The characteristics of normal labour in 977 Malay, Chinese and Indian parturients were established from a retrospective study. Indian babies were found to be significantly smaller than Malay babies which were significantly smaller than Chinese babies (P less than 0-05, P less than 0-05). The mean duration of the first stage of labour taken from the time of admission to the labour ward was 3-4 hours in primiparae and 2-7 hours in multiparae. The mean durations of the second stage of labour were 23-7 minutes and 13-1 minutes respectively. Curves of mean dilatation of cervix and probit analysis at 80% revealed significant differences in the progress of normal labour in primiparae among the three racial groups. The Indian primiparae not only had a slower rate of cervical dilatation but seemed to reach the accelerated phase of dilatation later. No significant differences were noticed in the labours of multiparae.
Matched MeSH terms: Continental Population Groups*
Over two years cord blood from 27 879 babies was screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency. The overall incidence was 3.1% in boys and 1.6% in girls. Sixty nine babies had severe jaundice (bilirubin concentration greater than 380 mmol/l (20 mg/100 ml], and exchange transfusion was performed. Parents were given written and verbal instructions to avoid herbs and drugs that trigger kernicterus, which reduced the incidence of kernicterus and thereby prevented mental retardation. G6PD deficiency is common in all three ethnic groups (Malays, Chinese, and Indians) in Malaysia and screening is recommended.
Healthy Malaysians from various parts of Peninsular Malaysia were examined for CF antibodies against cytomegalovirus (CMV) and herpes simplex virus (HSV) type 2. CMV antibodies were detected in 1114 out of 1556 persons (71.6%) and HSV antibodies were detected in 954 persons out of 1554 (61.4%). The age distribution patterns were similar for the two infections, with maximum prevalence at 5 - 14 years of age. Prevalence was higher in women than in men. There were no significant differences among the Malay, Chinese, and Indian groups of the population with respect to CMV, 72 - 78% possessing antibodies, but in the case of HSV, 76% of the Chinese had antibodies, compared with 57 - 60% of the Malays and Indians. More than 90% of newborn infants had CMV and HSV CF antibodies, confirming the highly immune status of childbearing women in Malaysia. No CMV-specific IgM was detected in the Malaysian neonates examined but this does not exclude the possibility of congenital infection.
As part of a large-scale international cooperative investigation into the side effects of thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia.It is concluded that the differences in the frequency of side effects to thioacetazone-containing regimens probably result from variation in the closeness of supervision of patients, in the recording and interpretation of side effects, and in environmental factors including the previous use of other medicaments or exposure to sensitizing substances.
Congo-red screening demonstrated intratumor deposits of amyloid in 35 of 53 unselected cases of basal cell carcinoma. Male subjects had a higher amyloid positivity rate than female subjects. The amyloid deposits were permanganate-resistant and located in the stroma between clumps of tumor cells, as well as abutting the advancing front of the neoplasm. Solar elastosis was often observed in the overlying and adjacent subepidermis. The relationship between amyloid positivity and the different histological subtypes of basal cell carcinoma, tumor ulceration, and density of the lymphoplasmacytic stromal infiltrate were also studied. The possibility that amyloid originates from the tumor cells and is a result of tumor apoptosis (degeneration) is discussed.
Cancer of the cervix is exceedingly uncommon in the Malaysian Orang Asli (aborigine), despite the presence of factors associated with an increased risk of developing this malignancy. In only three patients was the diagnosis of carcinoma of the cervix established, out of a total of nearly 18,000 female inpatients, admitted to the Gombak Orang Asli Hospital over a 13-year period. Over this same period, 81 female patients were diagnosed as having cancer. Interviews with female Orang Asli patients show the presence of alleged risk factors for cervical cancer, including early age of first intercourse, multiparity and non-circumcision of husbands. The low incidence of cancer of the cervix in this aborigine community may be due to the strict moral code of the Orang Asli, limiting extramarital sexual activity and associated venereal infection.
