A 7-year-old Indian girl developed complete paralysis of her lower limbs and acute urinary retention 10 days after suffering from mumps. Encephalomyelitis due to mumps was not suspected initially since it is a rare complication of mumps, although relatively well-documented. However, the preceding history of parotitis and the presence of mumps-specific IgM in both blood and cerebrospinal fluid led to the diagnosis. The initially severe acute neurological deficits resolved completely three months after onset of her illness. Serological investigations were helpful in diagnosing neurological complications of mumps in this case, and especially where there is no preceding parotitis.
Keywords: Mumps, encephalomyelitis, infection, Pulau Pinang, general hospital, Malaysia
The birth weight distribution, mean birth weight and incidence of LBW amongst the various ethnic groups in Malaysia is described briefly. The data collected and analysed is hospital data where all deliveries in 1980 were analysed. The mean birth weight showed that the Chinese had the highest Mean Birth Weight amongst the three ethnic groups and the Indians had the lowest mean birth weights. The overall incidence of LBW was 11.8% and the Malay and Indian babies constituted the high
incidence of LBW whereas the Chinese had a low incidence of LBW babies in the study. Amongst the various ethnic groups the Indians had a higher incidence of LBW compared to the Chinese and Malays.
A rare case of hepatic hydatidosis in non-endemic Malaysia is reported. It is important that clinicians treating the occasional patient be familiar with current diagnostic and therapeutic modalities.
Cardiorespiratory adjustments to maximal treadmill exercise were studied in young untrained Malaysia men representative of the three major ethnic groups in Malaysia and Singapore. Maximal values for oxygen uptake and cardiac performance were essentially similar In the three groups and were comparable to those reported for other populations.
Diabetes mellitus is a common chronic disease in Singapore. Its occurrence in pregnant women was 1.3% in a previous report. In a survey of 145 consecutive pregnant women registered at Alexandra Hospital the incidence of gestational diabetes was 13.1% when a total screen with 75 gm oral glucose challenge was used. The mean age of this sample was 27 years and the mean gestation at screening 33 weeks. There was an excess of Malay and Indian patients. Fifty percent had traditional risk factors tor gestational diabetes. Whether this higher incidence is a result of more stringent screening and/or increased occurrence remains to be confirmed.
The Middlesex Hospital Questionnaire (MHQ) with its subscales on anxiety, phobia, somatic symptoms, depression and hysteria was devised by Crown and Crisp(1). it has been used to differentiate between neurotic and normal population. The MHQ has been translated into the Malay language and this paper shows the results of an attempt to validate this translated questionnaire in the Malaysian population. The translated questionnaire is found to have useful validity as a whole and also for subscales on anxiety, somatic symptoms and depression.
The figures for abortions performed under The Abortion Act, 1974 of Singapore in a private clinic over a period of 20 months were studied. Overall, an alarming proportion of repeat abortions were found, and this was true for all age groups suggesting that abortions are being used as a regular method of family planning in Singapore.
An Indian family with all 3 sons having the fragile X syndrome is reported. The frequency of fragile X cells observed ranged from 4·16%. The phenotypically normal mother, although an obligate carrier, did not express any fragile X chromosomes in her Iymphocyte cultures. The range of mental retardation in affected
hemizygous males and heterozygous females as well as the significance of the fragile X chromosome in prenatal diagnosis are discussed.
This study presents the demographical characteristics of 271 cases of parasuicide seen at the Psychiatric Clinic, General Hospital, Kuala Lumpur, during 1982. The majority of cases were women in the 20 - 30 year age group, from a lower economic class, with minimal education. About one-half were single and 61.5% were actively religious. The racial breakdown was Indians 55%, Chinese 32% and Malays 13%. Self-poisoning using easily available drugs was the most common method employed and more than one-half intended to die at the time of the suicidal act. Most attempts were impulsive, carried out while alone, inside the
house. The findings are discussed and compared with earlier studies of attempted suicides in Malaysia and Singapore.
A retrospective analysis of 102 cases of hydatidiform moles seen in the Maternity Hospital, Kuala Lumpur, Malaysia, is presented. The incidence was 1 : 669. The tumour was more common In the Malays and in the lower social class patients. No specific age group or parity group was exempted. Vaginal bleeding and amenorrhoea were prominent features. Hyperemesis and abdominal cramps occurred less commonly. The uterine size was larger than dates in 62.7% of patients. Pre-eclampsia complicated 23.5% of the moles and Its severity was inversely related to the uterine size. Spontaneous abortion occurred In 57.8% of patients at a mean gestational period of 19 weeks.
