Cervico-vaginal smears from 350 IUCD users were analysed to ascertain the range of abnormalities induced in the genital tract of these women. Alteration of the microbial environment, inflammatory, degenerative, reparative and proplastic epithelial changes were the salient cytological findings. The clinical implications of these are briefly discussed.
Matched MeSH terms: Uterine Cervical Diseases/prevention & control
A questionnaire survey to study the smoking habits and attitudes toward smoking among secondary school teachers in Kelantan, Malaysia was conducted between July and September 1992. Questionnaires were sent to 5,112 teachers through their respective headmasters. Sixty-three percent (3,208 teachers; 61% males, 39% females) responded satisfactorily. Overall, 625 teachers (20%) were current smokers, 141 (4%) were occasional smokers, 317 (10%) were ex-smokers and 2,123 (67%) had never smoked. Only six (0.8%) of the 766 regular and occasional smokers were females. The rates of smoking among parents and siblings of smokers were higher than parents and siblings of non-smokers. Seventy-four percent of the smoking teachers admitted to smoking in the school premises. The teachers' attitudes about the health effects of smoking were statistically different between smokers and non-smokers. However, both smoking and non-smoking teachers had similar views regarding methods to control the smoking habit which included banning cigarette sales, putting a halt to the tobacco industry and banning cigarette advertisements.
A prospective study of blocking T10-L1 with local anaesthetic, bilaterally in 30 patients undergoing caesarean section under general anaesthesia has been shown to provide effective postoperative analgesia thus requiring significantly less narcotics (mean 66.6 mg of pethidine) compared to the 30 patients in the control group (mean 163 mg of pethidine). A cocktail of 0.5% of bupivacaine with adrenaline and xylocaine 1% produced analgesia for the duration ranging from 8 to 12 hours (mean 8.4 hours). Patients with abdominal field block were awake, alert and comfortable during the immediate postoperative period. They were pain-free sufficiently to put the babies to the breast early and frequently.
A study was conducted in the Dermatology cum Genitourinary Clinic, Hospital Sultanah Aminah Johor Bahru to determine a local population's knowledge of HIV and their sexual behaviour in relation to it. A total of 231 men and 217 women were interviewed. The sexual culture seen is one of relatively late age of first sexual intercourse, low level of partner change and low level of condom use. Men reported a higher involvement in risk behaviour. Nearly all the respondents (95.8%) have heard of HIV/AIDS but had incorrect perceptions of its mode of transmission and its associations with risk groups. This study enable us to gain background information about our patients sexual behaviour and HIV knowledge. There is a need to continue HIV education to improve our public's HIV knowledge and the results of this study provides a baseline against which future educational interventions can be gauged.
Matched MeSH terms: HIV Infections/prevention & control*
We have studied the antiemetic efficacy of droperidol alone, and in combination with metoclopramide in first trimester termination of pregnancy in day surgery. The aim was to determine whether the addition of metoclopramide could further reduce the incidence of postoperative nausea and vomiting (PONV) but avoid excessive sedation. Group I (control, n = 40) received i.v. droperidol 0.625 mg at induction. Group II (study, n = 40) received i.v. droperidol 0.625 mg and i.v. metoclopramide 10 mg at induction. The incidence of nausea at 1 and 2 hours postoperatively was 23% and 10% in group I, and 5% and nil in group II respectively. The difference in the incidence of nausea was significant at p < 0.05 at one hour but not at two hours postoperatively. No patients vomited. There was no difference in the sedation and pain score between them. We did not observe any significant side effects attributable to either drug. All patients were discharged home within 3 hours. We conclude that in the prevention of PONV, the combination of metoclopramide and droperidol is superior to the use of droperidol alone at one hour but not at two hours postoperatively.
Matched MeSH terms: Postoperative Nausea and Vomiting/prevention & control*
Circumstances surrounding accidental ingestion of poisons were investigated in families of 70 hospitalised children. Indian children were more likely to be hospitalised for poisoning. Poor safety measures directly contributed to poisoning incidents. Poisons had not been stored safely and only in 12.9 per cent of families were the poisons allegedly kept in cupboards. Kerosene had been ingested from soft drink containers in 70 per cent of instances. Medications had been taken mainly from plastic envelopes (57.9%) or bottles (31.6%). Safety practices in the homes of cases and 140 controls were compared. As a whole parents of victims had poor safety practices when compared with parents of controls. Poisoning incidents were discovered by mothers in 75.0 per cent of the cases. Vomiting was induced by parents in 32.3 per cent of cases involving medications and non-volatile items, and in 41.6 per cent of kerosene ingestions. Before hospitalisation 59.4 per cent were brought to general practitioners and 22.7 per cent to government clinics. Mothers were the main attendants when children were brought for medical care. This study highlights the need for measures to prevent childhood poisoning and reduce its morbidity. Household products and medications should be made safer to children through improved packaging, prescribing instructions and education. Safety and first aid education may be directed towards parents, particularly mothers, through the media and health facilities.
