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Using standardized patients to evaluate undergraduate medical students' proficiency in speaking English

Chur-Hansen A, Vernon-Roberts J

Acad Med, 1999 Jul;74(7):829-34.
PMID: 10429593

PURPOSE: To explore the use of standardized patients for evaluating medical student's proficiency in speaking English.
METHOD: In 1995, using a language rating scale constructed by the authors, six standardized patients evaluated the English-language proficiencies of 127 second-year medical student undergraduates enrolled at the University of Adelaide, Australia, many of whom were from a non-English speaking background.
RESULTS: An earlier standardized test (Screening Test for Adolescent Language) had identified approximately one third of the students as potentially experiencing difficulties in using English in their training. Students so identified were rated lower than were their peers by the standardized patients.
CONCLUSION: The study proved useful both in identifying aspects of speech that can be reasonably rated by standardized patients and also in identifying students who might benefit from language interventions. Replication studies with the new instrument are required to further establish its reliability, validity, and generalizability across different student cohorts.

Matched MeSH terms: Malaysia/ethnology
Fulltext Spinal cord stimulation for treatment of failed back surgery syndrome--two case reports

Vijayan R, Ahmad TS

Med J Malaysia, 1999 Dec;54(4):509-13.
PMID: 11072471

Severe, persistent back pain following back surgery is often referred to as Failed Back Surgery Syndrome (FBSS). Conservative measures such as physiotherapy, back strengthening exercises, transcutaneous electrical nerve stimulation and epidural steroids may be inadequate to alleviate pain. Spinal Cord Stimulators were implanted into two patients suffering from FBSS. Both patients responded successfully to spinal cord stimulation with reduction of pain and disability.

Matched MeSH terms: Malaysia/ethnology
Population based standards for pulmonary function in non-smoking adults in Singapore

Chin NK, Ng TP, Hui KP, Tan WC

Respirology, 1997 Jun;2(2):143-9.
PMID: 9441128 DOI: 10.1111/j.1440-1843.1997.tb00070.x

Ethnic differences in lung function are well recognized, hence the use of normative data should therefore be based on reference equations that are derived specifically for different ethnic groups. We have collected data (n = 406) for population-based reference values of lung function from randomly selected samples of healthy non-smoking adults of both gender (aged 20-79 years) for each of the three major ethnic groups (Chinese, Malay and Indians) in Singapore. Lung function forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, diffusion capacity (transfer factor) for carbon monoxide (DLCO), total lung capacity (TLC), residual volume (RV), RV/TLC and functional residual capacity (FRC) was measured using standardization procedures and acceptability criteria recommended by the American Thoracic Society. Lung function values were predicted from age, height, weight, body mass index (BMI) and transformed variables of these anthropometric measures, using multiple regression techniques. Ethnic differences were demonstrated, with Chinese having the largest lung volumes and flow rates, and Indians the smallest. These prediction equations provide improved and additional (TLC, RV, RV/TLC, FRC) population-based reference values for assessment of pulmonary health and disease in Singapore.

Matched MeSH terms: Malaysia/ethnology
Tooth wear in three ethnic groups in Sabah (northern Borneo)

Milosevic A, Lo MS

Int Dent J, 1996 Dec;46(6):572-8.
PMID: 9023582

The prevalence and associated aetiologies of tooth wear were investigated in three ethnic groups in Sabah (Northern Borneo) using the Tooth Wear Index (TWI). The number of surfaces with enamel wear only, dentine exposed for less than a third or dentine exposed for more than a third were categorised into the TW minimal, moderate or severe respectively. A structured questionnaire was used to elicit medical/dental history, oral hygiene practices, satisfaction with body image, diet and other personal habits/details. The sample comprised of a self selected sample of 148 dental hospital attenders; 47 (32 per cent) each of ethnic Chinese and Malay and 54 (36 per cent) of ethnic Kadazan, matched for age and with a similar number of scoreable teeth per subject. Dentine exposure within the total sample was a common finding (95 per cent TW with moderate, 41 per cent TW severe). The Kadazan group had significantly (P < 0.05) more surfaces with severe tooth wear than the Chinese or Malay. Tobacco chewing was positively associated (rho = +0.4, P < 0.05) with both moderate and severe tooth wear, as was the habit of crushing/eating bones. Neither carbonated beverages or fresh fruit intake were associated with tooth wear, but their frequency of consumption was low. The buccal and occlusal surfaces of the posterior teeth were the most severely worn. Generally, wear was greater in the upper anterior sextant compared to the lower anterior sextant, with the exception of the lower incisal edges in the Kadazan group. Tooth wear into dentine was a common occurrence, especially among the Kadazan subjects and least among the Chinese subjects. The aetiological factors associated with this tooth wear are different to those encountered in Western cultures.

