This study measured the body mass index (BMI), and assessed attitudes and knowledge about obesity, of 197 male and 217 female patients aged 20-59 years attending the primary care clinic of the university hospital in Kelantan, Malaysia. There was no significant difference between the mean BMI of males (23.7) and females (24.2). In the overweight group (BMI 25-29.9) were 60 men (30%) and 66 women (30%). In the obese group (BMI 30 and above) were 12 men (6%) and 22 women (10%). Both diabetes mellitus and hypertension were associated with significantly higher BMI's. Knowledge about obesity was lacking. Sixty-three (15%) failed to recognize that obesity is bad for health. When asked the causes of obesity, 88 (21%) failed to mention either diet or lack of exercise. "Being happy" was suggested as a cause by 32 (8%). When asked if certain foods would cause obesity if eaten in excess, 45 (11%) said "No" for fatty foods, and 164 (40%) said "No" for sweet foods. Concerning appearance, 30 (15%) men regarded an obese man as normal or even handsome, while 49 (23%) women regarded an obese woman as normal or beautiful. Obesity is common among our adult patients, and is associated with some of their common health problems. However, a substantial minority do not regard obesity as unhealthy, do not relate it to diet or lack of exercise, do not recognize important groups of fattening foods, and do not regard obesity as unattractive.
Trials using albendazole and mebendazole, as single 400 mg dose treatments, against soil-transmitted helminths, were carried out in 7-9 and 10-12 years-old schoolchildren living in urban and rural environments in Penang, Malaysia. Both drugs were equally effective in treating trichuriasis and ascariasis in both age groups and environments. However, mebendazole is not so effective in the treatment for hookworms when compared to albendazole. It is suggested that albendazole should be considered the drug of choice for mass chemotherapy for Penang.
There is an increasing prevalence of diabetes mellitus around the world associated with rapid sociocultural development and changing lifestyles. Increased prevalence of obesity, with a higher consumption of animal products and lower consumption of fruits and vegetables, increases the risk of diabetes mellitus and other chronic degenerative diseases. Insulin-dependent diabetes (IDD) is caused by insulin deficiency, whereas the main feature of non-insulin-dependent diabetes (NIDD) which accounts for more than 90% of diabetics, is hyperinsulinemia and insulin resistance, which may eventually lead to actual insulin deficiency. Hyperinsulinemia is undesirable because it increases the risk of developing vascular disease. In Malaysia, the prevalence of NIDD in some communities now exceeds 5%, and of impaired glucose tolerance 10%. Along with these increases in prevalence of hyperglycemia are increases in prevalence of overweight (BMI>25) and almost certainly abdominal fatness. In terms of management, nutrition is given priority. Insulin and hypoglycemic drugs (sulphonylureas or biguanides), where required, may adversely affect body composition if overused. Newer therapeutic strategies require greater attention to the underlying problem in NIDD of abdominal fatness by attention to the relevant nutritional factors, physical activity and other lifestyle factors like cigarette smoking and alcohol. The greater impact of obesity and diabetes on Malaysian women as opposed to men also needs to be addressed.
A cross-sectional exploratory survey was conducted in six West Malaysian schools involving 762 fifteen- to eighteen-year-old secondary school students. Periodontal health status was assessed using the Community Periodontal Index of Treatment Needs (CPITN), utilizing six index teeth to represent the six sextants of the mouth. The results indicated that 66.8% of the students examined had healthy gingiva (Score 0), 2.6% had bleeding of the gingiva on gentle probing, while 30.6% had calculus on their teeth. In terms of treatment needs, 35.0% of those examined needed oral hygiene education, 34.4%, on the other hand, required scaling. No student was found to require complex treatment. Sex-specific comparison revealed a slightly higher prevalence of calculus formation in male students. In terms of race, the Malays had a higher prevalence of calculus formation than either Chinese or Indians.
The prevalence of ocular abnormalities was studied in 165 children from a Malaysian school for the deaf. Ninety-five children (57.6%) had one or more ocular abnormalities. Rubella retinopathy was the commonest form of ocular abnormality (35.2%). Refractive errors were found in 23 children (13.9%). Refractive errors in the rubella group were significantly more common than in the non-rubella group of deaf children (p < 0.001) (chi 2 test). Thirteen children had congenital anomalies causing significantly impaired vision. Ophthalmological examination of deaf children helps in the detection of cases with rubella eye signs and thus helps to identify the cause of deafness. Since deaf children are at greater risk of visual and ocular abnormalities, periodical ophthalmological examination should be carried out in these children.
