Pneumonia and diarrhoeas are an important cause of toddler mortality and morbidity in developing countries. Of the 147 children admitted to the University Hospital at Kuala Lumpur in 1971 for pneumonia and diarrhoeas 50 (34%) were found to be suffering from protein-calorie malnutrition of varying degrees of severity. The malnourished children tended to come from poorer homes, and to have a larger number of siblings born in rapid succession when compared with normal weight children. Anemia was more common among the malnourished children. The interaction of infection and malnutrition and the social implications of these diseases are important. It is vital that hospitals in developing countries promote health in addition to their traditional curative role.
Three persons were experimentally inoculated with malaria by means of Anopheles ludlowi reared from larvae and infected with a pure strain of subtertian plasmodium (Plasmodium falciparum), thus proving that there exists no mechanical impediment or obstacle to the free exit of sporozoites from the salivary ducts or proboscis. In the dissection of infected mosquitoes there were no evidences of degenerated zygotes. Sporozoites appeared promptly in the salivary glands (9 to 12 days). Inoculation occurred with ease either in an interrupted feeding or after mosquitoes had been fed twice previously. The period of incubation was 14 and 18 days. The clinical manifestations were more severe in the subject that had never been infected with malaria previously, while the splenic enlargement was most pronounced in the subject infected after a long interval of freedom from malaria. In a third subject already suffering from tertian malaria there was only the slightest evidence of physical illness elicited by the superimposed subtertian infection; his temperature, however, became duly elevated. The type of febrile reaction in the two uncomplicated cases was at first tertian, becoming quotidian later, and this phenomenon in a pure strain leads strongly to the supposition that Plasmodium falciparum possesses inherently both tertian (or subtertian) and quotidian tendencies, as well as its well known tendencies to cause fever of the irregularly remittent or continued type. The creation of a specific plasmodium to account for clinical forms of aestivo-autumnal or subtertian malaria having a quotidian periodidty is probably unwarranted. In consideration of the facility with which this species can be infected and man inoculated experimentally, the occurrence of naturally infected wild specimens, and the positive epidemiological evidence, there should no longer exist in the minds of sanitarians any doubt as to its being a malarial carrier. Operations against this species can therefore be recommended without reservation and should be carried out without delay.
Complications resulting from the penetrating percutaneous foreign bodies almost always arise in the early post injury period. Delayed presentations of previous asymptomatic foreign bodies are rare. In this case report, symptoms of tracheal irritation arose seven years following the initial penetrating shrapnel injury to the neck. Computed tomography scans enabled localisation of the foreign body at the tracheal wall and carotid sheath interface. The usefulness of this radiologic modality in the evaluation of the penetrating soft tissue injury is highlighted. A review of the phenomenon of the migrating and asymptomatic foreign body follows.
The weights and heights of 3,312 Malaysian primary school boys and girls, aged 6 to 11 years, belonging to various ethnic groups in Malaysia were measured. On the whole, the Chinese children were taller and heavier than the Malay and the Indian children who were the least heavy among the three ethnic groups. Economically the Indians were the poorest among the three ethnic groups and they also had the largest family size. When the household incomes were taken into consideration it was found that the growth achievement of the higher income children was better than that of the poorer children, irrespective of their ethnic groups. It is interesting to note that, although the Indian children as a whole, were the least heavy of the three ethnic groups, yet the growth achievement of the higher income Indian children was similar to that of the higher income Chinese children. The differences in growth achievement of the various ethnic groups are probably due to environmental differences, rather than genetic differences. It seems likely that Malaysian children of different ethnic groups (Malay, Chinese and Indian) can attain similar statures if environmental conditions are similar.
From the start of the school milk feeding programme in February 1985 to October 1986, a total of 2,766 children aged six to nine years from 12 primary schools in Ulu Selangor were followed-up for about two years. The children's weight and height were monitored at the beginning, in the middle and at the end of the study. The study shows that there is a reduction in the prevalence of protein-energy malnutrition in terms of underweight (15.3% to 8.6%), stunting (16.3% to 8.3%) and wasting (2.6% to 1.7%) from the start of the school feeding programme to two years later. Associated with this there was an improvement in the attendance rate of the children during the same period. As there was no major developmental change in Ulu Selangor during that period, it is likely that the reduction in the prevalence of protein-energy malnutrition and the improvement of the attendance rate among the children are due to the impact of the school milk feeding programme.
Aim: To investigate cigarette consumption patterns exhibited by non-smokers, occasional smokers, and daily smokers in Malaysia.
Subjects and methods: A sample of 4204 individuals from the 2011 Malaysian Global Adult Tobacco Survey is analyzed. A zero-inflated ordered probit model is used to accommodate the ordinal nature of smoking outcomes with excessive zero observations of non-smokers.
Results: Socio-demographic characteristics are closely associated with consumption patterns of non-smokers, occasional smokers, and daily smokers. Specifically, urbanites, government employees, and Malays exhibit greater tendencies to be daily smokers and lower propensities to be non-smokers than others. Education is a deterring factor in cigarette smoking as higher education up to the tertiary level raises the propensity of being a non-smoker by 8.16 percentage points. The role of ethnicity is highlighted as individuals of Malay and other ethnic backgrounds are more likely to smoke daily, while exhibiting lower propensities of being non-smokers. Males are more likely to engage in occasional or daily smoking than females. Employment in government or non-government sectors increases the probability of daily smoking.
Conclusions: Our results suggest the need to include measures to cope with internal or external cues among smokers with specific socio-demographic characteristics. Cessation interventions should focus on daily smokers in urban surroundings with low education levels and those of Malay ethnic origins. Anti-smoking measures in line with occasional smoking may include ameliorating the male attitude toward smoking and policies to prohibit workplace indulgence.
Study name: Global Adults Tobacco Survey (GATS-2011)
Inverted papilloma is the most common benign tumor of nose and paranasal sinuses arising from lateral nasal wall and middle meatus. Histologically these tumors are composed of epithelial nests that are inverted, exophytic and cylindrical. Here we describe a clinical case of nasal cylindrical cell papilloma, which was treated by endoscopic excision.