This article examines the rationale behind the Heath government's 1970 decision to negotiate a Five Power Defence agreement with Australia, New Zealand, Singapore and Malaysia and to maintain a small British military contingent in Southeast Asia as a part of this new politico-military framework. It argues that while its overriding foreign policy concern was to end Britain's problematic relationship with the European Economic Community and to make membership of this grouping the cornerstone of its foreign policy, the Heath government was careful not to cast Britain's post-imperial future in purely European terms. The successful negotiation of the Five Power Defence Arrangements in 1970-71 was instrumental in achieving this by ensuring that London would maintain close links with key Commonwealth partners in the Asian region. In what was not only an attempt to neutralize potential domestic opposition to Britain's entry into the EEC, but also a lingering reluctance to do away with the rhetoric of Britain as a leading power with extra-European interests, Heath was eager to show that by making a contribution to the stability of Southeast Asia, Britain still had a role to play outside Europe.
PIP: The initial results of a study conducted to develop guidelines for the clinical management of family planning acceptors with regard to return of fertility following contraceptive use, are presented. 193 parous women attending an urban family planning clinic were interviewed regarding their last pregnancy conceived after stopping a method of contraception. The average interval to pregnancy was 3.9, 2.8 and 1.8 months for ex-users of oral pills, intrauterine devices and conventional methods of contraception, respectively, with median delays to conception of 1.9, 1 and within the 1st month for the 3 categories. In comparison, 149 women who had not used any method at all took 7.3 months before becoming pregnant. Selected variables including age and parity, duration of use and problems encountered, and outcome of pregnancy are further analysed. Follow-up investigations and treatment are recommended 12 months after stopping oral pills and 6 months after removal of intrauterine device for those who have not yet conceived.
We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningosepticaregistered in Southeast Asia. A 20-year-old female student who wasa regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E.meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E.meningosepticakeratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.
"Wide income differentials, the threat of increased illegal immigration from developing countries, and sub-replacement fertility in the developed countries are some reasons for the recent reassessment of the relationship between migration and development.... The model presented in this article proposes different roles for permanent immigrants, contract workers, professional transients, illegal migrants and others according to the stages of modernization of the sending and receiving countries. The model was found consistent with the experiences of Mauritius, Seychelles, Singapore and, to a lesser extent, Malaysia."
Introduction: A validated diagnostic questionnaire is needed in the South-East Asia region, particularly in Malaysia to detect Premature Ejaculation (PE). The objective of this study was to determine the linguistic validity of the Malay Premature Ejaculation Diagnostic Tool (MAPET). Materials and Methods: This study was conducted in a teaching hospital. The first phase involved experts’ group discussions to develop the face, content, and factorial validity of the MAPET. The second phase measured the concurrent validity of MAPET. Results: We found that the MAPET has specificity, sensitivity, positive predictive value, and negative predictive value of 79.3%, 92%, 76.7% and 93.1%, respectively in the assessment of PE. The higher score indicates severity of PE. Conclusions: MAPET is a valid self-report instrument for the assessment of PE.
Objectives: To examine the descriptive epidemiology of the patient population referred to paediatric rheumatology centres (PRCs) in Southeast Asia (SEA) and to compare the frequency of conditions encountered with other PRC populations.
Methods: A web-based Registry for Childhood Onset Paediatric Rheumatic Diseases was established in 2009 and seven PRCs in four SEA countries, where paediatric rheumatologists are available, participated in a prospective 24 month data collection (43 months for Singapore).
Results: The number of patients analysed was 4038 (788 from Malaysia, 711 from the Philippines, 1943 from Singapore and 596 from Thailand). Over 70% of patients evaluated in PRCs in Malaysia, the Philippines and Thailand had rheumatic diseases (RDs), as compared with one-half of the proportion seen in Singaporean PRCs, which was similar to the Western PRC experience. Among RDs diagnosed (n = 2602), JIA was the most common disease encountered in Malaysia (41%) and Thailand (61%) as compared with systemic vasculitides in the Philippines (37%) and Singapore (35%) among which Henoch-Schönlein purpura was the most prevalent. SLE and related diseases were more common, but idiopathic pain syndrome and abnormal immunological laboratory tests were rarer than those seen in the West. JIA subtype distributions were different among countries. Among non-RDs (n = 1436), orthopaedic and related conditions predominated (21.7-59.4%).
