exudates and Disease

Fat remains a hot topic because of concerns over associations between consumption of fats and the incidence of some chronic conditions including coronary artery disease, diabetes, cancer and obesity. Dietary fats serve multiple purposes. The effects of dietary fats generally reflect the collective influences of multiple fatty acids in the diet or food. This presentation highlights some recent developments on the role of dietary fats and oils in health and disease. Debate continues over the role of dietary modification in coronary prevention by lipid lowering. The degree to which a recommended diet will result in health benefits for an individual is difficult to predict, because the outcome will depend on the influence of other factors such as a person's genetic constitution, level of physical activity and total diet composition. There can now be little doubt about the importance of genetic factors in the etiology of cardiovascular disease, diabetes, obesity and cancer. The importance of antioxidant status in the prevention of cardiovascular disease as well as many cancers is being increasingly recognised. It is now evident that not all saturated fatty acids are equally cholesterolemic. Recent accounts evaluating palm oil's effects on blood lipids and lipoproteins suggest that diets incorporating palm oil as the major dietary fat do not raise plasma total and LDL cholesterol levels to the extent expected from its fatty acid composition. Palm oil is endowed with a good mixture of natural antioxidants and together with its balanced composition of the different classes of fatty acids, makes it a safe, stable and versatile edible oil with many positive health and nutritional attributes. In recent times, adverse health concerns from the consumption of trans fatty acids arising from hydrogenation of oils and fats have been the subject of much discussion and controversy. Trans fatty acids when compared with cis fatty acids or unhydrogenated fats have been shown to lower serum HDL cholesterol, raise serum LDL cholesterol and when substituted for saturated fatty acids, increase lipoprotein Lp (a) level, an independent risk factor for the development of coronary heart disease. The idea of which foods, nutrients and supplements are "healthy" is often being amended as new scientific data is presented and then simplified for the consumers. What was once perceived as a healthy diet is often no longer considered as such and vice versa. Dietary recommendations have to cha

Topics: Disease; Health; Humans; Lipids; Malaysia; Nutrition Policy

A study was conducted on a total of 100 women attending the Family Planning Clinic in Kuala Lumpur. 50 took combined low-dose estrogen and progesterone pills for a year or more and the other 50 used different methods of birth control. Platelet aggregation, ATP release, Thromboxane B2, and 6-keto-prostaglandin F1alpha estimations were made to evaluate the effect of oral contraceptives (OCs) on platelet function and prostanoid production. The results showed no significant differences in the parameters measured in the 2 groups investigated. These findings are comparable to those reported by other studies, suggesting relatively low risk, if any, of thrombosis in OC users.

Topics: Asia; Asia, Southeastern; Biology; Blood; Clinical Laboratory Techniques; Contraception; Contraceptives, Oral; Cross-Sectional Studies; Developing Countries; Diagnosis; Disease; Embolism; Family Planning Services; Malaysia; Physiology; Platelet Aggregation; Research; Research Design; Risk Factors; Thromboembolism; Vascular Diseases

The integration of oral health into primary health care denotes the important role of medical counterparts as the front liners in antenatal care to help screen mothers for oral symptoms and refer them to dentists accordingly. However, the validity of self-perceived oral health status is inconclusive. This study determined the association between self-perceived oral symptoms and the presence of clinically diagnosed oral diseases in a sample of pregnant women. A total of 192 pregnant women participated in this cross-sectional study. Clinical oral examinations were performed to record dental caries experience, gingival health and periodontal health. The women were also asked about their oral symptoms. Most women had at least one oral symptom (84.9%): cavitated tooth (62.0%), bad breath (38.5%), bleeding gums (28.6%), and toothache (22.9%). About half of the women had untreated dental caries (58.9%), and the odds were significantly higher in women who complained of having cavitated tooth. About half of the women had moderate to severe gingivitis (53.7%), and the odds were significantly higher in women who complained of bleeding gums. About half had periodontal pockets (46.3%), and the odds were higher in women who complained of bleeding gums and bad breath although lower in women who complained of swollen gums. In conclusion, the prevalence of dental caries and periodontal disease among pregnant women in this study were relatively high. The presence of untreated dental caries, moderate and severe gingivitis, and periodontal pockets were significantly associated with their corresponding oral symptoms.

Topics: Cross-Sectional Studies; Dental Caries; Disease; Female; Humans; Malaysia; Oral Health; Periodontal Diseases; Pregnancy; Pregnant Women

Diet-related metabolic diseases, and especially obesity, are metabolic disorders with multifactorial aetiologies. Diet has been a cornerstone in both the aetiology and management of this metabolic disorders. Rice, a staple food for over half of the world's population, could be exploited as part of the solution to check this menace which has been skyrocketing in the last decade. The present study investigated nine forms of rice from three widely grown Malaysian rice cultivars for in vitro and in vivo (glycaemic index and load) properties that could translate clinically into a lower predisposition to diet-related diseases. The germinated brown forms of MRQ 74 and MR 84 rice cultivars had high amylose content percentages (25.7% and 25.0%), high relative percentage antioxidant scavenging abilities of 85.0% and 91.7%, relatively low glycaemic indices (67.6 and 64.3) and glycaemic load (32.3 and 30.1) values, and modest glucose uptake capabilities of 33.69% and 31.25%, respectively. The results show that all things being equal, rice cultivars that are germinated and high in amylose content when compared to their white and low amylose counterparts could translate into a lower predisposition to diet-related diseases from the dietary point of view in individuals who consume this cereal as a staple food.

