A study into the incidence of urinary calculi over a 15-year period from 1962-1976 in the states of mainland Malaysia is presented. Figures from the Ministry of Health Returns are the only source for such information. The incidence from the various states over each five year period from 1962-1972 is tabulated and its significance especially, the pattern of incidence, and its relation to industrialisation is discussed. Malaysia is beginning to show the same pattern of incidence in the upper and lower urinary tract as that of other industrialised countries. A plea is made for the establishment of a central register at the Institute of Urology and Nephrology to carry out a national survey of urinary calculi so that a study into the epidemiology, and if possible, preventive aspects of urolithiasis can be undertaken.
Turner's concepts of structure and anti-structure are applied to the culture-bound syndromes to demonstrate that they are dialectical aspects of cultural reality, The Malay cases of amok, latah and possession hysteria are discussed as instances of anti-structural behaviors that dramatize role-reversals and role-enhancement. The performers of these behaviors are not subjected to the Malay code of moral conduct. The supernatural ethos in Malay culture plays an important role in shaping tolerance towards them. Although this tolerance has been gradually eroded as a result of the introduction of Western psychiatry, the anti-structural status of these syndromes has not faded away but has assumed new meanings in terms of psychopathology.
A cross sectional nationally representative survey of 33,110 school-going children in Singapore aged between 9 and 20 years was carried out to obtain, for the first time, baseline information on smoking among the school-going population in Singapore. The survey was carried out among students attending vocational institutes and public sector schools in Singapore in 1987. The overall smoking prevalence was found to be 2% (3% among boys and 0.2% among girls). Ex-smokers comprised 2% of respondents whilst those who had only experimented with smoking made up 9% of the respondents. Analyses of the data showed that cigarette smoking was more prevalent among Malays, among boys, among older children, and among the less academically inclined. On average, boys smoked a median of 20 cigarettes a week and girls, 12 cigarettes a week. On an international basis, the smoking prevalence among the school-going population in Singapore is significantly lower than that of developed countries like Australia, England and Wales and neighbouring countries such as Malaysia.
STUDY OBJECTIVE:The aim of the study was to analyse differences in mortality from the main cardiovascular diseases (ischaemic heart disease, hypertensive disease, and cerebrovascular disease) among Chinese, Malays, and Indians in Singapore.
DESIGN: The study was a survey using national death registration data in Singapore for the five years 1980 to 1984. The underlying cause of death, coded according to the ninth revision of the International Classification of Diseases, was taken for the analyses.
SETTING: The study was confined to the independent island state of Singapore, population 2.53 million (Chinese 76.5%, Malays 14.8%, Indians 6.4%, Others 2.3%). Death registration is thought to be complete.
SUBJECTS: All registered deaths in the age range 30-69 years during the study period were analysed by ethnic group.
MEASUREMENT AND MAIN RESULTS: Indians had higher mortality from ischaemic heart disease than the other ethnic groups in both sexes, with age-standardised relative risks of Indian v Chinese (males 3.8, females 3.4), Indian v Malay (males 1.9, females 1.6), and Malay v Chinese (males 2.0, females 2.2). The excess mortality in Indians declined with age. For hypertensive disease Malays had the highest mortality, with age-standardised relative risks of Malay v Chinese (males 3.4, females 4.4), Malay v Indian (males 2.0, females 2.5), and Indian v Chinese (males 1.6, females 1.6). For cerebrovascular disease there was little ethnic difference except for lower rates in Chinese females, with age-standardised relative risks of Malay v Chinese (males 1.1, females 1.9), Malay v Indian (males 1.0, females 1.1), and Indian v Chinese (males 1.1, females 1.7).
CONCLUSIONS: There are significant differences in mortality from the three main cardiovascular diseases in the different ethnic groups in Singapore.
