A pilot study on 250 foreign workers was undertaken during a 7 month period beginning December 1996. The study subjects were mainly males (88.8%). They were selected using non-probability sampling from two sources, that is, from University of Malaya Medical Centre (72.8%) and the PEREMBA group (27.2%). The study was clinic-based. Face-to-face interviews (using a structured questionnaires) were carried out to obtain socio-demographic, environmental, health and morbidity data. Physical examinations were also performed on the same day of the interview. Subjects were also required to give their stools, venous blood and urine specimens for microbiological, parasitological and clinical laboratory investigations. Chest X-Ray was done on all subjects. The other investigators had already reported findings on the various specific areas of their study. In this part of the report attempt was made to relate the infectious diseases to some of the socio-demographic and environmental variables on the 112 Indonesians and 133 Bangladeshi workers. Some aspects of health seeking behaviour of these foreign workers were also presented. Most of the Indonesian workers (84%) were from East Java, Jambi in the Sumatra, while majority of the Bangladeshis were from two neighboring administrative districts of Dhaka and Chittagong. The majority of the Indonesians (50.0%) were working in the service industry, while 53.5% Bangladeshis were in the manufacturing. One-fifth of the workers lived in squatter areas and nearly half of them were working in the service industry. About 70% of the workers had at least one infection. The proportion was slightly higher among the Indonesians (72.3%) compared to the Bangladeshis (67.7%). It is of interest to point out that 40% had multiple infections. Thirteen had five or more infections (details for the two of the thirteen cases are presented as case studies). However, the findings did not indicate any association between sanitation and infections. The Indonesian workers carried a higher risk of transmitting the diseases (33.9%) compared to 19.5% among the Bangladeshi workers. Those working in the construction industry were at a higher risk of transmitting the diseases compared to other industries. Slightly more than half of the workers experienced some form of minor illness or injury during the two week period preceding the interview. Majority sought private care (43.1%), while 42.3% either self-medicate or doing nothing at all. Nearly two-thirds paid out of their own pocket. Among the employers, those in the construction sector made negligible contribution (2.9%) to the payment. It is interesting to find that 41.0% of the workers took some form of health supplements, and the majority (48.4%) got it from the pharmacy or traditional sources. Nearly all (88.5%) paid on their own for their health supplements. The findings from this pilot project need to be interpreted with some caution. However, it appears that the foreign workers do have a considerable amount of health problems. If these are not addressed quickly it may endanger the health of the nation, while we readily acknowledge their contribution towards our national development.
A survey was done to assess the chest radiographs of a selected group of immigrants. The objective is to ascertain the rpesence of abnormalities especially the presence of tuberculosis. Five hundred and eleven (511) chest radiographs (PA view) were evaluated. majority of the chest radiographs were normal, except for 2 cases of hilar lymphadenopathy, 4 cases of scoliosis and cervical rib, an old case of fracture of the clavicle and a case of cardiomegaly. Only 2 cases of TB were detected.
The aim of this study was to determine the prevalence and extent of diseases present among migrant workers. A total of 809 migrant workers were examined. The mean BMI (Body Mass Index) was 22.3 kg/m2. Only 4.9% of the respondents had blood pressure greater than 140/90 mmHg. Generally the migrant workers examined were healthy, except for subjects with abnormal eosinophilia coutns, which may indicate occult parasitic infestation. Non-communicable disease in particular hypertension and diabetes mellitus are not major problems among migrant workers. Perhaps the target to aim at are the illegal migrant workers where more illness could be detected.
Many studies have shown that failure in the control of hypertension with oral antihypertensives could be associated with noncompliance. The present study was conducted to assess the compliance rate to antihypertensive therapies and also to determine factors related to any noncompliance. The study was conducted in a teaching hospital in Kuala Lumpur. Data was collected from patients' medical records and via personal interview using a structured questionnaire. Out of a total of 175 respondents recruited in the study, 49.1% missed at least a dose of their antihypertensive agents during a one·month period. The most common reason given by respondents who were not compliant to their antihypertensive therapies was forgetfulness (91.8%), followed by too busy (20.0%) and insufficient medication supplied to them (18.8%). None of the factors analysed, including the demography of the respondents, their knowledge about hypertension and the types of antihypertensive therapies they were on, had any statistically significant influence on the compliance behaviour of the respondents to their antihypertensive therapies. However, more than 80% of the respondents kept their appointment to see their doctor and only this factor appeared to be related to the medication compliance behaviour although it still did not reach any statistical significance. KEYWORDS: Compliance, antihypertensive agent, blood pressure, knowledge
