The Asia-Pacific region has at least 50% of its population at risk for malaria. In Malaysia, indigenous malaria is largely concentrated among the Orang Asli in Peninsular Malaysia. A cross-sectional study was conducted in an Orang Asli community in the district of Raub, Pahang, to determine the predictors of malaria. Age, seldom/never wearing protective clothing while in the jungle, going out at night, ever staying in another village, and living in bamboo-walled homes were found to be associated with malaria (crude odds ratio = 1.8-4.5; 95% confidence interval [CI] = 1.1-9.1) After adjusting for confounding, major predictors of malaria were age < or =12 years (adjusted odds ratio [aOR] = 4.3;95% CI = 2.2-8.4),), never/seldom wearing protective clothing while in the jungle (aOR = 3.8; 95% CI = 1.8-8.0), and going out at night (aOR = 2.5; 95% CI = 1.4-4.8). The findings lend support for intensifying behaviour modification in this population.
The nasal profile and skin thickness in the Caucasian Indian vary from the Oriental Chinese or Malay noses. Reduction rhinoplasty is more common in the Caucasian Indian noses whereas augmentation rhinoplasty is more common in the Oriental Chinese or Malay noses. Graft selection remains the greatest challenge for surgeons performing rhinoplasty. However, the preferred choice as far as possible for nasal reconstruction would be autografts as compared to allografts due to their lower rate of infection, extrusion and they do not induce an immune response. We have evaluated 40 patients and compared our experience with the grafts available over a period of 46 months.
Enteric duplication is an uncommon malformation of the gastrointestinal tract which is either asymptomatic or presents with vague symptoms mimicking other more common pathology. It is most commonly diagnosed when complications such as bleeding, intestinal obstruction or perforation occurs. This is a case report of a patient with this condition presenting with right iliac fossa pain and localised peritonitis mimicking acute appendicitis.
This is to report on the use of growing endoprosthesis, also known as lengthening prosthesis in the management of four patients in the paedriatic age group in the Orthopaedic Oncolgy Unit at University Malaya Medical Centre. These are custom made prosthesis, designed and made in India based on measured roentrograms. The ages of these patients vary from 6 to 13 years old. These are cases of Osteosarcoma and Ewing's sarcoma around the knee. This is the first time these custom made prosthesis have ever been used in Malaysia. We feel that this is a feasible option for limb salvage in the treatment of primary bone tumours in growing children.
Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral permanent canine (13) and premolars (14 and 15) have erupted. Upon radiographic examination, a mass which was diagnosed later to be compound odontome was detected. The treatment consisted of surgical removal of the odontome, extraction of the primary canine (63) and left permanent canine (23), and transplantation of the permanent canine (23). The management of this case and the literature related to autotransplantation are discussed.
Craniofacial resection is commonly performed in the surgical resection of sinonasal tumours involving anterior skull base. It entails a bicoronal scalp flap with lateral rhinotomy or an extended lateral rhinotomy to expose the anterior skull base. Transfacial approach is necessary in the resection of the nasal part of the tumour. The choice of surgical approach is based heavily on the surgeon's experience and training. The results of endoscopic-assisted craniofacial resection for sinonasal tumours performed in our center in eight patients from 1998 to 2005 were reviewed. There were seven males and one female with age ranging from 18 to 62 years (mean 42.4 years). There was each a case of mature teratoma, poorly differentiated squamous cell carcinoma, undifferentiated squamous cell carcinoma, olfactory neuroblastoma, fibrous dysplasia, inverted papilloma and two cases of sinonasal neuroendocrine carcinoma. The mean follow up duration for these eight patients post surgery was 21.4 months. Out of eight patients, five underwent surgery with no adverse complications. The complications encountered were a cerebrospinal leak and a postoperative transient V and VI cranial nerve palsy. One patient with sinonasal undifferentiated carcinoma died of lung metastasis at 11 months post-surgery. The endoscopic-assisted craniofacial resection is a highly useful surgical technique to avoid the unsightly facial scar of the lateral rhinotomy or the Weber-Ferguson incision, postoperative paranasal sinuses infection and avoidance of tracheostomy in selected cases. We found that this approach has lower morbidity rate in selected cases.
Orang Asli, the indigenous people of Peninsular Malaysia comprises only 0.5% of total Malaysia population but contribute to 0.06% of total notified HIV cases in the country. Their current knowledge, attitude and practice related to HIV was not known. A cross-sectional study on knowledge, attitude and practice among Orang Asli in Peninsular Malaysia was carried out involving 2706 Orang Asli from 33 remote and 47 fringe villages. Generally, the level of knowledge was fair (30%-50%) with mean scores of 55.7% (SD 31.7) while attitudes were negative. There was gender bias towards misconception on HIV transmission and sources of information. HIV seroprevalence of 0.3% was detected while risk behaviors were low. This study provides baseline information for HIV/AIDS preventive programs to the Orang Asli communities.