Study site: Maternity Hospital Kuala
Lumpur, Malaysia
Immunoglobulin G, A and M levels were determined in paired maternal and cord sera of premature, full term and postmature newborns of urban dwelling Chinese, Indian, Malay and full term newborn of the forest dwelling Orang Asli (Malaysian aborigines). The mean serum IgC level in the full term Orang Asli newborns (1254±441 mg per 100 mil is comparable to that of the Indians (1211±282 mg per 100 ml) and Malays (1169±286 mg per 100 ml) but these levels are higher than those of the Chinese
newborns (1092±270 mg per 100 ml). Statistical analysis indicates a significant dependence of cord serum IgG level on maternal serum IgG level in the . Chinese, Indians and Malays. In addition, in Indians the cord serum IgG was significantly dependent at 5% level on the gestation age. The fetomaternal serum IgG level ratios at term were equal to or just less than one. The cord serum IgM levels of the Chinese, Indian, Malay and Orang Asli newborns at term were 11.6.±. 6.5, 12.5.±. 7.3, 10.9.±. 5.8 and
16.7±6.9 mg per 100 ml respectively. Statistical analysis showed absence of correlation between cord serum IgM level and birthweight, gestation age or maternal serum IgM level in Chinese and Malays. In Indians the cord sera IgM level showed a dependence on the birthweight. Immunoglobulin A was present in 34.6%, 40.5%, 31.6% and 62.5% of full term Chinese, Indian, Malay and Orang Asli newborns respectively. These observations are discussed in relation to the immunoglobulin levels observed in populations residing in temperate and other tropical regions.
300 patients (185 males, 115 females) were examined for intestinal parasites. About 40% of these patients was infected, 14% of which was heavily infected. The highest prevalence and intensity of infection with soil-transmitted helminths was found among Malays and Indians of different ages. Heavy infections with these helminths were also frequently encountered in young Chinese. Helminthic infections in patients over 60 years of age was significantly lower. There was no significant differences in the prevalence and degree of infection among males and females. The commonest helminth encountered was Trichuris trichiura, which usually occurred as trace single infections. Mixed infections with Ascaris and Trichuris, usually with the former as the predominating parasite, were also frequently observed.
Investigations in 30 healthy control subjects of Indian, Chinese and Malay ethnic origin, revealed that all the Chinese and about two thirds of the Indians and Malays had a normal capacity to absorb D—xylose, Vitamin A, Co58 labelled Vitamin B12 and dietary fat. About a third of the Indians and Malays were unable to absorb one or two of the four test substances used in the absorption studies. Jejunal biopsies did not differ in the 3 ethnic groups and were normal or mildly abnormal. 27 patients presenting with anorexia, a sore tongue and pallor were also investigated. Indians formed the majority of the patients. Diarrhoea occurred in only 51 % of the patients. All had a megaloblastic anaemia. Absorption studies revealed malabsorption of xylose, Vitamin A and Vitamin B12 in the majority but steatorrhoea occurred in only 26% of the patients. Jejunal biopsies were mildly abnormal in 8% and moderately or severely abnormal in 92 % of the patients. All responded to folic acid or Vitamin B12 therapy. 16 patients were restudied after 5 to 24 months therapy and the majority were found to have improved. Results of investigations and response to therapy indicate that these patients were suffering from tropical sprue. These studies indicate that tropical sprue in Singapore affects Indians mainly and can often present without diarrhoea and steatorrhoea.
This is a study of 169 cases of attempted suicides who had been referred to or who had consulted a private psychiatrist. These patients were interviewed, examined and treated either as out- or in-patient in private hospitals during the years 1968-1976. Their demographic and clinical data were analysed, presented and discussed. The reasons and motivations tor the act were also obtained and summarized. In the follow-up study conducted, it was discovered that schizophrenic patients who had attempted suicide carries the highest completed suicide risk.
Coronary heart disease which was responsible for 2.9% of all deaths 30 years ago, today accounts for 19% of deaths. The rising trend which declined in 1985, appears to be stabilising now. Indians have mortality rates which are 3 times that of Chinese. This is the background against which the Singapore Myocardial Infarction Register was set up in 1967 to provide incidence and prevalence data for coronary heart disease in the country. in 1987 to provide incidence and prevalence data for coronary heart disease in the country.
Key words: Coronary heart disease mortality, Age standardised death rates, Ethnic differences, Singapore Myocardial Infarction Register
This study was conducted to determine the effect of ethnicity on maternal, placental and neonatal parameters. Maternal, placental, and the newborn parameters were corrected for gestational age. The male:female sex ratio was 1:1.03. One hundred and forty-four freshly delivered placentae from 55 Malaysian, 51 Chinese, and 38 Indian normal healthy patients were collected and standard stereological methods used to estimate the placental parameters. Pearson's correlation, Spearman's correlation and 1-way ANOVA were used to test significance of differences. Placental surface area, placental weight and placental volume of Indians were lower than Malays (P< 0.05). Placental weight correlated significantly with neonatal length (r=0.527), birthweight (r=0.665), head circumference (r=0.371) and booking weight (r=0.193) while placental volume correlated with neonatal length (r=0.588), birthweight (r=0.688), head circumference (r=0.384), parity (r=0.202) and booking weight (r=0.219) at P< 0.05. Indian babies weight and length were less than Chinese and Malay babies (P< 0.05) while booking weight of Indian mothers was less than those of Chinese mothers (P< 0.05). Even after being corrected for booking weight, placental parameters of Indian patients were still significantly less than Malays and Chinese (P< 0.05).
Prevalence of adult-type hypolactasia is known to vary among different countries and in different ethnic populations in the same country. The present study was undertaken to evaluate the prevalence of hypolactasia and lactose intolerance in three different ethnic populations living in similar environmental conditions in Malaysia. The correlation between different symptoms and lactose intolerance test was also studied.