Conclusion: The frequencies of RDs seen by SEA PRCs were different from those in the West. Systemic vasculitides and SLE were common in addition to JIA. Paediatric rheumatologist availability and healthcare accessibility partially explain these observed discrepancies.
Study site: multination + Selayang Hospital, Malaysia
BACKGROUND: Fibromyalgia syndrome (FMS) is a common but controversial condition. There appears to be different level of belief of its existence and awareness. We set out to explore the variations of perceptions and awareness of this condition among rheumatologists from the Southeast Asia (SEA) region.
METHODS: One hundred eight rheumatologists from the participating countries; 28 from Malaysia, 20 from Singapore, 26 from Thailand, 2 from Brunei, and 42 from Indonesia were approached to participate in this survey by answering specific questions regarding their beliefs in relation to FMS; 82% respondents from Malaysia, 100% from Singapore, 92% from Thailand, 100% from Brunei, and 90% from Indonesia completed the questionnaires.
RESULTS: Most rheumatologists (92.5%) from SEA believe that FMS is a distinct clinical entity, and also this condition is considered an illness rather than a disease. Eighty-seven percent rheumatologists from SEA believe that FMS is a mixture of medical and psychological illness, 9% believe that FMS is primarily a psychological illness, and 3% believe that it is a medical illness. Only 60% of those in a university setting include FMS in their undergraduate teaching. Eighty-five percent of the respondents ordered blood tests to exclude other serious pathologic conditions, and 100% of the respondents from SEA countries also prescribed some form of drugs to FMS patients.
CONCLUSION: FMS is apparently seen worldwide. This study confirmed that there was a variation of perceptions and knowledge of FMS among rheumatologists from SEA countries. However, most rheumatologists agreed that FMS is a distinct clinical entity with a mixture of medical and psychological factors.
PIP:
The NADI program (pulse in Malay) was initially launched as a pilot project in 1980 in Kuala Lumpur, Malaysia. It utilized an integrated approach involving both the government and the private sectors. By sharing resources and expertise, and by working together, the government and the people can achieve national development faster and with better results. The agencies work through a multi-level supportive structure, at the head of which is the steering committee. The NADI teams at the field level are the focal points of services from the various agencies. Members of NADI teams also work with urban poor families as well as health groups, parents-teachers associations, and other similar groups. The policy and planning functions are carried out by the steering committee, the 5 area action committees and the community action committees, while the implementation function is carried out by the area program managers and NADI teams. The chairman of each area action committee is the head of the branch office of city hall. Using intestinal parasite control as the entry point, the NADI Integrated Family Development Program has greatly helped in expanding inter-agency cooperation and exchange of experiences by a coordinated, effective and efficient resource-mobilization. The program was later expanded to other parts of the country including the industrial and estate sectors. Services provided by NADI include: comprehensive health services to promote maternal and child health; adequate water supply, proper waste disposal, construction of latrines and providing electricity; and initiating community and family development such as community education, preschool education, vocational training, family counseling and building special facilities for recreational and educational purposes.
PIP:
A total of 552 women in 1983 have undergone laparoscopic sterilization under local anesthesia with sedation in the family planning clinic at Maternity Hospital and the Specialist Center at Batu Complex. A review was made to evaluate the risks, benefits, and safety of outpatient surgery in view of the shortage of anesthetic personnel, operating theaters and costs to patients if general anesthesia were to be used instead. Anesthetic complications (0.9%) were found to be of a very minor nature, not requiring hospitalization. Surgical complication was higher at 3.8%. There was a high rate (21%) of difficulties encountered at operation, 15% for medical officers and trainees but only 6% for specialists. In summary, a very low complication rate was encountered with local anesthetics. The use of local anesthesia with sedation is advocated. This cuts down on costs, hospitalization and recovey time and overcomes the perennial problem of shortage of anesthetic staff and operating theaters. The rate of the surgical complications was related to the surgeon's experience.
Study site: family planning clinic at Maternity Hospital and the Specialist Center at Batu Comple