Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls. Thirty-four of these children were Malays, 16 Chinese, 26 Indians, three mixed and seven illegal immigrants. Twenty-one were below the age of one year, 24 from one to four years, 25 from five to nine years and 16 were ten years and above. The abusers were mainly close members of the family. Of these children, 24 were sent back to their parents and 11 to their relatives home. Twenty-seven were taken into care by the Ministry of Social Welfare and the remaining seven children who were illegal immigrants, were deported with their parents. Only one child was successfully fostered. Eleven children were taken away from the hospital by their parents or guardians without the knowledge of the health staff. There were five deaths in the series.
Two hundred and twelve of undescended testes were operated on in the Department of Surgery, Singapore General Hospital between the years 1974 through 1980. There was a 51.9% incidence of right undescended testis, 34.9% left undescended testis and 13.2% were bilateral. The method of treatment was surgical exploration with orchidopexy wherever technically feasible or orchidectomy if the testis was found to be severely hypoplastic. Of the total series, 42% were operated on before the age of 5 years. The oldest patient undergoing orchidopery was aged 40. Failure of orchidopexy to secure the scrotal position for the testis was noted in 14 cases. This was probably due to inadequate mobilisation at the first operation. There was no mortality and no significant morbidity following surgical treatment in this series.
Susuks or charm needles are a form of talisman inserted and worn subcutaneously, in the face and other parts of the body, in the belief that they will enhance or preserve the wearer's beauty, youth, charisma, strength or health, or bring success in business. This mystic practice is found among some south-east Asian people, especially Malayan and Muslim females. Most susuk wearers are secretive about their hidden talismans, but these gold or silver needles are being discovered with increasing frequency now that radiographs are used more widely. An understanding of this practice and an awareness of its existence is important to avoid misdiagnosis and mismanagement of these patients. The practice of susuk wearing and its relevance to dentistry is discussed. Nine cases of facial susuk wearers are presented and previous reports are reviewed.
The evidence for a hypothesis that eating salted fish is associated with nasopharyngeal carcinoma (NPC) is reviewed. The hypothesis was tested among Malaysian Chinese using a matched case-control design. The kinds of salted fish and patterns of use were also investigated in a control group comprising 100 Chinese, 50 Malay and 50 Indian households. During 1980, in Selangor, Malaysia, interviews with 100 Chinese cases of NPC and 100 non-disease controls indicated that salted fish consumption during childhood was a significant risk (relative risk = 3.0, P = 0.04), with an elevated risk for daily as opposed to less frequent consumption. Salted fish consumption during adolescence was a less significant risk, and current consumption not at all. There were 19 kinds of fishes reported as being eaten as salted fish by the 200 control households. There were marked differences between ethnic groups in preference for different kinds: Chinese preferred red snapper (74% of households), Malay jewfish (54%) and Indian red snapper (28%). Salted fish was hardly ever eaten daily by any household; weekly was a moderate frequency in all ethnic groups; less than weekly most common. There were no statistically significant differences between Chinese NPC case and non-disease control participants in kind of salted fish eaten. Results were the same when the data were analyzed by sex, subethnic group and income.
Thirty-four patients with intracranial arteriovenous malformations seen in the University Hospital, Kuala Lumpur, over a is-year period were reviewed. A VM was found to be more common in young, male patients with preponderance Chinese origin. The advent of the Cl-scan has increased the detection of small A VMs and intracerebral haematomas proportionally. The majority of the lesions were situated in the posterior half of the brain unlike the distributions in patients in the West and in Singapore. On the other hand, most of the intracranial bleeding were subarachnoid haemorrhage; a presentation similar to the western community, but unlike that reported from Singapore. The treatment policy is not unlike the western community with good results in 82% of patients selected for surgery.
The problem of dental decay was studied in a sample of 495 Chinese preschool children in Petaling Jaya. The children; 253 males and 242 females ranged in age from 3-6 years. 18.6% of the children was observed to suffer from rampant caries. Only 18.8% were caries free. The dft values ranged from 2.9 +/- 3.12 at 3 years to 5.85 +/- 3.41 at 6 years. The overall mean dft for this group was 4.99 +/- 3.81. Dental treatment was very inadequate. The decayed filled tooth ratio was 6.5:1.
The present study analysed the development of caries in 653 first permanent molars annually over a period of 5 years in children who were 7 years-old at baseline. The cumulative caries experience increased from 6.0% at baseline to 35.2% at the end of the study period. There were no appreciable differences in the annual incremental rate of caries experience among males and females. At baseline, the Malays and Indians have the highest and lowest caries experience respectively. At 12 years of age, the Chinese have the highest caries experience whilst the data for the Malays and Indians were comparable. The highest cumulative percentage increase in caries experience for the Malays, Chinese and Indians were between the ages of 7 to 8, 9 to 10 and 8 to 9 respectively while the average annual caries increment were 4.5%, 7.3% and 5.0% respectively.
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).
A review of our experience of 916 cases ofpartial bilateral vasectomy performed under local anaesthesia at the University Hospital, Kuala Lumpur during the
period between January 1971 and June 1980 is presented. Minor post-operative complications occurred in 5.8% of cases with a low post-operative infection rate of 1.2%. In 35% ofpatients, persistence of non-motile sperms in the semen were seen after at least ten ejaculations in each instance. In four of these cases non-motile sperms continued to persist into the sixth month of follow-up even after at least 50 ejaculations in each instance.
The Singapore Cancer Registry started operations on January 1, 1968. It is a population-based registry that seeks to obtain basic epidemiological and clinical data on all cases of cancer diagnosed in Singapore. The results presented pertain only to Singapore citizens and permanent residents and cover the period from 1973 to 1977. Of special interest are the cancer patterns of the main ethnic groups in Singapore. Generally, the Chinese (76% of total population) have significantly higher risks for cancer; the most prevalent sites are the nasopharynx, esophagus, stomach, liver, and lung. Within the Chinese group are also dialect group differences. The Malays (15% of population) have the lowest rates for most sites, whereas among the Indians (7% of population), mouth cancer is an important site for both sexes. All these variations provide useful clues in the search for etiological factors.
The history of efforts to establish a cancer registry in Malaysia since 1961 is reviewed. In 1980, the staff of the Institute for Medical Research in Kuala Lumpur was authorized to develop an official registry that would combine the resources of the various university faculties, the hospitals, research institutes, and the Cancer Society. Special registries operate for oral precancerous conditions and for nasopharyngeal carcinoma (NPC). The topics of recent epidemiological studies include: a review of all cancers diagnosed at the University Hospital during 1972-74, the association of Epstein-Barr virus and NPC, social and environmental factors associated with NPC, oral cancers, and childhood cancers.
A case report of right below-knee amputation successfully performed under acupuncture anaesthesia, supplemented with parenteral valium and. pethidine, is described.