The level of serum alpha-fetoprotein (AFP) was estimated by radioimmunoassay in 153 normal healthy Malysians of different ethnic groups. The mean level was 7.5 In1/ml (SD 2.28InU/ml). Among 330 patients with malignant tumors, 11 had increased levels of AFP. The only patient who had hepatoma had a very high level of serum AFP. High levels were also found in three of four patients with dysgerminoma of the ovary, in the only two patients with carcinoma of the testis, and in one patient with secondary carcinoma of the humerus of unknown origin. Lower, but significantly increased levels were observed in one patient (of 48) with breast carcinoma, one patient (of 8) with basal cell carcinoma of the nose, one patient (0f 27) with carcinoma of the lung, and one patient (of 59) with nasopharynegeal carcinoma.
A study of 207 benign ovarian tumors seen at the University Hospital, Kuala Lumpur between 1968 and 1975 was made to evaluate the clinical features that might be useful in the preoperative differentiation of mucinous cystadenoma, serous cystadenoma, and cystic teratoma of the ovary. This study indicated that the pertinent information included the mean age of the patient, the marital and menstrual status, and the estimated tumor size. The racial background was an additional factor in serous cystadenoma. Features like parity, the location of the tumor, and ABO blood group pattern were of no value in the preoperative differentiation.
Every woman experiences the menopause transition period in a very individual way. Menopause symptoms and management are greatly influenced by socioeconomic status in addition to genetic background and medical history. Because of their very unique cultural heritage and often holistic view of health and well-being, menopause symptoms and management might differ greatly in aboriginals compared to non-aboriginals. Our aim was to investigate the extent and scope of the current literature in describing the menopause experience of aboriginal women. Our systematic literature review included nine health-related databases using the keywords 'menopause' and 'climacteric symptoms' in combination with various keywords describing aboriginal populations. Data were collected from selected articles and descriptive analysis was applied. Twenty-eight relevant articles were included in our analysis. These articles represent data from 12 countries and aboriginal groups from at least eight distinctive geographical regions. Knowledge of menopause and symptom experience vary greatly among study groups. The average age of menopause onset appears earlier in most aboriginal groups, often attributed to malnutrition and a harsher lifestyle. This literature review highlights a need for further research of the menopause transition period among aboriginal women to fully explore understanding and treatment of menopause symptoms and ultimately advance an important dialogue about women's health care.
In order to examine whether erythrocyte membrane handling of sodium is influenced by factors other than hypertension, measurements of red cell sodium transport were studied in one hundred normotensive volunteers. Erythrocyte sodium content was found to increase with increasing age, body weight and mean arterial pressure (MAP). It is also significantly correlated with age, body weight and MAP. Total sodium efflux was found to be reduced and negatively correlated with age and body weight. A reduction in ouabain-sensitive sodium efflux was also observed with increasing age and body weight. In males, the rate of ouabain-sensitive sodium efflux is higher than in females. Race was found to have no effect on erythrocyte electrolyte content and cationic flux rates of subjects. These data suggest that when studies in hypertension are going to be carried out, control subjects carefully matched for age, body weight and sex should be used if confounding results are not to be obtained.
Matched MeSH terms: Continental Population Groups*
The expression and synthesis of IGF-I and IGFBP-3 have been shown to be regulated by hormones and nutrition. We study the effects of malnutrition and iodine deficiency on these growth factors and the height attainment of a group of children.
A total of 52 cases of NPC were found in a five-year survey from 1978 to 1982 in Malaysia. The annual rate of occurrence was 3.4, 3.0, 2.4 and 1.8 for Chinese, Malays, Kadazans and Sarawakians, respectively. The age-specific incidence rates per 100 000 were highest for Kadazans (2.34 to 7.59) in comparison to the other races (0.11 to 1.24). The proportion of NPC in young Malaysians formed 1.2% in Chinese, 7.2% in Malays and 6.9% for others. A sexual bias was present in Chinese (male:female = 2.2) and Sarawakians (1.7) but not in Kadazans and Malays (0.9). In most Chinese, the primary tumour histologically is of the poorly differentiated characteristic and this type is the predominant tumour in the country. The Kadazans presented with well differentiated primary tumour and the Malays with all three histological types i.e. well-, poorly- and undifferentiated. At first examination enlarged lymph nodes were found in 95.7% of the patients and 65.2% had epistaxis and growth in the postnasal space. Antibodies to IgA anti-VCA were present in half of the 6 patients serologically studied.
