The aim of this study was to compare and validate two simple methods of detecting excessive alcohol drinkers in a Malaysian hospital population. All 621 patients in the Medical, Surgical and Orthopaedic units of the General Hospital Kuala Lumpur were screened with the "CAGE" Questionnaire (a four question screening test to discriminate excessive drinkers) and two questions on the frequency and quantity of drinking called the Consumption Index. All CAGE scores had poor agreement (K = 0.37 to K = 0.1) with a psychiatric diagnosis of alcohol abuse and dependence using DSM III diagnosis. Reasons why the Consumption Index is a better screening instrument than the CAGE are discussed.
This study examines the usefulness of the "CAGE", (which is an acronym for "cut down", "annoyed", "guilty" and "eye-opener"), a 4-question screening test to identify excessive drinkers among Malaysian inpatients. The CAGE questionnaire after translation and back translation was administered to all inpatients in the General Hospital, Kuala Lumpur. The author interviewed 'blindly' all who score positive on the CAGE score and 10% of all negatives using the DSM III interview schedule for alcohol abuse dependence. The results show that the CAGE performs best at a cut-off point of 2 and above, with a sensitivity of 92%, specificity of 62%, positive predictive values of 38% and Kappa (K) of 0.37 with a DSM III R diagnosis for alcohol abuse/dependence. The poor agreement with a DSM III diagnosis indicates that the CAGE is not useful in the Malaysian population. Reasons suggested for this are: cultural factors in the Malaysian population resulting in the overrating of the question of 'guilt' by Muslims and translations into the local languages which are only the closest approximations.
The objective of this study was to describe preliminary experience with moclobemide in the treatment of depressive disorders in the University outpatient clinic in Malaysia. Twenty patients who satisfied DSM III R criteria for depressive disorders and scored more than 16 on the Hamilton Rating Depression Score at the initial interview were recruited into this open study. The primary diagnosis of 4 patients was later ascertained to be panic disorder(2), schizophrenia(1) and social phobia(1). Patients rated themselves as improved by first follow up (7-14 days), and rated their depression as very mild to mild by the third follow up visit (ie at a mean of 46 days). Side effects were minimal and compliance good.
Study site: outpatient psychiatric clinic at the General Hospital, Kuala
Lumpur.
The roots of Malaysia's drinking patterns lie in the introduction of most forms of alcohol by Europeans. Although Malaysia today has relatively low per capita alcohol consumption, available studies and interviews with alcohol industry officials point to a small segment of the population that drinks heavily and causes and experiences substantial alcohol related-problems. Indians are over-represented in this sub-population, but studies also reveal substantial drinking problems among Chinese and Malays. Government officials categorize alcohol as an Indian problem. The government devotes little resources to monitoring drinking patterns, use or problems; or to preventing, treating or educating the public about alcohol-related problems. Alcohol-producing transnational corporations own shares of all of Malaysia's major alcohol producers. In the face of high alcohol taxes and a ban on broadcast advertising of alcoholic beverages, these companies market alcohol aggressively, making health claims, targeting heavy drinkers and encouraging heavy drinking, employing indirect advertising, and using women in seductive poses and occupations to attract the mostly male drinking population. Monitoring of the country's alcohol problems is greatly needed in order to establish alcohol consumption more clearly as a national health and safety issue, while stronger controls and greater corporate responsibility are required to control alcohol marketing.
The aim of this study was to investigate how the prevalence and severity of psychiatric disabilities in patients with chronic schizophrenia compares with that in patients with chronic mood disorders. A total of 128 patients, 80 with chronic schizophrenia and 48 with chronic mood disorders as confirmed by DSM-III-R, were examined using the World Health Organization Psychiatric Disability Assessment Schedule (WHO/ DAS). There were no significant differences in the prevalence and severity of disabilities between the two disorders. Two-thirds of the patients with chronic schizophrenia and over half the patients with chronic mood disorders had dysfunctional behaviour and experienced significant disabilities. The prevalence of disabilities among these Malaysian patients was not markedly different from that seen in developed countries, suggesting that the prognosis in developing countries may not be as favourable as previously thought.
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.
Land application of sludge as fertilizers is a way of disposal and recycling of sludge. However, public concern has arisen due to the fact that organic contaminants in sludge may ultimately enter the food chain. Hence the need arises to analyse the organic contaminants such as PAHs and OCPs in sludge. In this study, Soxhlet was utilised as the extraction method and the extracts subjected to extensive cleanup via either silica columns or solid phase extraction cartridges prior to analysis using gas chromatography or high performance liquid chromatography. Sludge samples were collected from the drying beds of oxidation ponds in three locations in South Johore. OCPs such as heptachlor, dieldrin and pp-DDT were detected in low amounts (52-159 mg/kg) whereas PAHs such as naphthalene, phenanthrene, fluoranthene and benzo(a)pyrene were detected in the range of 0.2-5.5 mg/kg dry mass. Subcritical water extraction (SWE) recovery studies of PAHs were also performed from spiked sludge samples. Although a recovery range of 41-68% was obtained using the SWE method, the results indicated the usefulness of the technique as an alternative to Soxhlet extraction for the analysis of PAHs in sludge samples.