Data from 100 Chinese, 50 Malay, and 50 Indian adults resident in 1980 in the greater urban area of Kuala Lumpur, Malaysia, indicate a heavy use of cigarettes among males of all ethnic groups, light use among female Chinese, and none among female Malay and Indian. Consumption of other tobacco products was important only among Indian males; chewing betal quid among Indian males and also among Malay and Indian females. Alcohol use is increasing among both sexes and all ethnic groups, but Chinese and Indian groups use alcoholic drinks more frequently and in larger quantity than Malay. Beer and liquor are the most common drinks.
This study presents the demographical characteristics of 271 cases of parasuicide seen at the Psychiatric Clinic, General Hospital, Kuala Lumpur, during 1982. The majority of cases were women in the 20 - 30 year age group, from a lower economic class, with minimal education. About one-half were single and 61.5% were actively religious. The racial breakdown was Indians 55%, Chinese 32% and Malays 13%. Self-poisoning using easily available drugs was the most common method employed and more than one-half intended to die at the time of the suicidal act. Most attempts were impulsive, carried out while alone, inside the
house. The findings are discussed and compared with earlier studies of attempted suicides in Malaysia and Singapore.
In a study of suicide in Singapore in 1980 there were 230 cases and the suicide rate for the general population was 9.5 per 100,000. The age-specific rates increased steeply after 50 years and there was a male preponderance especially in the age group 60 years and over. Comparing the three major ethnic groups in Singapore, the highest rate was seen in the Indians and Chinese, whereas the Malays had the lowest. Amongst the suicides there were 59 (25.7%) with mental illness, mainly schizophrenia, and they were of a younger age group, 20-39 years. The commonest method of suicide was jumping from high-rise flats.
The prevalence rate of 749 cases of oral squamous cell carcinomas (SCC) recorded between 1978-1984 was studied. Results showed that the Indians formed the dominant group (63.8%) followed by the Malays (19.6%) and Chinese (16.6%). The peak incidences were generally located between the sixth and eighth decades. Only in the Chinese group a male preponderance was noted. In the Indians, the buccal mucosa was the most prevalent site; in the Malays and Chinese males, the gingiva and alveolus; and the Chinese female, the tongue. In all three groups, the well-differentiated SCC was the commonest type and the poorly differentiated least common.
A descriptive epidemiology of cancer in Sarawak, based on histopathology records in the Central Medical Laboratory, Kuching, Sarawsk, in 1981 and 1982 was presented. There were 8,219 patients from whom biopsies were taken and 485 from whom marrow biopsies were taken. Out of these, 1,326 were reported malignant. Most of the cases were from Kuching. There were slightly more males than females. The Chinese formed the majority of cases followed by the Sea Dayaks and Malays. The most common cancer sites among males were lymph nodes, nasopharynx, skin and stomach, while in the females the most common sites were the breast, cervix and lymph nodes. Among the Chinese the most common cancers were those of the nasopharynx in males, and breast in females. Among the Sea Dayaks, the most common cancers were those of the lymph nodes in males and cervix in females. Among the Malays, skin cancers were relatively common, and among the Land Dayaks nasopharyngeal cancers were common. Most of the patients were in the older age groups. The pattern of cancers has not changed much since 1966 and the findings of the present study are very similar to the series from the Institute of Medical Research, Kuala Lumpur, in 1969 to 1971.
Data from Malaysia on the reproductive goals of husbands and wives are analyzed to determine level of agreement, using new scale measures on preferences for number and sex of children as well as the conventional measure of desired number of children. The level of agreement between husband and wife varies considerably depending on the focus of analysis and the measure of agreement used. Overall aggregate agreement of men and women is high but lower for subgroups of the population, particularly among various ethnic groups. For marital partners, the agreement is much lower, especially on sex preferences. The level observed depends on whether the measure is identity of responses or an index of homogeneity which allows for couple concordance based on chance or common socialization factors. The views about the reproductive goals of one marital partner cannot with confidence be assumed to represent the views of the other.