Matched MeSH terms: Poisoning/prevention & control
In Malaysia, alpha-thalassaemia, beta-thalassaemia, haemoglobin (Hb) E, deltabeta-thalassaemia and Hb Constant Spring are prevalent. It has been estimated that 1 in 4 persons carries one of the above genetic abnormalities. In clinical practice, the major problems are: Hb Bart's hydrops fetalis (homozygous alpha(o)thalassaemia), homozygous 3(o)-thalassaemia, E-alpha thalassaemia and HbH disease. The laboratory procedures for diagnosis are standardised and the molecular basis of most of these genetic abnormalities are characterised. Thus it is possible to formulate a strategy for the detection and prevention of these disorders. The steps include the setting-up of population screening and genetic counselling service for the affected individuals, Society of Thalassaemias for public education and group support, and prenatal diagnosis with selective abortion of affected pregnancies. We embarked on such a programme between 1988 and 1992 in Kuala Lumpur General Hospital and hope to kindle similar effort in other state hospitals.
Two of the three buffaloes immunized with a non-adjuvanted broth bacterin were found to be protected against experimental challenge at 6 weeks but not at 3 months post-challenge. Similarly all buffaloes (4/4) immunized with alum-precipitated vaccine were protected at 6 months but only 1 of the 2 vaccinated animals were protected at 12 months post-immunization. On the other hand, buffaloes immunized with an oil adjuvant and a double emulsion vaccine were completely protected at 12 months post-immunization. Statistically significant differences between immunized versus non-immune animals became evident at 3 months post-immunization, although analysis of cumulative antibody titres of pre-challenge sera of vaccinated buffaloes surviving versus those succumbing to experimental challenge revealed significant by higher antibody titres in the former as compared to the latter group. These results suggested that there was a relationship between ELISA antibody titres and active protection in buffaloes. There also appeared to be a relationship between cutaneous delayed-type hypersensitivity and active protection in buffaloes. Preliminary analysis of the antibody isotype distribution in the pre-challenge sera of 2 buffaloes vaccinated with the oil adjuvant vaccine revealed predominance of IgG1 and IgG2 subclasses whose role in protection against haemorrhagic septicaemia was not eludicated.
Matched MeSH terms: Hemorrhagic Septicemia/prevention & control
This study investigates the practices and knowledge of a Control Authority dealing with the environment and the safety and control of hawker foods. Experience and background education are used as likely determinants of food safety practices and knowledge of the control authority. A total of 60 questionnaires were distributed to the Health Inspectors (HIs) in the Hawkers' and Health Departments, City Hall, Kuala Lumpur. The return rate was 93%. The structured questionnaire contained 14 main food safety practices and knowledge constructs. Significance was found pertaining to knowledge of HIs with different experience backgrounds but experience was not demonstrated to impact on practices of HIs. However, education was noted to have significantly but inconsistently influenced certain Practices and Knowledge scores of HIs. A Pearson bivariate coefficient characterised an association between food safety practices and knowledge of the control authority. The findings: (1) highlight the actual shortcomings in the staff resources relating to environmental health, food safety, foodborne illnesses and their control, and (2) provide information on the control aspect within the hawker micro-industry with the view of protecting the public from health hazards arising from the hawkers' practices and consumption of hawker foods.
Two laboratory trials were conducted to determine the effect of the addition of spores (conidia) of the nematophagous fungus, Arthrobotrys oligospora, on the development of the ruminant parasite, Strongyloides papillosus, in cultures of bovine faeces. Both studies showed that at a concentration of 2000 conidia/g faeces virtually eliminated infective larvae (> 99% reduction), following 14 days incubation under ideal conditions (25 degrees C and saturated humidity) for free-living development of this parasite species. In one trial, a high level of control was also observed at a 10-fold decrease in conidia concentration (200 spores/g faeces). This work has demonstrated, in principle, that A. oligospora could provide a practical biological control agent against S. papillosus infecting intensively raised young ruminants in the humid tropics/subtropics.