Matched MeSH terms: Malaysia/ethnology
Comparing perceptions of dental aesthetics in the USA with those in eleven ethnic groups

Cons NC, Jenny J

Int Dent J, 1994 Dec;44(6):489-94.
PMID: 7851991

The Standard DAI is an orthodontic index based on perceptions of dental aesthetics in the USA. The Standard DAI is a regression equation linking perceptions of the social acceptability of dental aesthetics with the objective intraoral measurements of ten occlusal traits. Since the Standard DAI is based on perceptions of dental aesthetics in the USA it can be used without modification only where perceptions of dental aesthetics are similar to those in the USA. This study was designed to determine whether perceptions of dental aesthetics of students in eleven diverse ethnic groups are similar to those of students in the USA. The same 25 stimuli (photographs of dental configurations, a subset of the 200 stimuli used in deriving the Standard DAI equation) were rated for dental aesthetics by Australian, Chinese, German, Japanese, Korean, Latvian, Native American, Singaporean Chinese, Singaporean Indian, Singaporean Malay, and Thai students. Their ratings were compared with the ratings of the same 25 stimuli by students in the USA. Spearman rank-order correlations ranged from 0.84 to 0.94. These correlations are sufficiently high to show that perceptions of dental aesthetics in all eleven ethnic groups are very similar to the perceptions of USA students. Therefore the Standard DAI can be used without modification in all eleven ethnic groups.

Matched MeSH terms: Malaysia/ethnology
Fulltext Vitamins, selenium, iron, and coronary heart disease risk in Indians, Malays, and Chinese in Singapore

Hughes K, Ong CN

J Epidemiol Community Health, 1998 Mar;52(3):181-5.
PMID: 9616423

STUDY OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly because of differences in antioxidants (vitamins A, C, and E, and selenium) and pro-oxidants (iron).
DESIGN: Cross sectional study of the general population.
SETTING: Singapore.
PARTICIPANTS: Random sample of 941 persons aged 30 to 69 years.
MAIN RESULTS: There were moderate correlations between vitamin A and vitamin E, and between these vitamins and selenium. Mean plasma vitamins A and E were similar by ethnic group. Vitamin A concentration for Indians were (men 0.66 and women 0.51 mg/l), Malays (men 0.67 and women 0.54 mg/l), and Chinese (men 0.68 and women 0.52 mg/l). Vitamin E concentrations for Indians were (men 12.9 and women 12.8 mg/l), Malays (men 13.6 and women 13.3 mg/l), and Chinese (men 12.6 and women 12.6 mg/l). In contrast, mean plasma vitamin C concentrations were lower in Indians (men 5.7 and women 6.9 mg/l) and Malays (men 5.1 and women 6.4 mg/l) than Chinese (men 6.3 and women 8.4 mg/l). Mean serum selenium was lower in Indians (men 117 and women 115 micrograms/l) than Malays (men 122 and women 122 micrograms/l) and Chinese (men 126 and women 119 micrograms/l). Mean serum ferritin was much lower in Indians (men 132 and women 50 micrograms/l) than Malays (men 175 and women 85 micrograms/l) and Chinese (men 236 and women 92 micrograms/l).
MAIN CONCLUSIONS: Lower vitamin C and selenium in Indians, particularly in combination, could play a part in their increased risk of CHD. Vitamins A and E, and ferritin (iron) have no such role. Lower vitamin C in Indians and Malays is probably because of its destruction by more prolonged cooking. In Indians, lower selenium is probably because of a lower dietary intake and the much lower ferritin to a lower dietary intake of iron and its binding by phytates.

