The Klang area of Peninsular Malaysia has experienced rapid industrial growth with intense activities, which can increase the concentration of pollutants in the environment that significantly impact on habitats and the human health. The purpose of this study was to determine the levels of selected heavy metals (Cu, Zn, Ni, Fe, and Pb) in the heart, lung, brain, liver, kidney, muscle tissues, and feathers of house crow, Corvus splendens, in Klang, Peninsular Malaysia. House crow samples were collected from the Klang area through the Department of Public Health at Majlis Perbandaran Klang. Quantitative determination of heavy metals was carried out using atomic absorption spectrophotometer (AAS). The result shows the presence of heavy metals in all biological samples of house crows. For heavy metals in all the house crow tissues analyzed, Fe concentrations were the highest, followed by those of Zn, Cu, Pb, and Ni. The feathers and kidney accumulated high concentrations of Pb, whereas the liver accumulated high concentrations of essential heavy metals (Fe > Zn > Cu > Ni). Significant variations were also detected in the concentrations of Pb among adult and juvenile and male and female bird samples. The results also revealed significant positive correlations between Pb metal concentration in the breast feathers and all internal organs. Accumulation of toxic heavy metals in feathers reflected storing and elimination processes, while the accumulation of toxic heavy metals in the kidney can be consequential to chronic exposure. The present study clearly shows the usefulness of house crow breast feather as a suitable indicator for heavy metal accumulation in the internal organs of house crows in the Klang area.
A total of 306 patients were admitted to the University Hospital in Kuala Lumpur in 1989 after attempting suicide. Fourteen of them succumbed to injuries. Psychosocial data of 296 patients out of the 306 survivors are reported. Suicidal behaviour is more common in the young and especially amongst the females. Nearly 45.0% of them are from social class IV and V. Persons of Indian ethnic origin are overrepresented, while in Malays suicidal behavior seemed to be less common. Self-poisoning was reported to be the commonest method in attempting suicide. Diagnosis of adjustment disorder was made in 58.5% of the patients. Two-thirds of the patients had an intention score of less than 10 on the Pierce's Scale.
Publication year=1992-1993
Dengue hemorrhagic fever (DHF), though endemic in the sixties, emerged as a major public health problem in Malaysia from 1973 onwards. The incidence rate of DHF which was 10.1 per 100,000 in 1973 has fallen down to 1.9 per 100,000 in 1987 with a mean case fatality rate of 6.4 per 100 persons. The Chinese appear to be more prone to DHF with the highest mean morbidity rate of 5.5 per 100,000 and case fatality rate of 6.1%. The incidence of DHF is higher in the males with a higher case fatality rate in females. Male Chinese appear to be mainly affected. The overall age-specific incidence rate is highest in two age groups, viz. 5-9 years and 10-19 years of age with a mean morbidity rate of 4.9 cases per 100,000. The mean age-specific case fatality rate was highest in the 0-4 years age group. Dengue hemorrhagic fever is predominantly an urban disease in Malaysia with a mean incidence rate of 5.3 cases per 100,000 as opposed to 1.2 cases per 100,000 being reported from rural areas. The mean overall incidence of deaths in the urban area is 0.5 compared to 0.1 per 100,000 for rural areas. There is a marked seasonal correlation between DHF cases and rainfall, with a peak in August. While all four serotypes of dengue viruses are found in Malaysia, Den 2 appears to be isolated with greater frequency during all the epidemics.
Publication year=1992-1993
A retrospective study of factors associated with poor patient compliance with antituberculosis therapy was conducted in Taiping, Perak. 219 patients were studied. Male patients and hospital referrals were significantly more likely to default. Patients with tuberculous lymphadenitis alone had a greater rate of default, but this just failed to reach significance (0.05 less than p less than 0.10). Six of 7 male hospital referrals with tuberculous lymphadenitis alone defaulted. Patients treated as outpatients from the start were more compliant. Housewives were also highly compliant. It was noticed that patients who defaulted tended to do so during early stages of treatment.
Various studies on toxoplasmosis in Malaysia have shown that specific antibodies to Toxoplasma gondii are common among Malaysians. Among the ethnic groups, the Malays have the highest prevalence rate followed by Indians, Orang Aslis (aborigines) and Chinese. Antibody is acquired early in life and increases with age. There is no significant difference in the prevalence rate between males and females. The disease is apparently more prevalent among rural dwellers and those in the lower socioeconomic group. It appears that the prevalence rate is also influenced by environmental conditions, occupation, diet and cultural habits. Studies with animals have shown the presence of antibody to T. gondii, but this does not seem to be the source of infection since Malaysians normally cook their meat well.
A survey of 61 canine and 26 feline fractures diagnosed between January 1980 and June 1983 at a veterinary teaching hospital was conducted. More than 80 per cent of the fractures occurred in animals less than two years old. Male animals were more frequently involved. In the dog, the femur, tibia, pelvis, radius and ulna were most often affected while in the cat, the femur, mandible, pelvis and spine were more often involved. All the findings were consistent with other reports in the literature.
