The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study.
This cross-sectional study aims to determine and compare health-related quality of life profiles of schizophrenia family caregivers on the basis of their sociodemographic characteristics. Thirty outpatient family caregivers completed the generic 36-Item Short Form Health Survey instrument (male = 53.5%; mean age = 51 years; married = 76.7%). The highest mean score was reported for social functioning while role limitation-emotional was rated the worst. Significantly better health-related quality of life profiles were demonstrated by caregivers who were male, younger than 50 years, adequately educated, employed, and without health problems and were receiving monthly income. Understanding of on health-related quality of life matters for family caregivers is crucial to improve the quality of care for schizophrenia patients.
Study site: tients were
identified with assistance from psychiatrists
and nursing staff in-charge at a governmentfunded public hospital in Selangor, Malaysia.
This article describes the homicide pattern in Penang Island, Malaysia over a three-year period (2007-2009). 65 homicide autopsies were performed at the Department of Forensic Medicine, Penang Hospital over the study period. The homicide rates ranged from 0.01 to 0.09/1000 population, the highest being in the Indian ethnic group. The majority (37%) of victims were in the 20-39 years age group. The male: female ratio was 3:1. The majority of deaths were caused by blunt instruments (46%), followed by stab/slash wounds (25%) and asphyxiation (12%). 63% of homicides occurred in areas served by the police stations at Jalan Patani (23.1%), Sg. Nibong (16.9%), Central (12.3%) and Bayan Lepas (10.9%). 56 (86%) victims were brought in dead to the hospital, while 9 (14%) died after admission. Most (39%) incidences occurred in the morning. The methods of homicide were different from Kuala Lumpur, another highly urbanised area of Malaysia.
Despite established country's tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the students is alarming in Bangladesh. This study was aimed to determine the prevalence of smoking and factors influencing it among the secondary school students. A two-stage cluster sampling was used for selection of schools with probability proportional to enrollment size followed by stratified random sampling of government and private schools. The 70-item questionnaire included 'core GYTS' (Global Youth Tobacco Survey) and other additional questions were used to collect relevant information. Analysis showed that the prevalence of smoking was 12.3% among boys and 4.5% among girls, respectively. The mean age at initiation of smoking was 10.8 years with standard deviation of 2.7 years. Logistic regression analysis revealed that boys are 2.282 times likely to smoked than girls and it was 1.786 times higher among the students aged 16 years and above than their younger counterparts. Smoking by teachers appeared to be the strong predictor for students smoking behaviour (OR 2.206, 95% CI: 1.576, 3.088) followed by peer influence (OR 1.988, 95% CI: 1.178, 3.356). Effective smoking prevention program should to be taken to reduce smoking behaviour. The school curricula had less impact in preventing smoking except teacher's smoking behaviour.
This study aims to describe the epidemiology of ocular burns and related injuries due to fireworks during the Aidil Fitri celebration on the East Coast of the Peninsular Malaysia. A prospective analysis of all patients with ocular burns and related injuries due to fireworks attended three tertiary hospitals in East Coast of Peninsular Malaysia during Aidil Fitri, which was from 10 September to 17 October 2008. We observed the demographic and injury characteristics, extent of the injuries and presenting visual symptoms. Thirty patients with 34 eyes with ocular burns and related injuries were identified. Patients ranged between 2 and 43 years of age. 70.00% of the patients were 12 years old and below. Of the 30 patients, 29 (96.67%) were male and the left eye was affected in 14 (46.70%). Thermal injuries accounted for 60.0% of the injuries whereas 40.0% were due to exploding firework. Burns to the eyelid and cornea (35.29%) were the most common injuries noted. Fifteen patients (50%) were bystanders whilst a majority of patients (96.67%) had no eye protection. At presentation, 15 (44.12%) eyes had a visual acuity of 6/6 to 6/9 in the injured eyes, while 3 out of 34 eyes (8.82%) had vision acuity 6/60 or worse. In conclusion, fireworks cause serious preventable ocular burns and related injuries especially in children who are the most affected age group. It affects mainly eyelid and anterior segment structures which result in moderate visual loss on presentation. Health education, public awareness and tighter legislation are essential preventive measures to limit the effect of fireworks to the public.
