OBJECTIVES: Better outcomes of human papillomavirus (HPV) vaccination would be expected if men become full partners and advocates in vaccination initiative. Men involvement has important implication especially within the context that they are equally responsible for spreading the virus.
METHODS: Twenty-seven men took part in four focus group discussions carried out to assess men's attitudes toward the HPV vaccine between October and November 2007.
RESULTS: The results revealed that men have low awareness about the newly release vaccine and minimal knowledge of HPV and its association with cervical cancer. When provided with information, most men were in favor of protecting their spouses, partners, or daughters from cervical cancer using the vaccine. They were aware of the effects of men's risk behavioral patterns on women's risk for acquiring HPV infections. Many needed assurance about the vaccine's long-term safety and efficacy. They also expressed concern over the high cost of the vaccine. Men in this study played an influential role in the vaccination decision of their child and sexual partners. Many were in favor of male vaccination for cervical cancer prevention of their spouse or partner.
CONCLUSIONS: Vaccine advocacy should put special emphasis on men as sexual partners, husbands, and fathers from a gender equality and partnership perspective. The findings are useful in facilitating the development of strategies for effective immunization initiatives.
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 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.
When specifically asked, about one third of people report recurrent upper abdominal discomfort, and irritable bowel syndrome (IBS) and chronic gastritis (CG) maybe the most frequently diagnosed ones among all. Consecutive patients with upper abdominal discomfort applying to the Internal Medicine Polyclinic were included into the study. IBS was diagnosed according to Rome II criteria and CG was diagnosed histologically. All cases with IBS were compared with the age and sex-matched randomly selected cases without IBS. One hundred and fifty-six patients with IBS and 179 patients without IBS were studied. CG was detected in 72.4% (113 cases) of cases with IBS, and only 36.3% (65 cases) in patients without IBS (p < 0.001). IBS probably is a cascade of many physiological events, being initiated by infection, inflammation, psychological disturbances-like many stresses and eventually leading to dysfunctions of gut and other systems of the body via a low-grade inflammatory process. CG may be one of the terminating points of the physiological events' cascade, IBS. This may explain the high prevalence of IBS in society. Keeping in mind this association will be helpful during prevention, treatment, and follow up of these common pathologies in Primary Health Centers and Internal Medicine and Gastroenterology Polyclinics for physicians.
A 13 year old boy presented with a huge mass on his right arm of 6 months duration. Histopathological examination revealed sheets of malignant small round blue cells with immunopositivity for LCA, CD43, CD45Ro, CD30, EMA, ALK-1 and CD99, and negativity for CD20, TdT, myogenin, myoD1, NSE, bcl-6, bcl-2 and CD10. Fluorescent In-Situ Hybridization (FISH) testing excluded the diagnosis of Ewing's sarcoma/PNET. Pathologists need to be aware of the diagnosis of a small cell variant of ALCL, as well as of the fact that CD99 expression commonly occurs in cases of ALK-positive ALCL, in order to distinguish this entity from Ewing's sarcoma/PNET.