported to be between 69% and 78%.2,3 Such improvements of survival have been attributed to the advances in the management of respiratory disease and intra-ventricular haemorrahge in the premature infants.',2 Thus, attention have recently been focused on the need to secure adequate nutrient intake of these premature infants. Parenteral nutrition has often been used to manage the transition between transplacental nutrition in-utero and post-natal enteral nutrition, but is associated with cholestasis and sepsis.4 However, the ability to deliver nutrition is limited not only by immature absorptive or digestive function but by inadequate motor activity. Gastroesophageal efflux (GER) and feeding intolerance are the major gastro-enterological problems of the premature neonates.
A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ¡Ã30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ¡Ã140 and/or DBP ¡Ã90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of “high risk†individuals (TC ¡Ã6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
Confirmatory factor analysis (CFA) was used to model a multitrait by multisource matrix to determine the convergent and discriminant validity of measures of attention-deficit hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) in 917 Malaysian elementary school children. The three trait factors were ADHD-IN, ADHDHI, and ODD. The two source factors were parents and teachers. Similar to earlier studies with Australian and Brazilian children, the parent and teacher measures failed to show convergent and discriminant validity with Malaysian children. The study outlines the implications of such strong source effects in ADHD-IN, ADHD-HI, and ODD measures for the use of such parent and teacher scales to study the symptom dimensions.
Matched MeSH terms: Attention Deficit Disorder with Hyperactivity/diagnosis; Attention Deficit Disorder with Hyperactivity/ethnology*; Attention Deficit Disorder with Hyperactivity/epidemiology; Attention Deficit and Disruptive Behavior Disorders/diagnosis; Attention Deficit and Disruptive Behavior Disorders/ethnology*; Attention Deficit and Disruptive Behavior Disorders/epidemiology
A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
A cross·sectional study was done to determine the capacity of Public Health Inspectors in Selangor using a seh administered questionnaire and universal sampling, to determine the enforcement of public health legislation and its influencing factors. A total of 99 respondents from the District Health Offices and 100 respondents from the Local Health Departments participated. The level of enforcement is generally low in all the units except for the Food Unit and Sanitary and Hygiene Units. Factors influencing enforcement of Public Health Legislations are the unit where the respondents worlc and the length of service with the unit. Further analysis using multiple logistic regression, found that respondents from the Food Unit (OR ZZ; 95% C1: 7 .9-58.9 ) , being in the
U8 category (OR 5; 95% C1: l.4» 17.6), service offour years and above in the same unit (OR 6; 95% C1: 2.2»13.8) , received service rewards (OR 3; 95% C1 : 1.2· 6.9); low exposure to bribery (OR 46; 95% C1: 2.3·100.0) and offered bribes while on the field (OR 3; 95% C1: 1.02» 4.8) have higher kvel enforcement performance. Attention must be given to the enforcement organization with respect to duration of service, service awards and monitoring of bribes exposure to help develop the enforcement of public health legislations.
Several studies had shown that the problem of plate waste in hospitals ranged from 17% to 67%. This study aimed to determine the extent of plate waste in a district government hospital, the type of food item wasted and the factors contributing to food waste. A oross»sectional study was conducted in a district hospital, involving four third class wards. A total of 300 patients were included in the study. A plate waste was dehned as the proportion of edible portion of food served that was discarded by patients. The serving size was established by weighing each food item served over breakfast, lunch and dinner on a seven·day rotation menu, using the procedure recommended by the National Food Service Management, During the study period, the left over from each patient’s plate was weighed for all meals. The plate waste for each patient was determined by dividing the total weight of the left over with the average serving weight for the same serving in the same ward. Each patient was also given a self-administered questionnaire to obtain information on reasons or not consuming the ood items served. The overall mean ercentage plate waste of all food served in the four wards was 42.6%. Plate wastage occurred most at dinner (53.2%) and least at breakfast (31 .3%). Vegetables were the most wasted food items. Females wasted significantly higher than males for all meals. Food taste, portion size, appetite and staff service efficiency were factors found signihcantly contributing to plate waste. With almost half of the food served was wasted, hospital management need to direct more attention towards addressing the problem of plate waste since it has both nutritional and cost implications.
