1. The Malayan Medical Journal as the offcial organ of the British Medical Association Malaya branch
2. The cure of opium habit
3. Infectious jaundice
4. The Institute for Medical Research Kuala Lumpur
5.
In a survey of over 1,000 patients with leprosy, 47 cases ( 4.4 per cent) were found to have glucose-6-phosphate dehydrogenase deficiency. A controlled clinical study suggests that such a deficiency does not modify the overall response to therapy but may predispose to a greater tendency to leprosy reactions. All patients were receiving 600 to 800 mgm. of sulphone per week and none had a frank haemolytic anaemia.
The data presented is part of the findings from a four-year collaborative research project between Universiti Putra Malaysia, the Institute for Medical Research and the Ministry of Health Malaysia. The project assessed the nutritional status of the major functional groups in Peninsular Malaysia. Mukim Sayong and Pulau Kemiri in the District of Kuala Kangsar, Perak were two of the subdistricts selected to represent small rubber holdings in Peninsular Malaysia. This paper attempts to analyse the socio-economic profile of the households and the nutritional status of children below 9 years of age. A total of 307 households were studied. Approximately 63% of the households were involved in rubber activities and the majority of them were hired tappers. The average monthly income of the households was RM467 and the income ranged between RM30 to RM2120. Based on the per capita poverty line income of RM84.38, it was found that 14.1% of the households earned less than RM42.19, which can be considered as hard-core poor, while 32.7% were poor (monthly per capita income between RM42.19 and RM84.38). Slightly more than half (52.7%) earned income above the poverty line. The average family size was 4.5, ranging from 1 through to 16. The majority of the heads of households (56.6%) had between 3 and 6 years of education, and 14.5% did not receive any formal education. The prevalence of stunting among children 0-5 years of age was 26%, while 31.5% were underweight and 3.8% wasted. Among children aged between 5 and 9 years, almost the same pattern of nutritional status was noted. The overall percentages of stunting, underweight and wasting among these children were 29.2%, 26.1% and 0.62%, respectively. Analysis on nutritional status according to income level showed a noticeable difference in the prevalence of malnutrition in children above and below the poverty line income. The Student's t-test indicated significant differences in weight-for-age and weight-for-height between the two poverty line income for children below 5 years of age. Pearson's correlation coefficient showed a significant correlation between height-for-age with household size (r = -0.26, p<0.05), and monthly per capita income with weight-for-height (r = 0.25, p<0.05). There was a highly significant correlation between acreage of land cultivated and weight-for-height (r = 0.42, p<0.01), and weight-for-age (r = 0.25, p<0.05). The findings indicated the influence of socio-economic factors on the nutritional status of children.
p53 is the most commonly mutated gene in human cancers. It encodes a 53 kilodalton protein with several evolutionarily conserved domains viz sequence-specific DNA binding, tetramerisation, SH3 molecule binding, C-terminal and N-terminal. Existing in the cell at a very low level and in a relatively inactive form, p53 protein is increased and activated during periods of cellular stress. Unlike other proteins, the increase in protein level and its activation result from modification of the protein rather than genetic transcriptional or translational upregulation. Normally, Mdm2 protein interacts with p53 protein and effectively targets it for ubiquitin proteolysis within an autoregulatory feedback loop. Phosphorylation at the N-terminus reduces p53 interaction with Mdm2 with a resultant increase in p53 protein level. Modification at the C and N termini via phosphorylation or acetylation upregulates binding to specific DNA targets increasing transcription of these downstream genes. The net effect of p53 protein increase and activation lies in arrest of the cell in cycle which allows time for repair of the incurred damage or apoptosis or death of the cell. Failure of these normal protective and adaptive mechanisms caused by mutation of the p53 gene with product of an abnormal protein, loss of p53 protein through interaction with and degradation by HPV E6 protein or overexpressed Mdm2 etc. permits DNA-damaged cells to continue replicating. Left unchecked, this frequently contributes to tumourigenesis. Various methods have been devised to screen for mutations of the p53 gene, still the most common source of failed p53 mechanism. These include immunohistochemical detection of mutated proteins or identification of altered electrophoretic mobility of mutated p53 sequences. Sequencing of the gene nonetheless remains the most accurate method for determination of mutation. Major advances have been made in p53 research but the most meaningful probably lies in the promising results achieved in tumour therapy where introduction of wild type p53 gene has resulted in regression of non-small-cell lung cancer (NSCLC). Many other notable developments in this field include description of p53 homologues, "gain of function" mutants, p53 polymorphisms, angiogenesis-inhibiting properties of wild type p53 protein etc.