Matched MeSH terms: Malaysia/ethnology
A dynamic bumiputera commercial and industrial class? A mismatch with market rationality

Lim L

Tonan Ajia Kenkyu, 1999;37:443-57.
PMID: 22532997
Matched MeSH terms: Malaysia/ethnology
Cephalometric analysis of Deutero-Malay Indonesians

Munandar S, Snow MD

Aust Dent J, 1995 Dec;40(6):381-8.
PMID: 8615744

A cephalometric study using Downs' analysis was undertaken with lateral cephalometric radiographs for a mixed sample of 50 child, adolescent and young adult Indonesians who presented with Angle Class I occlusions. Significant differences between this study group and the published results from comparative racial types were found for Downs' angle of convexity, Y-axis and incisor inclinations, indicating that Indonesians can be differentiated from other races with similar occlusions by using Downs' analysis.

Matched MeSH terms: Malaysia/ethnology
Age- and sex-related changes in lymphocyte subpopulations of healthy Asian subjects: from birth to adulthood

Lee BW, Yap HK, Chew FT, Quah TC, Prabhakaran K, Chan GS, et al.

Cytometry, 1996 Mar 15;26(1):8-15.
PMID: 8809475

Flow cytometric analysis of lymphocyte subsets were evaluated in 391 healthy Asian subjects ranging in age from birth to 40 years. Lymphocyte subsets were analysed using specific monoclonal antibodies: CD20 (B cells), CD3 and CD2 (T cells), CD16 and CD56+ (NK cells), CD4/CD3+ (helper-inducer T cells), CD8/ CD3+ (suppressor/cytotoxic T cells), HLA-DR expression on CD3 and CD25 (Tac) on CD3. The total white cell count, absolute lymphocyte counts, and B cell percentages peaked in infancy and declined steadily with age. Absolute counts of each subset, which were derived from absolute lymphocyte counts, also followed this trend. Increases with age were seen in the NK, T cell (CD2, CD3), and CD8 percentages. Males tended to have higher NK and CD8 percentages than females, and, conversely, females had higher CD3 and CD4 percentages than males. Comparison of our results with studies involving Caucasian subjects indicated higher NK percentages in our Asian population and lower CD4 absolute counts in the males of our population. These results indicate the presence of age, sex, and probable racial differences in lymphocyte subset expression. Our results may serve as reference standards for the Asian population.

Matched MeSH terms: Malaysia/ethnology
Racial differences in Helicobacter pylori seroprevalence in Singapore: correlation with differences in peptic ulcer frequency

Kang JY, Yeoh KG, Ho KY, Guan R, Lim TP, Quak SH, et al.

J Gastroenterol Hepatol, 1997 Oct;12(9-10):655-9.
PMID: 9407329

The aim of this study was to determine, first, whether racial differences exist in the seroprevalence of Helicobacter pylori infection in Singapore, and second, whether these differences correlate with racial differences in peptic ulcer frequency. A commercial serological test for immunoglobulin (Ig)G antibody to H. pylori which was 90% sensitive and 83% specific in our population was used to screen 403 adult blood donors of Chinese, Malay and Indian origin, aged between 15-60 years. Serum specimens from 84 paediatric patients admitted to the Paediatrics Department, National University of Singapore, with non-gastroenterological illnesses were also tested. In all three races, seroprevalence of H. pylori increased with age. Indians have the highest prevalence of infection followed by Chinese and Malays. Peptic ulcer prevalences are known to be highest in Chinese, followed by Indians and Malays. The Malays have the lowest prevalence of H. pylori and peptic ulcer among the three races in Singapore. Indians have a higher prevalence of H. pylori antibodies but a lower frequency of peptic ulcer than the Chinese. Racial differences in peptic ulcer frequency between Chinese and Indians are not explained by the prevalence of H. pylori infection; other environmental or genetic factors may be involved.