This study examines the structure of self-estimates of intelligence (SEI) across 12 nations (Australia, Austria, Brazil, France, Iran, Israel, Malaysia, South Africa, Spain, Turkey, UK and US). Participants rated themselves on general and specific abilities from three popular models of intelligence: Gardner's multiple intelligences, Sternberg's triarchic theory of intelligence, and Goleman's emotional intelligence. The results showed that (a) laypeople across nations have similar and invariant concepts of intelligence, (b) concepts of intelligence are cross-culturally closely related to academic notions of intellectual ability and (c) sex differences in general and specific SEI favouring men are consistent across countries. Male hubris and female humility in SEI seem independent of sex differences in actual cognitive ability and national levels of masculinity-femininity. Furthermore, international mean differences in general SEI could not be attributed to discrepancies in national intelligence quotient (IQ) levels or to cultural variations.
At present, 70% of the world's 1.1 billion smokers are in developing countries, with over 50% in Asia alone. The current study examined patterns of youth smoking in Thailand and Malaysia. Respondents were 2002 youths between the ages of 13 and 17 from Thailand (n = 1000) and Malaysia (n = 1002). Respondents were selected using a multistage cluster sampling design and surveyed between January 2005 and March 2005. Approximately 3% of youth between the ages of 13 and 17 were current smokers, with an additional 10% to 12% reporting experimental smoking. Males were between 7 and 15 times more likely to report smoking behavior than females. Less than 1% of females respondents in either country met the criteria for current smoking, and less than 5% met the criteria for experimental smoking. In contrast, more than 50% Thai males and approximately one-third of Malaysian males aged 17 met the criteria for either experimental or current smoking.
This study reports on the predisposing factors and prevalence of fractured anterior teeth among 12 and 16 years-old school children in Kubang Kerian, Kelantan, West Malaysia.
The objective of this study was to determine exposure to cysticercosis among a rural population in a selected village in Ranau, Sabah, Malaysia. A total of 135 serum samples were analyzed. The result showed that the seroprevalence of cysticercosis antibodies was 2.2%. There was no significant difference in the seroprevalence among age groups (p=0.307). Even though there was a slightly higher antibody titer in males compared to females, the difference was not significant (p=0.400). The results indicate evidence of exposure to cysticercosis in this rural population.
The purpose of this study was to report on the estimates and distribution of body mass index in a sample of Malaysian adolescents. The study utilized a cross-sectional design and multi-stage random sampling of secondary schools to select 5 urban and 9 rural schools in Kedah and Penang. A total of 6555 male and female adolescents (11-15 years old) of Malay, Chinese and Indian ethnic groups were measured for weights and heights for body mass index calculation. Information on household demographic and socioeconomic were obtained from parents through self-administered questionnaires. Analyses of body mass index distribution by location, ethnicity, gender and age were conducted using Chi-square test of SPSS 11.5. More of the rural (12.1%) and urban (19.4%) adolescents were underweight and overweight, respectively. While in all ethnic, gender and age groups, rural adolescents were more likely to be underweight, more of the urban adolescents were overweight. The prevalence of underweight was highest among the Indians (19.2%) and lowest in Chinese (7.2%). The prevalence of overweight in the three ethnic groups was in the range of 18-19%. More male than female adolescents were underweight (15% vs 7.8%) and overweight (19.5% vs 16.7%). Consistent patterns were also observed across location, ethnic and age groups. As age increased, the prevalence of overweight decreased across the ethnic and gender groups. The reported findings can serve as current reference on body mass index distribution of Malaysian adolescents and a basis for future efforts in health and nutrition interventions for Malaysian children and adolescents.