Matched MeSH terms: Strongyloidiasis/prevention & control
The maxillary tuberosity can fracture during extraction of a molar tooth. If a small bony fragment is affected, the extraction of the tooth and tuberosity continues; however, a conservative approach is advised if the bony fragment is large. In a modified blind surgical technique, the tooth is removed without the fractured bone.
Matched MeSH terms: Maxillary Fractures/prevention & control
The effect of heat-treatment on the internal temperature of raw cockles (Anadara granosa) and survival of their intrinsic flora of Vibrio spp. as well as of inoculated V. cholerae 0139 was examined. The cockles were purchased from markets in Malaysia and had an average weight including shells of 8.90+/-2.45 g. In one experiment heatpenetration of individual cockles was examined. Cockles weighing < 8 g (including shell) exhibited maximum internal temperatures of between 50 and 75 degrees C when heated in water at 99 degrees C for 10 s and 71-93 degrees C when heated for 30 s. Cockles weighing > 12 g exhibited maximum internal temperatures between 42 and 58 degrees C when heated in water at 99 degrees C for 10 s and 56-69 degrees C when heated for 30 s. In another experiment, heat-treatment of 10 cockles treated as a group at 99 degrees C for 10 or 30 s resulted in reduction of levels of intrinsic Vibrio spp. (enumerated directly on thiosulphate-citrate-bile salt sucrose agar; TCBS) from 5.73 to 3.15 log cfu g(-1) or below 1 log cfu g(-1), respectively. The levels of Vibrio spp. after heat-treatment decreased with an increase in numbers of cockles grouped together during treatment. In a third experiment V. cholerae 0139 was inoculated into cockles and subjected to heat-treatment at 99 degrees C for 0, 10, 15, 20, 25 or 30 s. The levels of Vibrio spp. in uninoculated, non-heat-treated cockles was 4.89 log cfu g(-1) on TCBS, and the predominant species were V. parahaemolyticus and V. alginolyticus. V. cholerae 0139 inoculated into cockles with an average weight of 13.5+/-1.90 g (including shell) decreased for samples examined immediately after heat-treatment from 6 log cfu g(-1) initially to 3.5 log cfu g(-1) after 25 s and < 1 log cfu g(-1) (TCBS) after 30 s of heat-treatment. The most probable number method by enrichment in alkaline peptone water gave in general within 1 log unit higher counts than TCBS direct enumeration. TCBS direct enumeration and MPN counts were up to 2.38 or 1.30 log units higher, respectively, for samples heat-treated for 20 s or longer and stored for 6 h at 30 degrees C before examination, than for samples heat-treated for same periods of time and examined immediately. This study shows that a mild heat-treatment of cockles for up to 25 s is inadequate to ensure a large reduction in numbers of Vibrio spp., including V. cholerae 0139.
Cyfluthrin (Solfac ULO15) and malathion 96 TG were evaluated against sentinel sugar-fed adults and 4th-instar larvae of Aedes aegypti at high-rise flats in Malaysia by ULV spraying. The impact of both insecticides on field populations of Aedes spp. (Ae. aegypti and Ae. albopictus) larvae were monitored weekly using containers. Both cyfluthrin and malathion 96 TG showed adulticidal effects but cyfluthrin showed more significant larvicidal effect than malathion 96 TG (P < 0.05).
Two new repellent formulations, KBR 3023 10% and 20% from Bayer AG, Germany, were evaluated together with DEET 10% and 20% as standard repellent formulations. Evaluation was based on two separate field studies: a daytime study (0900-1700 hr) in a forested orchard on Penang Island and a nighttime study (2100-0100 hr) in a squatter residential area on the adjacent mainland of peninsular Malaysia. Both studies were carried out by exposing humans with bare arms and legs to mosquitoes landing/biting for an eight hour period. Right arms and legs of the human baits were treated with different repellent formulations (KBR 3023 10%, 20% and DEET 10%, 20%) and the left limbs were left untreated to act as controls. The daytime study indicated that all four formulations were equally effective (P < 0.05) as repellents against the predominant Aedes albopictus with greater than 88.5% reduction in landing/biting in the first four hours and not less than 65.0% in the next four hours of the assessment period. In the night study, all four formulations were also found to be equally effective (P < 0.05) in repelling Culex quinquefasciatus, the predominant species. All four formulations provided complete protection against Cx. quinquefasciatus in the first two hours of exposure. The percentage reduction values were maintained above 90.0% for the next six hours of the assessment period. In conclusion, both the KBR 3023 and DEET formulations were found to be equally effective (P < 0.05) in providing a long-lasting reduction in human-mosquito contact in both the day and night field studies.
Matched MeSH terms: Insect Bites and Stings/prevention & control*