HBV-DNA were analysed in 330 HBsAg-positive carriers in Malaysia by dot-blot hybridization and polymerase chain reaction. Seventy-three (22.12%) were positive for the virus. Of these, 65 (89%) were males and 8 (11%) were females. Statistically, there was no significant difference (P = 0.13). No significant decline in HBV-DNA with age in the Malay and Chinese males was observed (P = 0.2). Prevalence of HBV-DNA was higher in the Chinese carriers than in the Malay carriers for most age groups in both sexes. Sixty-one HBV-DNA-positive carriers were also positive for HBeAg. However, three individuals were positive only for anti-HBe, one was positive for both HBeAg and anti-HBe, and eight were negative for both HBeAg and anti-HBe. Fifty-seven were positive for HBeAg but negative for HBV-DNA. No relation was observed between raised alanine aminotransaminase and aspartate aminotransaminase levels and the presence of HBV-DNA (P = 0.4).
Calcifying odontogenic cysts (COCs) represent a group of lesions that may be broadly classified into two main entities: cysts and neoplasms. In the present study 30 non-neoplastic cystic COCs were examined by a quantitative histological method in an attempt to calibrate the relative distribution of the type of epithelial lining, intensity of ghost cell formation and the amount of dentinoid present. The results showed that there are two main types of cystic COC: an odontoma-producing type and a non-odontoma-producing variant. Morphologically, tooth-like structures were a valid distinguishing feature, while morphometrically the odontoma-producing variant showed a greater amount of luminal and mural dentinoid as well as luminal ghost cells. Demographic analysis also revealed that the odontoma-producing COC occurred in younger patients and showed an even sex distribution, whereas the non-odontoma-producing type was seen in older patients and showed a predilection for females. Both subtypes were more prevalent in the Chinese population and occurred preferentially in the maxilla.
This study was the first assessment of a nationwide risk approach system to antenatal management introduced to Malaysia in 1989. Three rapid, record-based surveys on three different study groups were conducted to determine risk factor prevalence, accuracy of risk assignment, action after risk assignment and the relationship of risk level and place of delivery. The most frequent risk factors were short birth interval, high parity and first pregnancy. Accuracy of risk assignment was highest at the lowest levels of risk and poorest at the highest levels. Women at the lowest levels of risk were more likely to be seen by a doctor than women at highest risk. These was a trend to deliver in hospital, rather than at home, as level of risk increased; but many women at high risk still delivered at home. Recommendations are made on modifications to the system prior to future evaluation.
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.
A retrospective six-month study of serum calcium and albumin in patients treated at the Kuala Lumpur Hospital was carried out. There were 19,291 subjects, of which the prevalences of hypocalcemia (corrected serum calcium of < or = 2.1 mmol/l) and hypercalcemia (corrected serum calcium of > 2.7 mmol/l) were 18.0% (3460 subjects) and 2.4% (468 subjects) respectively. Persistent hypocalcemia (a minimum of first two consecutive corrected serum calcium of < or = 2.1 mmol/l) was found in 408/19,291 subjects 2.1%). Serum calcium values of < 2.00 mmol/l were found in 98.5% of this group. Persistent hypercalcemia (a minimum of first two consecutive corrected serum calcium of > 2.7 mmol/l) was found in 108/19,291 subjects (0.5%) and 52/108 subjects (48.1%) had serum calcium values of > or = 3.0 mmol/l. 2902/3460 subjects (83.8%) and 313/468 subjects (66.9%) the hypocalcemia and hypercalcemia groups respectively failed to be retested (singletons). In the hypocalcemia group, 1115/2902 (38.4%) showed corrected serum calcium values of < 2.00 mmol/l), whilst 100/313 subjects (31.9%) of the hypercalcemia group had corrected serum calcium values of > or = 3.00 mmol/l. There were no significant differences between the mean corrected serum calcium between 3 age groups of the test population, namely in childhood ( < or = 65 years).
A cross sectional study was conducted among 1007 children aged 1-2 years, from padi farming area. The percentage of male children was 51.4%. The prevalence of at least one of the chronic respiratory symptoms was 12.81%, and the prevalence of chronic cough, chronic sputum, wheezing and bronchial asthma as diagnosed by doctors were 9.33%, 3.87% 5.36% and 3.38% respectively. The overall prevalence of bronchial asthma was 6.26%. The prevalence of asthma was highest among children aged 11-12 years (8.9%) and higher among males (6.95%). No significant relationship was found between the prevalence of either chronic respiratory disease symptoms of bronchial asthma, and selected environmental factors, namely exposure to cigarette smoke, use of mosquito coil and wood stove. However there was a significant relationship between prevalence of asthma in children and history of asthma among parents and grandparents.
