A study of food ideology and eating behavior in a Malay village demonstrates that the relationship between belief and action is complex and not always predictable. Over-reliance upon stated beliefs, and generalizations derived from particular ecological settings, have influenced investigators into making universal and logical statements about Malay eating behavior and its health consequences--a logic which, however, does not always jibe with reality. Food ideology, like any other portion of a belief system, is subject to innovation, interpretation and rationalization, and contains within it 'rules to break rules' which assure the continued integrity of the symbolic system by patterning what might otherwise be seen as rifts in its fabric. An understanding of eating behavior must be based both on a knowledge of the subsidiary, as well as primary, clauses of food ideology, and on direct observation of the behaviors elicited by these beliefs and modified by the setting, the situation and the individual.
The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.
Torsion of ovarian tumors occurred predominantly in the reproductive age group. The majority of the cases presented in pregnant (22.7%) than in non-pregnant (6.1%) women. The major presenting symptom was pain but an abdominal mass was palpable in 79.4% of cases. Torsion was more common on the right ovary and 50% were gangrenous at laparotomy. Most of the tumors were benign cystic teratomas. Only 8.7% of the tumors were malignant.
A case of perforation of the uterus by the Multiload CU250 Device is described. To date no perforation of the uterus by this device has been reported. The device was successfully removed under laparoscopic control.
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.
In experiments conducted over a four-year period the effect of pasture type (Setaria sphacelata and a Brachiaria decumbens/Leucaena leucocephala mixture), management system (rotational grazing and cut and carry) and level of concentrate supplement (0, 4 and 6 kg fresh weight/cow per day) on milk production in smallholder dairy units was examined. All units were 1 ha in size and stocked with five Sahiwal X Friesian cows. Milk yields/ha were higher from rotational grazing and the brachiaria/leucaena pasture when compared with the cut and carry system and the setaria pasture respectively. In subsequent experiments smallholder units were based on brachiaria/leucaena and rotational grazing. A supplement of 4 kg fresh weight of concentrate (11 MJ/kg DM and 150 g/kg DM CP) increased milk yield/ha from 7,760 to 13,045 kg while in a third trial milk yield/ha was further increased from 14,148 to 16,760 kg when concentrate level was raised from 4 to 6 kg fresh weight/day. The results indicate that smallholder dairy units in Malaysia could be economically viable and competitive with other agricultural enterprises such as rubber and oil palm.
Over a 17-year period, 15 patients with acute puerperal inversion of the uterus were managed at the University Hospital, Kuala Lumpur, an incidence of 1 in 4,836 deliveries. Injudicious traction on the umbilical cord before the uterus was well contracted, was probably the most important causative factor. Haemorrhage was more severe when removal of the placenta was done prior to correction of the inversion. Either the hydrostatic method or manual replacement were used but more often a combination of both techniques was found necessary. With careful management of the third stage of labour, this complication can be avoided.
The birthweights of 13,614 singleton infants comprising 5376 Malays, 5352 Chinese and 2886 Indians born at the Maternity Hospital Kuala Lumpur, during 1973, 1975 and 1977 have been extracted and analysed. Male Chinese infants (3.16 ± 0.37 kg) were significantly heavier than Malay and Indian infants while the male Malay infants (3.12 ± 0.41 kg) were significantly heavier than the Indian (2.97 ± 0.41 kg). Both female Chinese (3.04 ± 0.38 kg) and Malay infants (3.05 ± 0.38 kg) were heavier than the female Indian (2.89 ± 0.39 kg) but there was no difference in birthweight between Chinese and Malay female infants. The mean gestational period and the proportion of full-term births were similar for all 3 races with averages of 39.9 weeks and 77.8 percent respectively. Maternal age at first birth was also closely similar for the three communities with an average of 22.9 years. Significant correlations were found between birthweight and length of neonates, birthweight and gravida, birthweight and maternal age. Indians have a higher incidence of low birthweight or small-for-gestational age infants (14.5 percent) compared to the Chinese (5.6 percent) and the Malays (7.6 percent); the incidence of low birthweights being higher in girls than in boys. Present-day Malay and Indian full-term male and female infants are significantly heavier than their counterparts born at the same Hospital two decades ago, but no difference in birthweight was observed for Chinese infants during this time interval. The gap between the incidence of low birthweight found in Malaysia and those in the developed countries seems to be narrowing and this may be taken to reflect the overall effects of socioeconomic development, including the greater availability of general health and ante-natal care throughout the country since its Independence in 1957.
