A descriptive study of 1,945 cancer cases discharged from the University Hospital, Kuala Lumpur, during the three-year period from 1972 to 1974, was carried out to analyse cancer patterns and frequency in the various age, sex and ethnic groups, The highest frequency of cancers occurred among the Chinese (68.8 percent) in excess of that expected from their utilization rate of the hospital (50.5 percent). The jive leading cancers in males were lung, liver, stomach, nasopharynx and rectum. In the females, the five leading cancers were cervix uteri, breast, stomach, lung and ovary. This was the pattern reflected among the Chinese, the patterns for the Malays and Indians were different. In addition, the Chinese constituted the highest proportions in most of the selected individual cancers analysed (including cancer of the nasopharynx, lung, liver, stomach, cervix, breast, rectum and colon). However, there was a high proportion of Indians in laryngeal and skin cancer. The age distribution of the patients showed that cancers of the oesophagus, stomach, colon, rectum, liver, lung, skin and bladder, were predominant in the older age groups (55 years and above). Carcinoma of the cervix uteri, ovary and breast were more common in the 45-54 years age group, while leukaemia, thyroid and nasopharyngeal carcinoma were more common in the younger age groups. Comparisons with other studies showed strikingly similar patterns to those found in Singapore, 1968-70.
The nutritional status of 158 soldiers drawn from four army camps in Selangor, Negeri Sembilan and Pahang has been assessed by biochemical procedures, nutritional anthropometry and dietary (chemical) analysis. Biochemical assessment showed that with the exception of thiamin and riboflavin nutriture, the nutritional status of the soldiers appeared generally satisfactory and seemed to have improved slightly over those examined by the Inter-Departmental Committee on Nutrition and National Defence (ICNND), USA, in 1962 by similar methods. The anthropometric assessment indicated that the present day soldiers have the same mean height as those examined in 1962. Although they appeared slightly heavier, obesity did not seem to be a problem. Chemical analysis of their diet showed that there is room for improvement in the dietary supply of vitamin A and some of the water-soluble vitamins, particularly riboflavin, thiamin and vitamin C. There was also a significant discrepancy between the nutritional content of the chemically-analysed cooked meals and those calculated from the ration scales using Food Composition Tables, suggesting a need to review the current system of food supply,
preparation and food sertnce unthin army camps in
Malaysia.
The serum alpha-1 acid glycoprotein of 9 euthyroid subjects, 14 hypothyroid patients and 21 hyperthyroid patients was determined by radial immunodiffussion in agar plates. The serum alpha1 acid glycoprotein level in both the hypothyroid and hyperthyroid patients were significantly lowered when compared to the euthyroid subjects. There was no significant correlation between the alpha-1 acid glycoprotein level mid the Liothyronine resin uptake (T3 resin. uptake) and the serum total Thyroxine Iodide (T4I) level.
A retrospective study of intraocular foreign bodies treated at the University Hospital over 10 years from 1970 - 1979 was carried out. Of the 48 cases reviewed, nine were anterior chamber foreign bodies while the rest were posterior segment foreign bodies. The anterior chamber foreign bodies had better visual prognosis as compared to the posterior segment foreign bodies. Most of the patients were young Chinese males and most of the injuries were due to accidents at work involving the 'hand hammer' (includes other implements used as a hammer).
Mortality in the early phase of acute myocardial infarction occurs both during the pre-hospital period and after admission to the Coronary Care Unit. This report is an analysis of deaths that occurred in the Coronary Care Unit within a 3 year period. Forty percent of 304 patients (13 percent) unth. acute myocardial infarction died in the Coronary Care Unit, Fifty percent of the deaths were due to cardiac arrhythmias and 45 percent attributable to myocardial pump failure. Mean delay in hospital admission from onset of symptoms was 15 hours. Factors affecting early mortality and their prevention are discussed.
The birthweights of 13,614 singleton infants comprising 5376 Malays, 5352 Chinese and 2886 Indians born at the Maternity Hospital Kuala Lumpur, during 1973, 1975 and 1977 have been extracted and analysed. Male Chinese infants (3.16 ± 0.37 kg) were significantly heavier than Malay and Indian infants while the male Malay infants (3.12 ± 0.41 kg) were significantly heavier than the Indian (2.97 ± 0.41 kg). Both female Chinese (3.04 ± 0.38 kg) and Malay infants (3.05 ± 0.38 kg) were heavier than the female Indian (2.89 ± 0.39 kg) but there was no difference in birthweight between Chinese and Malay female infants. The mean gestational period and the proportion of full-term births were similar for all 3 races with averages of 39.9 weeks and 77.8 percent respectively. Maternal age at first birth was also closely similar for the three communities with an average of 22.9 years. Significant correlations were found between birthweight and length of neonates, birthweight and gravida, birthweight and maternal age. Indians have a higher incidence of low birthweight or small-for-gestational age infants (14.5 percent) compared to the Chinese (5.6 percent) and the Malays (7.6 percent); the incidence of low birthweights being higher in girls than in boys. Present-day Malay and Indian full-term male and female infants are significantly heavier than their counterparts born at the same Hospital two decades ago, but no difference in birthweight was observed for Chinese infants during this time interval. The gap between the incidence of low birthweight found in Malaysia and those in the developed countries seems to be narrowing and this may be taken to reflect the overall effects of socioeconomic development, including the greater availability of general health and ante-natal care throughout the country since its Independence in 1957.
