200 doctors are gazetted as practising in Sarawak in 1982. 88% are males and only 12% are females. Of the 200, 65.5% are Chinese and the natives of Sarawak and Indians form 15.5% each. Nearly 30% are graduates from local universities, 44% from universities in Commonwealth countries and a few from universities in other countries. The majority of the doctors are under 40 years of age. 55 % are in government service, while 45% are in the private sector. All private practices are solo practices except three-one each in Kuching, Sibu and Miri which are based on partnership. The number of doctors with specialist qualifications is not known as it is not essential for these qualifications to be entered in the Register. The doctor-to-population ratio in Sarawak has improved from 1:14000 in 1964 to 1:6856 in 1982. To reach the Ministry of Health's target of 1:2500 by 1990, a yearly recruitment of 58 doctors would be needed from 1983 to 1990. This would be feasible if either an admission quota to the local medical faculties for Sarawakians is implemented or more doctors are posted to serve in Sarawak.
A 61 year old Indian man presented with clinical depression after a longstanding of “head heaviness”. Looking through the literatures, there is scant information on the subjective complaint of “a heavy head” despite it being a very common encounter at many primary care clinics. We feel that this is an unusual presentation of the symptom as it was very dramatic, to the extent that the patient was overly preoccupied with his head heaviness and subsequently became depressed. Here we undertake to present the case of a man who became clinically depressed due to his “heavy head”.
A review of 20 cases of neuroblastoma at the University Hospital, Kuala Lumpur from 1967 to 1980 reveals six infants aged 2 to 13 months with stage IV·S disease, associated with an unusually good prognosis. Four of the six patients presented with hepatomegaly, one had skin nodules and another paresis of the lower limbs. The primary tumour was located infra-diaphragmatically in all cases, four had disease in the bone marrow but none had radiological evidence of bone involvement. Although not systematic, with limited treatment of low dose radiation and mild chemotherapy, four patients are alive and well, one absconded and one died of septicaemia. It is important to define this special category as an unexpectedly good survival is possible with minimal therapy. Death is more likely to result from over-zealous treatment than from the disease itself.
Sickle cell disease (SCD) in pregnancy is uncommon in Malaysia. We present a case of sickle cell disease in pregnancy with maternal and fetal complications. The patient presented with acute pain crisis and hemolysis in the third trimester. Despite thromboprophylaxis, she developed deep vein thrombosis. The pregnancy was further complicated by severe pre-eclampsia and intrauterine growth restriction which require preterm caesarean section. The baby was admitted to Neonatal Intensive Care Unit due to prematurity and low birth weight. Multidisciplinary
approach in managing pregnant patient with SCD is essential in achieving good obstetrics outcome.
Keywords: anemia, sickle cell disease, pregnancy outcomes
Manifestations of vitamin deficiencies observed in 6,000 Tamil and 4,000 Malay children and young adults during a survey carried out by the Institute for Medical Research in the Federated Malay States included phrynoderma, Bitot spots
and angular stomatitis. They were more frequent in Tamils than in Malays. Phrynoderma and Bitot spots responded rapidly to administration of vitamin A or carotene, though in some patients with phrynoderma improvement was not attained unless also the protein intake was increased and vitamin B complex added. Angular stomatitis was benefited by administration of riboflavin or vitamin B complex. The clinical and histologie observations of phrynoderma in Tamils and Malays in Malaya were identical with those previously reported in Chinese, Ceylonese and southern Indians. A supplementary food ration, composed of soy beans, skim milk powder, dal and red palm oil, given to Tamil children on rubber estates not only increased the general state of health but led to a rapid regression of the manifestations of vitamin deficiencies.
Dermatoglyphic traits are formed under genetic control during early gestation and do not change through the entire life. A few studies have shown that dermatoglyphic traits were conservative in their evolution and were different between and within population groups. The objective of this study was to compare the variability of palm dermatoglyphs in three main populations i.e. Malay, Chinese, Indian and five sub-ethnic population of Negritos’ Orang Asli i.e. Bateq, Jahai, Kintak, Kensiu and Lanoh. We utilised fingerprints and palms of 390 healthy adult individuals, counted the total ridge for ten fingers
(TRC), a-b ridge counts (a-b RC) on palms, examined widening of the atd-angle, and classified the digital pattern configuration of arches, whorls, ulnar, and radial loops for all fingers. Variables obtained from both palm did not show any differences between males and females for all populations. TRC, a-b RC and atd-angle were the highest for Kensiu and were later on specially described to be in a group of its own by ANOVA and TUKEY test for TRC and a-b RC. The same test has put Chinese in a group of its own for atd-angle. Only a-b RC clearly separate Orang Asli populations from the three main races. Whorls and ulnar loops were the most predominant pattern in all groups. Malays and Chinese had similar distributional patterns for each ten fingers. Indian and Jahai similarly mimic each other, while Bateq has the reversal pattern distribution to them both. Kintak and Lanoh halfly mimics each other pattern and Kensiu had its own unique pattern. In conclusion, races, patterns, and pattern frequencies were related to each other and can be used to differentiate different races or Orang Asli
sub-ethnics. This study documents for the first time the comparative dermatoglyphic traits between Malaysian main races with Orang Asli populations show a list of informative variables that can be used to identify them as well as suggesting it’s used as a tool in tracing the etnohistorical background of populations.