This retrospective study was conducted in a state hospital set-up and aimed at identifying the magnitude of shoulder dislocations and their demographic data, characteristics of the injury, mechanism and predisposing factors, and the instituted treatment. Patients with radiographic evidence of shoulder dislocation admitted to the hospital from January 1999 to December 2002 were included. Data were recorded from the case notes. There were 105 shoulder dislocations with male predomination in 77% cases and age ranged between 11 and 90 years (average 30.9 years). The right shoulder was affected in 68% of the cases. The contributing events were fall in 37% of cases, road traffic accident 23%, sports 17% and pathological conditions 13%. Anterior dislocation occurred in 96.2% of the cases. Posterior and inferior dislocations encountered in two patients for each type. Twelve dislocations were associated fracture of the greater tuberosity, two each with humeral neck fracture and cerebral injuries. First time dislocation occurred in 73.6% of the cases. The recurrences ranged between 2 to 6 times (average 3.4 times). Closed manipulative reduction and strapping was the definitive treatment in 92.4% of the cases and the remaining needed surgical reconstruction. Four patients had open reduction and internal fixation of the associated fractures while another four had arthroscopic Bankart's repair. In conclusion, shoulder dislocation represents the most common shoulder problems. It afflicted young adults of reproductive age (21-40 years) and participation in sports was a risk factor in men. Women over 40 years and fall were at risk to develop shoulder dislocation.
OBJECTIVES: To determine the pattern of renal histology, clinical outcome of children with lupus nephritis and to identify any associated risk factors predicting renal failure in these children.
METHODS: Retrospectively, 27 children under 16 years of age with lupus nephritis who had renal biopsies done at Sultanah Aminah Hospital Johor, Malaysia from 1994 to 2002 were studied. The renal histology was graded according to WHO classification system (1982). The medical records, laboratory data and the clinical outcome of the patients were studied.
RESULTS: There were 24 cases of WHO Class IV, two cases of WHO Class II and a case of WHO Class V. Twenty children were in the good renal outcome group while six children progressed into the poor renal outcome group and required renal replacement. One child was lost to follow-up. All six children in the poor renal outcome group had WHO Class IV histology. The 5-year patient and renal survival rates were 84% and 75%, respectively. Age, sex, activity and chronicity indices in the renal histology, anaemia, elevated serum creatinine, depressed levels of C3 and C4, heavy proteinuria or presence of urinary active sediments were not associated with progression to renal failure.
CONCLUSIONS: Presently, children with lupus nephritis appeared to have better patient and renal survival rates. Assessment of renal histology in these children was important for diagnosis, treatment and probably prognosis. In this study, there was a 25% incidence of loss of renal function over 5 years in children with WHO Class IV renal histology.
The main aim of this study was to determine the causes and epidemiological aspects of homicidal deaths. Data were collected on 217 homicidal victims from the total number of 2762 autopsies performed in UMMC, Kuala Lumpur over a five-year period, from year 1999 to 2003. There were 194 male victims and 23 female victims. The largest number of victims (63.6%) were in the age group of 20-39 years. Indians comprised the maximum proportion of victims (28.1%). Approximately 71.9% of victims came from the semiskilled and unskilled group. A majority of victims were married (47%). Injuries caused by sharp weapons (41%) were the most common cause of death, followed by blunt trauma and firearm injuries.
The characteristics of patients and the endoscopic features of 196 patients with bleeding peptic ulcer in a multi-ethnic population were investigated. There was a male preponderance (M: F= 6.3: 1) and their mean age was 63.5 years. The prevalence of peptic ulcer bleeding in the Malays and Indians was similar to the ethnic distribution of population. However, the Chinese were over represented. Nearly 40% of patients studied had at least one co-existing medical illness. Hypertension and ischaemic heart disease were the most common diseases. History of non-steroidal anti-inflammatory drug usage was identified in 48% of the patients and it was the commonest risk factor associated with bleeding ulcers. More than 80% of bleeding ulcers were located in the duodenum and the pylorus. Endoscopic features of active bleeding or recent bleed were identified in more than 60% of the patients. The study notes that bleeding peptic ulcer is a serious and a potentially life threatening condition. It is a disease of the elderly and, with the steadily increasing elderly population in the country, the admissions rates of peptic ulcer bleeding is expected to rise. There is a need to plan for appropriate technical support, critical care facilities and expertise to avoid unacceptable outcomes.