Topics: Antioxidants; Color; Disease; Germination; Humans; Malaysia; Oryza; Plant Extracts; Seeds

This study examined beliefs about the causes and determinants of health, illness, and recovery in an opportunistic sample from Malaysia. In all, 371 women and 350 men completed the Health and Illness Scale, a 124-item scale that examined beliefs about current and future health, and beliefs about the causes of illness and recovery. Each of the four subscales of the Health Illness Scale were factor analysed to reveal the underlying structure. Results showed the emergence of a number of distinct factors in the case of each subscale, of which environmental, life-style, psychological, religious, and fate-related factors were fairly stable across subscales. Results also showed a number of differences in beliefs between religious groups, and that religiosity and sex were the strongest predictors of beliefs across the four subscales. The results are discussed in terms of the available cross-cultural literature on lay beliefs about health.

Topics: Adaptation, Psychological; Adult; Attitude to Health; Cross-Cultural Comparison; Culture; Developing Countries; Disease; Educational Status; Female; Humans; Internal-External Control; Malaysia; Male; Religion and Psychology; Social Values; Surveys and Questionnaires; Young Adult

Urgent action is needed to fight the alarming spread of HIV/AIDS that infected 1.3 million people in Southeast Asia last year alone, Malaysia's foreign minister said July 24, 2000. Syed Hamid said the Association of Southeast Asian Nations (ASEAN) should tackle at regional and national level an epidemic that was taking its most drastic toll among the region's youth. "HIV/AIDS not only represents a major public health and social problem but is a serious challenge to development as well," Syed Hamid told the opening ceremony of ASEAN's 33rd annual foreign ministers' meeting. The crisis requires commitment at the "highest political level," he said, warning that HIV/AIDS could become a transnational problem within the 10-member group. Foreign ministers have recommended their leaders discuss the crisis later this year at an informal summit in Singapore and hold a summit on HIV/AIDS in conjunction with the 7th ASEAN Summit in Brunei next year. "I think people recognized the importance and the adverse impacts on our social development," Syed Hamid told reporters later. "I think it is a real issue that we cannot run away from." Among ASEAN members, Thailand, Cambodia, and Myanmar have some of the highest infection rates in Asia of HIV, the virus that causes AIDS.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Developing Countries; Disease; Health; HIV Infections; Malaysia; Public Health; Social Problems; Virus Diseases

Islamic clerics, scholars, activists, and other authorities in Malaysia decided to lay in education for everyone as a solution to the AIDS epidemic in their country. In addition, they called on the community to be caring towards sufferers, which they believe is the way of Islam. This resolution was agreed upon during a meeting wherein religious officials recognized their role in AIDS prevention by equipping people with spiritual values and teaching everyone compassion. The resolution, however, has challenged the orthodoxy in some Islamic circles where AIDS is regarded as a "manifestation of God's punishment" which has consequently scared off many Muslim sufferers from approaching religious bodies. Religious advisers also admits that their call for full information about prevention, from urging abstinence and marital fidelity to promoting the use of condoms, still needs to be supported by individual state authorities. Among the AIDS council's future plans are to set up an information booth at a Kuala Lumpur mosque and to raise awareness in state religious departments through a booklet entitled AIDS Education Through Imams.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Communication; Developing Countries; Disease; Education; Health Knowledge, Attitudes, Practice; HIV Infections; Islam; Leadership; Malaysia; Religion; Virus Diseases

In Asia, attempts to control HIV/AIDS through education have not achieved the necessary behavior changes. This is especially true for young women who are unable to apply their knowledge to their sex behavior because of inequalities in gender relations. Thus, the impact of AIDS on women is significantly greater in settings where the status of women is low. Women in developing countries are at greatest risk because the epidemic is fueled by poverty, lack of information, and lack of autonomy. Prosperity in a developing country, such as Malaysia, entails its own risks because it creates new social norms and values that exist in tandem with debilitating old norms, such as the patriarchy that disempowers women and a resurgence in polygamy and wife abandonment. Subservient gender roles not only increase women's chances of infection, they also target women as the primary caregivers for infected individuals. Young girls may have to abandon school to care for infected parents, and female health care providers are assigned to the lowest ranks of the profession. While most women have been infected by their husbands, they must also bear the stigma of being considered immoral infectors of their husbands. The futures of AIDS widows and orphans is jeopardized by the discrimination that attends the disease, and if the mother dies, her young children face a higher death rate. In settings new to the epidemic, it is difficult to convince men of the importance of addressing women's needs and of seeking the input of women in policy and program development. Only by empowering both sexes to work together to protect society will there be a reasonable chance of reducing the impact of HIV/AIDS.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Developing Countries; Disease; Economics; Evaluation Studies as Topic; HIV Infections; Interpersonal Relations; Malaysia; Socioeconomic Factors; Virus Diseases; Women's Rights

Despite the fact that Malaysia has good treatment centers for reproductive cancer, mortality rates from breast and cervical cancer are high because of a lack of early detection. Breast cancer mortality rates have risen since 1985, while cervical cancer mortality rates declined from 1985 to 1993 and then increased in 1997. There is no standardized cancer registry, so incidence and mortality rates are likely to be higher than reported. In 1995, the government launched its first nationwide cancer prevention campaign and stressed breast self-examination and yearly examination by a medical professional for woman aged 20 years and above. The same year, eligibility for pap smears was extended to all women who have been or are sexually active and are aged 20-65 years. Between 1993 and 1996, 35% of the breast cancer cases presented at stage 3 or 4, and 93% of these women had a lump of a mean size of 5.3 cm. Cultural taboos prevent women from examining their own bodies, and women fear their husbands will leave them if they have a mastectomy. Malay women also deny themselves preventive care, and sometimes physicians and nurses deny Pap smears to unmarried women. Women are not empowered with the knowledge they need to seek preventive screenings, and older women are difficult to reach with information because they are unlikely to visit maternal-child health or family planning clinics. Malaysia needs to institute a standardized cancer registry and to conduct research that will address the barriers faced by women.

