In a cross-sectional study of 7 to 12-year-old primary school children in Kuala Lumpur, the prevalence of chronic cough and/or phlegm, persistent wheeze, and doctor-diagnosed asthma were 8.0%, 8.0% and 8.7%, respectively. The prevalence of asthma (defined as persistent wheeze and/or doctor-diagnosed asthma) was 13.8%. 4.3% experienced at least one episode of chest illness that resulted in inactivity for at least 3 days in the previous year. The mean age of commencement of symptoms in the doctor-diagnosed asthma group was 2.75 years. The prevalence of chronic cough and/or phlegm and persistent wheeze were highest among Indian children (p less than 0.05). More Malays had been diagnosed as having asthma than the other ethnic groups but the differences were not statistically significant. The patients' fathers' low levels of education were associated with chronic cough and/or phlegm (p less than 0.05) but not with other complaints. Asthma was significantly more common among boys than girls. No age differences were noted. Further analysis showed that persistent wheeze and doctor-diagnosed asthma were associated with increased likelihood of other respiratory illnesses or doctor-diagnosed allergy before the age of 2 years.
JE is neither classified as an entity in the Malaysian Medical records system nor is it a notifiable disease but is grouped under the broad umbrella of viral encephalitis. There is no centralised program by the Ministry of Health specially for JE surveillance and control. JE is endemic, occurs sporadically throughout the country all year round. Asymptomatic inapparent infections have been found to be more frequent than acute clinical encephalitis cases, judging from results of previous serosurveys (Pond et al., 1954). JE vaccination has never been tried in Malaysia. In a relative sense, JEV infection unlike dengue virus infection, does not appear to be much of a problem in Malaysia. Perhaps, the laboratory confirmed cases represent only a small proportion of the total hospitalised cases that actually occurred. The reasons may be that these cases could not be confirmed by laboratory tests due to improper timing or failure to obtain the second serum specimen, or failure to perform lumbar puncture on patient's refusal. Attempts to improve the case detection rate of JE in Malaysia should be made namely, by increasing clinical index of suspicion, instituting better specimen collection procedures and by adopting rapid diagnostic tests.
Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls. Thirty-four of these children were Malays, 16 Chinese, 26 Indians, three mixed and seven illegal immigrants. Twenty-one were below the age of one year, 24 from one to four years, 25 from five to nine years and 16 were ten years and above. The abusers were mainly close members of the family. Of these children, 24 were sent back to their parents and 11 to their relatives home. Twenty-seven were taken into care by the Ministry of Social Welfare and the remaining seven children who were illegal immigrants, were deported with their parents. Only one child was successfully fostered. Eleven children were taken away from the hospital by their parents or guardians without the knowledge of the health staff. There were five deaths in the series.
The combined epithelial odontogenic tumour represents a hybrid lesion comprising primarily areas of adenomatoid odontogenic tumour intermixed with foci of calcifying epithelial odontogenic tumour. Five such cases retrieved from the files of the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, and four others from the existing literature were analysed. A mean age of 18.8 years, a female preponderance (66.7%) with a male to female ratio of 1:2 and predilection for the mandible (55.6%) were observed. All cases were treated by conservative surgery and the lack of recurrence confirmed the innocuous nature of this lesion.
