This study was proposed to identify specific radiological appearances in Malaysian patients with bronchial asthma. All consecutive patients, seen in the Medical Unit, Universiti Kebangsaan Malaysia between 1976 and 1979, satisfying the American Thoracic Society [1962] criteria for bronchial asthma formed the subjects of this study. Analysis of 207 patients led to the following conclusion. There are specific radiological changes present in a proportion of bronchial asthmatics during the acute episode. These changes are more frequent in the younger age group and in those in which the age of onset are early, The duration of asthma seems to have some bearing to the radiological changes.
Malignant neoplasms diagnosed histologically in the state of Sabah during the period November 1983 to October 1988 were analysed to determine the distribution of malignant neoplasms according to site, age, sex and major ethnic groups. The five commonest malignant neoplasms in males were carcinomas of the nasopharynx, stomach, skin, lung and liver. In females the five commonest malignant neoplasms were carcinomas of the cervix uteri, breast, ovary, thyroid and skin. There was variation in these frequencies among the major ethnic groups. The most striking of these was the high frequency of nasopharyngeal carcinoma among Kadazan and Chinese males but not in males of the other indigenous groups. A significant number of patients with nasopharyngeal carcinoma was found in the younger age groups and most of the patients in the younger age groups were Kadazans. A relatively high frequency of carcinoma of the stomach, skin and liver was seen among Kadazans and other indigenous groups while carcinoma of the lung was seen relatively frequently among Chinese males. Among females carcinomas of the breast and cervix uteri were the most frequent malignant neoplasms in all the main ethnic groups. Possible reasons for these findings are discussed.
A total of 164 patients with IgA nephropathy were diagnosed at the Department of Medicine, Universiti Kebangsaan Malaysia and the Department of Nephrology, General Hospital, Kuala Lumpur between 1981-1988. This represented an incidence of 20.1% of all primary glomerulopathies seen in both units. The 3 major ethnic groups were equally affected with 59.7% occurring between the ages of 20-36 years. It was not uncommon in females. The high prevalence of hypertension, renal failure, heavy proteinuria at presentation and the increased chronicity index in the biopsy, suggest that IgA nephropathy is progressive disease leading to chronic renal failure.
The combined epithelial odontogenic tumour represents a hybrid lesion comprising primarily areas of adenomatoid odontogenic tumour intermixed with foci of calcifying epithelial odontogenic tumour. Five such cases retrieved from the files of the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, and four others from the existing literature were analysed. A mean age of 18.8 years, a female preponderance (66.7%) with a male to female ratio of 1:2 and predilection for the mandible (55.6%) were observed. All cases were treated by conservative surgery and the lack of recurrence confirmed the innocuous nature of this lesion.
In this paper, urolithiasis is remarked from the standpoint of descriptive epidemiology, which examines the frequency distribution of a given disease in a population in terms of time, place and personal characteristics with an aim of identifying risk factors or some clues to the etiology. Some descriptive epidemiological features of urolithiasis are summarized. Prevalence rate is around 4% (4-15% in males and 4-8% in females), and incidence rate varies from area to area: 53.2 per 100,000 population in 1975 in Japan, 364 in 1976 in Malaysia, and 540 in 1979 in West Germany. Prevalence and/or incidence rates have, in general, increased in the developed countries since World War II and in the developing countries as well, where upward trends are quite analogous to the trends observed in the nineteenth century in Europe. Recurrence rate, which is much higher in males than in females, ranges from 31% to 75%, depending on the follow-up periods. In the industrialized countries, upper urinary (renal and ureteral) stones account for more than 90% of total stones, which are ordinarily calcium complexes in composition. More common in the developing countries are lower urinary (bladder and urethral) stones, frequently composed of magnesium ammonium phosphate, which indicates a close association with urinary tract infections. Variations in frequency are evident by season and by region within a country. Age and sex differentials in urinary stone formers are substantial: more common in males 30-40 years old in the industrialized countries and in children under 10 years old in the developing countries. Racial differentials are also noted; blacks appear to suffer less frequently than whites. Stone formers experience more frequent episodes of stone formation in their family members, particularly father and brothers, than non-stone formers. These findings on racial differentials and family preponderance suggest the possible relevance of genetic factors in stone formation. Stone formers are more likely to be occupationally sedentary and socially affluent. This observation and differentials by age and sex suggest the probable relevance of lifestyle and environmental factors in stone formation. Epidemiological factors incriminated for stone formation will be discussed in a separate paper.
The clinical and electroencephalographic (EEG) features were evaluated in a consecutive series of 50 infants with complex partial seizures. The age of onset of seizures showed a peak at age of 2 months. Significant development delay was seen in 60% of the infants. In 92% an underlying aetiological factor could be identified. Birth asphyxia was the commonest aetiological factor (30%). The seizure patterns were most frequently described as behavioural arrest, upward deviation of eyes, tonic posturing of the limbs, apnoea and cyanosis. Interictal EEG showed bilateral temporal lobe foci in 22%, unilateral foci in 78% and multiple foci in 46% of the cases. The response of the seizures to anticonvulsant drugs is discussed.
Recent work with samples of black and white urban American women showed a clear behavioral sequence relating age at menarche to age at first intercourse to age at first birth. This paper shows that the linking of ages at menarche, intercourse, marriage, and first birth is a pattern which occurs in very diverse cultures. We present confirmatory data from the United States, Belgium, and Pakistan, and from Malay and Chinese women in Malaysia. We interpret our findings as indicating a biological process leading to (a) social interpretations of readiness for reproduction, and (b) persisting biological differences between early and late maturing women.