Matched MeSH terms: Malaysia/ethnology
Lead exposure in the lead-acid storage battery manufacturing and PVC compounding industries

Ho SF, Sam CT, Embi GB

Occup Med (Lond), 1998 Sep;48(6):369-73.
PMID: 10024732

This study was conducted as part of the Human Exposure Assessment Location (HEAL) Project which comes under the United Nations Environment Programme/World Health Organisation (UNEP/WHO) Global environmental Monitoring System (GEMS). The objective of the study was to evaluate workers' exposure to lead in industries with the highest exposure. All subjects were interviewed about their occupational and smoking histories, the use of personal protective equipment and personal hygiene. The contribution of a dietary source of lead intake from specified foods known to contain lead locally and personal air sampling for lead were assessed. A total of 61 workers from two PVC compounding and 50 workers from two lead acid battery manufacturing plants were studied together with 111 matched controls. In the PVC compounding plants the mean lead-in-air level was 0.0357 mg/m3, with the highest levels occurring during the pouring and mixing operations. This was lower than the mean lead-in-air level of 0.0886 mg/m3 in the lead battery manufacturing plants where the highest exposure was in the loading of lead ingots into milling machines. Workers in lead battery manufacturing had significantly higher mean blood lead than the PVC workers (means, 32.51 and 23.91 mcg/100 ml respectively), but there was poor correlation with lead-in-air levels. Among the lead workers, the Malays had significantly higher blood lead levels than the Chinese (mean blood levels were 33.03 and 25.35 mcg/100 ml respectively) although there was no significant difference between the two ethnic groups in the control group. There were no significant differences between the exposed and control group in terms of dietary intake of specified local foods known to contain lead. However, Malays consumed significantly more fish than the Chinese did. There were no ethnic differences in the hours of overtime work, number of years of exposure, usage of gloves and respirators and smoking habits. Among the Malays, 94.3% eat with their hands compared with 9.2% of the Chinese. Workers who ate with bare hands at least once a week had higher blood lead levels after adjusting for lead-in-air levels (mean blood lead was 30.2 and 26.4 mcg/100 ml respectively). The study indicated that the higher blood lead levels observed in the Malay workers might have been due to their higher exposure and eating with bare hands.

Matched MeSH terms: Malaysia/ethnology
Epstein-Barr virus (EBV) and Hodgkin's disease in a multi-ethnic population in Malaysia

Peh SC, Looi LM, Pallesen G

Histopathology, 1997 Mar;30(3):227-33.
PMID: 9088951

The Epstein-Barr virus (EBV) has been implicated as a contributing factor in the development of Hodgkin's disease. Western cases of Hodgkin's disease have shown the presence of EBV in Hodgkin and Reed-Sternberg cells in approximately 50%. We studied a total of 100 consecutive cases of Hodgkin's disease from Malaysia, with the aim to elucidate its association with EBV in a multi-ethnic Asian population. Of 34 patients (34%) less than 15 years of age (childhood), 25 had classical Hodgkin's disease (eight nodular sclerosis, 16 mixed cellularity, one lymphocyte depleted) and nine had lymphocyte predominance Hodgkin's disease. Of the 66 from patients aged 15 years and above, 33 had nodular sclerosis, 24 mixed cellularity, two lymphocyte depleted, one unclassifiable and six lymphocyte predominance Hodgkin's disease. The ethnic distribution of classical Hodgkin's disease was: Malay 23, Chinese 32 and Indian 30 (Malay:Chinese:Indian = 1:1.4:1.3), and the ethnic distribution in the 15 cases of lymphocyte predominance Hodgkin's disease was: Malay four, Chinese 10 and Indian one. Taking into account the ethnic distribution of the general population and of hospital admissions, there appears to be a significant predilection of classical Hodgkin's disease cases in ethnic Indian compared to non-Indian patients (chi-squared test, 0.025 > P > 0.01). Eighty-one cases were tested for the presence of EBV by in situ hybridization for EBV encoded RNA, and 57 cases by immunostaining for EBV latent membrane protein 1. In the younger age group, all except one of the 15 cases (nine mixed cellularity, six nodular sclerosis) showed the presence of EBV (93%). In the older age group, EBV was detected (52%) in the following proportion: 6/27 nodular sclerosis, 19/22 mixed cellularity, 1/2 lymphocyte depleted, 1/1 unclassifiable. None of the 14 cases of lymphocyte predominance Hodgkin's disease showed the presence of EBV in the Hodgkin and Reed-Sternberg cells. The findings suggest a strong association of EBV with Hodgkin's disease in Malaysians (41/67, 61%), in particular childhood cases (93%). In adults, the association with EBV is significantly higher in the mixed cellularity subtype (86%) compared with the nodular sclerosis subtype (22%).