The objectives of this study is to evaluate subjective symptoms and neurobehavioral performances among workers exposed to lead and its relation with blood lead levels. The methodology of this study was restricted to 141 Malaysian battery manufacturing factories male workers with mean (SD) age of 35.2 (9.6) years, years of employment 9.1 (7.1), current blood lead concentration 40.5 (16.8) μg/dl were given WHO neurobehavioral core test battery. Results showed that highly exposed group blood lead level (high ≥ 40 μg/dl) performed less well in 4 of 13 responses reported higher subjective symptoms of weakness of lower limbs and anorexia. Significant correlation was found between blood lead and Digit Symbol, Digit Forward, Digit Backward, Aiming Pursuit Test and Trail B. Regression analysis showed reduction in cognitive, memory and concentration functions at ≤ 30 μg/dl blood lead levels with maximum lead effect at Digit symbol’s score at 40 μg/dl. In conclusion, this study is consistent with the larger body of neurobehavioral tests in lead exposure and has proven the ability of these tests in detecting low level of lead toxicity.
Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.
Increased oxidative stress and mitochondrial dysfunction have been identified as common pathophysiological phenomena associated with neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease (PD) and Huntington's disease (HD). As the age-related decline in the production of melatonin may contribute to increased levels of oxidative stress in the elderly, the role of this neuroprotective agent is attracting increasing attention. Melatonin has multiple actions as a regulator of antioxidant and prooxidant enzymes, radical scavenger and antagonist of mitochondrial radical formation. The ability of melatonin and its kynuramine metabolites to interact directly with the electron transport chain by increasing the electron flow and reducing electron leakage are unique features by which melatonin is able to increase the survival of neurons under enhanced oxidative stress. Moreover, antifibrillogenic actions have been demonstrated in vitro, also in the presence of profibrillogenic apoE4 or apoE3, and in vivo, in a transgenic mouse model. Amyloid-beta toxicity is antagonized by melatonin and one of its kynuramine metabolites. Cytoskeletal disorganization and protein hyperphosphorylation, as induced in several cell-line models, have been attenuated by melatonin, effects comprising stress kinase downregulation and extending to neurotrophin expression. Various experimental models of AD, PD and HD indicate the usefulness of melatonin in antagonizing disease progression and/or mitigating some of the symptoms. Melatonin secretion has been found to be altered in AD and PD. Attempts to compensate for age- and disease-dependent melatonin deficiency have shown that administration of this compound can improve sleep efficiency in AD and PD and, to some extent, cognitive function in AD patients. Exogenous melatonin has also been reported to alleviate behavioral symptoms such as sundowning. Taken together, these findings suggest that melatonin, its analogues and kynuric metabolites may have potential value in prevention and treatment of AD and other neurodegenerative disorders.
The purpose of this study was to examine the measurement (configural, metric, scalar, and residual) and structural (factor variance, factor covariance, and factor means) invariance of parent ratings of the attention-deficit/hyperactivity disorder - inattention (ADHD-IN), ADHD - hyperactivity/impulsivity (ADHD-HI), and oppositional defiant disorder (ODD) symptoms as described in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) across boys and girls. In an American pediatric sample (N = 1,015) and a Malaysian elementary school-age sample (N = 928), there was strong support for configural, metric, scalar, residual, factor variance, and covariance invariance across gender within each sample. Both American and Malaysian boys had significantly higher scores on the ADHD-IN and ADHD-HI factor means than did girls, whereas only in the American sample did boys score significantly higher on the ODD factor than did girls. The implications of the results for the study of gender, ethnic, and cultural differences associated with ADHD and ODD are discussed.
Matched MeSH terms: Attention Deficit Disorder with Hyperactivity/epidemiology*; Attention Deficit Disorder with Hyperactivity/psychology*; Attention Deficit and Disruptive Behavior Disorders/epidemiology*; Attention Deficit and Disruptive Behavior Disorders/psychology*