In this paper, urolithiasis is remarked from the standpoint of descriptive epidemiology, which examines the frequency distribution of a given disease in a population in terms of time, place and personal characteristics with an aim of identifying risk factors or some clues to the etiology. Some descriptive epidemiological features of urolithiasis are summarized. Prevalence rate is around 4% (4-15% in males and 4-8% in females), and incidence rate varies from area to area: 53.2 per 100,000 population in 1975 in Japan, 364 in 1976 in Malaysia, and 540 in 1979 in West Germany. Prevalence and/or incidence rates have, in general, increased in the developed countries since World War II and in the developing countries as well, where upward trends are quite analogous to the trends observed in the nineteenth century in Europe. Recurrence rate, which is much higher in males than in females, ranges from 31% to 75%, depending on the follow-up periods. In the industrialized countries, upper urinary (renal and ureteral) stones account for more than 90% of total stones, which are ordinarily calcium complexes in composition. More common in the developing countries are lower urinary (bladder and urethral) stones, frequently composed of magnesium ammonium phosphate, which indicates a close association with urinary tract infections. Variations in frequency are evident by season and by region within a country. Age and sex differentials in urinary stone formers are substantial: more common in males 30-40 years old in the industrialized countries and in children under 10 years old in the developing countries. Racial differentials are also noted; blacks appear to suffer less frequently than whites. Stone formers experience more frequent episodes of stone formation in their family members, particularly father and brothers, than non-stone formers. These findings on racial differentials and family preponderance suggest the possible relevance of genetic factors in stone formation. Stone formers are more likely to be occupationally sedentary and socially affluent. This observation and differentials by age and sex suggest the probable relevance of lifestyle and environmental factors in stone formation. Epidemiological factors incriminated for stone formation will be discussed in a separate paper.
Formal population education is designed to teach children in school about basic population issues and, in many cases, to encourage them eventually to have smaller families. Some programs include specific units on human reproduction and family planning, while others do not. National population education programs began during the 1970s in about a dozen countries, mainly in Asia. These include Bangladesh, India, Indonesia, South Korea, Malaysia, the Philippines, Sierra Leone, Sri Lanka, Singapore, Thailand, Egypt, Tunisia, and El Salvador. A strong case can be made for including an important contemporary issue like population in the school curriculum. Nevertheless, educational innovation is a difficult and long-term process. As a rule, it takes 5 to 10 years before new material can be fully incorporated in a school curriculum. Curriculum changes must be carefully planned, thousands of teachers trained, and appropriate materials prepared for classroom use. Moreover, differences of opinion over the need, acceptability, goals, content, methods, and other aspects of population education have held back programs in some countries. Where population education programs have been implemented, student knowledge of population issues increases, but it is not yet clear whether in-school education has a measurable impact on fertility-related attitudes or behavior.
A total of 164 patients with IgA nephropathy were diagnosed at the Department of Medicine, Universiti Kebangsaan Malaysia and the Department of Nephrology, General Hospital, Kuala Lumpur between 1981-1988. This represented an incidence of 20.1% of all primary glomerulopathies seen in both units. The 3 major ethnic groups were equally affected with 59.7% occurring between the ages of 20-36 years. It was not uncommon in females. The high prevalence of hypertension, renal failure, heavy proteinuria at presentation and the increased chronicity index in the biopsy, suggest that IgA nephropathy is progressive disease leading to chronic renal failure.
126 Malaysian children, 65 boys and 61 girls from higher income families were followed-up regularly from birth to six years of age in the University Hospital, Kuala Lumpur. The study confirms the observations of previous studies that growth velocity of head circumference is most rapid during the first few months of infancy and then decreases so that by the fifth year of life the increment is minimal. It also confirms the fact that boys have bigger head circumferences than girls. The paper also presents the head circumference distance and velocity percentile charts which can be used to monitor the head circumference of Malaysian children.
74 cases of radiologically proven urinary calculi between 1975 and 1979 were analysed by race, sex and age. The relative frequency of single and multiple stones was also studied. The disease was found in all the ethnic groups present in Limbang except for the Punans. Possible reasons for this observation of their apparent absence were given. The absence of patients from one of the Malay Kampongs in Limbang town was also noted.
A survey of 308,101 primary school children in Peninsular Malaysia conducted in 1979 by the School Health Services, Ministry of Health, Malaysia, revealed that 10.7% of children were infested with Pediculus humanus capitis. The prevalence rate was higher in the economically less advanced states of Terenganu (34%), Kelantan (23%), and Perlis (21%) than in the other states (4-13%). Of 14,233 school children examined in the State of Melaka, 26% of Indians, 18.7% of Malays, 6.1% of Europeans, and 0.7% of Chinese had pediculosis. The prevalence rate, which has remained unchanged over the past 5 years, does not appear to vary with age but is higher in children with long hair and those from the lower socioeconomic groups. Boys have a lower infestation rate than do girls. The higher incidence in Indians and Malays correlates well with their lower socioeconomic status in the community, and their cultural habit of maintaining longer hair than do the Chinese. The difference become less apparent in the higher socioeconomic groups.
