In the light of present HIV worldwide epidemic. there is a need to teach the busy general practitioners how to recognise HIV & AIDS. Due to the deadly nature of this infection and its manifold presentations from opportunistic diseases. the busy general practitioners in primary care may be misled in making the correct diagnosis. In Malaysia. the doctors in the primary care level constitute 70 to 75% of the doctors' population. The rest are specialists in secondary and tertiary care institutions. Family Physicians from the Font liners to recognise and detect early cases of HlV in all its early manifestalions on the various systems. Any doctors in primary medicine whether from private or public sector, amy be confronted by patients who present with trivial complaints. These patients may be fee-paying, or particularly those doctors involved with welfare and health of factory workers and the other forms of the main work force should well arm themselves with updates in HIV and AIDS.
This paper reviews the literature on blood pressure profile and hypertension studies carried out in Peninsular Malaysia from 1952 to 1988. From these studies, the following key information is summarised: 1. Blood pressure profiles of Malaysians, irrespective of sex and the three major ethnic groups viz., Malay, Chinese and Indian followed a similar rising trend with age. 2. The mean systolic and diastolic pressures were 134 mmHg and 84 mmHg respectively across the major ethnic groups. 3. The prevalence of hypertension for Malaysians was 16.0%, 4.2% and 3.4% when 140/90 mmHg, 150/90 mmHg or a diastolic pressure of 100 mmHg or greater were taken as cut-off values respectively. Males generally showed a higher prevalence of hypertension than females. 4. Orang Asli living in the deep jungle had relatively low blood pressures (Mean: 109/70 mmHg) and their blood pressure did not rise with increasing age. 5. There was generally no difference in the prevalence of hypertension amongst the major ethnic groups. However, there was a tendency for the Malays to have a higher prevalence of hypertension than the Chinese or the Indians. 6. There was an increased prevalence of hypertension among subjects who smoked heavily or who did very little or no physical exercise. Differences in prevalence of hypertension among subjects living in changing environment and lifestyle, such as urban versus rural, alcohol versus non-alcohol consumers and low income versus moderate income groups were not evident in the studies reviewed. 7. Percent unawareness of hypertension in hypertension subjects was generally high i.e. 57 % - 69% except in one sample which recorded a moderately value (33%).
In the evaluation of the infertile couple, male factors account for up to 50% of causes. These factors may occur alone or in combination with female causes. Transrectal ultrasound has allowed imaging of the urogenital tract to be less invasive. New assisted reproductive techniques (ART) have revolutionised management. Many previously "hopeless" cases now have a good chance of fathering a child. Such ART include microscopic epididymal sperm aspiration (MESA) and intracytoplasmic sperm injection (ICSI).
Despite time, mobility, knowledge and other constraints, it is still possible for General Practitioners to play an active role in Palliative Care. This article offers various roles where GP can play. Differences between hospice, palliative medicine, palliative care are discussed. Suggestions are made on where to seek formal or informal education on palliative care. Key Words: role, hospice, palliative medicine, palliative care, illness, sickness
The population of Malaysia is approximately 14 million and theoretically 1 in 2500 marriages are between heterozygotes for thalassaemia and 1 in 10,000 children can be expected to have thalassaemia major. Hypertransfusion is not possible because of insufficient blood supplies and each child requires an iron chelator, Desferal, at US$5800 a year for life: this high cost makes it sizeable proportion of the 'active reproductive' population. Abortion is not legal and antenatal diagnosis has not bee established. An approach to the prevention of this disease would be public education and identification of carriers. Numerous techniques have been utilised in population screening for traits of thalassaemia and haemoglobinopathy. These include osmotic fragility tests; blood smear examination for basophilia, microcytosis, and hypochromia; and genetic studies. Blood smear examinations are extremely subjective and interpretations depend upon the skills of a trained technologist. Osmotic fragility tests although cheap are cumbersome and require accurate preparations of saline solutions. Genetic studies are not available in the region. The medical examination for entrance to colleges and institutions includes investigative procedures such as chest x-ray and urine examinations. In addition a blood sample could be analysed for the red cell parameters. A similar study could be attempted for all secondary school leavers. The current estimated cost on the Coulter S as in this study was 80 cents (U.S.) in contrast to the prohibitive costs of managing a case of transfusion-dependent thalassaemia. These two groups would cover a sizeable proportion of the 'active reproductive' population. Analysis of the red cell parameters provides useful information for the identification of carriers of alpha-, beta-, delta-beta-thalassaemia and HbE. Additional studies which include haemoglobin analysis and serum ferritin would provide the necessary evidence for the confirmation of these findings.
