505 primary school children in Singapore aged 10-14 were surveyed regarding fear of the dentist. Sixty-eight children were classified as having high fear, giving a sex and race adjusted population prevalence rate of 177 fearful children per 1000 population. Females were 2.64 times more fearful than males. There were no significant racial differences in the prevalence rate. Children with high state anxiety are almost three times as likely to report dental fear as those with low state anxiety. Children with trait anxiety scores above the population mean were just as likely as those reporting below the mean to be fearful. Access to dental care is an important intervening variable in dental fear.
Three different ethnic groups from Singapore comprising 79 Chinese, 34 Malays and 23 Indians of Dravidian origin, were investigated for the HindIII RFLP at the DNF15S2 locus. The three populations had very similar allele frequencies and the frequency of rarer(S) allele was significantly (p less than 0.01) lower (0.21) in these ethnic groups compared to that in Caucasians (0.41). The phenotypic distributions were at Hardy-Weinberg equilibrium.
Based on data collected by the population-based Singapore Cancer Registry over the period 1968 to 1982, baseline epidemiological characteristics and incidence trends of primary liver cancer were described. This will facilitate the interpretation of future trends, especially in the light of new interventions such as hepatitis B immunisation. The primary liver cancer incidence is four times higher in males than in females, with the incidence peaked in the seventh decade. The incidence rate was higher in the Chinese than in Malays and Indians and marginally higher among foreign born than Singapore born Chinese. A general declining trend in liver cancer incidence was especially notable in the local born Chinese. Misclassification of metastatic carcinomas in the earlier years of cancer registration may have contributed to the initial higher incidence. Definitive decrease in incidence as a result of hepatitis immunisation will only be seen in another two to three decades.
This article examines retest reliability and digit preference in retrospective survey data on breastfeeding duration and type of supplementary food, covering three decades and reported by more than 1200 Malaysian women. Women with little or no education, rural residents, and those of Malay ethnicity are found to give less reliable data. In a logistic regression analysis, these respondent characteristics are more important determinants of data quality than the length of the recall period.
Different groups of people will view and use modern dental services differently. This is determined by their traditional beliefs and cultural background. The aim of this study is to identify variations in utilization among adults in the three major ethnic groups in Malaysia. Dental records of 500 adults attending the University dental center were randomly selected and analyzed by sex and ethnic group. Results from this pilot study clearly indicate that different ethnic groups tend to use certain types of services more than others. Similarly, there is evidence of variation in the type of dental service preferred between males and females. The implications of these findings for dental health educators, program planners and further research is emphasized in order to promote a more positive pattern of utilization among the various ethnic groups.
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.
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
A total of 23 patients with psychoses associated with thyrotoxicosis were admitted to the psychiatric unit of a University Hospital over a 13-year period, of which 20 patients were included in this retrospective study. It was found that a parallel relationship between thyrotoxicosis and psychosis appears to exist in six patients, while in the remaining 14 patients, the course of the two disease processes were largely independent of each other. Paranoid delusions and auditory hallucinations were the most prominent psychiatric symptoms. Depression was commonly seen even in patients who were not having an affective illness. In four patients, a mixed schizo-affective psychosis was seen, suggesting that the diagnostic distinction between the affective and schizophrenic reactions are often blurred in psychosis associated with thyrotoxicosis.
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.
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.
This study reviews experiences in the management of three cases of lacerations of the vagina following coitus. A brief review of the recent literature is made. Although the extent of injuries can be very variable, the principles of management consist of prompt
resuscitation and arrest of haemorrhage, appropriate surgical repair under general anaesthesia, and systemic or local antibiotic therapy to combat infection. Avoidance of vigorous or abnormal coital practices, especially in single women, in the immediate postpartum period, and in postmenopausal women, can help to reduce the frequency and severity of such injuries.
Tests of pulmonary function (FVC, FEV1, FEV 1%, and single breath CO diffusion), renal function (serum creatinine and BUN), liver function (serum ALT, AST, and ALKP) and a full haematological screen were performed on 27 paraquat spraymen (mean spraying time 5.3 years; mean individual annual quantity of paraquat handled, 67.2 kg as paraquat ion) and on two control groups. One of the control groups consisted of 24 general plantation workers with minimal exposure to paraquat arising from occasional work in recently sprayed areas, and the second consisted of 23 latex factory workers with no known occupational exposure to paraquat. The results showed no significant differences as a consequence of occupational exposure to paraquat. Long-term paraquat spraying at the concentrations used produced to quantifiable harmful effects on health as measured by the indices selected for this study.