This study was a cross-sectional random survey of the whole of Singapore, based on 2143 subjects (aged 18-69 years, response rate 60.3%). The presence of corneal arcus was determined by a doctor using the naked eye in good light. Cardiovascular risk factors were measured by standardized techniques. The prevalence rates overall of corneal arcus were: 18-29 years (males 0.5%, females 0.3%), 30-49 years (males 18.1%, females 13.3%) and 50-69 years (males 70.7%, females 55.3%). In the 30-49 age group, people with arcus had higher serum low density lipoprotein (LDL) cholesterol concentrations than people without arcus, the mean differences being, males 0.31 mmol/l (P = 0.040) and females 0.62 mmol/l (P less than 0.001) with an increased likelihood of having values greater than 5.5.mmol/l of males 1.8 (95% confidence interval (95% CI): 1.0-3.4) and females 2.6 (95% CI: 1.4-4.8). There were no significant differences for LDL-cholesterol in the 50-69 age group. Arcus was weakly associated with fasting plasma glucose in the 30-49 age group. Arcus was not associated with serum high density lipoprotein (HDL) cholesterol, serum fasting triglyceride, blood pressure and cigarette smoking. It is concluded that while corneal arcus is primarily an age-related change, its formation is accelerated by high serum LDL-cholesterol so that in people under 50 years it is a marker for the condition.
Three cases of muscular sarcocystosis from West Malaysia are reported. The morphological features of the parasites from these three cases are similar to the eight cases previously reported from this country. A review of this total of eleven cases of muscular sarcocystosis showed that they were all incidental findings, where man acted as intermediate hosts of as yet unknown Sarcocystis spp. These cases of muscular sarcocystosis were probably zoonotic in origin and associated with close contact with definitive hosts (both domestic and wild animals) thus permitting the contamination of food and drink with sporocysts shed by these definitive hosts. These infections were probably acquired locally as most of the subjects were born in Malaysia and none had ever left the country to stay elsewhere. Eight of the eleven cases reported were associated with malignancies, especially of the tongue and nasopharynx.
Few attempts have been made to determine the risk factors for diabetic retinopathy which is a major cause of visual impairment and blindness. One hundred and forty patients of diabetes mellitus were studied to determine the prevalence and types of retinopathy, and its relation to various risk factors. Nearly half (48.6%) of the patients suffered from retinopathy. The significant associated risk factors were long duration of diabetes, proteinuria and elevated serum creatinine level. However, there was no significant association between the prevalence of retinopathy and high levels of serum cholesterol, C-peptide levels, associated hypertension, and glycaemic control of diabetes mellitus. An effective screening programme for detection of retinopathy in the patients of diabetes as a regular practice is encouraged.
Study site: Diabetic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
This study attempted to determine whether contact lens wear has any adverse effect on the Meibomian glands. The study also tried to elucidate the prevalence of Meibomian gland dysfunction in the general population. The results of the study showed that Meibomian gland dysfunction exists in 43% of the population (lens wearers and nonlens wearers), 49% of the contact lens wearing population (81 subjects), and 39% of nonlens wearers (150 subjects). No statistically significant difference was found in the prevalence of Meibomian gland dysfunction between healthy contact lens wearers and the control group of nonlens wearers. The study therefore could not prove that contact lens wear is a contributing factor to Meibomian gland dysfunction.
This study was conducted to investigate the nutritional status of the rural population in Malaysia, especially women and children. A total of 262 women aged 18 and over and 183 children aged 2-6 years were selected using multistage cluster sampling from four locations in rural areas. It was found that the prevalence of malnutrition among children 2-6 years old ranged between 25.5% in the Malays Felda settlement scheme to 80% in the Orang Asli settlement. Malnutrition was associated with worm infestations, bottle feeding and early weaning. More than 30% of Orang Asli women were malnourished compared to less than 15% of Malay Felda settlement women. On the other hand, Malay women in the land settlement scheme had a higher risk of developing overweight and diabetes. Goitre was found among 11.5% of children; however, no cretinism was found. Breast feeding was still a common practice among rural mothers, but inadequate health education tended to reduce the duration of breast feeding and increased early weaning. Upgrading women's status in the rural areas will ultimately improve the nutritional and health status of the children and community as a whole.