The aim of this study was to assess overweight or obesity and associated factors in school-going adolescents in the Association of Southeast Asian Nations (ASEAN) member countries. The analysis included 30,284 school children 13-15 years of age from seven ASEAN members participating in the Global School-based Student Health Survey (GSHS) between 2007 and 2013. The overall prevalence of overweight or obesity across seven ASEAN countries (excluding Brunei) was 9.9%, significantly higher in boys (11.5%) than in girls (8.3%). Among eight ASEAN countries, the highest prevalence of overweight or obesity was in Brunei Darus-salam (36.1%), followed by Malaysia (23.7%), and the lowest was in Myanmar (3.4%) and Cambodia (3.7%). Multivariate logistic regression analysis found that younger age, coming from an upper middle country, never been hungry, and not walking or biking to school were associated with overweight or obesity. In addition, among boys, having three or more servings of vegetables per day and having no close friends, and among girls, having fast foods two or more times per week, been victims of bullying and having peer support were additional factors associated with overweight or obesity. Increased strategies utilizing a number of the risk factors identified are needed to prevent and treat overweight or obesity in adolescents in ASEAN member countries.
Study name: Global School-Based Student Health Survey (GSHS)
A retrospective review of medical records was carried out to determine the pattern of drug and chemical poisoning cases admitted to a teaching hospital in Malaysia. Medical records of patients admitted during the period January 1987 to December 1995 were reviewed. They accounted for 0.2% of total admissions during the period. While all ages were represented, there was predominance of children, which showed little change throughout the nine-year period. Of all cases of poisoning, 77.8% were unintentional, 12.6% intentional and 9.6% were undetermined. Kerosene, pesticides and medicinal substances remained the common agents associated with poisoning. A significant number of patients sought treatment elsewhere before being admitted to the hospital. Of those who came directly to the hospital, many were presented late in the course of their poisoning. Only seven patients died and none were children. This study supports the need for greater emphasis on prevention of poisoning in children and among farmers in the state.
A malaria survey was conducted to examine the presence of common clinical features of malaria in individuals living in an endemic area of malaria. The overall infection rate was 11.0% with 7.5% and 3.5% infected with Plasmodium vivax and Plasmodium falciparum respectively. The mean parasitaemia level of both species was 2905.9 parasites/microliter blood, with the mean parasitaemia level of P. vivax and P. falciparum at 682.7 parasites/microliter blood and 6981.7 parasites/microliter blood respectively. The infection rates were higher in the younger age group. Hepatomegaly, hepatosplenomegaly and clinical anaemia were significantly associated with malaria. None of the patients were febrile. In conclusion, in low endemic areas, the presence of clinical anaemia, hepatomegaly and hepatosplenomegaly in afebrile individuals could be considered as useful criteria for the presence of asymptomatic parasitaemia. It is important to carry out laboratory diagnostic investigations, to ensure all the asymptomatic parasitaemia which act as reservoirs are detected and treated.
A prospective observational study was carried out at the Emergency Department, Hospital Kuala Lumpur to determine the proportion of accidental head injury among children and the circumstances of injury. The study was carried out from November 1993 to January 1994 on all children below 14 years who presented to the Emergency Department with accidental head injury. Accidental head injury made up (4.75%) of all cases seen at the Casualty Department. The ratio of boys to girls was 2:1. The mean age of head injured children was 5.2 (S.D. 3.63) years. The leading cause of head injury was fall (63%) followed by road traffic accidents (RTA) in (30.7%) while the rest were due to 'impact' (injury caused by flying object or missiles) injuries. More than half (54.4%) of those injured in RTA were pedestrians. Pedestrian injury was particularly important in the 5-< 14 years age group, where adult supervision was lacking in two thirds of the children. None of the patients who were involved in vehicle-related injuries had used a suitable protective or restraining device. All three patients who died were from this group. This study emphasises the need for stricter enforcement of laws related to the use of protective devices and measures to decrease child pedestrian injury. The issues of lack of adult supervision, both in and outside the home need to be addressed.
To describe trends in hospital admissions and mortality from congestive heart failure in the elderly population aged 65 years and over in Singapore, 1991 to 1998.