Study site: Two villages in Tg. Karang (Kg. Sawah Sempadan and Kg Sri Tiram Jaya), Selangor, Malaysia
The study was conducted to compare the prevalence of goitre among Malays and Aborigines in remote inland rural areas to those in coastal areas. All subjects were examined thoroughly by an experienced endocrinologist for the presence of goitre. The overall goitre prevalence in coastal areas was 6.3%; 6.0% (4/67) of Aborigines and 6.7% (4/60) of Malays were affected. However, in remote inland areas, the prevalence of goitre was almost 5 times higher compared to coastal areas. The prevalence of goitre was 30.7% in Baling; 30.2% (19/63) Aborigines and 30.8% (92/299) Malays were affected. Iodine deficiency is the most likely cause for the high prevalence of goitre in the remote inland areas.
Chronic mastoiditis and subperiosteal abscess are rarely seen nowadays in most countries. Thirty-four cases of mastoiditis were reviewed to find out the prevalence of chronic mastoiditis in the east coast of Malaysia. Twenty (58.82%) of these cases were a sequelae of chronic suppurative otitis media with cholesteatoma. All the patients with chronic mastoiditis were more than six years old. Forty-five percent of cases with chronic mastoiditis had a well pneumatized mastoid air cell on the unaffected side. The occurrence of chronic mastoiditis or cholesteatoma in a well pneumatized mastoid is not really as rare as was thought to be. X-ray of the mastoids is very useful in diagnosing patients with chronic mastoiditis and cholesteatoma. Mastoiditis is uncommon in adults and whenever a case is seen, an underlying pathology like cholesteatoma should be suspected.
This paper highlights the marked presence of nutritional disorders in a sample (190 males, 237 females, aged 18-80 years) obtained from the adult population in three kampungs i.e. Pasang Api, Sungai Nipah Baroh and Sungai Balai Darat, in the Mukim of Bagan Datoh, Perak in 1992. All subjects (except pregnant females) were measured for blood pressure, weight, height, waist circumference, and hip circumference from which the body mass index (BMI) and waist-hip ratios (WHR) were calculated. A random blood sample was obtained by finger-prick from each subject and analysed for total cholesterol (TC) and glucose, using the Reflotron compact analyser. Elevated means for BMI and WHR indicated that obesity (BMI ≥30.0) was a serious public health problem in these three kampungs, affecting about 5% of males and 14% of females. Another 24% of males and 46% of females had an overweight problem (BMI 25.0-29.9), indicating that on the average, about half the adult population in these kampungs were either overweight or obese. This contrasted with the situation a decade ago in similar-type kampungs in the Peninsula where underweight was the major nutritional disorder in adults, especially males. Overall, there was a shift of an underweight problem to one of overweight, as exemplified by increments of 2.0 to 3.0 BMI units in the adult population, with the phenomenon being more marked in the females. Hypertension (21%) and hyperglycaemia (6.5%) affected the males and females approximately equally. Female adults had higher mean plasma TC compared to males (204 versus 199 mg/dl); these means were some 20 mg/dl (0.52 mmol/L) higher than the corresponding means for adults in similar rural communitites in the early eighties, and approximate the corresponding means for present-day urban adults. The above findings serve to emphasise the nutritional transition undergoing in the rural communities in the Peninsula, viz, the marked emergence in these rural communities of nutritional disorders normally associated with affluent populations.
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.
In hookworm endemic areas where sanitation is often wanting, reinfection of treated children is a problem. This study was conducted to enumerate the prevalence and the reinfection rate of hookworm in 193 Orang Asli children following treatment with stat dose of 400mg of albendazole at 2 and 4 months post-treatment. All samples were examined using the Kato-Katz and Harada Mori techniques. The overall initial prevalence was 31.0%, with 27.0% in males and 34.0% in females although there was no statistical difference. Only 7.0% of the children had moderate intensity of infection. The overall infection rate at 2 and 4 months post-treatment was 11.0% and 8.0%. New cases were detected at 1.0% and 5.0% at 2 and 4 months post-treatment period. Reinfection rate 2 months post-treatment was 24.0%, and it was 30.0%, 4 months after treatment. All infection at 2 and 4 months post-treatment were light. Long-term strategies incorporating health education on personal hygiene, provision of toilets and safe water supply need to be adopted in these Orang Asli villages to control rapid reinfection.