This paper examines the symbolic properties and cultural relevance of latah, a behavioral state noted in Malay and Indonesia since the 19th Century. Most interpretations of latah have been psychological, latah being perceived as a 'mental disorder.' In the following, it is concluded that latah is intimately related to other aspects of Malayo-Indonesian culture and that it is a well-known cultural pattern and not a mental disorder as such, though it may occur among persons, largely women, in a socially and psychologically marginal situation. Latah is a symbolic representation of marginality, and it is as appropriate to certain mythological and religious figures to the socially marginal.
505 primary school children in Singapore aged 10-14 were surveyed regarding fear of the dentist. Sixty-eight children were classified as having high fear, giving a sex and race adjusted population prevalence rate of 177 fearful children per 1000 population. Females were 2.64 times more fearful than males. There were no significant racial differences in the prevalence rate. Children with high state anxiety are almost three times as likely to report dental fear as those with low state anxiety. Children with trait anxiety scores above the population mean were just as likely as those reporting below the mean to be fearful. Access to dental care is an important intervening variable in dental fear.
The presence of supernumerary teeth in the premaxillary region may cause a variety of pathological effects. This study was carried out to determine the various aspects of supernumerary teeth in the premaxillary region, particularly the effects of the supernumerary teeth on the permanent incisors and surrounding tissues. Approximately 20 percent of the patients (n = 49) with supernumerary teeth did not present with any abnormality. A high proportion of patients (37.9 percent) had delayed or failure of eruption of permanent teeth and 24.1 percent had rotation or displacement of permanent teeth. Other effects observed were median diastema and cystic changes around the unerupted supernumerary tooth. The high proportion of pathological effects seen showed that early diagnosis of the anomaly is important to intercept damage to the adjacent normal teeth and surrounding tissues. However, no cases of root resorption of the permanent teeth due to the presence of supernumeraries were observed.
A cross-sectional survey involving 303 6-15-year-old aboriginal children was carried out in Selangor, West Malaysia. Dental caries status was assessed on the basis of the methods of the World Health Organization Oral Health Survey. The findings indicated a generally low prevalence of dental caries with a mean df of 4.94 for children below the age of 10 years. Mean DMFT and DMFS values of 1.71 and 3.22, respectively, were also observed for the 6-15-year-old children.
A serological study on dengue infection conducted in Singapore during the period 1982 to 1984 showed that 54.4% of the healthy population between 6 months and over 50 years of age surveyed possessed no haemagglutination-inhibition antibody to dengue type 2 virus. Children below 10 years of age showed the lowest antibody prevalence and were at the greatest risk, with 96.6% susceptible to infection, whereas virtually all adults over 40 showed evidence of prior dengue infection. The geometric mean titre showed a rising trend indicating continuing acquisition of infection in the older age groups. The seropositivity rate of dengue infection of males was twice that of females. Among the 3 major ethnic groups, no significant difference in seropositivity was noted between the Malays and Indians, but the differences between Malays and Chinese and between Indians and Chinese were statistically significant. The study confirmed that the successful implementation of the nation-wide Aedes control programme is reducing endemic dengue virus transmission in the country.
There has been a rapid increase in the past five years in the numbers of hospitalized drug dependents. While the studied population was clearly unrepresentative of the country-wide drug using population, it illustrates how the problem is neither limited to one particular stratum of society, nor to the few "traditional" drugs. Indeed, an increasingly youthful group of individuals drawn from all backgrounds is not only becoming dependent upon opiates, but is also using a range of other drugs, all of which are available on the market at relatively low cost. The market prices of drugs have an effect on the pattern of drug use; and many individuals move directly from tobacco to heroin smoking. Drug abuse continues to be a considerable public and governmental concern, and enforcement and treatment programmes are rapidly expanding in attempts to resolve this problem.
A study was made of the clinical statistics of odontogenic cysts treated at two hospitals in West Malaysia over a 6-year period. The general incidence of the individual cyst-types is similar to that reported in previous studies. A marked difference in the age distribution of radicular cysts emerged and 80% of the residual cysts in the survey occurred amongst the Chinese population. Reasons for the distribution variation are discussed.