A survey of malnutrition and helminth infections among 268 pre-school children living in the Kuala Betis Orang Asli resttlement villages in Kelantan. The prevalence of helminth infections was 47.4% with Ascaris lumbricoides being the most common helminth (43.9%), followed by Trichuris trichiura (29.7%) and hookworm (6.3%). The prevalence of Ascaris lumbricoides and Trichuris trichiura infections increased with age, with the highest prevalence found in the 6-7 years age group. The overall prevalence of stunting, underweight and wasting were 61.7%, 60.4% and 17.5% respectively. Both stunting and underweight were significantly higher among the infected children. Factors associated with helminth infections in the pre-school children were older age group, poor water supply and households with more than 5 members. Rountine regular deworming is recommended based on the World Health Organisation recommendations for school children.
A survey of career choices was conducted for two batches of physicians applying for a medical speciality course in Malaysian medical schools. There were a total of 952 applications, with 477 males and 475 females. Surgery ranked highest, followed by obstetrics and gynaecology, fanlily medicine and orthopaedic surgery. The minor specialities of otorhinolaryngology, psychiatry and pathology were the least popular choices. Questionnaires were sent to a random sample of 250 physicians in each batch to note factors affecting their choices of speciality. A total of 359 physicians responded, giving a response rate of 71.8%. Fixed hours of work and the ability to have direct contact with patients were relatively important factors for choice of speciality. Working as a clinical consultant was the nlost popular nature of employment while worliing in the health office, service consultant in a public hospital, a non-clinical lecturer in a university hospital and working in a private clinic were less popular choices for these physicians. KEYWORDS: Career choice; medical speciality; doctors; Malaysia.
A relTospective study was conducted in Hospital Kuala Lumpur, May, 2001.49 (12.1%) of 406 AIDS patients were diagnosed as opportunistic infections related to the central nervous system. The sex ratio (M:F) was 7.2. The median age was 34 years. The predominant age group for male as same as female was 25-34 years.The majority of the study subjects were Chinese (79.6%), married (49%), unemployed (42.9%) and heterosexuals (95.9%) as the risk behavior related to HlV infection. The most frequent clinical manifestations was headache (71.4%). At the time of diagnosis, the greater number of patients 39 (79.6%) had CD4 count < 200 celVcumm. Outcome of acute therapy the patients had a complete (85.7%), treatment continued (10.3%), and transfer to other hospital (2.00/0). Toxoplasmic encephalitis (7.6%) and cryptococcosis (3.9%) were the frequent cause of focal intracerebral lesions and meningitis in these patients respectively. Oral candidiasis (32.7%) was the most common among other opportunistic infections in this study. KEYWORDS: AIDS, Opportunistic infections. central nervous system, clinical manifestations, outcome.
Chronic fatigue syndrome (CFS) is a chronic debilitating condition affecting both physical and mental functioning. It was first quoted as a 'new disease' spreading in the developed countries. It bei:ame a major issue by doctors, professionals and the media for the past 15 years. CFS was not only affecting the adults but childhood fatigue has also been noted. The CFS patients commonly described themselves to be perfectionists, highly driven, energetic U1d motivated before the condition started. Studies have been focused on the definition, diagnosis and management of CFS. However, the understanding of CFS and what cause it is stili unclear and controversial. Thus the aetiological factors of CFS are reviewed in this article. KEYWORDS; Chronic fatigue syndrome (CFS), Aetiology, Psychiatric disorders, Viral infection, Immunology
Angioedema due to whatever cause is potelltially life threatening, especially if it involves the head and neck region. Patients at risk need to be identified and precautionary measures are necessary. The use of Angiotensin Converting Enzyme Inhibitors (ACEIs) has been associated with angioedenia of the face and tongue. Its widespread use has resulted in an increased awareness of this rare but important camplication. We report liere a case of angioedenla secondary to ACEls developing a few months after initiation of therapy and discuss its clinical importance. KEYWORDS: Angioedema, Angiotensin Converting Enzyme Inhibitor.