Eight-hundred patients recruited between September 1981 and December 1984 were admitted to a randomized prospective trial of the Nova T (NTCu200Ag) and Multiload 250 (MLCu250) IUDs. At the cut off date, 31 December 1986, 206 patients had completed the 4-year trial period, 379 had terminated before completion and 215 were in the fourth year of use. For the third and fourth years, the MLCu250 had a significantly lower accidental pregnancy rate (p less than 0.05).
The estimation of fecundability from survey data is plagued by methodological problems such as misreporting of dates of birth and marriage and the occurrence of premarital exposure to the risk of conception. Nevertheless, estimates of fecundability from World Fertility Survey data for women married in recent years appear to be plausible for most of the surveys analyzed here and are quite consistent with estimates reported in earlier studies. The estimates presented in this article are all derived from the first interval, the interval between marriage or consensual union and the first live birth conception.
PIP: The estimation of fecundability from survey data is plagued by methodological problems such as misreporting of dates of birth and marriage and the occurrence of premarital exposure to the risk of conception. The availability of data collected with a standard interview schedule from over 40 countries in the World Fertility Survey (WFS) is an invaluable resource for assessing the potential utility of measures of fecundability derived from single-round surveys as well as for comparing estimates across countries and regions of the world. In this article, data are used from 5 WFSs in Latin America (Colombia, Costa Rica, Panama, Mexico and Paraguay) and 3 in Asia (Korea, Malaysia and Sri Lanka) to determine the general usefulness of single-round survey data for the estimation of fecundability from survey data, given the limited information on contraceptive use available from many surveys and the data quality problems associated with reports of dates of marriage and dates of birth. Explored in the process are several different procedures for estimation and variations in estimates of fecundability by country, time period, and women's age. For most of this analysis, the median waiting time to conception in the absence of contraception is used as a measure of fecundability. All of the estimates presented are derived from the 1st birth interval. The estimates are based on data collected in both the birth and the marriage histories in the WFS individual interviews. The 8 surveys chosen for this analysis are characterized by relatively complete reporting of dates of birth and marriage. The primary conclusion of this exercise is that reasonable estimates of fecundability can be derived from WFS data only if one is careful to avoid numerous methodological pitfalls. The most plausible estimates appear to be for women married in the period from about 2 to 10 years before the survey. The average waiting times to 1st conception range from about 4 to 7 months; the corresponding monthly probabilities of conception lie between 0.17 and 0.26. The effect of age at marriage on fecundability is most apparent for ages below 16; differences between women married at ages 16-17 and at ages 18 and above are more modest. Suggestions for improvement of the estimation of fecundability by including a number of questions in survey questionnaires are presented.
Studies made on aqueous root extract of Selayak Hitam, a plant alleged to possess abortifacient activity in pregnant mothers established that the extract is teratogenic and did in fact cause abortion in mice. It was also observed that the aqueous root extract is relatively toxic as judged by the number of deaths occuring following administration of the extract. The mechanism by which abortion is brought about is unknown but it is possible that the abortifacient effect is due to the induced teratogenic activity, brought about by the extract.
The propensity of choriocarcinoma to metastasize to lungs, liver and brain is well known. Though theoretically metastases are possible to anywhere in the body, renal metastases are rare. A 56 year old Malay woman who had total abdominal hysterectomy in 1985 for molar pregnancy presented with haemoptysis and dyspnea in 1990. Examination showed she had choriocarcinoma with pulmonary and renal metastases.
The relevant investigations and management of a case of alpha-thalassaemia major suspected antenatally is discussed. The value of ultrasonically guided cordocentesis in the definite diagnosis of this condition is emphasised in the management of this pregnancy. We believe that this is the first time such a procedure has been done in this country.