Ten patients (5 males and 5 females) with gastroschisis were treated in Alor Setar Hospital from January 1989 to December 1993. Two patients had associated congenital anomalies. Primary closure was possible in 9 patient while the other patient had stage closure. All patients received prophylactic antibiotics, 9 patients were ventilated electively in the post-operative period and 7 patients received parenteral nutrition. There were 9 survivors. Complications especially wound infection and breakdown were seen in 7 patients. The average hospital stay was 36 days.
A field trial of the use of expanded polystyrene beads (EPSB) to control the breeding of mosquito larvae in household septic tanks was conducted in Sarawak. One week after treatment, the breeding of Culex quinquefasciatus and Aedes albopictus was reduced by 100% and 68.7% respectively. For both species combined, a 57.25% reduction in the adult emergence rate was achieved. No adult was caught in the emergence trap one month after treatment. A reduction in mosquito biting rates was reported by 87.3% of respondents. All households regarded the EPSB treatment as effective. This study has reduced the relatively high infestation rate of A. albopictus in the septic tanks to 16-20%. The EPSB treatment is feasible and practical. Post-treatment assessment using adult emergence traps and the implications for the vector control programme of the local authority are discussed.
The Klang River Basin is located in the most densely populated region in Malaysia, with its heavy concentration of industries and population. A systematic study of the pollution to this river system caused by phenolic compounds have been carried out under this project. Analyses of water samples from the Klang River by high performance liquid chromatography (HPLC) with an ultraviolet (UV) detector at 280 nm have shown the presence of some priority phenolic pollutants.
The author recently spent 4 months at the University of Malaya in Kuala Lumpur, Malaysia, as a visiting professor of radiology. In this report he describes his experiences in the country and at the hospital and medical school, which is one of only three in Malaysia. Each day, the author worked one-on-one with a different resident, supervising either procedures or image interpretation. Additional activities included conferences, grand rounds, and medical student teaching. Because of the mixed ethnicity of the population, the incidence and variety of pathologic conditions that were encountered clinically provided an unparalleled educational experience. The author encourages anyone with available time to consider a sabbatical such as this; it is a rewarding personal and professional experience.
Emergence of antimicrobial resistance in bacteria associated with community acquired infections has made the choice of empirical therapy more difficult and more expensive. The problems due to possible spread of MRSA to the community, emergence of penicillin resistance in S. pneumoniae, ampicillin resistance in H. influenzae, and multiresistance among common enteric pathogens are highlighted. Bacteria have a remarkable ability to develop resistance to many of the newly synthesized antimicrobial agents but the appropriate use of antibiotics will delay and in many cases prevent the emergence of resistance.
An analysis of 524 unclaimed prescriptions (which contributed 0.9% of the total prescriptions) showed that 23.8% were for vitamins, 17.7% for anti-inflammatory drugs, 16.4% medications for skin and mucous membrane and 9.9% for antibiotics. The unclaimed prescription rates varied inversely to the staff-strength working in the dispensary. Sixty-eight point nine per cent of the unclaimed drugs could be purchased at the pharmacy shops without doctor's prescription.
Giardiasis, a gastrointestinal disease caused by Giardia intestinalis is endemic in Malaysia. The prevalence rate has been reported to range from 1.4% to 11.1%. The present study was undertaken between 1992-1994 in three health districts in three states viz. Pahang, Negeri Sembilan and Selangor. Seven thousand five hundred and fifty seven (7557) primary school children between the ages of 6-12 years from the lower socio-economic groups were screened. The prevalence was 0.21%. The study suggests that improved water supply, toilet facilities and sanitation have lowered the prevalence of a waterborne disease in the areas surveyed.
A total of 234 samples of food, consisting of 158 of raw and 76 samples of ready-to-eat food were examined for the presence of Listeria monocytogenes. The frequencies of L. monocytogenes contamination in raw foods were: chicken portions (60%), liver (60%) and gizzard (62%), beef (50%), beansprout (85%), prawns (44%), kupang (dried oysters) (33%), bean cake (25%), satay (48%) and leafy vegetables (22%). Of the ready-to-eat foods: satay (26%), prawns, squids, clams and chicken dishes (22%), cucumber (80%) and peanut sauce (20%) were found to yield L. monocytogenes.
A study in Sarawak, Malaysia, revealed diverse opinions, prejudices and degrees of knowledge about leprosy among various ethnic groups. The information gathered was used as the base on which a health education package relating to the disease was established. It is intended that this will lead to the early detection and treatment of a higher proportion of cases than has previosly been possible