The W.H.O. self reporting questionnaires were distributed to 50 psychiatric outpatients with neurotic disorders and 50 medical staff as controls. This pilot study shows that it can differentiate between normal and neurotic patients and that if a cut off point of 3 is taken, there Is a very good chance that no psychiatric case in any epidemiological study will be missed. This study also picked up the 10 most sensitive items in the S.R.Q. which will be validated In future studies.
Study site: Psychiatric clinic, Hospital Kuala Lumpur, Malaysia
Nonfermentative Gram-negative bacilli were commonly isolated from clinical material in a Malaysian hospital over a two year period of study. Pseudomonas aeruginosa, Acinetobacter sp and other Pseudomonas were the most common organisms seen. Although these bacteria occurred regularly in clinical specimens their pathogenetic role could be established in only a small proportion of cases. Most 01 these organism were either contaminants or
commensals 01 the normal bacterial flora. It is important to interpret the isolation of a nonfermentative Gram-negative bacillus with caution, and in the light of clinical findings. Failure to do so may result in the unnecessary use of antibiotics.
An Indian family with all 3 sons having the fragile X syndrome is reported. The frequency of fragile X cells observed ranged from 4·16%. The phenotypically normal mother, although an obligate carrier, did not express any fragile X chromosomes in her Iymphocyte cultures. The range of mental retardation in affected
hemizygous males and heterozygous females as well as the significance of the fragile X chromosome in prenatal diagnosis are discussed.
The feasibility of using a computer database management system based on an 8·bit microcomputer for storing, retrieving and analysing patient data in a limited setting (oesophago·gastro-duodenoscopy records from a peripheral general surgical department over a 1 year period) is presented. A program developed by the author was used to enter the relevant records of 208 patients undergoing the above examination, and to retrieve and analyse any desired data. Compatible statistical and graphics software packages can be used to access and analyse the data and display or print out the results. The limitations and scope for further expansion of the system are discussed.
Areca catechu (betel) nut is widely used as a chewing agent. The nut alkaloids have been implicated in the pathogenesis of oral precancerous lesions. Quantitative analysis of the chloroform extracts by gas-liquid chromatography of ten commercial nut samples from Bombay have shown a wide variations In their arecoline contents (0% - 1.4%; mean: 0.7%). Nut samples of Identical processing method also vary in their arecoline levels. These variations were suggested to be due to the difference In the raw materials and processing methods. Comparisons were made between the arecoline contents and the Incidence of oral precancerous lesions from the present studies and also from those of Kerala and Mysore. It was concluded that the difference in nut arecoline contents not only reflect their appeal, potency but also influence upon the incidence of these diseases.
Porphyrias are uncommon disorders of haem metabolism and we report the first documented case of acute intermittent porphyria in Malaysia. The biochemical, clinical features and the management of this order are discussed.
A study of cancer deaths registered in the Federal Capital of Malaysia during a three-year period from 1979-1981 was carried out to analyse the cancer patterns by age, sex and ethnic group. There were altogether 2524 cancer deaths, constituting 14.5% of the total 17,446 deaths in the three years. Analysis was based on the medically certified and inspected deaths, which constituted 98.2% of the total deaths. Classification was based on the Eighth (1965) Revision of the WHO International Classification of Diseases. A detailed description of the most common cancer deaths among males and females in the total study population, and in each of the three major ethnic groups (Malays; Chinese, Indians) was carried out. Ethnic variations in mortality from some of the common cancers were described and discussed, and compared with another series based on hospital admissions.
Methicillin resistant Siaphylococcus aureus Is a common isolate from clinical specimens obtained from babies at the special care nursery of the Kuala Lumpur Maternity Hospital. Major Infections due to this organism were, however uncommon and the organism had in the majority of cases been present as a coloniser or as a cause of superficial infection. Netilmicin is a valuable antibiotic in the treatment of the severe infections.
A cytogenetic survey 01 124 children in lour special schools for the mentally handicapped was carried out to determine the contribution of chromosomal abnormalities to the aetiology of mental retardation in these children. All the children were karyotyped employing the G·banding technique 01 43 (34.7%) with an abnormal chromosome complement, 40 had Down's Syndrome, and 3 had other chromosomal abnormalities, namely a translocation 1;17, a mosaic male/trisomy 18 and a Klinefelter's syndrome. Polymorphic variants involving chromosomes 1, 9, and 14 were also observed. Two other children showed variants of the Y chromosome (one a small Y and the other a metacentric Y). The possible contribution by these abnormal variants to mental retardation is discussed. Details of the abnormal cytogenetic findings are reported.