To explore the possibility that environmental and/or genetic factors may yield clues to the etiology of osteogenic sarcoma, an epidemiologic retrospective study of all cases of osteogenic sarcoma in a country with clear geographic and racial variables (Malaysia) was conducted covering a 4-year period. Sixty-eight cases were identified (+85% of the predicted total). The incidence (cases per 100,000 population per year) was 0.11 in Malay, 0.23 in the Chinese, and 0.23 in the Indian. The urban versus rural incidence in the Malay was 0.22 versus 0.09, and in the Chinese 0.31 versus 0.18. The Indian population was too small when dividied into urban and rural segments to be significant.
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases are both common among patients with diabetes mellitus.
OBJECTIVE: The aim of this study is to determine if ultrasonography-diagnosed NAFLD is associated with prevalent ischemic heart disease (IHD) among patients with diabetes mellitus.
METHODS: This is a cross-sectional study on consecutive patients seen at the Diabetic Clinic, University of Malaya Medical Centre. The medical record for each patient was reviewed for documented IHD. Patients without documented IHD but had symptoms and/or electrocardiographic changes suggestive of IHD were referred for cardiac evaluation.
RESULTS: Data for 399 patients were analyzed. Mean age was 62.8±10.5 years with 43.1% male. NAFLD and IHD were present in 49.6 and 26.6%, respectively. The prevalence of IHD among patients with and without NAFLD was 24.7 and 28.4%, respectively (P=0.414). The prevalence of IHD was highest among the Indians (34.1%) followed by the Malays (29.2%) and the Chinese (20.1%). No association was found between NAFLD and IHD when analyzed according to ethnicity. On multivariate analysis, independent factors associated with IHD were older age, lower levels of physical activity, greater waist circumference and higher serum glycated hemoglobin level.
CONCLUSIONS: Ultrasonography-diagnosed NAFLD was not associated with prevalent IHD among patients with diabetes mellitus in a multiracial Asian hospital clinic population.
Study site: Diabetic clinc, University Malaya Medical Centre (UMMC)
Matched MeSH terms: Continental Population Groups/statistics & numerical data
A dental health survey of 15,197 schoolchildren age 6-18 years was conducted in West Malaysia. The caries experience in the permanent teeth of the three racial groups, namely Malay, Chinese and Indian/Pakistani, showed a distinct variation. The prevalence was highest among the Chinese children, being about twice that of the Malay and Indian/Pakistani children. In the primary dentition, however, the caries experience in the three racial groups was comparable. An analysis of the factors contributing to the racial variation showed that dietary influence was not the only factor responsible. The possibility of a racial variation in caries susceptibility has been postulated. In the primary dentition the similar caries experience observed in the three groups of children was most probably due to the widespread occurrence of rampant caries which would heavily weight the dift score of the children in all three groups. The need to fluoridate the public water supply as an effective preventive measure is emphasized.
Matched MeSH terms: Continental Population Groups*
This paper uses wavelets in the detection comparison of breast cancer among the three main races in Malaysia: Chinese, Malays, and Indians followed by a system that evaluates the radiologist's findings over a period of time to gauge the radiologist's skills in confirming breast cancer cases. The db4 wavelet has been utilized to detect microcalcifications in mammogram-digitized images obtained from Malaysian women sample. The wavelet filter's detection evaluation was done by visual inspection by an expert radiologist to confirm the detection results of those pixels that corresponded to microcalcifications. Detection was counted if the wavelet-detected pixels corresponded to the radiologist's identified microcalcification pixels. After the radiologist's detection confirmation a new client-server radiologist recording and evaluation system is designed to evaluate the findings of the radiologist over some period of cancer detection working time. It is a system that records the findings of the Malaysian radiologist for the presence of breast cancer in Malaysian patients and provides a way of registering the progress of detecting breast cancer of the radiologist by tracking certain metric values such as the sensitivity, specificity, and receiver operator curve (ROC). The initial findings suggest that no single race mammograms are easier for wavelets' detections of microcalcifications and for the radiologist confirmation even though for this study the Chinese race samples detection average were a few percentages less than the other two races, namely the Malay and Indian races.