A restropective study on a case of recurent salmonellosis in a 3 month old child due to Salmonella bovismorbificans and Salmonella matopeni was carried out using pulsed field gel electrophoresis (PFGE) and antibiotic susceptibility analysis. PFGE clearly distinguished the two serovars and that the recurrent infection was shown to associated with variant forms of Salmonella bovismorbificans. The chromosomal changes detected among the seqential isolates of Salmonella bovismorbificans appeared to be associated with varing antibiogram patterns. The study also showed that the recurrent infection in the patient could be related to prolonged antibiotic therapy. KEYWORDS: Recurrent salmonellosis, PFGE typing, Antibiograms, Salmonella bovismorbificans.
Malaysia, like many aspiring developing countries, is undergoing a health transition that has seen the concomitant decrease in communicable diseases and increase in chronic diseases due to urbanization, modernization and ageing population. Health in the Malaysian society will thus increasingly focus on emerging problems that are both chronic and infectious in nature, such as, heart disease, diabetes, cancer, mental health, hepatitis and HIV/AIDS. Re-emerging diseases previously well-controlled, such as, tuberculosis for instance is another addition to these immediate health issues facing Malaysian society today. Despite the tremendous health gains and above average health status that Malaysians now enjoy, we are compelled to take stock of these urgent issues as well as to anticipate and handle serious challenges to our health in the 21st century. In this paper, we review the changing trends and discuss related challenges in disease pattern, environmental health, demographic impacts on health, migration influxes and health, effects of globalization on health, mental health and wellness as well as fundamental access and equality in health care. Being proactive, resilient and innovative, Malaysian society would forge ahead towards our Vision for Health in this new era. KEYWORDS: Society and health, health trends and issues, Vision for Health, Malaysia
Activation of the synlpathetic nervous system (SNS) and renin-angiotensin system (RAS) plays a pivotal role in the pathophysiology and progression of the disease in chronic heart failure (CHF). Blocking the activation of the RAS with angiotensin converting enzyme inhibitors not only improves sylnptonls but also prolongs life in symptomatic CHF. Does a similar analogy hold true for the use of ß-blockers in CHF? Evidence from a number of small trials and several recent large prospective trials show that b-blockers may improve ventricular function and symptoms in CHF. In a combination of trials investigating the use of carvedilol (an α, and ß-blocker) in congestive heart failure a mortality benefit appears to be evident. There are still a number of key questions that relnaill unanswered regarding the tolerability, patient type and stage of CHF in which ß-blockers should be advocated. Several large scale trials are in progress to answer some of these questions and also to add further information regarding its efficacy and impact on survival. KEYWORDS: Beta-adrenoreceptor antagonist, congestive heart failure.
Anaemia in patients on renal replacement therapy is a cornmon problem and response to treatment with erythropoietin may be limited by functiollal iron deficiency. We recently studied prospectively for 22 weeks the effect of iron supplemetltation via intramuscular and oral vs intramuscular vs oral routes in 16 patients on chronic haemodialysis with renal anaenlia treated with erythropoietin injections. The rise in haemoglobin was significant in all patients except those on intramuscular iron only. This study supports unconfirmed observations that oral iron supplementation may be effective in patients with renal anaemia associated with functional iron deficiency. KEYWORDS: Renal, Anaemia, Erythropoietin, Iron deficiency, Oral, Parenteral.
The use of steroid therapy and its treatment impact on children hospitalised with viral croup between 1994-1998 were reviewed by comparing 30 patients who received steroid therapy with 65 patients who did not. There was no difference in the socio-demographic and clinical profile between the two groups. The hospital stay (2.8 ± 1.3 vs 3.5 ± 1.2 days, p = 0.02) and duration of documented stridor (1.3 ±0.5 vs 2.8 ± 1.0 days, p = 0.001) were shorter for patients who received steroid therapy although they appeared to have more severe respiratory distress. There were no complications associated with steroid therapy use. Despite reluctance in administering steroid therapy for viral croup, patients who received the treatment had a shorter hospital stay and duration of stridor. KEYWORDS: Croup, steroid therapy, hospital stay.