A survey of 308,101 primary school children in Peninsular Malaysia conducted in 1979 by the School Health Services, Ministry of Health, Malaysia, revealed that 10.7% of children were infested with Pediculus humanus capitis. The prevalence rate was higher in the economically less advanced states of Terenganu (34%), Kelantan (23%), and Perlis (21%) than in the other states (4-13%). Of 14,233 school children examined in the State of Melaka, 26% of Indians, 18.7% of Malays, 6.1% of Europeans, and 0.7% of Chinese had pediculosis. The prevalence rate, which has remained unchanged over the past 5 years, does not appear to vary with age but is higher in children with long hair and those from the lower socioeconomic groups. Boys have a lower infestation rate than do girls. The higher incidence in Indians and Malays correlates well with their lower socioeconomic status in the community, and their cultural habit of maintaining longer hair than do the Chinese. The difference become less apparent in the higher socioeconomic groups.
Forty patients with tubal ectopic pregnancies seen over an 18 month period are studied. Epidemiological parameters in the three major groups are compared. The diagnostic problems, signs and symptoms are discussed. Aetiological factors in this area are compared with changing trends in other centres. Pelvic inflammatory disease remains an important cause. The role of conservative approach in surgical treatment of ectopic pregnancy Z5 discussed. The crude incidence rate of ectopic pregnancy in Johore Baru Hospital between January 1978 and June 1979 is 1:358 deliveries.
A retrospective review of patients with congenital dislocation of the hip (CDH) seen in the Institute of Orthopaedics, Kuala Lumpur General Hospital from 1975 to 1988 is presented. There was a female predominance of 17 to five. The average follow-up was 43 months and the average age at final assessment was 63 months. The results were assessed clinically and radiographically using Severin criteria. Eighty eight percent of the hips had excellent or good clinical results at final review compared with 40% of the hips which had excellent or good radiological grading (Severin I and II). Initial acetabular angle before treatment and types of treatment appeared to have a correlation with the final result. The incidence of avascular necrosis was 16%.
Nonhuman primates can be used as models for the study of immune-complex-associated diseases. Recognizing that very little is known about the levels of circulating immune complexes (CICs) in normal monkeys, we have used three assays to measure the levels in serum collected from 313 adult and 106 juvenile cynomolgus macaques (Macaca fascicularis). The prevalence was higher than expected. There was a strong statistical association between CIC levels and country of origin. Monkeys from Indonesia were more likely to have elevated CICs than those from Malaya or the Philippines. This relationship was observed with all three assays. Furthermore, juvenile macaques tended to have lower levels than did adults. This study indicates that it may be important to consider genetic factors, the country of origin, or both when selecting cynomolgus macaques for research on immune-complex-associated diseases.
A questionnaire on smoking habits was administered to 4106 Form IV school children in Kuala Lumpur. The period of survey was from 9 to 20 April 1984. 2099 boys and 2007 girls were studied and their mean age was 16.1 years. 32.8% of the students had been initiated to smoking and the mean age of initiation was 13.3 years. The prevalence of smoking was found to be 9.8% and the mean duration of smoking was 2.5 years. Most of the smokers and occasional smokers were boys. About 42% of the smokers wished to stop smoking and only 1% of the non-smokers intended to smoke in the future. The study recommended that health education programmes should be started earlier in school.
Some information on cancer in Malaysia are available, and its epidemiology is described. There is a need for systematic and coordinated collection of cancer statistics which are essential to patient management, cancer control programme formulation, implementation and evaluation. The decision of the Ministry of Health to introduce National Cancer Registry and to encourage epidemiological studies, which will ultimately lead to the utilization of data and introduction of control and preventive activities for cancers are positive steps in the right direction. Meanwhile, curative and palliative treatment is available from the existing hospital facilities, and preventive activities such as actions on smoking and health will be continued until such time when a comprehensive prevention and control programme for cancers in the country is evolved.
About 10% of 3887 ever-married women included in the 1984-85 Malaysian Population and Family Survey revealed that they were influenced by the new population policy to desire more children than they had originally wanted. These women were more likely to be rural Malays from the lower socioeconomic class. Ideal family size was more than four children. Children are desired for economic benefits and emotional support. The natality of the Malays has risen since 1980: their total fertility rate has increased while their contraceptive prevalence rate has dropped sharply. Coupled with a decline in the crude death rate, the present fertility preferences and behaviour of the Malays will render the target of the population policy more attainable than is reflected by the survey data.
A total of 90 cases of pneumococcal infections were identified at a major referral hospital in Kuala Lumpur, Malaysia during a study period of four years. Pneumonia was the most common clinical presentation (41 cases) followed by meningitis (19 cases). Of 48 patients who were followed-up during the microbiology consultation round, 11 died, 9 were children below two years old. Capsular typing was carried out on 57 strains of Streptococcus pneumoniae isolated from blood and body fluids of 43 children and 14 adults. 38 strains isolated from pharyngeal specimens were also typed. Types 6A (11 strains), 6B (7 strains), 14 (8 strains) and 19A (8 strains) predominated in children. The strains from older patients comprised 3 isolates from cerebrospinal fluid (types 18B, 6B and 14), five from blood (4 strains, type 1 and 1 strain, type 4) and six from pus (1 strain, type 14, 3 strains type 23F and 2 strains type 34). The isolates from pharyngeal specimens belonged to capsular type similar to those implicated in infections. 90% of the types reported in this study are included in the 23 valent pneumococcal vaccines. Minimum inhibitory concentrations of penicillin, cefuroxime, chloramphenicol and rifampicin were determined for selected strains. 4.1% of isolates were resistant to penicillin (3/74), 4.5% to cefuroxime (2/44), 6.5% to chloramphenicol (3/46) and 14.6% to rifampicin (6/41).