Topics: Asia; Asia, Southeastern; Breast Neoplasms; Delivery of Health Care; Developing Countries; Diagnosis; Disease; Evaluation Studies as Topic; Health; Health Services; Health Services Accessibility; Malaysia; Mass Screening; Neoplasms; Organization and Administration; Program Evaluation; Uterine Cervical Neoplasms

At a 3-day meeting sponsored by the Association of Southeast Asia Nations (ASEAN), Thailand, Malaysia, Viet Nam, the Philippines, Indonesia, Singapore, and Brunei pledged to implement a series of high-profile projects to combat the acquired immunodeficiency syndrome (AIDS) epidemic. Although details of the projects were not revealed, they focus on education, information sharing, and improved surveillance. Voluntary groups, the private sector, community organizations, and government departments will be enlisted in the AIDS prevention effort. Participants noted that earlier concerns that condom promotion would encourage premarital and extramarital sex have proved unfounded. A survey conducted in Thailand indicated that AIDS education programs have increased condom use with prostitutes to 60%. Almost 3000 new cases of human immunodeficiency virus (HIV) occur each day in South and Southeast Asia.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Brunei; Condoms; Contraception; Developing Countries; Disease; Family Planning Services; Health Planning; HIV Infections; Indonesia; Malaysia; Organization and Administration; Philippines; Policy Making; Singapore; Thailand; Vietnam; Virus Diseases

Interruption of the spread of human immunodeficiency virus (HIV) across southeast Asian borders by legal and illegal migrant laborers is a major concern of the Association of Southeast Asian Nations (ASEAN). ASEAN intends to move immediately to implement regional projects focused on education, information sharing, and improved surveillance. HIV transmission from laborers from poorer countries in search of jobs in economically booming regions underscores the global nature of the AIDS problem. Malaysia, for example, has over 1 million illegal workers. Moreover, many legal guest workers who enter Malaysia with letters from a physician stating they are not HIV-infected have falsified documents.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Demography; Developing Countries; Disease; Economics; Emigration and Immigration; Employment; Health Workforce; HIV Infections; Malaysia; Population; Population Dynamics; Prevalence; Research; Research Design; Thailand; Transients and Migrants; Virus Diseases

Malaysia has an estimated population of 18.8 million people. The first AIDS case of Malaysian origin was detected in December 1986. As of April 30, 1995, there were cumulatively 12,122 reported HIV infections and 228 cases of AIDS. Of the 12,122 HIV cases, 78% are attributed to IV drug use, 17% to other unknown routes, and 2% to heterosexual sex. While the Malaysian government's initial anti-AIDS campaign used fear tactics, public campaigns have recently been revised to employ a softer approach, minimizing fear tactics and referring to transmission risks as high-risk behavior. The government's main anti-AIDS strategy has concentrated upon preventing transmission through mass awareness campaigns and motivating behavioral change. Harm reduction measures such as condom distribution remain limited to specific target groups such as people already infected with HIV/AIDS. Syringe and needle exchange activities are not allowed under Malaysia's anti-drug laws. Complementing and supporting the government's anti-AIDS campaign are nongovernmental organizations working upon HIV/AIDS which are affiliated with the Malaysian AIDS Council. The majority of programs concentrate upon basic education and awareness, although some programs provide direct service-oriented activities.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Developing Countries; Disease; Government Programs; HIV Infections; Malaysia; Organization and Administration; Virus Diseases

We developed a computer model which measures the impact of disease on a population, has the ability to track changes in disease incidence over time, and incorporates costs of disease prevention and treatment. This model was developed with data for Malaysia and used by the Ministry of Health in the development of their national health plan. The model uses the DHLL (DALY) measure which incorporates morbidity and mortality impacts of disease. The ability of the model to adjust for changes in disease incidence over a period of years allows health planners to accurately reflect demographic and development related changes in disease incidence. This model is of value to health planners because in incorporates information on population health status, costs of prevention and treatment, and changes in health status over time. It produces an evaluation of the cost effectiveness of possible interventions that can be used by health planners in making decisions on resource allocation.

Topics: Computer Simulation; Disease; Epidemiology; Health Planning; Health Status; Humans; Malaysia

Five positive and negative experiences of families dealing with AIDS are recounted. Imrat in Malaysia is an HIV-infected son who was not rejected by his family. Prudence of Botswana is an infected widow with five children who had a less positive experience with her in-laws, while Eric of Sweden considers his friends to constitute his family. His relationships with friends have only strengthened since his HIV-positive status became known. Mary of Zimbabwe, however, was infected with HIV by her husband. She was formerly angry at him for having brought home the virus, but they have since stop quarreling and are focusing upon building a stronger relationship. Finally, the brief story of Juan in Colombia is told. Thirty-two years old, married, and with a 17-month old daughter, Juan did not tell his wife that he was actively bisexual. Once infected with HIV, Juan's wife threw him out, more because he had sex with men than because of his HIV serostatus.