A comparative study was carried out to identify the prevalence of intestinal parasitic infestation among students in 3 different types of primary school localed in Ampang area, Kuala Lumpur. A survey of infection rate was done from April 10 June 2001. Stool samples were randomly collected from one·hundred and eleven schoolchildren aged 9-12 years were examined for intestinal parasites, using a light microscope (or direct smear and after concentration for formol-either method. It was found that an overall prevalence of intestinal parasite infection of schoolchildren was 51%. The infection rate of males and females was (60.3%) and (29.2%) respectively. Prevalence seems to be higher in the younger age groups. Also, the usual intestinal parasites were found more commonly in local and foreign schools than international schooL The local school had the highest prevalence (62%), followed by the foreign school (52%) and international school (38.9%). The prevalence in the international school was much lower compared to the local and foreign schools. KEYWORDS: Intestinal parasites, faecal samples, prevalence, schoolchildren
Four calves from each group of purebred Kedah kelantan (KK), halfbred KK X Friesian, and quarterbred KK X Friesian were experimentally infested with Boophilus micropills larvae. Two calves from each genotype were injected, intramuscularly with antihistamine while the remaining two animals in each genotype received the same dose of antihistamine and dexamethasone. Dexamethasone combined anti-histamine treatment suppress tick resistance as manifested by the production of higher number of engorged female ticks, higher mean weight of replete ticks, mean weight of eggs and mean number of larvae hatched from 1 g of eggs. In anti-histamine treated animals there was no reduction of resistant in all animals as manifested by a few ticks were able to feed successfully. At 1, 2, and 3 hours post-larval attachment in anti-histamine and dexamethasone treated cattle there was complete ablation of the cellular infiltration in the dermis beneath the tick mouthparts, especially eosinophil and basophils. There was little destruction of tissue. However, in anti-histamine treated cattle there were more cellular infiltration and degranulation in the dermis. The cells infiltrating the dermis were mainly eosinophils followed by neutrophs, mast cells and basophils and some of these cells showed sign of degranulation. At 24 hours postlarval attachment, animals lTeated with anti-histamine and dexamethasone showed reduction of, cellular infiltration, degranulation, size of the epidermal lesion and tissue damage. The neutrophils were the predominant cells within the epidermal lesions. However, animals in anti-histamine treatment showed edema, more cellular infiltration and degranulation, and destruction of tissues as compared to antihistamine and dexamethasone treated animals. In anti-histamine treated cattle the epidermal lesions were obviously larger and the percentage of eosinophils and basophils were higher than those of antihistamine and dexamethasone treated animals. KEYWORDS: Kedah-Kelantan cattle, KK X Friesian callie, B. micropflls, dexamethasone, antihistamine, cellular response.
Euthanasia is one of the most controversial topics of the 21st century after cloning and genetic engineering. Has this issue arisen now due to changes in attitude and perception on life of the modem society? This project was undertaken to study the opinions of 2 selected groups of people and secondly, to highlight the legal, ethical and religious controversies on euthanasia. Two groups comprising medical undergraduates and medical personnel were given a questionnaire pertaining 10 his/her opinion and altitude towards euthanasia. The second part of the project was conducted via interviews. The overall opinion from 399 respondents showed that 67.91% are against the practice of euthanasia. Religion is a powerful force against it as Malaysians in general are God-fearing people. There should be proper guidelines explaining how a doctor should respond to patients or family members of patients who request for euthanasia to be performed. It is not legal in Malaysia, but the court has the inherent power to permit it should a particular case have substantial reasoning and evidence. In conclusion, the level of awareness on euthanasia among medical staff and undergraduates is satisfactory. However, most of them do not approve euthanasia in Malaysia.
This paper examines the results of a section on recent illness of the health survey among 799 foreign workers from three selected study locations. The main objective was to study illness/injury patterns and the utilisation of available health care services. It also attempts to examine the use of health supplements as an indicator of self-care. Findings indicate that the illness/injury rate was 46.6%. The illness/injury rate increased with age and was highest in the 45-54 age group (65.0%) and among the Thai workers (69.6%). The main illnesses reported were injuries and accidents (19.6%), musculoskeletal problems (18.0%) and gastrointestinal complaints (16.7%), and it varied with gender, age and nationality. Almost 90 percent of the foreign workers sought treatment at modern health care facilities, with a third utilising government health care services. The employers contributed towards 60% of all the treatment costs. Nearly a third of the foreign workers took health supplements, and the rates were higher among the younger age group (40.0%) and among the Indonesian workers (52.0%). Majority had obtained the health supplements from the pharmacies or retail shops (43.4%) and private health care facilities (35.4%), and about 70 percent paid out of their own pocket. Some of the implications and limitations of these findings are discussed.
A case of an unusual foreign body aspiration in a child was managed T&ently. The mainstay in treahnen! is urgent extraction of the aspirated foreign body via a bronchoscope under general anaesthesia. A thoracotomy may sometimes be required when endoscopic retrieval fails, as illustrated by this case. She had an increased hospital Slay of 16 days, was ventilated for 8 days and her most serious complication was septic shock from which she recovered. KEYWORDS: Foreign body aspiration, children.
The serology result of parasitic infections of 260 foreign workers who were seen at the University of Malaya Medical Center, during 7 months period is reported here. The 260 foreign workers comprised 114 Indonesians, 142 Bangladeshis, 2 Myanmarese and 2 Pakistanis.
