In Malaysia, the elderly are still a relatively neglected group of people in that little priority is given to the important health issues associated with an aging population. This paper examines some of the relevant findings obtained during a survey which was carried out in 1984/1985. These findings have serious policy implications concerning family support, work, income, retirement, community involvement, social network, transport, and housing as pertaining to the elderly. There is an urgent need, as the population ages and social changes occur in society, for health planners, politicians and policy-makers to scrutinise the existing policies and develop new policies so as to retain those traditional practices that support, improve and maintain the psychological and social well-being of the elderly; and to develop new policies and programmes thus promoting a better lease of life for this small but important group to whom we owe so much.
Over a period of nine years, from June 1976 through May 1985, 18 cases of ruptured sinus of Valsalva aneurysms were seen at the University Hospital, Kuala Lumpur (UK KL). Seven of these cases were treated surgically. The majority of patients were males, with a mean age of 26.6 years. All cases were symptomatic. The site of aneurysm was the right coronary sinus in five patients and the non-coronary sinus in two patients. All aneurysms ruptured into the right ventricle. The fistula was closed via a transaortic approach. In addition, repair of the right heart chamber was necessary in six patients. There were no deaths. Clinically significant morbidity included aortic regurgitation in one patient and residual fistula requiring reoperation in another. The long term follow-up at two years was excellent.
Forty-eight patients treated surgically for chronic subdural hematoma in General Hospital Kuala Lumpur were studied retrospectively. The clinical presentations were insidious and nonspecific. A high clinical index of suspicion for this disease is required. Diagnosis is confirmed by CAT Scan of the brain with or without cerebralangiography. Treatment consists or burr-holes and drainage
Potential tumor imaging radiopharmaceutical agents have been prepared by attaching a cisplatin derivative to a ligand capable of forming a stable complex with 99mTc. Three new organometallic compounds, with iminodiacetic acid as the 99mTc chelating group and 2,3-diaminopropionamide as the platinum complexing group, have been prepared and characterized. Preliminary biodistribution studies in tumor bearing mice support the utility of this approach.
In his article, 'The Effectiveness of Symbols,' Lévi-Strauss contends that the details of a Cuna birth incantation evoke specific physiological responses from parturient women, aiding them through difficult labors. His argument, which analyzes the incantation as a text divorced from its social setting, has drawn criticism from students of Cuna society on a number of substantive points, primarily centering around the difficulties that the special linguistic form of ritual language would present to a non-adept. If the patient lacks a thorough comprehension of the mythic details, how can the incantation change her physiological processes? In an attempt to evaluate the effect of myth upon a woman in labor, this article calls upon Cuna and Malay ethnographic data, and presents a Malay birth incantation as interpreted by the ritual practitioner who recited it. Following a discussion of the non-semantic aspects of the incantation and the extent to which the patient shares the interpretation of the healer in both the Malay and Cuna societies, recent biomedical studies are cited in support of hypotheses concerning the physiological and biochemical effects of myth in the management of childbirth.
In 1954, with the assistance of the World Health Organization and the United Nations Children's Fund, a campaign against yaws was initiated in Malaysia with the formation of a yaws elimination unit in the Ministry of Health. Between 1954 and 1975, the reported annual incidence of yaws fell from 140.85 to 1.25 per 100,000 population. When rates dropped to less than two per 100,000, the program was merged with the general health services. Currently when cases are reported, contacts are traced, school and village surveys are carried out, and appropriate treatment is given. The major problems facing the control program today are a loss of interest in control activities; a smaller number of health workers experienced in the diagnosis, management, and control of the disease; and a growing reluctance to treat asymptomatic contacts with penicillin for fear of anaphylactoid reactions. Despite these problems, it is not an unreasonable expectation that, with continued stimulation from the individuals responsible for infectious disease control, yaws will eventually be eliminated.