A total of 52 cases of NPC were found in a five-year survey from 1978 to 1982 in Malaysia. The annual rate of occurrence was 3.4, 3.0, 2.4 and 1.8 for Chinese, Malays, Kadazans and Sarawakians, respectively. The age-specific incidence rates per 100 000 were highest for Kadazans (2.34 to 7.59) in comparison to the other races (0.11 to 1.24). The proportion of NPC in young Malaysians formed 1.2% in Chinese, 7.2% in Malays and 6.9% for others. A sexual bias was present in Chinese (male:female = 2.2) and Sarawakians (1.7) but not in Kadazans and Malays (0.9). In most Chinese, the primary tumour histologically is of the poorly differentiated characteristic and this type is the predominant tumour in the country. The Kadazans presented with well differentiated primary tumour and the Malays with all three histological types i.e. well-, poorly- and undifferentiated. At first examination enlarged lymph nodes were found in 95.7% of the patients and 65.2% had epistaxis and growth in the postnasal space. Antibodies to IgA anti-VCA were present in half of the 6 patients serologically studied.
Two hundred and three patients with psoriasis, who attended the skin clinic were studied to identify the pattern of sporiasis. The incidence was 4%. It was more common in Indians than in the other ethnic groups and this was found to be statistically significant. Males were affected twice as common, 12.5% gave a positive family history, the lower limbs and the scalp were the commonest site, and pruritus was frequent. The pattern appears similar to those in the west.
Study site: Skin clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
A total of 82 persons have been found to be positive for microfilaria a sub-periodic Brugia malayi out of 1,613 examined in seven villages in Serian District. This represents an average microfilaria infection rate of 5.1% with a range of zero to 10.7%. It is found that males are more predominantly affected than females with a ratio of 3:1. It is also confirmed that Mansonia dives and M. bonneae are possible vectors for the transmission of the disease although Anopheles species cannot be ruled out owing to the small number of specimens examined. The study is confined to areas where indoor DDT spraying has been done since 1960 and only in two of the areas it has been terminated in 1966. Yet to be published data shows higher filaria infection rate than any of these villages.
Non-haemoglobin liver iron was estimated in 275 presumably normal individuals from Kuala Lumpur and Singapore at necropsy. Liver Iron concentrations were highest during the first two years after birth but declined sharply during childhood. They then rose gradually and reached a value of 20 mg/100gm in adult males. Liver iron concentrations of childbearing women remained low and it was only after menopause that values in women rose to those of males. Liver iron stores increased with age to a plateau of about 300 mg in adults, suggesting that this value may represent the adult size for liver iron store. Among the three major ethnic groups in Malaysia and Singapore, Chinese, being in a better socio-eonomic class, had larger liver iron stores. The median liver iron concentrations of Malaysians and Singaporeans, on the whole, were lower than those reported from western populations and as many as 35 per cent of the women were in a subclinical state of iron deficiency.
Previous studies in Malaysia and in Singapore report a higher schizophrenic admission rate for males than for females and this is in contrast to findings in Western societies. Characteristics by age, sex and race of 5% and 619 first schizophrenic admissions during 1977 and 1978 respectively to the Psychiatric Department, General Hospital, Kuala Lumpur were examined. It was found that the male to female sex ratio for Malay schizophrenic admissions was significantly higher than male to female sex ratio for Malays to other departments of the hospital. A similar trend for the Chinese did not reach significance. Possible reasons for these findings are discussed.
We collected data on patients above the age of 5 years with acute bronchial asthma who presented to the emergency room of Hospital Sains Universiti Sains Malaysia during the period between 1 January to 31 March 1990. Two hundred and twelve patients (57% males and 43% females) who made a total of 271 visits were recorded. This constitutes 16.3% of all adults and paediatric medical cases seen in the emergency room during this period. The majority of patients presented between 8 pm and 6 am which contrasts with the attendance pattern due to other causes. We also recorded two peak periods of presentation (between 8 pm and 12 midnight and between 6 am and 10 am). Thirty-one (11.4%) cases resulted in admission. Of the 240 cases that were successfully treated and discharged from the emergency room, there were 59 relapses (in 45 patients). Twenty-two percent of the relapses occurred within 24 hours of the last visits. We recorded lower rates of admission as well as relapses compared to all previous studies. Our finding of bimodal pattern of presentations was also not previously reported.
Study site: Emergency department, Hospital Sains Universiti Sains Malaysia, Kelantan, Malaysia
Prediction equations for peak expiratory flow rate (PEFR) of Malay, Chinese and Indian children were obtained by analysing 1020 PEFR recordings of children free of respiratory symptoms and illnesses. Boys had significantly higher PEFR than girls. For both sexes the highest levels of PEFR were observed in Malays and the lowest in Indians. The differences between Malay and Chinese boys were not statistically significant but the levels of PEFR for Malay and Chinese boys were significantly higher than those for Indian boys. In girls the differences among the ethnic groups were not statistically significant. Although ethnic differences were observed in boys these differences might not be clinically important. A common prediction equation for each sex should be both practical and accurate. When compared with predicted levels for white American and Australian children the predicted levels of PEFR of Malaysian children were found to be lower; these differences could be clinically important and the use of standards for Western children when assessing Malaysian children might not be appropriate.