Malaysia, like many aspiring developing countries, is undergoing a health transition that has seen the concomitant decrease in communicable diseases and increase in chronic diseases due to urbanization, modernization and ageing population. Health in the Malaysian society will thus increasingly focus on emerging problems that are both chronic and infectious in nature, such as, heart disease, diabetes, cancer, mental health, hepatitis and HIV/AIDS. Re-emerging diseases previously well-controlled, such as, tuberculosis for instance is another addition to these immediate health issues facing Malaysian society today. Despite the tremendous health gains and above average health status that Malaysians now enjoy, we are compelled to take stock of these urgent issues as well as to anticipate and handle serious challenges to our health in the 21st century. In this paper, we review the changing trends and discuss related challenges in disease pattern, environmental health, demographic impacts on health, migration influxes and health, effects of globalization on health, mental health and wellness as well as fundamental access and equality in health care. Being proactive, resilient and innovative, Malaysian society would forge ahead towards our Vision for Health in this new era. KEYWORDS: Society and health, health trends and issues, Vision for Health, Malaysia
Malaysia has undergone rapid pace of industrialization and urbanization in recent decades and this has brought about imminent changes in the lifestyle of Malaysians. This is a cross-sectional study which attempts to examine the lifestyle practices and the prevalence of obesity of a group of security guards and their spouses of the University of Malaya, Kuala Lumpur. Data collection was conducted by both the methods of face-to-face interview and self-administered questionnaire. The respondents were surveyed on lifestyle practices such as smoking habits, exercise and eating pattern. Anthropometric measurement such as weight and height were also taken to establish the extend of obesity by using Body Mass Index (BMI). This study reveals that the community did have some unhealthy lifestyle practices such as smoking (27.7%; 95%CI 20.2%, 36.2%), low prevalence of adequate exercise (13.8%; 95%CI 8.4%, 21.0%); high prevalence of overweight and obesity (64%; 95%CI 55.1%, 72.3%); and high prevalence of co-morbidities such as diabetes mellitus and cardiovascular diseases. In conclusion, the community is considered to be a vulnerable and high-risk group for morbidity and mortality with the above predisposed risk factors. KEYWORDS: Lifestyle practices, overweight and obesity
To see the trend in managing singleton breech pregnancy after the term breech trial. Secondly to compare the safety of different modes of delivery for term, singleton breeches by looking at the immediate neonatal outcome, based on our own experience. Breech infants were identified by examining computer-stored maternal discharge records of hospitalization for the years 1990 and 2000 respectively. Parameters studied included planned mode of delivery, actual mode of delivery, parity, previous vaginal delivery, Apgar score at five minute, birth weight, referral to special care nursery and neonatal morbidity. Of 6,496 deliveries in 1990 and 5,081 in 2000, there were 220 (3.4%) and 148 (2.9%) term breech infants respectively, of which 115 (for 1990) and 102 (for 2000) case records were available. In 1990, 62.6% of the women had trial of vaginal breech delivery but only 24.5% of the women in 2000 were allowed to do so (p < 0.05). Caesarean section rate for singleton breeches increased from 51.3% in 1990 to 84.3% in 2000 (p < 0.05). Mean Apgar score at five minutes was significantly lower after vaginal breech delivery (9.40 ± 1.36) compared to after Caesarean section (9.72 ± 0.712) but there was no clinical significance. There was a noticeable trend towards Caesarean section and less trial of vaginal delivery. Neonatal outcomes of babies born abdominally were statistically better than those born vaginally but there was little clinical impact. Perhaps in properly selected cases, a planned vaginal breech delivery still has a role to play.
Six groups of adult male Sprague Dawley rats, each consisting of six animals were used throughout the experiment. The gastroprotective effects of aqueous plant extract alone, honey alone or honey in combination with ethanolic or aqueous extracts of A. conyzoides and cimetidine were investigated in rats against ethanol-HCl induced gastric ulcer. Efficacy was assessed by determination of ulcer index and inhibition percentage. Oral administration of ethanol-HCl (5 ml kg-1 body weight) to fasted rats produced extensive lesions of gastric mucosa (Group 1). Pre-treatment with honey (2.5 g kg-1 body weight) alone (Group 2), aqueous plant extract alone (10% w/v 5 ml kg-1) (Group 3), or honey in combination with each of alcoholic extract (10% w/w 5 ml kg-1) (Group 4), aqueous extract (10% w/w 5 ml kg-1) (Group 5) or cimetidine (10 mg/ml honey 5 ml kg-1) (Group 6) orally 30 minutes before administration of absolute ethanol-HCl significantly (p < 0.05) protected gastric lesions by 46.74%, 61.50%, 76.68%, 78.39% and 56.55% respectively. Although the mechanism of gastric protection is unknown, honey in combination with each plant extract appears to increase the resistance of gastric mucosal cells to the necrotizing effect of strong irritants in the absolute ethanol-HCl mixture. The results suggest that honey in combination with each plant extract might be beneficial in the treatment of a variety of diseases in which gastric mucosal injury is present.