A study of food ideology and eating behavior in a Malay village demonstrates that the relationship between belief and action is complex and not always predictable. Over-reliance upon stated beliefs, and generalizations derived from particular ecological settings, have influenced investigators into making universal and logical statements about Malay eating behavior and its health consequences--a logic which, however, does not always jibe with reality. Food ideology, like any other portion of a belief system, is subject to innovation, interpretation and rationalization, and contains within it 'rules to break rules' which assure the continued integrity of the symbolic system by patterning what might otherwise be seen as rifts in its fabric. An understanding of eating behavior must be based both on a knowledge of the subsidiary, as well as primary, clauses of food ideology, and on direct observation of the behaviors elicited by these beliefs and modified by the setting, the situation and the individual.
Features of the typical ameloblastoma of the mandible are outlined. Three cases managed by conservative surgical treatment maintaining the continuity of the mandible are described. The factors taken into consideration when instituting this method of treatment are discussed. Results obtained are encouraging.
Carcinoma of the buccal mucosa is the commonest intra-oral malignancy seen in Malaysia. The purpose of this paper is to present 12 patients with carcinoma of the buccal mucosa who were seen by the authors between January 1981 to September 1981. The principal problems are those of late presentation and treatment, these aspects are illustrated, with a view of early return to normal life.
Morphological and neuroelectrical changes of the skeletal muscle fibres after various types of injury to the nerve was studied in monkey. The percentage of normal and atrophic muscle fibres after various types of injury to the nerve was compared with the proportion of innervated and denervated muscle as shown by the position of the bend (kink) on the I.D. at corresponding stages. It was found that the pattern and the position of the I.D. curve when considered together only gave an approximate estimation of the proportion of all innervated and denervated muscle fibres as well as the condition ofthe muscle after denervation.
This paper investigates the structure of the relationship between female education and fertility. It is based on data published in First Country Reports of the World Fertility Surveys for eleven countries--Costa Rica, Colombia, Dominican Republic, Panama, Fiji, Korea, Malaysia, Pakistan, Sri Lanka, Thailand, and Indonesia. The cumulative marital fertility of educated women is shown to be similar in different settings. A lack of uniformity in the education and fertility relationship including the curvilinear nature of this relationship observed across countries is shown to be attributable to marked differences between countries in the average fertility of women with no education rather than to the presumed differences in the average fertility of the educated women. The structure of the relationship is shown to be similar across several developing countries. This analysis suggests that advancement in female education can be expected to influence fertility behavior even without simultaneous changes in other factors such as increasing opportunity for participation in the paid labor force in the modern sector.
Out of a group of 12 M. nemestrina (originating from Malaysia), 9 adults had shown clinical signs induced by ILS at 25 c/sec. Six of them (3 males, 3 females) were very photosensitive; however, only 2 presented eyelid and/or head jerks after the end of ILS (level 4), but never a generalized seizure. Tactile periorbital stimuli favoured myoclonus. In all but the two of level 4, the intensity of clinical signs varied from one day to the next. In all implanted adult macaques, spontaneous paroxysmal EEG activities were seen during slow sleep in mostly anterior areas, but also during waking and REM sleep in some of them; however, their occurrence depended upon the individual and were not in all cases related to their level of photosensitivity. During ILS, paroxysmal discharges (spikes and waves and/or polyspikes and waves), isolated or in bursts at 3-4/sec were bilateral and symmetrical. They started in fronto-rolandic regions, then became generalized. This observation constitutes a new fact since the discovery, in 1966, of the photomyoclonic syndrome of Papio papio, Macaca nemestrina being another species of subhuman primates with a marked predisposition to photosensitive epilepsy.
This study was proposed to identify specific radiological appearances in Malaysian patients with bronchial asthma. All consecutive patients, seen in the Medical Unit, Universiti Kebangsaan Malaysia between 1976 and 1979, satisfying the American Thoracic Society [1962] criteria for bronchial asthma formed the subjects of this study. Analysis of 207 patients led to the following conclusion. There are specific radiological changes present in a proportion of bronchial asthmatics during the acute episode. These changes are more frequent in the younger age group and in those in which the age of onset are early, The duration of asthma seems to have some bearing to the radiological changes.
A 103 year old patient was admitted with pain in the right iliac fossa. There was no response to conservative treatment. Subsequent laparatomy showed the presence of a perforated ulcer in the pyloric region. The condition improved gradually after the surgical management.
The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.