45 patients (50 eyes) were treated for juvenile rhegmatogenous retinal detachments between August 1979 and July 1984. A review of these cases revealed high myopia and trauma to be the main aetiological factors. Eight-six per cent detachments were successfully reattached. Visual acuity of 6/36 or better was present in 16% preoperatively and in 52% postoperatively, some of the characteristics of juvenile rhegmatogenous retinal detachments in Malaysian population are discussed.
A total of 45 patients with IgA nephropathy were seen at the Department of Nephrology, General Hospital, Kuala Lumpur and the Department of Medicine, Universiti Kebangsaan Malaysia (National University ofMalaysia) between January 1982 to June 1985. This represents an incidence of 10.7% of all primary glomerulopathies. There does not appear to be any racial predilection and the clinicopathological features generally conforms with those reported elsewhere. However it seems to be as common in females as in males but the latter have a worse prognosis. The high incidence of renal failure and hypertension in our patients within the short follow-up period is noteworthy.
Sera from 200 Malaysian male drug abusers were tested for markers of Hepatitis B virus (HBV) infection, viz. HBsAg, HBeAg, anti-HBs and anti-HBc using commercially available enzyme immunoassay (EIA) kits supplied by Abbot Laboratories, Chicago. Of these, 103 (51.5%) were positive for at least one HBV marker, 11 (5.5%) were positive for HBsAg; 4 (2%) for HBeAg, 74 (37%) for anti-HBs and 85 (42.5%) for anti-HBc. The HBsAg carrier rate was roughly the same as the carrier rate in the general population of Malaysia. The majority of drug abusers (95%) have had subclinical, asymptomatic HBV infection. Racially the Malay drug abusers had the highest exposure rate (54.2%). The HBsAg carrier rate was highest in the Chinese drug abusers (15.3%) and lowest in the Indians (0%). The mean age for the HBsAg carriers was found to be 26 years with a mean duration of drug abuse of 72 months. The Malaysian Anti-Narcotics Task Force of the National Security Council reported in the Malay Mail (July 13, 1985) that there were about 106,000 identified drug abusers in Malaysia and that 63% of these were in the 20-29 age groups. It appears from our study that this age group also coincides with the period of high HBsAg carrier rate. Age wise, those less than 21 years old had the highest HBsAg (11%) and HBeAg (5.6%) prevalence rates indicating high infectivity. After the age of 30 years, nearly 50% of the drug abusers appear to be immune with the HBe prevalence of 0%.(ABSTRACT TRUNCATED AT 250 WORDS)
We analysed clinical and histological diagnoses in patients admitted with liver-related illnesses in order to determine the spectrum ofliver disease in our community. In a total of 380 such patients, liver disease was sixfold more frequent in males than in females. Admissions for cirrhosis were more common amongst the Indian ethnic group. Indians constituted 39% of the admissions (expected 11. 7%), Chinese 37% (expected 51%) and Malays 21% (expected 36%) (~2 = 293, p = H 0.001). Liver histology from 179 of the patients was reviewed blind by one pathologist. Based on the histological findings, the pre-biopsy diagnosis was 'wrongin 75%of cases. The age standardized incidence rate of hepatocellular carcinoma was 22/100,000/year in males 225 and 5/100,000/year in females. However, the peak age of onset was in the seventh decade and the age specific incidence in males aged 60 years or older was 93/100,000/year. The ethnic group representation of patients with hepatocellular carcinoma did notshow a racial preponderance. This study highlights a public health problem related to acute viral hepatitis and alcohol abuse. It also confirms a high incidence of hepatocellular carcinoma
Review of the haemodialysis experience revealed patient survival between 1976 and 1982 to be 90%, 77% and 44% at one, three and six years respectively. This was similar to other published reports. Patients under the age of 50 years did better than those above 50 years, and diabetics did worst of all. There was a high rate of rehabilitation and return to employment or household responsibilities. Our policy of self-care dialysis allowed more patients to be treated without increasing the number of staff Dialysis encephalopathy and sudden deaths were important causes of death.
During the period 1971-1982, 57 salmonella strains other than S. typhi and S. paratyphi were isolated from sites other than stools and blood. Cerebrospinal fluid was the commonest specimen followed by urine and pus. The commonest serotypes of the 22 encountered were S. typhimurium and S. enteritidis. Twenty-four of the 57 patients were children under one year of age. These findings highlight the need to remember the unusual manifestation of salmonellosis in differential diagnoses.
Singapore is an island republic of 616 km2. Four main ethnic groups make up its population of 2.4 million; these are the Chinese, Malays, Indians and others. Singapore's successful housing, industrialization and modernization programmes have caused tremendous changes in the lifestyles and expectations of the people. This very success has rendered some traditional customs impractical and irrelevant. Older Indians and Malay women still chew betel-nut. During the Hindu Thaipusam ceremony a traditional practice of dental interest is the piercing of devotees' cheeks and tongues with slivers of silver. There is no pain, bleeding or permanent tissue damage. The Chinese pick their teeth, crack melon seeds and scrape their tongues every morning. They also drink large quantities of unsweetened tea. Yet they remain caries-prone. Singaporeans have recently adopted the practice of eating at all hours of the day and night. This may have a bearing on their future caries state. Singapore has two categories of dental practitioner: the graduate and the registered but unqualified dentist who is invariably of Chinese descent. The swaged metal crown over sound and diseased tooth structure is frequently the unfortunate trademark of the latter. Often abscesses and cysts develop beneath these crowns. Successful dental health programmes have produced a DMFT of 2.8 in 12-year-old children, which betters the DMF target of 3.0 set by WHO for the year 2000. The progressive outlook of Singaporeans may eventually reduce further the number of traditional practices which are harmful to oral health.
