985 medical certificates issued by primary care doctors at the Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia were analysed. Most common diagnoses were URTls, conjunctivitis, and gastro-enteritis. Mean duration of absence ranged from 1.3 to 3.4 days. HUSM staff with skin infections were given certificates nearly twice more often than the public. Backache earned more time off for the staff compared to the public. There is a need to formulate guidelines for medical certificates.
Study site: Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia
Disability self-help organizations have emerged as an important element of response to the advancement of people with disabilities throughout the developing world in recent years. There are now self-help organizations in all regions of the developing world, their memberships are growing, and the scope of their activities is enlarging. This paper draws on field research in Malaysia to present an organization developed by and for people with physical disabilities as a case study of self-help action in the Southeast Asian region. This paper reviews the origins and growth of the organization, describes its current programme of activities, and offers comment about the nature and future of disability self-help in the region and its continued advancement in the developing world generally. A combination of internal factors that relate to organization and programming, and external political and social conditions is indicated as important.
Acute-phase serum samples collected during an outbreak of dengue fever and dengue haemorrhagic fever in Penang, Malaysia, were tested by a method involving antibody-dependent enhancement of infectivity in the mouse macrophage-like cell line, P388D1. 58 of 71 (81.7%) serologically positive cases yielded virus.
Minamata disease is a well-known mercury contamination that happened in Japan in 1953. Due to demand during world war, second mercury disaster occurred in Niigata Prefecture in 1965. This is a review on the Niigata Minamata disease based on available documents and local expert opinions on the disaster. The aims of this paper are to record exposure history like the source of mercury in Agano River and specific fish that was associated with the disease. It is for an appraisal of the basic mercury exposure control, particularly to protect Japanese and world population during that time. There was indication that initial exposure limit for mercury was calculated incorrectly, and higher safe dose was applied. This epidemiological study is very useful and significant in comprehend the correct estimation of the human exposure to any hazardous substances.
Declines in density of one natural, three artificially-seeded and eight experimental populations of Anadara granosa were monitored over periods ranging from seven to twelve months. For three of four large populations the decline in density has been adequately described by a model of the form N t=N 0·e zt where N t is density at time t, N o is initial density and z is the instantaneous mortality coefficient. The mean value of the latter was found to be-1.88·yr-1 with 95% confidence limits-1.54 to-2.25. The data obtained from the experimental populations demonstrated that mortality is unaffected by initial densities upto 2,500·m-2, but increases as shore elevation decreases due at least partly to greater access by predators at the lower levels.The data on mortality rates have been combined with previously-published information on growth rates in order to arrive at estimates of production. At one of the artificially-seeded sites the 95% confidence limits of estimates of mean production are 24 and 62 g dry tissue·m-2·yr-1 with an average value of 42 g·m-2·yr-1. Examination of the effects of shore elevation on production revealed that the latter is greatest at the uppermost shore level studied because down-shore increases in growth rate are more than offset by increases in mortality. Production per individual has been shown to decrease with increasing density. This latter fact has been used to estimate the maximum possible production which, for one site 250 cm above chart datum, lies between 49 and 72 g·m-2·yr-1 (95% confidence intervals). It has been demonstrated that for one of the culture sites variation about an estimate of mean mortality rate does not contribute as much to the variation of the final estimate of production as does the variation about the estimates of the mean values of the constants in a growth equation.As far as possible production of Anadara granosa has been compared with values reported for other marine and estuarine bivalve molluscs and it is concluded that A. granosa may be considered moderately to highly productive.
Dengue virus infection is now a global problem affecting tens of millions of people. The spread of the four dengue virus serotypes had led to increased incidence of dengue haemorrhagic fever (DHF) reported and with 2.5 billion people at risk, efforts towards the development of safe and effective vaccines against dengue must be accelerated. This chapter reviews some of the important lessons of pathogenesis which may be learnt from classical studies in the field and place these in the context of current knowledge about the molecular biology of the virus. The issues which have to be addressed in designing a safe vaccine against dengue are raised and the problems of designing subunit as well as whole virus vaccines are pointed out, particularly with regard to the phenomenon of antibody dependent enhancement and, more generally, the problem of immune potentiation of disease. More efforts must be made to understand the basis of pathogenesis in DHF and in finding out what nature has to teach about protection against and recovery from dengue virus infection.
The aim of this study was first to analyse the prescribing habits of primary care doctors with a view to providing feedback which may help them to rationalise their prescribing. This analysis was helped by comparing the prescribing practices in two different settings and thus highlighting anomalous differences. The second aim of this study was to obtain data on the diagnoses being made in primary care settings in Malaysia as this information, though available from other countries, is limited here. Lists of the most commonly prescribed drugs and most common diagnoses made are provided, together with tables showing the most commonly prescribed drugs for the ten most common diagnoses. Differences in prescribing habits between the two settings are discussed and possible reasons are suggested.
Outbreaks of Paederus dermatitis have been reported in several Asia-Pacific countries when rove beetles (genus Paederus) are accidentally brushed or crushed on the skin, releasing haemolymph pederin. An investigation was conducted in a school to ascertain the causative agent, establish the case definition, epidemiological characterisation of cases, entomological and environmental survey and data analysis. This outbreak occurred among 36 schoolchildren attending a night tuition class conducted by their teacher. Dermatitis developed within 24 hours in 33/37 (89.2%) cases with itchiness as the first presenting symptom in 87.9% of cases. Periorbital oedema and erythematous-vesicular plaques on the upper extremities were seen in 57.6% of cases, on the back (36.4%) and on the nape (24.2%). Signs and symptoms were present 12 hours after exposure in 66.7% of cases with burning sensation within four hours in 9.1%. Seven cases received out-patient treatment. Thirty cases (90.9%) recalled exposure to Paederus fuscipes with 28 (84.8%) cases admitting crushing or brushing the insects. (Relative risk = 2.2; 95% CI: 1.2; 4.2). The school with fluorescent lighting, was located next to paddy fields. P. fuscipes was easily found in the paddy fields and along the school corridors. This strongly supports it as the likely causative agent for the dermatitis. Boarding the ventilation panes and use of insect spray were successfully implemented to control the outbreak. Increased awareness of this condition is important to prevent misdiagnosis.
This study describes the use of an IgM capture ELISA using cell culture derived antigens and a polyclonal rabbit antiflavivirus antisera for the detection of dengue positive cases. The IgM capture ELISA is compared with the dot enzyme immunoassay and the results are discussed in the context of dengue endemicity.