We determined the prevalence of cholelithiasis, by ultrasound in 728 Asian subjects and calculated the annual incidence of disease amongst the gallstone carriers. The prevalence of asymptomatic cholelithiasis in the age group> 29 years, was 11.8% (95% confidence interval: 7.2-16.4%) in males and 13.7% (8.4-19.0%) in females. The median diameter of the stones 10mm (range 4-17) did not differ from that of symptomatic stones - 12.5mm (3·21). The odds of having cholelithiasis increased by 5% each year of life (p 29 years) developing symptoms leading to a hospltal-based investigation was estimated as only 1/1000, whilst the annual cholecystectomy rate was 6/100,000. The chance of a carrier having a cholecystectomy in Malaysia was approximately 5 times less than the chance in the United Kingdom. We conclude that asymptomatic gallstones are common In Malaysians, but the risk of disease is low. The low cholecystectomy rate may be the result of a conservative approach to cholelithiasis due to limited surgical resources.
Plesiomonas shigelloides was isolated from 5 (2.1%) of the 234 children with diarrhoea and none of the 230 controls. In one child, the organism was found in association with Salmonella. Two strains had Shigella sonnei phase I antigen. All the strains were susceptible to the aminoglycosides, cephalosporins, nalidixic acid, nitrofurantoin, chloramphenicol and cotrimoxazole; but resistant to the penicillins. Alkaline peptone water enrichment subcultured to desoxycholale citrate agar proved to be a useful method for isolating this organism from faeces. As the roie of P. shigelloides in causing gastrointestinal disease remains controversial, further studies are necessary to determine its enteropathogenicily.
The traditional birth attendant (bidan kampong) or the TBA is still responsible for a substantial number of deliveries in Peninsular Malaysia. In the study area, the TBA s were responsible for about 47.2% of the deliveries in 1976. They were also responsible tor a substantial number of maternal deaths in the district. Therefore it was decided to identity and train the TBAs to identity ‘at risk’ cases at mothers and children and refer them to the nearest health facility. The TBA s were trained to use simple hygenic and aseptic procedures. At the end oi their training all at them were presented with a UNICEF midwifery kit. The short training proved useful because they now deliver fewer ‘at risk' cases and there is an in- creasing trend among them to refer the ‘at risk’ cases to the hospitals. The utilizations of TBA s in the maternal and child health program is a useful tool for the attainment at primary health care objective for developing countries by the year 2000.
This paper represents a reappraisal of the gross and histological features of 45 cases of adenomatoid odontogenic tumours as observed under conventional light and fluorescence microscopy. The findings conformed largely to those of previous studies. Usage of the term adenomatoid odontogenic tumour in preference to its old name 'adenoameloblastoma' is emphasized. The differential diagnosis of this entity from the ameloblastoma and salivary gland tumours is discussed.
Diabetes mellitus is a common chronic disease in Singapore. Its occurrence in pregnant women was 1.3% in a previous report. In a survey of 145 consecutive pregnant women registered at Alexandra Hospital the incidence of gestational diabetes was 13.1% when a total screen with 75 gm oral glucose challenge was used. The mean age of this sample was 27 years and the mean gestation at screening 33 weeks. There was an excess of Malay and Indian patients. Fifty percent had traditional risk factors tor gestational diabetes. Whether this higher incidence is a result of more stringent screening and/or increased occurrence remains to be confirmed.
The Middlesex Hospital Questionnaire (MHQ) with its subscales on anxiety, phobia, somatic symptoms, depression and hysteria was devised by Crown and Crisp(1). it has been used to differentiate between neurotic and normal population. The MHQ has been translated into the Malay language and this paper shows the results of an attempt to validate this translated questionnaire in the Malaysian population. The translated questionnaire is found to have useful validity as a whole and also for subscales on anxiety, somatic symptoms and depression.
83 Malays with HbE beta-thalassaemia who were not transfusion dependent were investigated. 79 persons showed no beta0 formation indicating the predominant gene in Malays with HbE beta-thalassaemia was beta0. HbF assays showed levels that were similar to transfusion dependent patients. Further studies are necessary to determine the presence of the alpha, (alpha+) gene Interacting with HbE and beta0 to produce the milder phenotype of HbE beta-thalassaemla.
The figures for abortions performed under The Abortion Act, 1974 of Singapore in a private clinic over a period of 20 months were studied. Overall, an alarming proportion of repeat abortions were found, and this was true for all age groups suggesting that abortions are being used as a regular method of family planning in Singapore.