An immunization survey was carried out in early 1983 in a military community. The survey covered 192 children from 147 families. 98% had BCG scars. and 94% had completed their primary course of immunization against diphtheria, pertussis, tetanus and poliomyelitis. The acceptance rate for booster was however low. The time frame for the immunization was also not adhered to strictly. An immunization register has been started in all centres for recall of defaulters. Publicity has also been mounted to ensure all are aware of the immunization programme.
A rare case of pilocarpine-induced retinal detachment occurring in the only useful myopic eye of a young Chinese woman is described. Problems of treating raised intraocular pressure in high-risk cases of retinal detachment are discussed.
A unilateral true ankylosis of the temporomandibular joint of traumatic origin and of 23 years duration is reported. Its pathogenesis and treatment are discussed.
A 70 million population for Malaysia by the year 2010 has been officially targetted for in the Mid-Term Review of the Fourth Malaysia Plan, 1981-1985. In response to this, a preliminary investigation was undertaken into the health aspects of population growth. For this exercise, infant mortality rate was used as the health indicator. From trends seen vis-a-vis population growth, it appears that thus far, population growth has not been associated negatively with health (as measured by IMR). In recognition of the relevance of the medical, economic and education factors to health, trends in Malaysia's population ratio, per capita GNP and rates of school enrolment were also drawn; the selection of these as proxies being based on completeness of time-serial records. Although statistical regressions established the high correlation between medical doctors.population ratio and school enrolment rate with IMR, the limitations in this analysis did not permit any reliable inferences. In view of the difficulties in projections of trends, a comparison of health and related variables was carried out for several countries with high populations as near to 70 million as were available. The characteristics associated with low mortality and high life expectancy (health indices) were identified as low population growth, high literacy and high per capita GNP; this being stated with explicit qualifications. Other determinants of health were also discussed in brief, and the need for careful planning in the distribution of human and material resources was noted.
Percentile head circumference charts, from six to eleven years of age, for boys and girls are presented. These can be used to monitor the head circumference of Malaysian children.
Percentile growth charts of weight, length and head circumference, from birth to six years of age, for boys and girls, are presented. These can be used to monitor the growth of Malaysian children.
The plasmid profiles of 66 strains of penicillinase-producing Neisseria gonorrhoeae (PPNG), isolated in Peninsular Malaysia, were determined by agarose gel electrophoresis. All the isolates harboured two common plasmid species, a 4.4 x 10 6 Far-East type R plasmid associated with beta-lactamase production and a 2.6 x 106 plasmid of unknown function. In addition to these two plasmids, 51 (77%) PPNG isolates also carried a 24.5 x 106 conjugative plasmid.
Sixty patients with uncomplicated gonococcal urethritis were treated with a single dose oral regime comprising 3 g of cefaclor and 1 g of probenecid. Forty-eight patients (80%) returned for follow-up and the overall cure rate among them was 91.6%. Among the isolates, 25 (41.7%) showed penicillinase producing Neisseria gonorrhoeae (PPNG) strains. The cure rate for patients infected with PPNG was 85% while the cure rate for non-PPNG was 96.4%. Further work is required to establish the optimum dosage for this particular regimen.
This communication describes a survey on 94 cases of alleged paraquat poisoning for a period of one-and a-half years in Perak state. The highest prevalence of such cases was noted in the district of Batang Padang. The incidences between males and females as well as between married and single persons were found to be equal, 81.9% were Indians and 73.4% were suicidal cases. More than 80% of the cases were in the 10-to-40-years age group.
The transcutaneous (Tc) bilirubinometer was evaluated in 105 jaundiced neonates, comprising 38 Malays, 37 Chinese and 30 Indians, who had not been treated with phototherapy or exchange transfusion. Tc bilirubin index and serum bilirubin concentration correlated at statistically significant levels in all the three racial groups. Unlike the Chinese and Malay babies, the action levels, using Tc bilirubin index, in the Indian babies are not reliable due to the wide variation of skin pigmentation. Neonatal jaundice is conventionally monitored by estimation of serum bilirubin level. This involves blood sampling. The transcutaneous (Tc) bilirubinometer, however, is non-invasive, small and portable. In this study, the use of the Tc bilirubinometer in the management of neonatal jaundice' in the three racial groups was evaluated.
The overall mortality rate of babies delivered in the University Hospital, Kuala Lumpur has improved significantly from 18.5 in 1969-1971 to 9.9 per thousand live births in 1979-1981. This drop in mortality is also seen in those infants weighing 1001 - 2000 g at birth. Indian babies in the weight group 1001 - 1500 g at birth appear to have a significantly lower mortality than the other races. Babies referred from outside have a much higher mortality rate compared to babies delivered in University Hospital, Kuala Lumpur.
Correlation analysis of mid-arm circumference (MAC), weight-for-age and weight-for-height obtained from 807 Malay preschool children aged 12-71 months show that MAC had a relatively low correlation with weight-for-age (r = 0.59, P <0.001) and weight-for-height (r = 0.63, P<0.001). MAC percentiles and sensitivity-specificity analysis indicate that when weight-for-age and weight-for-height were used separately to define 'true' malnutrition, MAC was not sensitive enough to detect Malaysian children with only mild to moderate protein-energy malnutrition (PEM). The value of MAC as a screening measure in malnutrition is only limited to identifying the more severe forms of PEM in young children and the present study indicates that a MAC of 13.0-13.7 cm may be used for identifying moderate to severe PEM and under 13.0 cm for severe PEM.
This is a report of a case of vulvovaginitis due to Shigella flexneri in a three-year-old child. This is probably the first documented case of shigella vulvovaginitis In Malaysia. The patient was successfully treated with cotrimoxazole. Extraintestinal infections by Shigella are rare and are briefly reviewed in this article.
Aqueous root extract of Selayak Hitam a plant commonly found in Malaysian jungles and reported to have abortifacient property was screened for oxytocic effect. Results obtained from in vitro experiments on isolated uterus preparation from both pregnant and non pregnant rats and in vivo experiments on uterus contraction in rats in situ, showed that the extract lacks oxytocic effect. It is concluded that the alleged abortifacient property if any, is not mediated through oxytocin or oxytocic-like effect.
The usefulness of counterimmunoelectrophoresis (CIEP) and coagglutination (COAG) methods in the diagnosis of bacterial meningitis was evaluated. Out of the 31 cerebrospinal fluid (CSF) specimens which had a cell count of >5 x10^6 wbc/l and were negative on gram stain and culture, pneumococcal antigens were detected in four specimens and Haemophilus influenzae type b antigen was detected in one specimen by both the methods. No false positives were detected in 10 specimens obtained from cases of febrile fits whose CSF showed no evidence of meningitis. One CSF sample, from which Klebsiella spp. was isolated, cross reacted with the meningococcal polyvalent group A-D antiserum in the CIEP test. From this study we found that these methods are rapid, simple and useful adjunctive tests In the diagnosis of bacterial meningitis, especially in the partially treated cases.
The MtC tests performed prospectively was correlated with graft survival in 73 living, related grafts. The MLC was expressed as the relative response (RR), and graft survival assessed at six months, one year and two years. The l-haplotype matched grafts with high RR had poorer graft survival at one and two years than those with low RR, but this difference was not statistically significant.