Differences in fertility between the three major ethnic groups (Malays, Chinese and Indians) in Peninsular Malaysia and Singapore have existed since before the onset of fertility decline in the late 1950s and remain today, although the relative positions and the actual differences have changed due to the varying rates of decline. By 1987, the Malays experienced the highest fertility and the Chinese the lowest in both countries but in Singapore the Malay fertility was lower than the Chinese fertility in Peninsular Malaysia. The fertility differentials will lead to changes in the ethnic composition in both countries but more so in Peninsular Malaysia.
A 29 year old Chinese female who presented with spontaneous purpura, was found to have gross hepatomegaly and thrombocytopenia. The thrombocytopenia responded to steroid therapy but relapsed when the dose of steroid was tapered down. Subsequent investigations revealed that the hepatomegaly was due to a large haemangioma of her liver. For symptomatic hepatic haemangioma, surgical excision is the treatment of choice; this was refused by the patient.
Anterior sacral meningocele is a rare congenital meningeal cyst herniating through a bony defect in the sacrum. Since its description by Bryant in 1837, only 154 cases have been reported in the world literature. The application of ultrasound and C.T. scan following myelography is discussed.
Heat stroke is hardly seen in Malaysia. However, it occurs commonly in Saudi Arabia during the Haj season. Many Malaysian pilgrims are affected every year and some die. Having faced this environmental hazard for eight years, the Malaysian Medical Mission, sent each year to look after our pilgrims, modified its treatment strategy in 1988 and successfully decreased the overall morbidity and mortality of affected patients without the use of sophisticated equipment. A brief account of the management of 17 cases seen in 1988 is given. Only one died following treatment. The rest recovered fully without any residual neurological deficit or other complications.
The clinical and electroencephalographic (EEG) features were evaluated in a consecutive series of 50 infants with complex partial seizures. The age of onset of seizures showed a peak at age of 2 months. Significant development delay was seen in 60% of the infants. In 92% an underlying aetiological factor could be identified. Birth asphyxia was the commonest aetiological factor (30%). The seizure patterns were most frequently described as behavioural arrest, upward deviation of eyes, tonic posturing of the limbs, apnoea and cyanosis. Interictal EEG showed bilateral temporal lobe foci in 22%, unilateral foci in 78% and multiple foci in 46% of the cases. The response of the seizures to anticonvulsant drugs is discussed.
Tuberculous liver abscess is uncommonly seen in our experience. We report a case of a 17-year-old boy who presented with typical clinical features of liver abscess, where a diagnosis of tuberculous liver abscess was made on laparotomy and biopsy of the abscess wall.
The eye harbours bacteria from the time of birth throughout life. Owing to its antibacterial properties, the normal conjunctival flora plays a significant role in the defence against superficial ocular infections. In view of its protective action as well as its probable role in causing ocular disease under certain circumstances, the study of the normal flora and its pattern of antibiotic susceptibility could provide useful information in the prevention and treatment of post-surgical infections. While several such surveys have been reported from various parts of the world, no data is available for the Malaysian population. This survey seeks to establish the pattern of bacterial flora in healthy conjunctivae of Malaysians. In addition, the bacterial flora of a nondiabetic population was compared to that of a diabetic population to see if there were any differences.
Only 8.4% of 1,286 Chinese boys and girls from the ages of 5-12 years in Pulau Ketam were infected with soil-transmitted helminths. The majority of these children had single infections with Trichuris or Ascaris alone. Mixed infections made up less than 5% of all infected cases. The worm burdens of infected children were very low. There was no definite pattern of distribution of infection among children of different ages and no differences in the distribution of infection between boys and girls. The main factors for the low prevalence and intensity of infection were the absence of suitable soil for the development and survival of infective helminth stages and the lack of contact with contaminated soil on this island. These two factors acted as very effective barriers to the transmission of soiltransmitted helminths on Pulau Ketam.
Stevens-Johnson syndrome is relatively rare. The authors report a retrospective study of 34 patients seen at the University Hospital in Malaysia over 16 years and discuss the epidemiology, clinical features, complications, investigations, etiologic association, mortality, sequelae, course of the disease, and the use of steroid.
A questionnaire on smoking habits was administered to 4106 Form IV school children in Kuala Lumpur. The period of survey was from 9 to 20 April 1984. 2099 boys and 2007 girls were studied and their mean age was 16.1 years. 32.8% of the students had been initiated to smoking and the mean age of initiation was 13.3 years. The prevalence of smoking was found to be 9.8% and the mean duration of smoking was 2.5 years. Most of the smokers and occasional smokers were boys. About 42% of the smokers wished to stop smoking and only 1% of the non-smokers intended to smoke in the future. The study recommended that health education programmes should be started earlier in school.
A survey was conducted on three different groups of population viz. inpatients in the medical wards of General Hospital, Kuala Lumpur, the people of Kampong Pandan and two rubber estates as to their analgesic consuming habits. It is found that 0.5 to 2.0% of the people surveyed had consumed more than 2 kg of analgesics and 4.6 to 9.6% of the people surveyed had consumed more than 250g of analgesics. The commonest analgesic consumed is paracetamol followed by Chap Kaki Tiga and Chap Harimau. The commonest reason for consuming analgesic is headache. The implications of the above findings are discussed.