A cross sectional descriptive study of 2048 subjects was conducted to determine the prevalence of depression and factors influencing depression among students in secondary school from urban and rural areas in the state of Selangor, Malaysia. The children's depression inventory (CDI) developed by Maria Kovacs was used in this study. Students who participated in this study come from two urban schools and three rural schools. It was found that in the yield for scores for five factors were 9.2% have negative mood, 5% have interpersonal problems, 8.3% have ineffectiveness, 9.8% have anhedonia and 10.6% have negative self esteem. Following the interpretive guidelines for the T-scores, it was found that 10.3% of the students were much above average in the depression scale. This study also found that: 1% of students were smoking, 1.6% of students were gum sniffling, 0.9% took drugs, 4.1% took alcohol and 9.9% took things from other people. Females were more depressed than males. The Chinese students were more depressed compared to Indian students. Students whose parents had no formal education or had only primary education were more depressed than students whose parents had secondary, college or university education. Depression increased with increasing number of siblings. Depression contributed to the habit of drug abuse, gum sniffing and stealing but not to smoking and alcohol abuse. Suicidal tendencies were more likely among the depressed students. It is imperative that not only caregivers but also teachers have to be equipped with the knowledge, attitude and skills to assist secondary school children cope with their emotions, handle conflicts and manage stress early so that a more productive society will develop in the future.
Invasive Neisseria meningitidis infection is rare but carries a high mortality rate. The carriage rate in the normal population is around 10% and can be higher in confined populations. A study on the prevalence of carriage of N. meningitidis was conducted among 3195 army recruits after 2 months of intensive training in an army camp. N. meningitidis was isolated from 37.0% of these recruits. Two hundred and ten of N. meningitidis isolates were subjected to serogrouping and 100 to antibiotic sensitivity testing by the disc diffusion method and E-test for penicillin. Ten (4.8%) of 210 Neisseria meningitidis serogrouped belonged to serogroup W135, 3.33% serogroup A and 81.4% belonged to either serogroup X, Y or Z. With the agar disc diffusion method, all the N. meningitidis showed susceptiblity to chloramphenicol, rifampicin, cefotaxime and levofloxacin; 85% of the strains were resistant to cotrimoxazole and 12.5% resistant to penicillin. However, based on minimum inhibitory concentration, none of the Neisseria meningitidis tested was resistant to penicillin.
This study examines the structure of self-estimates of intelligence (SEI) across 12 nations (Australia, Austria, Brazil, France, Iran, Israel, Malaysia, South Africa, Spain, Turkey, UK and US). Participants rated themselves on general and specific abilities from three popular models of intelligence: Gardner's multiple intelligences, Sternberg's triarchic theory of intelligence, and Goleman's emotional intelligence. The results showed that (a) laypeople across nations have similar and invariant concepts of intelligence, (b) concepts of intelligence are cross-culturally closely related to academic notions of intellectual ability and (c) sex differences in general and specific SEI favouring men are consistent across countries. Male hubris and female humility in SEI seem independent of sex differences in actual cognitive ability and national levels of masculinity-femininity. Furthermore, international mean differences in general SEI could not be attributed to discrepancies in national intelligence quotient (IQ) levels or to cultural variations.
Trait and cultural psychology perspectives on cross-role consistency and its relation to adjustment were examined in 2 individualistic cultures, the United States (N=231) and Australia (N=195), and 4 collectivistic cultures, Mexico (N=199), the Philippines (N=195), Malaysia (N=217), and Japan (N=180). Cross-role consistency in trait ratings was evident in all cultures, supporting trait perspectives. Cultural comparisons of mean consistency provided support for cultural psychology perspectives as applied to East Asian cultures (i.e., Japan) but not collectivistic cultures more generally. Some but not all of the hypothesized predictors of consistency were supported across cultures. Cross-role consistency predicted aspects of adjustment in all cultures, but prediction was most reliable in the U.S. sample and weakest in the Japanese sample. Alternative constructs proposed by cultural psychologists--personality coherence, social appraisal, and relationship harmony--predicted adjustment in all cultures but were not, as hypothesized, better predictors of adjustment in collectivistic cultures than in individualistic cultures.
Aim To examine the association of socio-economic position (education, income and employment status) with cigarette consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia. Design and setting The data were based on a survey of adult smokers conducted in early 2005 in Thailand and Malaysia as part of the International Tobacco Control-South-East Asia (ITC-SEA) project. Participants A total of 1846 men in Thailand and 1906 men in Malaysia. Measurement Participants were asked questions on daily cigarette consumption, intention to quit and self-efficacy to quit in face-to-face interviews. Findings Analyses were based on multivariate regression models that adjusted for all three socio-economic indicators. In Thailand, higher level of education was associated strongly with not having self-efficacy, associated weakly with having an intention to quit and was not associated with cigarette consumption. Higher income was associated strongly with having self-efficacy, associated weakly with high cigarette consumption and was not associated with having an intention to quit. Being employed was associated strongly with having an intention to quit and was not associated with cigarette consumption or self-efficacy. In Malaysia, higher level of education was not associated with any of the outcomes. Higher income was associated strongly with having self-efficacy, and was not associated with the other outcomes. Being employed was associated moderately with higher cigarette consumption and was not associated with the other outcomes. Conclusion Socio-economic and cultural conditions, as well as tobacco control policies and tobacco industry activities, shape the determinants of smoking behaviour and beliefs. Existing knowledge from high-income countries about disparities in smoking should not be generalized readily to other countries.