A survey to assess the degree of occupational and physical rehabilitation was conducted on patients treated on chronic haemodialysis, using the semiquantitative Karnovsky scale. The survey revealed that over 90% of patients achieved good rehabilitation and returned to employment or to household duties. Chronic haemodialysis is effective in prolonging life and most patients were rehabilitated with useful levels of physical activity.
Accidental organophosphate poisoning may occur in persons coming in close contact with animals being treated toitb organophosphate pesticides. The poisoning may manifest itself as a severe systemic disorder, but can be diagnosed by an alert physician and confirmed by specific tests of reduced cholinesterase activity in the blood, plasma and red blood cells. Treatment is with intravenous atropine. Supportive measures may be necessary.
In 1982, Malaysia experienced the worst dengue/dengue haemorrhagic fever outbreak in its history. All states in Peninsular and East Malaysia were similarly affected. There was a total of 3,005 cases with 35 deaths, with the majority of cases occurring between the months of July to October. There was a total of 1,001 laboratory confirmed cases. Most of the cases were in patients over the age of 15 years. The Chinese population was mainly affected, although a much higher proportion of Malays was noted in comparison to previous years. The main serotypes involved were dengue-1 and dengue-3. No dengue-4 serotype were isolated.
The influx of refugees from Vietnam to the industrialized countries has attracted a certain interest to studies describing the oral health status of these population groups. The present study comprises 361 refugees arriving in Malaysia from Vietnam and collected immediately at the refugee camp on Pulau Bidong. Dental caries, calculus, gingival bleeding and loss of periodontal attachment were recorded. Mean dmft increased from 1.3 for 0-2-yr-olds to 7.4 for 3-5-yr-olds. For 6-9-yr-olds mean DMFT was 2.4 while it ranged between 8.5 and 10.10 for the older age groups. The frequency of secondary lesions was high for all age groups. Calculus increased consistently with age, while gingival bleeding was common even in the youngest age group. Loss of periodontal attachment greater than or equal to 6 mm was rare in all age groups except the oldest (45 yr or older). A strategy for oral health care for these population groups is discussed.
The sexual identity of 65 Malaysian male medical students was investigated by anonymous questionnaire. Of these students, 40% were aware of homosexual feelings prior to age 15 years, and 16% were so aware currently. There were correlations between current homosexual feelings and feminine sex dimorphic behavior during childhood and between current homosexual feelings and feminine gender identity. The results are discussed in light of results of a similar questionnaire completed by 138 male medical students in Sydney, Australia.
Study site: National University of Malaysia (Universiti Kebangsaan Malaysia), Kuala Lumpur, Malaysia
One hundred and forty-eight patients over the age of 12 years seen from July 1972 through December 1980 were accepted for this review of minimal change glomerular disease (MCGD). The diagnosis was based on a typical clinical presentation, and renal biopsy findings. MCGD forms 43.5 per cent of our patients with idiopathic nephrotic syndrome. The patients were predominantly young adults (82 per cent) and the onset of nephrotic syndrome (NS) occurred below the age of 30 years. Most patients had severe oedema and hypoalbuminaemia. Few patients recovered spontaneously. One hundred and thirty patients were given long-term alternate-day steroid (LASt) therapy. Four had cyclophosphamide alone, 21 patients had cyclophosphamide after a trial of LASt. Eighty-four patients (62.7 per cent) were initial responders: 17 of these after cyclophosphamide, 26 (19.4 per cent) were initial non-responders: five cyclophosphamide, 19 were late responders. Nine patients were partial responders, six were non-responders and one went into renal failure. Forty-one patients defaulted, emigrated or were seen only locally at the time of study. Ninety-nine patients were followed for three to 102 months (mean 23 . 3 months). Thirty-seven patients were followed for 36 to 102 months. Relapses were infrequent but occurred as late as 60 months.
Screening by culture of endocervical specimens revealed four cases of gonorrhea among 744 pregnant women attending the prenatal clinic at the University Hospital in Kuala Lumpur, Malaysia. The observed prevalence of gonorrhea (0.54%) in pregnant women is similar to that in Great Britain (0.2-0.7%), but lower than the prevalences reported for North America (2.5-7.5%) and Thailand (11.9%). The results indicate that routine screening of pregnant women attending prenatal clinics in Malaysia would aid in the control of gonorrhea in that country.
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
This paper describes the characteristics of Malay psychiatric inpatients, their attitudes towards hospitalisation and their practice of consulting traditional healers (bomohs). The behaviour patterns which prompted hospitalisation were: acute disorganised behaviour directed at the community, behaviour of a less acute nature distressing the family and life-threatening crises. The social interaction life styles of urban and rural Malays are discussed in relation to the differences observed between urban and rural hospitalised patients. When the traditional healers were consulted there was a delay before hospitalisation, but there was an awareness of the need for hospitalisation shown by a small number of the traditional healers. Some patients who had consulted the traditional healers had the tendency to continue the consultations after leaving the hospital, but this practice became less frequent after each discharge from hospital.