The clinical and electroencephalographic (EEG) features were evaluated in a consecutive series of 50 infants with complex partial seizures. The age of onset of seizures showed a peak at age of 2 months. Significant development delay was seen in 60% of the infants. In 92% an underlying aetiological factor could be identified. Birth asphyxia was the commonest aetiological factor (30%). The seizure patterns were most frequently described as behavioural arrest, upward deviation of eyes, tonic posturing of the limbs, apnoea and cyanosis. Interictal EEG showed bilateral temporal lobe foci in 22%, unilateral foci in 78% and multiple foci in 46% of the cases. The response of the seizures to anticonvulsant drugs is discussed.
Some information on cancer in Malaysia are available, and its epidemiology is described. There is a need for systematic and coordinated collection of cancer statistics which are essential to patient management, cancer control programme formulation, implementation and evaluation. The decision of the Ministry of Health to introduce National Cancer Registry and to encourage epidemiological studies, which will ultimately lead to the utilization of data and introduction of control and preventive activities for cancers are positive steps in the right direction. Meanwhile, curative and palliative treatment is available from the existing hospital facilities, and preventive activities such as actions on smoking and health will be continued until such time when a comprehensive prevention and control programme for cancers in the country is evolved.
A questionnaire on smoking habits was administered to 4106 Form IV school children in Kuala Lumpur. The period of survey was from 9 to 20 April 1984. 2099 boys and 2007 girls were studied and their mean age was 16.1 years. 32.8% of the students had been initiated to smoking and the mean age of initiation was 13.3 years. The prevalence of smoking was found to be 9.8% and the mean duration of smoking was 2.5 years. Most of the smokers and occasional smokers were boys. About 42% of the smokers wished to stop smoking and only 1% of the non-smokers intended to smoke in the future. The study recommended that health education programmes should be started earlier in school.
This was a retrospective study of 177 patients above the age of 45 who were admitted to the Psychiatric Unit, University Hospital Petaling Jaya during the period October 1975 to October 1978. The available socio-demographic and clinical data from the case files were studied. The patients were divided into two groups - those with effective illnesses and those with non-affective illnesses. The differences in socio-demographic background and clinical symptomatology between the two groups and how the data compares with that in other studies was reported. The sick elderly person is an economic and psychological liagility to .his family and society. Absence of illness in the elderly not only fosters their continued independence but also improves the quality of their individual life. Though no definite correlations or conclusions could be arrived at, this study has sought to bring into awareness the necessity of delineating possible illness precipitating stress factors in the social and domestic environment of patients in later life.
Usability and affective issues of using automatic speech recognition technology to interact with an automated teller machine (ATM) are investigated in two experiments. The first uncovered dialogue patterns of ATM users for the purpose of designing the user interface for a simulated speech ATM system. Applying the Wizard-of-Oz methodology, multiple mapping and word spotting techniques, the speech driven ATM accommodates bilingual users of Bahasa Melayu and English. The second experiment evaluates the usability of a hybrid speech ATM, comparing it with a simulated manual ATM. The aim is to investigate how natural and fun can talking to a speech ATM be for these first-time users. Subjects performed the withdrawal and balance enquiry tasks. The ANOVA was performed on the usability and affective data. The results showed significant differences between systems in the ability to complete the tasks as well as in transaction errors. Performance was measured on the time taken by subjects to complete the task and the number of speech recognition errors that occurred. On the basis of user emotions, it can be said that the hybrid speech system enabled pleasurable interaction. Despite the limitations of speech recognition technology, users are set to talk to the ATM when it becomes available for public use.