Topics: Acquired Immunodeficiency Syndrome; Africa; Africa South of the Sahara; Africa, Eastern; Africa, Southern; Americas; Asia; Asia, Southeastern; Botswana; Colombia; Developed Countries; Developing Countries; Disease; Europe; Family Characteristics; Family Relations; HIV Infections; Latin America; Malaysia; Scandinavian and Nordic Countries; South America; Sweden; Virus Diseases; Zimbabwe

Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies.

Topics: Acne Vulgaris; Asia; Asia, Southeastern; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Dermatitis; Desogestrel; Developing Countries; Disease; Ethinyl Estradiol; Family Planning Services; Health Planning; Malaysia; Menstruation Disturbances; Prospective Studies; Research

Infection with the human immunodeficiency virus (HIV) is spreading rapidly among injection drug users (IDUs), particularly in countries of the Golden Triangle where Myanmar (Burma), Thailand, and Laos converge and the pure heroin China White is refined. Thailand, Myanmar, Hong Kong, Malaysia, Singapore, the southern provinces of China, and the northeastern states of Mizoram, Manipur and Nagaland in India are affected. Infection has reached 50% and more in some groups of IDUs in these countries. In Thailand, 63% of the 23,845 known cases of HIV infection are among an estimated 400,000 IDUs. It is estimated that Myanmar has 160,000 IDUs, of whom half are infected with HIV, and among 85,000 IDUs tested, 85% were infected. The Myanmar sector of the Golden Triangle produces double the amount of the mid-1980s, more than 2000 tons of raw opium a year impaction northeastern India and China's southwest Yunnan province. The HIV infection rate among IDUs tested in Manipur was 50% in 1991, and 40% of an estimated 10,000 IDUs in neighboring Nagaland carry the virus. In China 398 of the 493 registered HIV cases are among IDUs in Yunnan. In Malaysia, there are nearly 4000 cases of HIV infection, approximately 80% of which are IDUs. The epidemic of heroin injection swept over Asia in the last decade, since Afghanistan, Pakistan, and Iran were major heroin producers. An estimated is 10 of Karachi's 8 million population uses drugs. Criminal syndicates in Pakistan, Afghanistan, and India control production, manufacture and wholesale distribution of heroin using sophisticated systems. Addiction is punishable in only a few countries, as most countries distinguish between the selling of drugs and consumption. WHO placed the interdiction of IDUs and HIV in Asia on its agenda at a meeting in Thailand, in October 1991, to prevent a shift toward drug injecting in countries where drugs are still largely inhaled.

Topics: Asia; Asia, Eastern; Asia, Southeastern; China; Crime; Developing Countries; Disease; HIV Infections; India; International Agencies; Malaysia; Myanmar; Organizations; Pakistan; Social Problems; Substance-Related Disorders; Thailand; United Nations; Virus Diseases; World Health Organization

Between December 1990 and May 1991 in Malaysia, clinicians at the Sultanah Aminah Hospital in Johor Bahru screened 200 women with a diagnosis of threatened miscarriage with ultrasound to determine whether ultrasound could evaluate the viability of the fetus and thus the outcome of pregnancy in cases of threatened abortion. A fetal heartbeat was absent in 65% of cases with the remaining 35% of cases having a fetal heartbeat. Nonviability of the fetus or an abnormal or very early pregnancy may have accounted for an absent fetal heartbeat. The pregnancy of 46% of cases continued while 41% experienced spontaneous abortion. Just 6.2% of cases with a fetal heartbeat suffered from spontaneous abortion compared with 69.7% of those without a fetal heartbeat. 93.8% of cases with a fetal heartbeat continued their pregnancies compared with 30.3% of those without a fetal heartbeat. Inability of ultrasound to detect fetal heartbeats during early pregnancy probably accounted for the somewhat high percentage of those without a fetal heartbeat who continued their pregnancies. Among patients with a fetal heartbeat, the number of pregnancies that continued. Ultrasound detected 13% abnormal pregnancies (i.e., molar pregnancy or ectopic pregnancy). Surgery on these cases confirmed the ultrasound findings. These results showed that ultrasound should be used in every case of threatened miscarriage and that a fetal heartbeat does indicate the viability of the fetus.

Topics: Abortion, Spontaneous; Asia; Asia, Southeastern; Developing Countries; Diagnosis; Disease; Fetal Viability; Fetus; Longitudinal Studies; Malaysia; Mass Screening; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy, Ectopic; Reproduction; Research; Ultrasonics

Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response.

Topics: Asia; Asia, Southeastern; Biology; Blood; Blood Coagulation; Clinical Laboratory Techniques; Clinical Trials as Topic; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Contraceptives, Oral, Combined; Developing Countries; Diagnosis; Disease; Embolism; Family Planning Services; Fibrinolysis; Hematologic Tests; Levonorgestrel; Malaysia; Physiology; Research; Thromboembolism; Thrombosis; Vascular Diseases