Mortality statistics of Peninsular Malaysia for the period 1950-1989 have been studied in relation to cardiovascular diseases, with particular emphasis on coronary heart disease as an important cause of death. It was observed that among six major disease groups reviewed, cardiovascular diseases which occupied third place as a cause of death in 1950 emerged as the number one killer during the 1970s and has remained so since (with exception in 1980). In contrast, infectious diseases which ranked first in 1950 dropped to fourth position in 1980. Between 1960 and 1980, mortality due to cardiovascular diseases was higher in males than in females. This tendency became less apparent during 1985-1989. With reference to race, the incidence of cardiovascular deaths was highest in Indians followed by Chinese and Malays. Among the specific cardiovascular diseases, coronary heart and cerebrovascular diseases accounted for the main causes of mortality. Mortality due to coronary heart disease has increased by more than three fold over the last 40 years and is still rising. However, mortality incidence due to rheumatic heart disease and hypertension decreased during the same period. In 1965, mortality due to coronary heart disease was highest in the 55-59 age group. In recent years (1985 to 1989), it shifted to the older age group (i.e. 65-69). There was a tendency for higher mortality due to coronary heart disease in males compared to females. Indians had a higher mortality due to coronary heart disease than Chinese and Malays.
This is a retrospective study of 525 posterior chamber implants in diabetics performed by A S M Lim and B C Ang of Singapore. The patients were reviewed by visiting ophthalmologists--J E Kennedy (Sydney), M Ngui (East Malaysia) and P M Hart (Belfast). This study did not show any significant difference in the complication of post-operative visual acuity between diabetics and non-diabetics. 95% obtained 6/12 vision or better when pre-existing disease was excluded. It also showed that posterior chamber implants can be inserted in eyes with maculopathy or proliferative retinopathy if laser treatment was effectively done before or after surgery.
Coronary heart disease which was responsible for 2.9% of all deaths 30 years ago, today accounts for 19% of deaths. The rising trend which declined in 1985, appears to be stabilising now. Indians have mortality rates which are 3 times that of Chinese. This is the background against which the Singapore Myocardial Infarction Register was set up in 1967 to provide incidence and prevalence data for coronary heart disease in the country. in 1987 to provide incidence and prevalence data for coronary heart disease in the country.
Key words: Coronary heart disease mortality, Age standardised death rates, Ethnic differences, Singapore Myocardial Infarction Register
The present study analysed the records of 342 elderly subjects aged 55 years and above of different ethnic groups to ascertain the types and level of their unperceived dental needs. The overall percentage of unperceived needs was highest among the Malays (96.1% or 74/77 subjects) and among the men (88.5% or 139/157 subjects). The unperceived need for prosthetic treatment was highest among the Malays and Chinese as well as among women, whereas the unperceived need for treatment for periodontal disease was highest among the Indians. The data for unperceived needs for prosthetic treatment as well as for treatment for caries and periodontal disease were somewhat similar among men. Within each ethnic group, variations among sex in the unperceived needs for the various dental symptoms were also noticeable. Further research is indicated to ascertain the role of traditional and cultural concepts and dogmas in determining the importance attached to the various dental health symptoms within each ethnic group.
Twenty-three patients with ulcerative colitis are reported from Kuala Lumpur, Malaysia. Sixteen were newly diagnosed over a six-year period between 1982 and 1987. The disease was commoner in men (16 men : 7 women). The peak age of onset was in the third decade. The ethnic distribution of the patients was 10 Malays, eight Indians and five Chinese making the disease relatively commoner amongst Indians. The extent of colonic involvement varied and six (26%) had a total colitis. Extra-intestinal manifestations were seen in seven patients. Diagnosis was delayed for over 10 years in four. Colorectal cancer was not seen. There was no mortality. Ulcerative colitis remains an uncommon disease amongst Malaysians. During the same period, only four male patients with Crohn's colitis were seen.
Updated data on permanent cardiac pacing in Malaysia is presented. Over the past 3 1/2 years (1976-1980), 75 patients underwent insertion of pacemakers giving an annual incidence of about 20 cases as compared with a total of 21 cases in the previous 8 years (1968-1977). Many of the features reported in an earlier paper in 1977 viz mode of presentation, age and sex distribution and indications for pacing remain unchanged. Over this period only 4 patients required lead replacement. Since concentrating mainly on the use of epicardial leads implanted via a subxiphoid approach, complications have been remarkably low. The problem of availability of pacemakers has been averted. Cost remains a major consideration when recommending one pacemaker in preference over another. The details concerning clinical features, indications for pacing, complications and other problems encountered in the management of these patients are discussed.