This is a study of 169 cases of attempted suicides who had been referred to or who had consulted a private psychiatrist. These patients were interviewed, examined and treated either as out- or in-patient in private hospitals during the years 1968-1976. Their demographic and clinical data were analysed, presented and discussed. The reasons and motivations tor the act were also obtained and summarized. In the follow-up study conducted, it was discovered that schizophrenic patients who had attempted suicide carries the highest completed suicide risk.
Ninety-six cases of severe malnutrition and associated nutritional disorders were encountered in children in the department of paediatrics for the year 1971. The predominant age group was in children under the age of two years. Malay and Indian children were affected more than the Chinese children with malnutrition. Protein caloric malnutrition had already affected the growth pattern of these children as the majority were below the 50th percentile in height and weight comparing them with Hong Kong childrens’ height and weight standards. Seventy-five per cent of the children presented with infection. Fifty-four per cent of the families with malnutrition had three to six children and in two thirds of the families the income was from $100/- to $249/- per month. Forty per cent of the children lived in the kampong type of houses with no proper sanitation. Worm infestation was common in this group. The mean haemoglobin, serum iron levels, and serum folic acid levels were lower in the Indians and Malays. Protein caloric malnutrition must be treated early because of its irreversible effects on brain and bone growth. It is recommended that some form of allowance either in the form of food or money be given to these children from poor social-economic background.
One hundred and ninety-nine children brought by 181 adults to a child health clinic based in a rural health sub-centre in Peninsular Malaysia are studied. It is noted that the families from which they come are relatively poor, with a large number of children, and that they are fairly highly motivated. Forty-four per cent of children attending the clinic at the time of the study are symptomatic indicating the need to organise the child health clinic on a "preventive-curative" basis. It is also noted that the young child is initially seen in early infancy but is lost to the clinic when he is older making it judicious to formulate immunization schedules that take this into account.
During a routine medical examination of 5280 government employees (2736 males, 2544 females; age range 17 to 66 years; 3386 Chinese, 1252 Malays, 508 Indians and 134 other ethnic groups) diabetes was found in 31 (0.59%). The prevalence was higher in males (0.95%) than in females (0.20%). The highest prevalence was in the age-group 50 to 59 years (5.4%); at ages 30 to 66 years, the overall prevalence was 2.18%. The prevalence of diabetes is higher in Indians (2.76%) than in Chinese (0.30%) and Malays (0.48%); the difference is statistically significant, as it also is in the age-group 30 to 66 years (Indians 6.36%, Malays 1.39%, Chinese 0.9%). Of the 31 cases, only four were previously known and only nine were overwieght. The possible reasons for the higher prevalence of diabetes in Indians are discussed.
Serum was collected from six adults participating in a field trial of sulfadoxine and pyrimethamine in combination which was being administered once monthly for malaria suppression. Samples were drawn during each of two consecutive months three hours, and 7, 14 and 28 days following a dose of 1 500 mg sulfadoxine. Serum sulfadoxine concentration was measured using the method of Bratton and Marshall (1939). Initial serum concentrations averaged 19-9 plus or minus 2-4 (SD) mg/100 ml and decayed to 6-2 plus or minus 2-8 mg/100 ml at 14 days. Serum sulfadoxine concentrations were still detectable at 28 days following a dose (2-1 plus or minus 1-5 mg/100 ml). Elimination half-time averaged 195 plus or minus 44 hours. The presistent serum concentrations of sulfadoxine following monthly doses documented here during field-use of this drug are in agreement with the successful clinical results reported for such a regimen (Lewis and Ponnampalam, 1974; O'Holohan and Hugoe-Mathews, 1971; Wolfensberger, 1971).
One hundred and ninety hepatitis B surface antigen positive (HBsAG+) sera were subtyped, belonging to : blood donors, hepatitis patients, patients and staff in a hemodialysis unit, all from Kuala Lumpur; Malaysian aborigines from three jungle locations in Peninsular Malaysia; and East Malaysians from Sarawak, East Malaysia; Three subtypes adr, adw and ayw were present in Malaysia in the following frequencies: 44%, 29%, and 27%, respectively; In Kuala Lumpur 87% had subdeterminant d and 13 per cent y, whereas in the deep jungle aborigines of Perak and Pahang, the y subdeterminant was present in 87% and the d in 13%. A similar pattern of preponderance of y prevailed in Sarawak, East Malaysia. In Kuala Lumpur the two main ethnic groups, Malays and Chinese, differed in subtype distribution, in that adr predominated in the Malays (61%), while the adw predominated in the Chinese (51%); Subtype distribution was not related to age or sex of carriers of the antigen, or to whether they had hepatitis, or asymptomatic antigenemia.
Alpha-Fetoprotein (AFP) levels of 1,335 males (15 years and older) of seven ethnic groups (Chinese, Indians, and Malays from Singapore, Caucasians from Lyon, and Blacks from Nairobi, forest, and the savanna region of the Ivory Coast) were determined by radioimmunoassay. A few elevated levels (up to 30 nanounits/ml) were detected in some normal individuals, especially in the older age-groups. In addition, there was a systematic age-dependency of AFP levels particularly evident in the groups from Singapore-Lyon, in which there was a 50% AFP increase between the ages of 20 and 40. Comparison between Africans on the one hand and people from Singapore-Lyon on the other hand revealed highly significant differences (p less than 0.001), especially in the younger groups, whereas Chinese, Malays, and Indians from Singapore had very similar AFP pattern; this suggests an important role for environmental factors in the regulation of AFP levels. The age dependency of the presumed effect of environmental factors is in keeping with experimental data showing that young animals respond more vigorously to AFP-stimulating factors. Although the incidence of hepatocellular carcinoma (HCC) differs in the three Singapore groups (the highest in Chinese and the lowest in Indians), no relationship was observed in this study between mean AFP level and HCC incidence in Singapore.