Researchers compared the results of hematocrit and blood viscosity tests of 16 women using a combined oral contraceptive (COC) with 30 mcg ethinyl estradiol/150 mcg desogestrel (group 1), 11 women using a COC with 30 mcg ethinyl estradiol/150 mcg levonorgestrel (group 2), and 16 women who did not use any OCs (control group), all who attended the National Population and Family Development Clinic at the General Hospital in Kuala Lumpur, Malaysia. They wanted to examine the effects of COCs on blood viscosity, which is inversely related to blood flow, and hematocrit. The women were matched for age. The hematocrit level of women who took the ethinyl estradiol/desogestrel COC was significantly higher than that of the control group (41.5% vs. 37.4%; p.001). On the other hand, the hematocrit level of women who took the ethinyl estradiol/levonorgestrel COC was close to that of the control group (38.5% vs. 37.4%). Even though the mean whole blood viscosity for group 2 was higher than that of group 1 and the control group (6.6 cps vs. 5.5 cps), the difference was insignificant. Yet whole blood viscosity of group 2 at the higher shear rates (46, 115, and 230 per second) was significantly higher than the control group (p.05). The whole blood viscosities of group 1 and the control group did not differ considerably. This supported the theory that hematocrit contributes to blood viscosity. Further these results agreed with those of another study which also showed increased blood viscosity and hematocrit in healthy women taking OCs. Thus thromboembolic events in women taking OCs could be a result of a drop in rate of blood flow which at the lower shear rates could increase red cell aggregation and clotting. In conclusion, health providers could use these indicators to monitor women who have used OCs over a considerable period for thrombotic risks to determine if OC use should continue.

Topics: Asia; Asia, Southeastern; Biology; Blood; Blood Coagulation; Case-Control Studies; Clinical Laboratory Techniques; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Cross-Sectional Studies; Desogestrel; Developing Countries; Diagnosis; Disease; Embolism; Ethinyl Estradiol; Family Planning Services; Hematocrit; Hematologic Tests; Levonorgestrel; Malaysia; Methods; Physiology; Research; Research Design; Thromboembolism; Thrombosis; Vascular Diseases

Previous studies have shown the users of intrauterine devices have a 4.4 times greater risk of pelvic inflammatory disease. This present study intends to categorize the distribution of microbes in cultures from different types of extracted copper intrauterine devices (IUCDs). Bacteriological studies of aerobic and anaerobic organisms were performed on the extracted IUCDs of 522 IUCD users; 480 wearing a Multiload Cu 250, 15 wearing a Copper T, 22 Lippes Loop and 5 a Copper 7. Cultures were negative in 46 (8.8%) IUCD cultures where 43 were Multiloads, Copper T (1) and Lippes Loop (2). 91.2% yielded bacterial growth and the commonest organisms isolated were Staphylococcus species, (23%), E.coli (9.6%) and Staphylococcus aureus (4.0%. Candida albicans, E.coli and Staphylococcus sp. were commonly isolated from Multiload, Copper T, Lippes Loop and Copper 7. Beta-hemolytic streptococci, Staphylococcus aureus and Candida sp. were frequently recovered from Multiload, Copper T and Lippes Loop. Only Multiload cultures yielded Bacillus, Streptococcus viridans, Klebsiella, Proteus, Enterobacter, Citrobacter diversus, Citrobacter freundii, Moraxella, Pseudomonas and Acinetobacter. One woman with complaint of PID yielded E.coli in her IUCD culture.

Topics: Asia; Asia, Southeastern; Contraception; Developing Countries; Disease; Family Planning Services; Infections; Intrauterine Devices; Intrauterine Devices, Copper; Malaysia; Pelvic Inflammatory Disease; Prevalence; Research; Research Design

The authors examine age at menopause and menopausal symptoms among 677 Malaysian women interviewed in 1986. Consideration is given to psychological as well as physical effects. Findings indicate that approximately 7 out 10 women entered menopause between ages 45-54 and that socioeconomic status did not affect onset or symptoms.

Topics: Age Factors; Asia; Asia, Southeastern; Behavior; Biology; Demography; Developing Countries; Disease; Malaysia; Menopause; Population; Population Characteristics; Psychology; Reproduction; Signs and Symptoms

The effect of low-dose oral contraceptives (OCs) on hemorheology and fibrinolytic response was investigated in 107 women attending the Malaysia Maternity Hospital in Kuala Lumpur. The OC contained 0.03 mg estrogen and 0.15 mg progestagen. Study subjects were divided into 3 groups. The 30 women in Group 1 took the low-dose OC for 3-6 months, while the 27 subjects in Group 2 took the pill for a duration of 1-2 years. Group 3 was comprised of 49 controls. The 3 groups were comparable in terms of age, weight, height, and parity and included Malays, Chinese, and Indians. No significant differences were noted between the 3 groups in any of the parameters analyzed (platelet aggregate ratio, fibrinogen levels, red blood cell deformability index, euglobulin clot lysis time, and full blood count). Since the level of estrogen in the OC analyzed in this study did not cause significant alterations in any of these blood parameters, it is concluded that low-dose OCs do not confer a risk of thrombosis in their users.

Topics: Asia; Asia, Southeastern; Biology; Blood; Blood Coagulation; Cardiovascular System; Cerebrovascular Circulation; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Developing Countries; Disease; Embolism; Family Planning Services; Fibrinolysis; Malaysia; Physiology; Platelet Aggregation; Research; Risk Factors; Thromboembolism; Thrombosis; Vascular Diseases

The defendant, an obstetrician and gynaecologist, was accused of voluntarily causing a woman to miscarry, such miscarriage having been performed without good faith and an intention to save the woman's life. The Court upheld the conviction of the defendant, rejecting his argument, supported by an expert witness, that he had performed the abortion in order to avoid the possibility of pulmonary embolism, which might result because the woman had enlarged varicose veins. It held that the argument was not reasonable under the current law and that procuring an abortion was a serious matter to be done only as a last resort to save the life of a woman or to save her from becoming a mental "wreck."