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
Merital is a recently introduced antidepressant agent which is structurally unrelated to the traditional antidepressant agents and which is reported to have minimal side effects. This study aimed to establish the olerance of a single compared to a spaced dose .schedule of Merital. It was found that a single morrung dose of Merital 100 mgs compared to a similar dose of the drug given in two divided doses did not appreciably increase the frequency or severity of side effects.
Peptic ulcer occurs with different frequencies in the three main racial groups in Singapore. This study aimed firstly to determine the prevalence of Helicobacter pylori in peptic ulcer and non-ulcer dyspepsia patients of the different races and secondly, to assess the relation between H pylori, histological gastritis, patient diagnosis, and race. Gastric antral biopsy specimens from 1502 patients undergoing gastroduodenoscopy were studied and 892 (59%) were positive for H pylori. H pylori was strongly associated with gastritis: 873 of 1197 (73%) patients with gastritis were positive compared with 19 of 305 (6%) without gastritis (p less than 0.0001). The prevalences of H pylori and gastritis were similar in peptic ulcer patients of different races. Malay patients with non-ulcer dyspepsia, however, were less likely to be positive for H pylori (10 of 46 (22%] or to have antral gastritis (17 of 46 (37%] than Chinese (292 of 605 (48%) were positive for H pylori and 421 of 605 (70%) had gastritis) and Indians (35 of 61 (57%) were H pylori positive and 42 of 61 (69%) had gastritis). Patients with duodenal ulcer were more likely to be positive for H pylori than those with non-ulcer dyspepsia, even when subjects with gastritis were considered separately. While our results do not help to explain the observed racial differences in peptic ulcer frequency it may be that the pathophysiology of non-ulcer dyspepsia is different in the different races in Singapore.
STUDY OBJECTIVE:The aim of the study was to analyse differences in mortality from the main cardiovascular diseases (ischaemic heart disease, hypertensive disease, and cerebrovascular disease) among Chinese, Malays, and Indians in Singapore.
DESIGN: The study was a survey using national death registration data in Singapore for the five years 1980 to 1984. The underlying cause of death, coded according to the ninth revision of the International Classification of Diseases, was taken for the analyses.
SETTING: The study was confined to the independent island state of Singapore, population 2.53 million (Chinese 76.5%, Malays 14.8%, Indians 6.4%, Others 2.3%). Death registration is thought to be complete.
SUBJECTS: All registered deaths in the age range 30-69 years during the study period were analysed by ethnic group.
MEASUREMENT AND MAIN RESULTS: Indians had higher mortality from ischaemic heart disease than the other ethnic groups in both sexes, with age-standardised relative risks of Indian v Chinese (males 3.8, females 3.4), Indian v Malay (males 1.9, females 1.6), and Malay v Chinese (males 2.0, females 2.2). The excess mortality in Indians declined with age. For hypertensive disease Malays had the highest mortality, with age-standardised relative risks of Malay v Chinese (males 3.4, females 4.4), Malay v Indian (males 2.0, females 2.5), and Indian v Chinese (males 1.6, females 1.6). For cerebrovascular disease there was little ethnic difference except for lower rates in Chinese females, with age-standardised relative risks of Malay v Chinese (males 1.1, females 1.9), Malay v Indian (males 1.0, females 1.1), and Indian v Chinese (males 1.1, females 1.7).
CONCLUSIONS: There are significant differences in mortality from the three main cardiovascular diseases in the different ethnic groups in Singapore.
A retrospective study of 1000 cases of microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur was done. Head and neck neoplasms comprise 7.1% of all tumours diagnosed in this Hospital and the commonest sites of involvement are the nasopharynx (29.1%), cervical lymph nodes (22.6%), oral cavity (10.2%), thyroid (8.2%) and skin (6.5%). Histologically, 87% of tumours are epithelial in nature. The results of this study show that nasopharyngeal carcinoma is commonest in Chinese males, while oral and laryngeal malignancies occur more frequently in Indians.