Matched MeSH terms: Malaysia/ethnology
Fulltext Non-Hodgkin's lymphoma in an Asian population: 1968-1992 time trends and ethnic differences in Singapore

Seow A, Lee J, Sng I, Fong CM, Lee HP

Cancer, 1996 May 1;77(9):1899-904.
PMID: 8646691

BACKGROUND: Non-Hodgkin's lymphoma has increased in incidence in many countries, particularly in the West. Advances in diagnostic methods and the understanding of the disease over time pose a challenge to the interpretation of these trends. The aim of this study was to determine if the disease has increased in Singapore, a newly industrialized Asian country, and to examine the possible factors that may account for any observed changes.
METHODS: Data from the population-based Singapore Cancer Registry for the period 1968 to 1992 were reviewed to determine time trends based on sex and ethnic group. The Poisson regression model was fitted to the cross-tabulated data to obtain the adjusted incidence density ratios.
RESULTS: A total of 1988 cases of non-Hodgkin's lymphoma were included in the analysis. There was an overall increase in incidence among both Chinese and Malaysians. However, the rate of increase was greater in females (age-standardized rate from 1.8 per 100,000 in 1968-1972 to 4.5 per 100,000 in 1988-1992) than in males (3.2 per 100,000 to 5.9 per 100,000 in the same time periods). Between ethnic groups, Malay females were at higher overall risk compared with their Chinese counterparts (incidence density ratio 1.32; 95% confidence interval, 1.08-1.61). Although a substantial proportion of patients diagnosed with Hodgkin's disease between 1968 and 1972 were reclassified on review, using present criteria, as having non-Hodgkin's lymphoma, it is unlikely that this, and other recent changes in histologic interpretation, could have accounted for an increase of this magnitude.
CONCLUSIONS: Non-Hodgkin's lymphoma has increased in incidence among the Chinese and Malay populations in Singapore. The pattern of increase differs from that of the common cancer sites, and suggests the need to look for environmental and genetic factors that have not yet been elucidated.

Matched MeSH terms: Malaysia/ethnology
Prevalence of snoring and sleep breathing-related disorders in Chinese, Malay and Indian adults in Singapore

Ng TP, Seow A, Tan WC

Eur Respir J, 1998 Jul;12(1):198-203.
PMID: 9701437

This study investigated the prevalence of snoring and symptoms of sleep breathing-related disorders in the multi-ethnic population of Singapore (3 million people, comprising 75% Chinese, 15% Malay and 7% Indian). A multistaged, area cluster, disproportionate stratified, random sampling of adults aged 20-74 yrs was used to obtain a sample of 2,298 subjects (65% response), with approximately equal numbers of Chinese, Malay and Indian and in each 10 yr age group. An interviewer-administered field questionnaire was used to record symptoms of snoring and breathing disturbances during sleep witnessed by a room-mate and other personal and health-related data. The weighted point estimate (and 95% confidence interval) of the whole population prevalence of snoring was 6.8% (53-83). There were pronounced ethnic differences among Chinese, 6.2% (4.4-8.1); Malay, 8.1% (6.1-10.2) and Indian, 10.9% (85-13.4). The minimum whole population prevalence by the most restricted symptom criteria for defining sleep breathing-related disorder was 0.43% (0.05-0.8%). Similar marked ethnic differences in rates were observed using various symptom criteria. The ethnic differences in sleep breathing symptoms paralleled the differences in body mass index, neck circumference and hypertension, but statistically significant differences remained after adjustment for sex, age and these known associated factors. Marked ethnic differences in snoring and sleep breathing-related disorders were observed in Chinese, Malays and Indians in Singapore, which were only partly explained by known factors of sex, age and body habitus.

Matched MeSH terms: Malaysia/ethnology
Trigeminal neuralgia. A retrospective survey of a sample of patients in Singapore and Malaysia

Loh HS, Ling SY, Shanmuhasuntharam P, Zain R, Yeo JF, Khoo SP

Aust Dent J, 1998 Jun;43(3):188-91.
PMID: 9707784

This survey was undertaken to study the clinical features of trigeminal neuralgia in an Asian population. Demographic data of 44 patients treated at the Dental Faculty of the National University of Singapore and at the University of Malaya were reviewed. The results of the survey were analysed and comparisons made with those of Caucasian patients as reported in other studies where there was a general similarity in the clinical findings. Trigeminal neuralgia presented predominantly in females. Right-sided involvement occurred at a greater frequency, and the peak age at onset was between the sixth and seventh decades of life. The only significant variant in the present sample was the greater involvement of the mandibular branch of the trigeminal nerve rather than the maxillary division. In addition, there was a much greater representation from Chinese patients over Malays as compared with their ratios in the general population.