Topics: Abortion, Induced; Abortion, Therapeutic; Asia; Asia, Southeastern; Crime; Delivery of Health Care; Developing Countries; Disease; Embolism; Family Planning Services; Health; Health Personnel; Jurisprudence; Legislation as Topic; Malaysia; Physicians; Pulmonary Embolism; Social Problems; Vascular Diseases

Out of a total of 6992 pregnancies which occurred among the 1616 Malaysian women at their various stages of reproductive cycles in 1982. 1.1% ended in stillbirths, 6.1% in spontaneous abortions, an 2.2% in induced abortions. Life cycle and family formation variables provided far sharper differentials in pregnancy wasstage as compared to the ethnic and educational variables. Pregnancy wastage rate varied from 5% at maternal age below 20, to 24% at maternal age 40-44, and from about 7.5% at the 1st 2 pregnancy orders to 13.8% at the 7th and higher orders. Intervals of 1 year or less had a wastage of 29.4%. Pregnancy outcome was strongly associated with the outcome of the preceding pregnancy. Data is based on analysis of the 1982 Survey on Health and Family Planning in Johore an Perak.

Topics: Abortion, Induced; Abortion, Spontaneous; Age Factors; Asia; Asia, Southeastern; Birth Order; Data Collection; Demography; Developing Countries; Disease; Family Characteristics; Family Planning Services; Family Relations; Fetal Death; Health; Health Surveys; Malaysia; Maternal Age; Mortality; Parents; Population; Population Characteristics; Population Dynamics; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Reproduction; Research; Sampling Studies; Statistics as Topic

Topics: Cultural Characteristics; Culture; Disease; Female; Food; Health Education; Humans; Infant; Malaysia; Pregnancy; Taboo; Therapeutics

This paper describes failures associated with sterilizations performed by the mini-laparotomy/pomeroy technic conducted in a private maternity home (Klinik Puravi) in Klang, Malaysia. The majority of the women sterilized had 3 or more living children at the time of sterilization, and the majority were Chinese (81.2%). Among Indians it was in the order of 17.7% and among the Malays only 1.2%. About 71.5% of the women sterilized were between 20 to 39 years of age, while only 0.2% were below 20 years of age and the remaining 2.4% were above 29 years of age. Complications during the procedure and during the post operative period were minimal and easily overcome. Of the sterilizations performed in 517 women, failure occurred in 5 subjects. Of these 5 failures, 3 were ectopics. All ectopics were treated by a bilateral salpingectomy.

Topics: Age Factors; Asia; Asia, Southeastern; Contraception; Contraception Behavior; Developing Countries; Disease; Ethnicity; Evaluation Studies as Topic; Family Planning Services; General Surgery; Health Facilities; Health Planning; India; Laparotomy; Malaysia; Maternal Age; Organization and Administration; Patient Acceptance of Health Care; Pregnancy Complications; Pregnancy, Ectopic; Program Evaluation; Sterilization, Reproductive; Sterilization, Tubal; Therapeutics

A study of 2 low-dose oral contraceptives, Loestrin and Nordette, was conducted in association with the National Family Planning Board in Kota Bharu, Kelantan, West Malaysia, to determine differences in continuation rates and reasons for discontinuation. This report includes analysis of 96 women, 91.7% of whom were interval patients, randomly allocated to 1 of the above OCs between December 1979 and January 1981. Follow-up visits were scheduled at 1, 3 and 6 months after admission with symptom grids completed during the 1st, 3rd, and 6th cycles. The continuation rates at 6 months were 85.9 and 89.8 for Loestrin and Nordette, respectively. The corresponding follow-up rates were 73.9 and 68.3. The side effect reported most often among both groups was breakthrough bleeding (BTB). In addition, the proportion of Loestrin users who reported BTB at least once during the study was significantly higher than the proportion of Nordette users (38.3% versus 18.4%, p 0.05). Other symptoms reported were nausea, headaches, intestinal problems, and abdominal pain. No accidental pregancies were reported during this study. There were a total of 6 (11.8%) discontinuations in the Loestrin group and 4 (8.9%) in the Nordette group.

Topics: Asia; Asia, Southeastern; Biology; Contraception; Contraception Behavior; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Data Collection; Developing Countries; Disease; Endocrine System; Family Planning Services; Hemorrhage; Hormones; Levonorgestrel; Malaysia; Menstruation Disturbances; Metrorrhagia; Norethindrone; Patient Acceptance of Health Care; Physiology; Research; Sampling Studies; Signs and Symptoms; Statistics as Topic

Pelvic inflammatory disease (PID) is a well-documented complication of IUD use. The presence of tails on the IUDs appears to facilitate ascent of bacteria from the vagina into the uterus. In this study, cervical smears of 128 IUD users were stained by Gram's stain and screened for the presence of Actinomyces-like organisms. 5.5% of the smears were positive for these organisms. Pus was seen in 20.1% of the smears, and yeast cells were seen in 10.2%. The average duration of IUD insertion was 8 months. Smears of 103 controls were negative for Actinomyces-like organisms, pus cells were present in 8.7%, and yeast cells in 4.8%. Of the 7 smears positive for the organisms, only 1 was from the user of a plastic device. All cases included were asymptomatic and were visiting the clinic for routine follow-up. These data suggest that colonization by Actinomyces-like organisms does not appear to be a significant problem in IUD users in Malaysia.

