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.
Plaque reduction neutralization tests, using five group A arboviruses (chikungunya, Ross River, Getah, Bebaru and Sindbis), were done on sera from human populations in 44 Southeast Asia and Pacific island localities. Specificity of the plaque neutralization test was determined by examining convalescent sera from patients with known alphavirus infections. Chikungunya-specific neutralizing antibodies were demonstrated in sera of persons living in South Vietnam, Northern Malaysia, Indonesia (Kalimantan and Sulawesi), as well as Luzon, Marinduque, Cebu and Mindanao islands in the Philippines. Evidence of Ross River virus infection was found among populations living in West New Guinea and Papua New Guinea mainland, the Bismark Archipelago, Rossel Island and the Solomon Islands. There appeared to be no geographic overlap in the distribution of chikungunya and Ross River viruses, with the separation in their distribution corresponding with Weber's line in the Pacific. Sindbis neutralizing antibodies were found in 7 of 21 populations sampled, but in general the prevalence of infection was low. Four sera, from Vietnam, Malaysia and Mindanao gave monospecific reactions with Getah virus. No evidence of specific Bebaru virus infection was detected. The epidemiology of these five alphaviruses in Southeast Asia and the Pacific islands is discussed.
A review of 352 patients with primary liver cell carcinoma treated by the author is presented. The poor rate of resectability (7 per cent) has necessitated various forms of treatment over the years. These are described in detail. Based on this experience, the current form of treatment for nonresectable carcinoma is summarized. Although it is too early to assess this form of treatment, initial results appear to be promising. A second report in the near future is planned.
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.
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.
A study of glutathione reductase (GR) activity and its stimulation by flavin adenine dinucleotide (FAD) in erythrocytes of Malaysian newborns and adults of different racial groups showed that GR stimulation by FAD was greater than 20% in 50% of 866 newborns (57% of Malays, 55% of Indians and 41% of Chinese) and 54% of 274 adults (46% of Malays, 65% of Indians and 45% of Chinese). There was a significant negative correlation between GR activity and percentage FAD stimulation in both newborns and adults in all racial groups. Low GR activity and a high percentage FAD stimulation were more prevalent among parents of newborns with low GR activity than among parents of newborns with higher GR activity. Administration of riboflavin to mothers with low GR activity resulted in increased GR activity and a decreased percentage of FAD stimulation. None of the individuals examined had clear clinical manifestations of riboflavin deficiency. It is concluded that subclinical riboflavin deficiency leading to low GR activity is prevalent in Malaysia among adults and newborns, especially among Malays and Indians.
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%).