Matched MeSH terms: Malaysia/ethnology
Fulltext A Malaysian Well Person's Clinic--review of patients seen between April and December 1995

Chan SC

Med J Malaysia, 1997 Mar;52(1):53-9.
PMID: 10968053

The Well Man & Well Woman's Clinic in Ipoh Hospital provides screening for coronary risk factors and early detection of cancer. This retrospective review of 1095 patients screened between April and December 1995 showed 48% had one or more coronary risk factors--1 risk (29%), 2 risks (14%), 3 or more risks (5%). Modifiable risks included hypertension (10%), obesity (9%), diabetes mellitus (8%) and smoking (7%). Sixteen abnormal Papanicolaou smears and six cancers (three cervical, two breast and one ovarian) were detected. Public response was good. There is a need for clinics offering comprehensive screening in Malaysian primary health care.

Study site: The Well Man & Well Woman's Clinic in Ipoh Hospital

Matched MeSH terms: Malaysia/ethnology
Oral healthy conditions in Cocos (Keeling) and Christmas Islands children

Riordan PJ, Panaeff C

Community Dent Oral Epidemiol, 1996 Feb;24(1):85-6.
PMID: 8833521
Matched MeSH terms: Malaysia/ethnology
Prevalence of dental fluorosis in children in Singapore

Lo GL, Bagramian RA

Community Dent Oral Epidemiol, 1996 Feb;24(1):25-7.
PMID: 8833510

Prevalence and severity of dental fluorosis was assessed in 1739 Singaporean children aged 9, 12 and 16 yr in three different ethnic groups. All subjects had resided since birth in Singapore, which has a tropical climate. The water supply was fluoridated in 1957 at a level of 0.7 ppm. In this sample, mouth prevalence was 82.6%, tooth prevalence was 66.9%, the community fluorosis index was at 1.96; 9.2% of children had severe fluorosis and 26.2% had moderate fluorosis. There were no significant gender or racial differences. Prevalences were higher than those reported in most other studies. Due to differences in indices used and methodology, comparisons could not be made directly with other studies.

Matched MeSH terms: Malaysia/ethnology
Fulltext Warfarin--topical salicylate interactions: case reports

Ramanathan M

Med J Malaysia, 1995 Sep;50(3):278-9.
PMID: 8926909

This paper deals with two patients on warfarin in whom the use of topical methylsalicylate preparations led to clinically significant bleeding problems. The first patient required fresh frozen plasma to tide over the crisis while the second patient recovered spontaneously on stopping the warfarin temporarily. The possible mechanisms by which salicylates potentiate the anticoagulant effect of warfarin are briefly outlined.

Matched MeSH terms: Malaysia/ethnology
Fulltext A microbiological study of genital ulcers in Kuala Lumpur

Zainah S, Cheong YM, Sinniah M, Gan AT, Akbal K

Med J Malaysia, 1991 Sep;46(3):274-82.
PMID: 1839925

The microbial aetiology of genital ulcers was studied in 249 patients (241 men and 8 women) attending a Sexually Transmitted Disease Clinic in Kuala Lumpur, Malaysia. Herpes simplex virus type 2 was isolated in 48 (19.2%) patients, Haemophilus ducreyi from 22 (8.8%), Neisseria gonorrhoeae from seven (2.8%) and Chlamydia trachomatis from four (1.6%). Syphilis was diagnosed in 18 (7.2%) patients on the basis of dark field microscopy. Two (0.8%) patients were found to have both chancroid and syphilis and one (0.5%) had both gonorrhoea and syphilis. No organism was isolated in the remaining 151 (61.5%) patients. Overall, the accuracy of clinical diagnosis was 58% for single infection, 67% for herpes, 63% for syphilis, 47% for chancroid and 0% for lymphogranuloma venereum. Therefore, our study confirms the need for laboratory tests to diagnose accurately the aetiology of genital ulcer disease.

Matched MeSH terms: Malaysia/ethnology

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