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%).
A prospective case controlled study was conducted to determine the incidence of asymptomatic bacteriuria in pregnancy (ASB), causative organisms and fetal outcome. Out of 510 antenatal mothers screened, 46 (9%) had ASB. The main organisms isolated were E. coli (16%), Staphylococcus aureus (15%) and Beta-Haemolytic Streptococcus (11%). Oral Nitrofurantoin and Cefuroxime axetil achieved sensitivity levels of 96%. There was no significant difference in period of gestation at birth and birthweight between the control and study groups. The reasons for routine antimicrobial therapy for ASB are discussed.
Smoking cessation helps patients with COPD more than any specific medical treatment. By commencing treatment early, the main symptoms of COPD, i.e. cough, dyspnoea, and excessive mucus production, can be relieved and premature mortality from respiratory failure can, in many cases, be prevented. An anticholinergic aerosol offers the greatest bronchodilator benefit with the least side-effects to a patient with COPD. After maximising the dosage of an anticholinergic agent, either an inhaled beta2-agonist or oral theophylline may be added for additional bronchodilator effects. Corticosteroids may be beneficial in a subset of the patients. Selected patients with exercise limitation despite optimal medical therapy may gain from an increased sense of well-being enrolled in a supervised exercise rehabilitation progromrne. Long-term domiciliary oxygen therapy improves survival for patients who are chronically hypoxaemic. Antibiotics are reserved for acute exacerbations. The role of alpha-1-antitrypsin replacement and lung transplantation is still investigational.
The knowledge of 16 medical officers and 21 house officers from the Department of Medicine regarding the technique of using the pressurised metered dose inhaler (MDI) was evaluated. The doctors were interviewed individually and each was requested to demonstrate the use of a placebo inhaler. Only 21.6% of the participants correctly performed all the ten steps considered to constitute correct inhalation technique. The most common mistake was failure to actuate the inhaler at the start of breathing in through the mouth. Although inhaler technique was better among the medical officers, all of whom claimed to have instructed patients on the use of pressurised MDIs, house officers who were also involved in patient instruction performed equally well. Unfortunately, doctors with inadequate technique had also instructed patients and this could be one of the causes of incorrect technique among patients. Key words: Correct technique, doctors, pressurised metered dose inhaler
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
Anaemia still constitutes a public health problem in the world, especially in the developing countries (1). Nutritional deficiency remains a major causative factor (2). During pregnancy, growth of the foetus, placenta and the larger amount of circulating blood in the expectant mother will lead to an increase in the demand for nutrients, especially iron and folic acid. Many women start their lives with insufficient iron stores, but also, because of inadequate child spacing, they have little time to build up their iron levels between pregnancies. In pregnancy, anaemia has been shown to be associated with an increased risk of maternal and fetal morbidity and mortality (3,4,5). Iron and folic acid supplementation is routinely given to pregnant mothers in Malaysia. It is anticipated that pregnant mothers who comply strictly with the prescribed iron supplement will maintain adequate iron stores at parturition. However, the compliance rate among rural mothers in Kelantan is often poor (6). Kelantan is also one of the most socio-economically underdeveloped
A survey of laws and regulations governing the practice of radiology by general practitioners in Malaysis and ten other selected countries wascarried out. It showedvaryingdegrees oflegal restrictions on the use of x-ray machines in the countries studied. Most regulations reflected the concern of radiation protection forpatients andstaff. Only some countries provide training for non-medical persons in the use of x-ray machines. Radiology has an important role in primary care. Undergraduate and post-graduate education should ensure competence in basic radiological practice. KEYWORDS: X-ray, general practice, regulations.