Influenza has always been wrongly perceived as a minor disease which is no dwerent than common cold. Influenza affecting all age groups cause a considerable morbidity and mortality although the data are not well established in Asia Pacwc. In the United States, it claims similar order of mortality as that due to car accidents. Inflluenza A and B can cause epidemic human disease. New Influenza virus variants develop frequently due to antigenic dry?. The rapid evolution of both influenza A and B virus is responsible for annual influenza epidemics in humans. Although in Malaysia, Influenza Surveillance began in 1954, the disease awareness is still low. It is
prudent to continue the surveillance throughout in order to monitor the seasonal trend, circulating strain as well to prepare us from an epidemic or pandemic. Institute for Medical Research, being the sole WHO National Reference lab in this country committed in improving the Influenza Surveillance which will involve all the states in Malaysia in the near future.
The hand, foot, and mouth disease (HFMD) outbreak occurred in the state of Johor, Malaysia in the months 0f October and November 2000 aber the HFMD outbreak started in Singapore in September 2000. The HFMD notification and investigation forms sent to the Epidemiology Unit of the Johor Health Department from district health offices and hospitals during the outbreak were analysed. Patients’ specimens were sent to the Institute for Medical Research, Kuala Lumpur and the Universiti Malaya Medical Centre, Kuala Lumpur for viral isolation. A total of 1,122 HFMD cases were notified during the outbreak period with 2 deaths giving 0.2% casefatality rate. From all the cases, 544 (48.5%) patients were admitted to the hospital while the rest were treated as outpatients. Majority (81.7%) of children with HFMD were aged below 5 years old with the commonest age group (46.9%) being between 1 to 2 years old. Sixty-eight patients had positive specimens for viral isolation belonging to enteroviruses namely Enterovirus 71 (43 cases), Coxsackievirus Type A16 (11), Echovirus 7 (3), and Coxsackievirus Type B (2); and non-enteroviruses namely Herpes Simplex Virus Type 1
(5), and Adenovirus (4). Fever and mouth ulcer were the two most common symptoms among HFMD children but vesicles on palms and soles were more common than rashes in children with positive enteroviral isolation.
Study site: University Malaya Medical Centre (UMMC)
University Malaysia Sabah campus moved to its present site in Kota Kinabalu, Sabah, Malaysia in 1999. A health centre was included in the development plans and a two-storey building was constructed to provide the facility for in-patient and out-patient care. Clinical catchments include 10,000 students, 1000 academic and support staff. The medical faculty was inaugurated in 2003, and it was given the responsibility to establish and run the facility for students and staff of the University. This paper describes the development of the facility from merely a physical structure to what is now a comprehensive, functional outpatient service catering for student healthcare, screening, preventive medicine and health promotional activities. Currently, these services are provided by the faculty members of the Medical School. The incorporation of the medical student teaching and collaborative research adds intangible value to the facility. Future plans for expansion include specialist medical services.
Evidence thus far still supports the contention that fish derived omega-3 fatty acids, EPA and DHA, are good for heart patients. But this controversy tells us something about the medical research, and the acquisition and application of medical knowledge. Being scientists, doctors try to perform studies as rigorously as possible with randomised, placebo-controlled trials and using tests of statistical significance. But since the studies are on humans, with all their individual differing habits and inconsistencies, different results are produced by different researchers. And so while medicine is a science, in that the trials are scientifically conducted, the interpretation of the results, and in particular its application for the individual patient, is very much an art. A good doctor, like the good artist, must spend much time, energy and effort sieving through the good from the not so good data before coming out with the correct picture. Only by keeping an unbiased, inquisitive mind can the evidence be reviewed to solve the problem at hand. Almost always, the balance of data will favour a particular stand. In this day when newspapers are full of medical articles, a family physician has to be educated, interested and inquisitive to be a source of accurate and relevant information for the patients.