A study conducted in. all the government schools in Wilayah to find the prevalence rate of worm infection in. urban schools revealed that 50 percent of the 7,682 school children. examined suffered from helminthiasis. More than 50 percent had mixed infections, worm infection was more prevalent among Malays and Indians. Both males and females had an equal prevalence of worm infection. Schools near the squatter areas had high infection rates. This was attributed to poverty, cultural factors, and environmental sanitation in the squatter areas.
This is a retrospectioe study of epidemiological and riskfactors ofischaemic heart disease in Malay patients admitted into the Coronary Care Unit, General Hospital, Kuala Lumpur between October 1977 and December 1979 unth. proven myocardial infarction. Ofthe 116patients (M/F sex ratio 9.5 : 1), the incidence of various risk factors were smoking 82 percent, hypertension 42 percent, hypercholesterolemia 23 percent, diabetes mellitus 20 percent and family history 9 percent. Anterior infarctions were more common than inferior. Hyperuricemia was detected in 19 percent and 96 percent had at least one major riskfactor. In terms ofoccupation, a majorproportion ofthose afflicted were pensioners, security personnel and businessmen.
Thyrotoxic psychosis is an uncommon phenomenon and the presentation is usually of the affective disorders. Three cases manifesting psychotic symptoms akin to schizophrenia are described. The neurobiocheinistry and treatment are discussed.
A young Chinese female presented with severe bilateral chemosis without any other systemic evidence ofoedema or systemic lupus erythematosus (SLE). Investigations confirmed the diagnosis of SLE with early diffuse proliferative glomerulonephritis. The condition improved with steroid therapy.
A survey on mosquito breeding in septic tanks in several residential areas was carried out on 211 septic tanks in the Ipoh Municipality. The septic tanks inspected comprised two types; the contact filter-bed with pump sump and pump motor type (Type A) and the subsoil [ilter trench type (Type B). Mosquito breeding occurred in. both types of septic tanks, with Type A septic tanks showing heavier breeding, Seventy-two (55.4 percent) of the 130 Type A septic tanks inspected had Aedes albopictus breeding. Besides being a nuisance, mosquito breeding is a potential threat to public health, as Ae. albopictus is a vector of dengue fever. Prolific breeding by Ae. albopictus was encountered in areas where Type A septic tanks were used. Other mosquitoes encountered in the survey were Culex qusnquefasciatus, Armigeres subabaltus and Uranotaenia spp. Analysis of effluent samples from Type A and Type B septic tanks revealed that of the 4 parameters measured (PH, chloride, BOD5 and Free Ammonia}, only pH was not significantly different at the 95 percent level of confidence. Chloride, BOD5 and Free Ammonia levels in. the Type B septic tanks were significantly higher than that in Type A septic tanks. Turbidity of the effluent in Type B septic tanks probably deters Ae. albopictusfrom breeding. Several methods to prevent breeding of mosquitoes in septic tanks were discussed. The easiest method is to mosquito-proof the septic tanks but this has been tried not too successfully. A method using expanded polystyrene balls is suggested. Other methods include the use of parasitic nematodes and the use of insecticides but these are not favourable.
The role of multiple pleural biopsies in malignant pleural effusion to achieve better diagnostic yield was evaluated. The specific diagnosis was established in 43.8 percent (14/32) of cases on first biopsy, and improved to 93.8 percent (30/32) of cases by three biopsies. The contribution of multiple biopsies was stressed.
The early Malaysian experience of laparoscopic sterilisation with the Fallope tubal rings, as undertaken at the Obstetrical and Gynaecological Unit of the University Hospital, University of Malaya in Kuala Lumpur, Malaysia is reported in a study of 291 consecutive females that had had the procedure undertaken during the one year period, May 1975 to April 1976. Of the 291 cases, 247 women were sterilised in the "interval" period, 43 after "menstrual regulation" procedure and one after a spontaneous abortion. General anaesthesia was used in all except one case. The salient socio-demographic, contraceptive and reproductive characteristics of study cases are presented and discussed. The technical problems, the early complications and morbidity encountered in this study are presented and discussed in the light of other similar studies, and in relation to sterilisation by laparoscopic tubal electrocoagulation. The overall impression is that laparoscopic sterilisation with the Fallope tubal rings is preferred to that by tubal electrocoagulation, in view of the possible inadvertent serious electrical burns of other structures during the use of the latter procedure.