The pattern and outcome of patients with chronic renal failure (CRF) in Kelantan, the northeastern state of Malaysia was determined. A total of 60 patients with CRF managed at the Hospital Universiti Sains Malaysia between January 1991 and June 1993 were reviewed retrospectively. The prevalence of CRF was 24.8 patients per year. The ratio of male to female patients was 1.5 : 1.0. Their mean age at presentation was 51.4 +/- 13.7 years. The cause of CRF in majority of our patients was unknown. Their mean blood urea and serum creatinine were 38.9 +/- 9.8 mmol/l and 1,154.9 +/- 458.7 mumol/l respectively. Sixty-five percent of our patients were already in end-stage renal failure (ESRF) at the time of presentation and only 53.8% of them could afford a definitive renal replacement therapy. Their mortality rate was 21.7% and majority of the death occurred in patients who were not receiving definitive renal replacement therapy. This debilitating course will continue unless the cost of renal replacement therapy is subsidised or a renal transplantation program is activated. Hence public education to encourage organ donation in this part of Malysia is necessary.
Screening for proteinuria and hematuria is important in the prevention of chronic renal disease. In Malaysia to date no such attempt has been made to establish the prevalence of proteinuria and hematuria. A total of 45,149 primary school children from three districts in Kelantan were screened for proteinuria and hematuria. They were 23,289 boys and 21,860 girls. The prevalence of abnormal urinary sediments after third screening was 0.17% ie 0.07% were in boys and 0.10% were in girls. The commonest abnormality was proteinuria (0.12%), followed by hematuria (0.03%) and combination of proteinuria and hematuria (0.02%). Hematuria was more commonly seen in girls compared to boys while proteinuria was seen in almost equal proportion in boys and girls. Despite screening large number of children the prevalence of asymptomatic proteinuria and hematuria was far lower than in an earlier reported study. Furthermore the majority had mild abnormalities.
In a retrospective analysis of paediatric referrals to a Neurology Outpatient Clinic, the largest single category of 47 patients (32%) presented with acute recurrent headache. There were 30 girls and 17 boys. Age of onset ranged from 4 to 11 years (8.35 +/- 1.98) and duration of headache from half month to 42 months (19.2 +/- 11.9). Only 6 children were unable to describe the quality of their pain. Using conventional criteria, 43 of the children could be classified as classical migraine (10), common migraine (20), basilar migraine (3), ophthalmoplegic migraine (1) and tension tension headache (9). None had any positive physical signs, and all responded to simple measures.
Study site: Paediatric Neurology Clinic, Neurology Institute, Hospital Kuala Lumpur, Malaysia
Little new evidence on the prevalence of injury to the anterior teeth of children has been reported in the past five years and, in South Africa, trauma to the teeth of children in different ethnic groups has not been compared respectively. The purpose of this investigation was to determine the prevalence of dental trauma using well-defined criteria and to sample a specific age-group. Five regions were chosen and 1035 children in the eleven-year age-group were examined. No statistical significance was found between the ethnic groups related to the amount of injury sustained. For all groups, boys received more injuries than girls. The most common injury was fracture of the enamel of the maxillary central incisor. With 15 percent of the children receiving some level of trauma by age eleven years, this is one of the main dental treatment needs for South African children.
The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the "lost time" percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.
The objective of this paper is to assess the perception of bodyweight status among the office workers in two government departments in Kuala Lumpur. A total of 385 Malay workers aged between 18 to 55 years were randomly selected from the Prime Minister’s Department and the Ministry of National Unity and Community Development. The weights and heights of all subjects were measured and their Body Mass Index (BMI) determined. In this study, obesity is defined as individuals having ï‚³ï€ 25 kg/rn 2 . A questionnaire was prepared to obtained information on socioeconomic status, health aspects, dietary intakes, activity levels and perception on bodyweight status. The study revealed a high prevalence of obesity (38.1 %) and among the obese subjects, 21.7 % perceived themselves as having normal weight. The normal weight and underweight subjects perceived themselves as obese (33.5 % and 6.3 % respectively). A small percentage (5.7 %) of the obese individuals who perceived themselves as obese did not wish to lose weight. In contrast, 9.7 % of the normal weight subjects who perceived themselves as having normal weight wanted to lose weight. A third person’s perception on the subjects’ bodyweight status is significantly associated with the subjects’ bodyweight status (P
This paper represents a study of35casesofodontogenic keratocyst (OKC) diagnosed in a Malaysian population. The clinical, radiological and histopathological features, treatment modalities and recurrence of this lesion were analysed. There was a higher prevalence rate among Malaysian Chinese (51.42 percent), while the Malays and Indians accounted for22.86 percent and 25.72 percent respectively. The male to female ratio was 16 : 19.Age at presentation ranged from nine to 71 year,with about 70percent occurring between ages ten to 39 years. A total of40cysts were analysed. Of these, 67.5 percent occurred in the mandible and 32.5 percent in the maxilla. About 88percent of OKC presented as unilocular radiolucencies and 42.0 percent were associated with unerupted or impacted teeth. Histologically, the parakeratinized OKC was the predominant variant found (75.8 percent). The majority of caseswere treated by enucleation (85 percent), and a recurrence rate of20percent was recorded.