Hereditary haemolytic anaemias, in particular, thalassaemia and the haemoglobinopathies, have been found to be a significant cause of hereditary haemolytic disease in West Malaysia. Theoretically 1 in 2500 marriages are between heterozygotes for beta-thalassaemia and 1 in 10,000 children can be expected to have thalassaemia major. An approach to the prevention of this disease would be public education and identification of carriers: to develop some approach to the identification and genetic counselling of beta-thalassaemia trait.
Periods of extreme food abundance, such as irregular masting events, can dramatically affect animal populations and communities, but the extent to which anthropogenic disturbances alter animal responses to mast events is not clear. In South-East Asia, dipterocarp trees reproduce in mast fruiting events every 2-10 years in some of the largest masting events on the planet. These trees, however, are targeted for selective logging, reducing the intensity of fruit production and potentially affecting multiple trophic levels. Moreover, animal responses to resource pulse events have largely been studied in systems where the major mast consumers have been extirpated. We sought to evaluate the influence of human-induced habitat disturbance on animal responses to masting in a system where key mast consumers remain extant. We used motion-triggered camera traps to quantify terrestrial mammal and bird occurrences in Sabah, Malaysian Borneo, relative to variation in fruit biomass from 69 plant families during a major (2014) and minor (2015) masting event and a non-mast year (2013), in both logged and unlogged forests. Bearded pigs (Sus barbatus) showed the clearest responses to masting and occurrence rates were highest in unlogged forest in the year following the major mast, suggesting that the pulse in fruit availability increased immigration or reproduction. We also detected local-scale spatial tracking of dipterocarp fruits in bearded pigs in unlogged forest, while this was equivocal in other species. In contrast, pigs and other vertebrate taxa in our study showed limited response to spatial or temporal variation in fruit availability in logged forest. Our findings suggest that vertebrates, namely bearded pigs, may respond to masting via movement and increased reproduction, but that these responses may be attenuated by habitat disturbance.
After twenty-four years of government efforts, the latest national recycling rate in Malaysia rose from 5% in 1993 to approximately 24.6% in 2017. However, the practice of solid waste recycling in developing countries is still challenging compared to developing countries. Especially in Malaysia, a multi-ethnic country where people with different ethics have different living lifestyles. Still, Malaysia faces rapidly increasing solid waste and management costs, lacks appropriate data on solid waste management and recycling, lacks awareness of the 3R's (reduce, reuse and recycle) culture and lacks policies to promote 3R's culture. In addition, prior to the enforcement of ACT 672, information and networks between stakeholders have been limited for more than 20 years. Some scholars believe that the success of recycling practices is mainly influenced by community recycling behaviours. Therefore, in order to improve and evaluate the effectiveness of current national solid waste recycling management systems, research and assessment of community recycling behaviours are essential. This paper aims to evaluate the factors that attract communities to implement recycling in their daily lives and to obtain data through quantitative survey methods. Face-to-face questionnaires are conducted through purposive sampling and collected data is further analysed by PASW statistical tools. The comparison between recyclers and non-recyclers are presented in terms of frequency, means scores and radar chart. The results indicate that policy makers involved in the planning, organisation, and implementation of community recycling programs have to focus on strategies that engage community members and adopt recycling practices to improve environmental impact by changing their attitudes. Based on the results of means scores, the type of age, occupation and place of life must be taken into consideration in order to organize future recycling campaigns or awareness programs. In conclusion, the information will help policymakers make better solid waste recycling management to meet the needs of the public.