Dacrycystorhinostomy (DCR) is a procedure performed to drain the lacrimal sac in cases of nasolacrimal duct obstruction or in chronic dacryocystitis. It can be performed externally or endoscopically. This is a prospective, nonrandomized study involving twenty-two consecutive patients (16 Females and 6 Males; mean age 45.54 y; range 18-74 y) who presented to the DCR clinic with epiphora secondary to nasolacrimal duct obstruction and recurrent infection. All patients underwent primary powered endoscopic DCR. A total of 24 procedures were performed using a standardized surgical technique. Post-operatively, symptom evaluation and endoscopic assessment of the newly created lacrimal ostium were done. Twenty-two of the 24 DCR's were patent after a mean follow-up of 21.5 months, yielding a success rate of 91.66%. Patency was assessed by symptomatic evaluation and endoscopic visualization at each post-operative visit. Two patients had complications, one orbital fat exposure and the other secondary haemmorhage. The two failures were due to synechiae formation. Therefore, powered endoscopic DCR with mucosal flaps without stenting has a success rate comparable to that achieved with stents and external DCR.
Little research on body dissatisfaction and body change behaviors, and the sociocultural influences on them, has been undertaken in non-Western contexts. The current study investigated these variables and the relationships between them among a sample of 529 Malaysian high school students (103 Malays, 344 Chinese and 82 Indians), who completed a set of measures in classroom settings. Chinese girls were more dissatisfied with their bodies than Chinese boys, but no gender difference was found for Malay and Indian participants. Girls were more likely to engage in behaviors to lose weight, and boys were more likely to engage in behaviors to increase muscle. The influence of sociocultural factors on body dissatisfaction and body change behaviors was limited and varied across both sex and ethnicity. Findings are discussed in relation to Western research, and it is concluded that cultural nuances need to be considered when investigating these phenomena.
The purpose of this study was to investigate the association between pregnancy-induced hypertension and low birth weight. A population-based case control study was conducted. Antenatal mothers who attended the government health centers in the district of Kuala Muda, Kedah, Malaysia from June 2003 to May 2004 were recruited. Cases were 312 mothers who delivered low birth weight babies, and controls were 312 mothers who delivered normal birth weight babies. Face-to-face interviews using a structured questionnaire and a review of medical records were carried out. After controlling for important confounders such as gestational age at delivery, maternal age, ethnicity, education, parity, and previous history of abortion, pregnancy-induced hypertension was found to be an independent risk factor (adjusted odds ratio = 5.06; 95% confidence interval: 2.63, 9.71) for low birth weight. There was a significant association of pregnancy-induced hypertension with low birth weight. Women who delivered low birth weight babies were 5 times more likely to have had pregnancy-induced hypertension.
This study was conducted to measure the prevalence of cigarette smoking and to determine the individual, family, and environmental factors associated with smoking among young urban women. A cross-sectional study through self-administered questionnaire was conducted on female students enrolled in private higher learning institutions in Kuala Lumpur and Selangor, Malaysia, between July and October 2005. Analysis on 408 respondents showed that current smoker prevalence rate was 18.6%. Adjusted analyses showed significant association between smoking and individual factors, which are the importance of slim image, average monthly allowance, and car ownership. For family factors, analyses showed significant association between smoking and parental marital status and smoking status of male siblings. Strong associations were seen between female smoking and environmental factors, such as having more smoker friends, having smokers as best friends, keeping cigarette-brand items, being offered free cigarette, and perceiving female smoking as normal. The identified risk factors could be used to develop more effective prevention programs to overcome smoking among young urban women.
At present, 70% of the world's 1.1 billion smokers are in developing countries, with over 50% in Asia alone. The current study examined patterns of youth smoking in Thailand and Malaysia. Respondents were 2002 youths between the ages of 13 and 17 from Thailand (n = 1000) and Malaysia (n = 1002). Respondents were selected using a multistage cluster sampling design and surveyed between January 2005 and March 2005. Approximately 3% of youth between the ages of 13 and 17 were current smokers, with an additional 10% to 12% reporting experimental smoking. Males were between 7 and 15 times more likely to report smoking behavior than females. Less than 1% of females respondents in either country met the criteria for current smoking, and less than 5% met the criteria for experimental smoking. In contrast, more than 50% Thai males and approximately one-third of Malaysian males aged 17 met the criteria for either experimental or current smoking.
The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.