Topics: Asia; Asia, Southeastern; Biology; Cervix Uteri; Contraception; Developing Countries; Diagnosis; Disease; Family Planning Services; Genitalia; Genitalia, Female; Intrauterine Devices; Malaysia; Pelvic Inflammatory Disease; Physical Examination; Physiology; Research; Time Factors; Urogenital System; Uterus

This article descripes the compilation and analysis of basic perinatal statistics in the Maternity Hospital, Kuala Lumpur (MHKL), the largest maternity hospital in the country. The study period covered is 1980-1. Because consented autopsies are difficult to obtain in the social and religious setting of Malaysia, the approach of clinical classification of causes of neonatal deaths was adopted. Determinants of neonatal mortality included very low birthweight (less than 1.5kg), gestational age of less than 32 weeks, and clinical conditions of asphyxia, meconium aspiration syndrome, bacterial sepsis, and respiratory distress syndrome. The resulting charts underscore how simple neonatal data can be compiled to assess perinatal performance in a way which requires little statistical sophistication. Accurate perinatal statistics will enable better comprehension of preventable causes of perinatal deaths, and enhanced outcomes. Wider application of this approach is recommended in hospitals throughout Malaysia.

Topics: Age Factors; Asia; Asia, Southeastern; Birth Weight; Cause of Death; Culture; Data Collection; Delivery of Health Care; Demography; Developing Countries; Disease; Health; Health Facilities; Hospitals; Infant Mortality; Malaysia; Mortality; Population; Population Dynamics; Research

The efficacy of a recently marketed posttesticular male oral contraceptive, Contrasperm, was assessed in a clinical trial involving 32 Malaysian volunteers ages 21-39 years. Contrasperm is claimed to be a pure botanical extract free of toxic chemicals, steroids, and hormones. The drug is believed to cause cells surrounding the sperm in the seminiferous tubules to secrete carbon dioxide, producing a weakly acidic environment that greatly increases the sperms' metabolism and reduces the pH of semen from its normal level of 7.5 to 1.5. The manufacturer claims that this drop in pH decreases motility from 95% to 0%. Semen samples were collected by masturbation from subjects to provide baseline data. 3 days after the initial sperm analysis, subjects were given 1 capsule of Contrasperm containing 10 mcg of the active ingredient. Additional semen analyses were conducted 30 minutes, 6 hours, and 24 hours after ingestion. Sperm count and sperm motility were greatly reduced in most subjects 30 minutes after ingestion. However, 6 subjects had increased sperm counts and 4 subjects demonstrated increased sperm motility, indicating an enhancing effect. At 6 hours after ingestion, 20 subjects had lowered sperm motility and 12 subjects showed normal sperm motility, contradicting the manufacturer's claim that motility is reduced to 0%. Although Contrasperm is claimed to be effective for 6-8 hours after ingestion, its effect wore off in less than 6 hours in 37% of subjects. Both sperm count and sperm motility returned to normal levels 24 hours after ingestion, confirming the reversibility of this drug. Most subjects reported mild side effects such as muscle weakness, blurred vision, dizziness, perspiration, urgency, abnormal muscle tension, and dry throat which persisted longer than 24 hours. Further studies, with proper controls, are needed to assess the reliability and toxicity of this preparation.

Topics: Asia; Asia, Southeastern; Biology; Cells; Clinical Laboratory Techniques; Contraception; Contraception Behavior; Contraceptive Agents; Contraceptive Agents, Male; Delivery of Health Care; Developing Countries; Diagnosis; Disease; Evaluation Studies as Topic; Family Planning Services; Health; Health Services; Malaysia; Medicine; Physiology; Plants, Medicinal; Sperm Count; Sperm Immobilizing Agents; Spermatocidal Agents

The effect of oral contraceptives (OC) on folate and vitamin B12 levels was studied in a group of 180 women of the 3 ethnic groups in Malaysia attending family planning clinics. These findings confirm previous reports of a drop in serum B12 levels, from a mean of 596.8 pg/ml in the control group to 393.3 pg/ml in women who had been OC users for more than 3 years. The incidence of vitamin B12 deficiency, however, was only 8.0% in the longterm OC users. A significant drop in serum folate levels was seen only in women who had been OC users for more than 3 years; the incidence of folate deficiency, however, increased with the duration of OC therapy. These data justify the need to supplement OC users with folates. Vitamin B12 supplementation does not appear to be indicated. Previous studies have suggested that it is the metabolism, and not the absorption, of folate and vitamin B12 which is affected by OC use.

Topics: Asia; Asia, Southeastern; Biology; Blood; Contraception; Contraceptives, Oral; Deficiency Diseases; Demography; Developing Countries; Disease; Family Planning Services; Folic Acid; Longitudinal Studies; Malaysia; Metabolism; Nutrition Disorders; Physiology; Population; Population Dynamics; Research; Time Factors; Vitamin B Complex; Vitamins

Previous studies have suggested the possible involvement of oral contraceptives (OC) in enhanced red blood cell production (erythropoiesis). The present study attmepts to determine the effect of OC use on iron storage, as measured by serum ferritin, and on erythropoeitic activity in Malaysians. Health women of the 3 major Malaysian ethnic groups (Malays, Chinese, and Indians), all of whom were low-dose OC users, served as the study group. The findings confirm previous reports that serum iron levels are significantly increased in women taking OCs. Serum ferritin, a better measure of total body iron stores, dropped during the 1st 1-12 months of OC therapy. The drop was most pronounced at 4-6 months. However, by 1 or 2 years, the serum ferritin levels were comparable to those of the control group. Coinciding with the drop in serum ferritin was an increase in hemoglobin synthesis and erythropoiesis. These findings suggest that the initial drop in serum ferritin may be attributed to increased mobilization and utilization of iron as a result of increased erythropoiesis. This enhanced red blood cell production appears to be a consequence of OC therapy. After the 1st year, a new equilibrium is reached, at which the mean hemoglobin level, as well as total white blood cell and platelet count, is higher in OC users than in controls. Such changes have been shown to affect the flow properties of blood; further studies are needed to determine if these factors bear on the thromboembolic complications of OC use.

