The technique of radical vulvectomy with lymphadenectomy in which primary skin. closure of the large defect is achieved is described. Experience with this operative technique at the University Hospital, Kuala Lurnpur from 1968 to 1980 is reviewed. The technique allows for wide clearance of the tumour and of regional lymphatic channels and nodes in continuity. We have been impressed by the good immediate results and at the primary skin closure achieved in all our cases.
Radioimmunoassay technique has been used to investigate the variation in the serum human prolactin (hPRL) levels at different stages of menstrual cycle and during a 24-hours period in Malay women. The results showed that the serum hPRL concentrations during menstrual (24.5 ± 4.3 ng/ml), preovulatory (36.6 ± 7.4 ng/ml), ovulatory (29 ± 5.3 ng/ml) and postovulatory (26.6 ± 5.2 ng/ml) periods were not significantly different among each other. The hPRL level was highest during night-sleeping, at 0200hr and was significantly different from the values obtained at 1400, 2000, 0800 and 1400 (last sampling) hours (P < 0.01).
Leptotrombidium (Leptotrombidium) umbricola, described here as a new species, is a member of the L. (L.) deliense group and most closely resembles L. (L.) vivericola. L. (L.) umbricola was collected from the ground surface and from animal hosts, in similar habitats to the scrub typhus vector, L. (L.) deliense. The host and habitat distribution records and the Rickettsia tsutsugamushi infection rates within unengorged specimens suggest that L. (L.) umbricola may be an important vector of scrub typhus in Peninsular Malaysia.
While much is known generally about predictions of customer-perceived service quality, their application to health services is rarer. No attempt has been made to examine the impact of social support and patient education on overall service quality perception. Together with six quality dimensions identified from the literature, this study seeks to provide a more holistic comprehension of hospital service quality prediction. Although 79 percent of variation is explained, other than technical quality the impact of the remaining factors on quality perception is far from constant, and socio-economic variables further complicate unpredictability. Contrary to established beliefs, the cost factor was found to be insignificant. Hence, to manage service quality effectively, the test lies in how well healthcare providers know the customers they serve. It is not only crucial in a globalized environment, where trans-national patient mobility is increasingly the norm, but also within homogeneous societies that appear to converge culturally.
Dispersal-assembly theories of species coexistence posit that environmental factors play no role in explaining community diversity and structure. Dispersal-assembly theories shed light on some aspects of community structure such as species-area and species-abundance relationships. However, species' environmental associations also affect these measures of community structure. Measurements of species' niche breadth and overlap address this influence. Using a new continuous measure of niche and a dispersal-assembly null model that maintains species' niche breadth and aggregation, we tested two hypotheses assessing the effects of habitat heterogeneity on the ability of dispersal-assembly theories to explain community niche structure. We found that in both homogenous and heterogeneous environments dispersal-assembly theories cannot fully explain observed niche structure. The performance of the dispersal-assembly null models was particularly poor in heterogeneous environments. These results indicate that non-dispersal based mechanisms are in part responsible for observed community structure and measures of community structure which include species' environmental associations should be used to test theories of species diversity.
A study conducted between 1998-2001 on the semiconductor industry in Penang and Selangor found that irregular menstruation, dysmenorrhea and stress were identified as the three leading health problems by women workers from a checklist of 16 health problems. After adjusting for confounding factors, including age, working duration in current factory, and marital status, in a multiple logistic regression model, wafer polishing workers were found to experience significantly higher odds of experiencing irregular menstruation. Dysmenorrhea was found to be significantly associated with chemical usage and poor ventilation, while stress was found to be related to poor ventilation, noise and low temperatures.
In conjunction with a nationwide motorcycle safety program, the provision of exclusive motorcycle lanes has been implemented to overcome link-motorcycle accidents along trunk roads in Malaysia. However, not much work has been done to address accidents at junctions involving motorcycles. This article presents the development of predictive model for motorcycle accidents at three-legged major-minor priority junctions of urban roads in Malaysia. The generalized linear modeling technique was used to develop the model. The final model reveals that motorcycle accidents are proportional to the power of traffic flow. An increase in nonmotorcycle and motorcycle flows entering the junctions is associated with an increase in motorcycle accidents. Nonmotorcycle flow on major roads had the highest effect on the probability of motorcycle accidents. Approach speed, lane width, number of lanes, shoulder width, and land use were found to be significant in explaining motorcycle accidents at the three-legged major-minor priority junctions. These findings should enable traffic engineers to specifically design appropriate junction treatment criteria for nonexclusive motorcycle lane facilities.