Questionnaires (4000) on experience of menopausal symptoms in Singaporean women aged 40-55 were distributed by students. In total, 524 envelopes were returned (13.1%) and of these 420 were analyzed. Of these, 366 were classified as either pre-, peri- or postmenopausal on the basis of their menstrual patterns. Menopausal symptoms in this sample of Singaporean women were, in general, similar to those experienced in the West though the prevalence was low compared to European studies. No significant differences in individual symptoms were found between the 3 groups but, taken together, symptoms were significantly highest in the perimenopausal and lowest in the other menopausal groups. In the postmenopausal group 50% had been menopausal for at least 1 year at 50.5 years.
To obtain the profile of periodontal conditions in West Malaysian adults, five small scale surveys were carried out on selected occupational adult groups, 20-54 years old, between 1987 to 1990. Periodontal assessment was made using the CPITN index. In all, 779 subjects were examined. Results indicated that only 16% of the adults examined had healthy gingivae. Bleeding of the gingivae was limited to the younger (20-24 years) age group. Calculus is highly prevalent in at least 65.5% of all the subjects examined. Periodontal pockets were limited to mostly shallow pockets and the risk of developing pockets increased with increasing age. Both navy personnel and factory workers showed a higher number of healthy sextants across all ages as compared to the other three occupational groups; viz., rubber tappers, villagers and government workers. The rubber tappers were the only group with deep pockets, with the prevalence ranging between 8 to 25%. Implications of the findings to the Malaysian dental delivery system are discussed.
Soil-transmitted helminthiasis is a common problem in communities with poor socio-environmental conditions. This study was undertaken to identify important socio-environmental predictors of soil-transmitted helminthiasis in Bachok, a rural community in Kelantan for the development and implementation of an effective prevention and control program. Of 363 children randomly sampled, 38.8% were infected with soil-transmitted helminthiasis. Risk predictors of soil-transmitted helminthiasis found to be significant after adjustment included poor household hygiene score and large household size. The probability of being infected was 0.58 amongst children with both of these risk factors.
A house to house survey on elderly subjects aged 60 years old and above was undertaken in a large district in Malaysia. A total of 486 subjects in randomly selected Enumeration Blocks were interviewed and examined. The prevalence of oral precancerous lesions was recorded at 3.3%, of which leukoplakia was the most common. When the ethnic distribution of these oral precancerous and cancerous (OPC) lesions was compared, 72% of those inflicted were Indians. Oral cancer was detected in two subjects (0.4%), both of whom were of Indian origin. Among subjects with OPC lesions, 4.2% were smokers, 12.7% were betelquid chewers, 11.8% had indulged in both habits, whilst one subject had not practised any of the oral habits of interest (0.4%). The findings suggest the occurrence of OPC lesions to be related to betelquid chewing.
Publication year=1996-1997
Anti-HCV antibody was detected in 1.9% of the blood donors in University Hospital. Among the risk groups, 33.3% of the patients with post-transfusion hepatitis were tested positive for anti-HCV antibody. The anti-HCV antibody was detected in 30% of the IDU. Haemodialysis patients, patients with acute and chronic hepatitis and patients with liver cirrhosis appeared to have increased risk of Hepatitis C virus infection. The results indicate that the frequency of HCV infection increases with the exposure to blood or blood products.
Food-borne parasitic zoonoses have emerged as a major public health problem in many countries and are posing a medical challenge. They are not only important from the economic point of view but also because of their severe sequelae. In Malaysia, these parasitoses are a tip of an iceberg problem. The article documents all the food-borne parasitic zoonoses reported in Malaysia. An epidemiological assessment of the diseases with research needs is highlighted.
A total of 14,342 patients with skin diseases who had attended either the National University of Malaysia skin clinic or a private dermatological office were analysed. Five hundred and thirty-four cases (3.7%) had atopic eczema, the prevalence being highest among the Malays (4.3%). The prevalence of atopic eczema among clinic attenders is lower in all three major Malaysian races when compared with studies from England.
This study establishes the prevalence rate for alcoholism among the inpatients of the General Hospital, Kuala Lumpur, as 11%, but as 25% among the drinking population. It also describes the demographic profile of the alcoholic as compared to the non-alcoholic drinker and the non-drinker and suggests that certain vulnerability factors could contribute to the development of alcoholism. A trend noted is also the changing racial trends in the use of alcohol.