In a study during 1972 of smoking habits of Malaysian medical students, smoking rates of medical students was seen to be higher than that of students in four other faculties in the University of Malaya. Male Malaysian medical students had higher smoking rates than their counterparts in Glasgow in 1971 (UM 20.3%, Glasgow 19.1%) but Malaysian females had very low smoking rates (male 25.2%, female 1.6%). Despite the fact that in the medical curriculum students are made aware of the scientific evidence on the health hazards of smoking, smoking rates were higher in students int their later years of study. Ethnicity was associate with smoking rates although father's smoking habit was not - and Malays had the highest smoking rates (malay 28.2%, chinese 16.3%, indian and others 23.5%).
The interest in epidemic hysteria has been due to an increased prevalence of the phenomena in Malaysia in recent years. This paper describes the prevalence and characteristics of epidemic hysteria in Malaysia. An outbreak in a rural Malay lower secondary girls' school was described and the factors precipitating the outbreak were studied in detailed. The social interactions, native interpretation and psychodynamic constellations in the microcosm of tensions and interpersonal conflicts leading to the outbreak of hysteria were analysed and discussed. The paper also deals with the problem of social change within a closed-in rural community and how the various key personalities involved grappled with a problem thereby instituting social change.
The response to lepromin and Kveim antigens was compared and studied in 15 leprosy patients who were tuberculin negative. Of the 11 lepromin positive tuberculoid patients, 4 were Kveim positive, 1 was equivocal, and the rest were negative. Of the four lepromin negative lepromatous patients, one gave a positive Kveim test while the other three were negative. It has been shown that false-positive Kveim reactions are found in a higher percentage of South Indian leprosy patients than in those of other backgrounds, such as Japanese and Malaysian Chinese patients. It is also suggested that no definite relationship exists between the reaction of leprosy patients to lepromin and Kveim antigens. We further suggest that the anergy exhibited by lepromatous patients to the antigen of M. leprae is specific, as evidenced by the positive Kveim response in one lepromatous patient.
Certain uncommon genetic disorders occur relatively frequently in the various population groups of Southern Africa. Prominent among these are porphyria, colonic polyposis and sclerosteosis in the Afrikaner community, Huntington's chorea in the British, Gaucher's and Tay-Sachs diseases in the Jewish population, glucose-6-phosphate dehydrogenase deficiency (G-6-PD deficiency) and thalassaemia in the Greek community, various skeletal dysplasias in the Black group, lipoid proteinosis and cleidocranial dysostosis in the Cape Coloured population, diabetes mellitus in the Indian community and retinitis pigmentosa in the Tristan da Cunha islanders. In addition, 'private' syndromes have been encountered in virtually every group. Awareness of the ethnic distribution of unusual genetic conditions is of considerable practical importance during the differential diagnosis of obscure disease.
The incidence of congenital hypertrophic pyloric stenosis among 141,215 Chinese, Malay and Indian live births in Singapore from 1972 to 1974 was determined. The incidence per 100,000 live births among these ethnic groups are: Chinese 21.2, Malay 9.7 and Indian 35.0. Pyloric stenosis is not absent although rare in oriental babies.
The clinical features and pathology of 17 patients with gastrointestinal lymphoma are reviewed. The small intestine was the site most commonly involved. Emergency presentation was usual: 11 of the 17 patients presented as acute abdomen or gastrointestinal haemorrhage. The frequency of gastrointestinal lymphoma to carcinoma in the Chinese and Indians was comparable to that in the West but a higher frequency was found in the Malays and Orang
Asli.
An explanation was sought for the disparity between the low reported incidence of scrub typhus and the high prevalence of antibody to Rickettsia tsutsugamushi in the rural population of Malaysia. A combination of isolation of the organism, titration of antibody by indirect immunofluorescence, and the Weil-Felix test was used to confirm infections. Scrub typhus was found to be very common, causing 23% of all febrile illnesses at one hospital. The infection was particularly prevalent in oil-palm workers, causing an estimated 400 cases annually in a population of 10,000 people living on one plantation. The clinical syndrome, whether mild or severe, was difficult to distinguish from that due to other infections. Eschars, rashes and adenopathy were uncommon. When used to examine early sera, the Weil-Felix test failed to confirm the diagnosis in most infections.20
Benign cystic teratoma of the ovary has a varied incidence, varying from 30 to 50 per cent of all benign ovarian tumours. This tumour tends to occur in the reproductive age group (20 to 40 years), and the majority of patients are married with children. About 40 per cent of patients are symptomless. Of those with symptoms, abdominal pain and mass are the commonest. Torsion is the most frequent complication encountered, and the presence of acute pain should make one suspect this complication. The tumour is bilateral in 10 to 20 per cent of patients. This high bilateral occurrence places a responsibility on the gynaecologist to inspect the opposite ovary in all cases of unilateral dermoid cyst of the ovary at the time of laparotomy. Germ·layer derivatives are predominantly ectodermal in origin, although both mesodermal and entodermal derivatives occur frequently.
Data for the ABO blood groups and for handclasping, arm folding, handedness, ear lobe types and camptodactyly are presented for 104 Malay and 57 Chinese males in the city of Alor Star, Kedah, Malaysia. The two groups exhibit marked differences in the frequencies of most of these attributes.