Topics: Asia; Asia, Southeastern; Biology; Blood; Chemical Phenomena; Chemistry; Contraception; Contraceptives, Oral; Demography; Developing Countries; Disease; Endocrine System; Estrogens; Family Planning Services; Hemoglobins; Hormones; Inorganic Chemicals; Iron; Longitudinal Studies; Malaysia; Metals; Physiology; Population; Population Dynamics; Progesterone; Progestins; Research; Time Factors

As part of a wider evaluation of the Multiload Copper 250 IUD, bleeding patterns were studied longitudinally during the 1st year following insertion in 150 women. The women were menstruating regularly and had not been pregnant or on hormone or intrauterine contraception in the preceding 2 months. Detailed counseling was given, including instruction on collection of menstrual data. The mean age of the patients was 28 years (19-35) and mean parity was 2-3; none was nulliparous. 12 subjects could not be contacted after insertion and were not considered further. At 12 months, there were 11 terminations: pain and/or bleeding, 2; other medical reasons, 1; accidental pregnancy, 1; planning pregnancy, 5f other personal reasons, 1; and lost to follow-up, 1. Following device insertion menstrual duration was initially increased, followed by a fall to levels which were not significantly different from preinsertion values after about 6-9 months of use. Similar trends were noted when menstrual bleeding and spotting were separately analyzed. The mean number of bleeding days decreased from 4.5 during the first 90 days to 4.2 and then 3.9, respectively, in the last 2 segments; the corresponding figures for menstrual spotting were 3.5, 2.8, 2.7, and 2.8 days. Intermenstrual bleeding and spotting were common after insertion but their frequency rapidly decreased with time. To a large extent, bleeding disturbances determine IUD acceptability. Thus, its perceived improvement would tend to encourage continued use and suggests that the potential risk of anemia in longterm users need not necessarily be serious.

Topics: Asia; Asia, Southeastern; Biology; Contraception; Developing Countries; Disease; Evaluation Studies as Topic; Family Planning Services; Genitalia; Genitalia, Female; Health Planning; Hemorrhage; Intrauterine Devices; Intrauterine Devices, Copper; Malaysia; Menstruation Disturbances; Patient Acceptance of Health Care; Physiology; Research; Research Design; Signs and Symptoms; Urogenital System

The official government policy in Malaysia is to reduce the rate of population growth through decreasing fertility levels and a program of economic and social restructuring. Population policy was conceived as encompassing wider dimensions than family planning, with emphasis on spatial distribution policies. The first Population and Housing Census was undertaken by the government in 1970. Regular decennial census taking occurred between 1891 and 1957. Birth and death registrations are considered incomplete. Population issues are integrated by various organizations into their ongoing programs such as those of the Ministries of Health, Education or Agriculture. The National Family Planning Board, an interministerial body in the Prime Minister's Department, has input from development planning units. A population studies group was established within the Economic Planning Unit. The total 1980 population was 13,640,000; the rate of population growth was 2.6 from 1975-80. Life expectancy was 61.3. Morbidity and mortality rates have dropped because of disease control and malnutrition reduction. 7.4% of the population are foreign born. Spatial distribution is to be adjusted through rural land development and resettlement; promotion of industrial development in low-income states; development of new growth centers and towns; and, urban development and renewal.

Topics: Asia; Asia, Southeastern; Demography; Developing Countries; Disease; Economics; Emigration and Immigration; Family Planning Services; Fertility; Geography; Goals; Health Planning; Malaysia; Morbidity; Mortality; Organization and Administration; Population; Population Control; Population Density; Population Dynamics; Population Growth; Public Policy; Social Planning

Topics: Cross-Cultural Comparison; Disease; Ethnicity; Humans; Indians, North American; Malaysia; Medicine, Traditional; Mexico; Self Concept; Sick Role; Social Environment; Sociology, Medical; Terminology as Topic

Topics: Age Factors; Aged; Child, Preschool; China; Disease; Female; Humans; Infant; Malaysia; Male; Sex Factors; Singapore

Topics: Culture; Disease; Humans; Islam; Malaysia; Medicine; Rural Health; Superstitions

Topics: Disease; Malaysia

Topics: Disease; Humans; Incidence; Malaysia; Military Medicine; Sweating; Toes

Topics: Disease; Malaysia; Military Medicine; Military Personnel; Naval Medicine; Tropical Medicine

Topics: Animals; Culicidae; Disease; Humans; Leptospirosis; Malaysia; Military Personnel

Topics: Disease; Leptospirosis; Malaysia; Military Personnel; Penicillins

Topics: Animals; Chloramphenicol; Culicidae; Disease; Ethnicity; Humans; Leptospirosis; Malaysia; Military Personnel; Penicillins

Topics: Disease; Humans; Malaysia; Medicine; Military Medicine; Military Personnel; Naval Medicine; Wounds and Injuries

Topics: Disease; Humans; Incidence; Malaysia; Mouth Diseases; Stomatognathic Diseases; Tooth; Tooth Diseases

Topics: Asian People; Dentistry; Disease; Ethnicity; Humans; Malaysia; Occupations; Prisoners; Prisoners of War; Singapore; Tooth; Tooth Diseases; Warfare