exudates and Syndrome

We describe two Malay male term neonates with congenital limb reduction defects. The first neonate had hypodactyly of limbs associated with micrognathia, microstomia, glossopalatine ankylosis and congenital mitral stenosis. He developed gram-negative septicaemia and died on day 14 of life. The second neonate had tetraperomelia without any other associated congenital abnormality. He developed staphylococcal skin infection which was treated conservatively. Very few cases of congenital limb reduction defects have been reported in the Asian population and we are not aware of any other reports describing Malay infants with the congenital abnormalities described in this report.

Topics: Abnormalities, Multiple; Humans; Infant, Newborn; Limb Deformities, Congenital; Malaysia; Male; Mitral Valve Stenosis; Syndrome; Tongue

The objectives of the study were to compare the demographic characteristics, presenting complaints, timeliness of diagnosis, and treatments given to all patients diagnosed with obstructive hemivagina ipsilateral renal agenesis (OHVIRA) between the adolescent group (age 10-19) and the adult group (age 20 and above) and to propose a feasible screening test consisting of routine bedside ultrasound to detect renal anomalies in addition to pelvic ultrasound during the assessment of females with gynecologic complications in resource-limited settings.. We conducted a retrospective cohort analysis of all patients with OHVIRA at our institution, Sabah Women and Children's Hospital, Malaysia, between the 2013 and 2022. Data were collected by reviewing patients' medical notes.. There were a total of 18 patients diagnosed with OHVIRA from 2013 to 2022, aged 10-41 years old. Nine patients (50%) presented during adolescence. Most (88.9%) came with symptoms such as abdominal pain, urinary symptoms, abnormal uterine bleeding, foul-smelling vaginal discharge, and primary infertility, whereas only 2 patients (11.1%) were asymptomatic and diagnosed incidentally. Acute abdomen was more common in the adolescent group (P = .015). No significant difference was found on the side of the renal anomaly.. Presenting symptoms vary and are often mimicked other gynecologic or surgical conditions, making the diagnosis difficult and delayed. Some patients were incidentally diagnosed while being managed for other problems, and it was not uncommon to have unnecessary surgery before the correct diagnosis was made. We suggest that all female patients with abdominal and pelvic complaints should be screened for renal anomaly during pelvic scan to improve diagnostic rates.

Topics: Abnormalities, Multiple; Adolescent; Adult; Child; Female; Humans; Kidney; Malaysia; Retrospective Studies; Syndrome; Uterus; Vagina; Young Adult

Biodiversity research relies largely on knowledge about species responses to environmental gradients, assessed using some commonly applied sampling method. However, the consistency of detected responses using different sampling methods, and thus the generality of findings, has seldom been assessed in tropical ecosystems. Hence, we studied the response consistency and indicator functioning of beetle assemblages in altitudinal gradients from two mountains in Malaysia, using Malaise, light, and pitfall traps. The data were analyzed using generalized linear mixed-effects models (GLMM), non-metric multidimensional scaling (NMDS), multivariate regression trees (MRT), and indicator species analysis (IndVal). We collected 198 morpho-species of beetles representing 32 families, with a total number of 3,052 individual beetles. The richness measures generally declined with increasing altitude. The mountains differed little in terms of light and Malaise trap data but differed remarkably in pitfall-trap data. Only light traps (but not the other trap types) distinguished high from middle or low altitudes in terms of beetle richness and assemblage composition. The lower altitudes hosted about twice as many indicators as middle or high altitudes, and many species were trap-type specific in our data. These results suggest that the three sampling methods reflected the altitudinal gradient in different ways and the detection of community variation in the environment thus depends on the chosen sampling method. However, also the analytical approach appeared important, further underlining the need to use multiple methods in environmental assessments.

Topics: Altitude; Animals; Biodiversity; Coleoptera; Ecosystem; Humans; Malaysia; Syndrome

Motoric cognitive risk (MCR) syndrome is characterized by slow gait and memory complaints that could be used to predict an increased risk of dementia. This study aims to determine the MCR syndrome and its risk factors among low-income (B40) older adults in Malaysia.. Data from TUA cohort study involving 1366 older adults (aged 60 years and above) categorized as low-income were analysed, for risk of MCR syndrome based on defined criteria. Chi-square analysis and independent t test were employed to examine differences in socioeconomic, demographic, chronic diseases and lifestyle factors between MCR and non-MCR groups. Risk factors of MCR syndrome were determined using hierarchical logistic regression.. A total of 3.4% of participants fulfilled the criteria of MCR syndrome. Majority of them were female (74.5%, p = 0.001), single/widow/widower/divorced (55.3%, p = 0.002), living in rural area (72.3%, p = 0.011), older age (72.74 ± 7.08 year old, p <  0.001) and had lower years of education (3.26 ± 2.91 years, p = 0.001) than non-MCR group. After adjustment for age, gender and years of education, participants living in rural area (Adjusted OR = 2.19, 95% CI = 1.10-4.35, p = 0.026), with obesity (Adjusted OR = 3.82, 95% CI = 1.70-8.57, p = 0.001), diabetes (Adjusted OR = 2.04, 95% CI = 1.01-4.11, p = 0.046), heart disease (Adjusted OR = 2.50, 95% CI = 1.00-6.20, p = 0.049) and cancer (Adjusted OR = 6.57, 95% CI = 1.18-36.65, p = 0.032) were associated with increased risk of MCR syndrome.. Only 3.4% of older adults from low-income group were identified as having MCR syndrome. Women, those living in rural areas, had obesity, diabetes, heart disease and cancer were more likely to have MCR syndrome. Further investigation on MCR as a predementia syndrome will help in development of preventive strategies and interventions to reduce the growing burden of dementia, especially among individuals with low socioeconomic status.

Topics: Aged; Cognition Disorders; Cohort Studies; Dementia; Female; Humans; Malaysia; Male; Middle Aged; Poverty; Risk Factors; Syndrome

Middle-aortic syndrome is a surgically curable cause of childhood hypertension. Open surgery is traditionally offered but with the advance of medical technology, endovascular approached is available in many country. Failure to control BP in open surgery is as low as 4.1% compares to 13% in endovascular approaches. However, mortality is 4% in open surgery almost 2 times higher than 2.3% in endovascular approach. This article presents a case of 10 years old child treated successfully without complication with endovascular balloon dilatation, as a first case of such disease in East Malaysia.

Topics: Angiography; Aorta; Aortic Diseases; Child; Endovascular Procedures; Humans; Hypertension; Malaysia; Male; Syndrome

The Pan-Asian REVIVE survey aimed to examine women's experiences with genitourinary syndrome of menopause (GSM) and their interactions with health-care professionals (HCPs).. Self-completed surveys were administered face-to-face to 5992 women (aged 45-75 years) in Indonesia, Malaysia, Singapore, Taiwan, and Thailand.. Of 638 postmenopausal women with GSM symptoms, only 35% were aware of the GSM condition, most of whom first heard of GSM through their physician (32%). The most common symptoms were vaginal dryness (57%) and irritation (43%). GSM had the greatest impact on sexual enjoyment (65%) and intimacy (61%). Only 25% had discussed their GSM symptoms with a HCP, and such discussions were mostly patient-initiated (64%) rather than HCP-initiated (24%). Only 21% had been clinically diagnosed with GSM and only 24% had ever used treatment for their symptoms. Three-quarters of those who had used treatment for GSM had discussed their symptoms with a HCP compared to only 9% of those who were treatment-naïve.. GSM is underdiagnosed and undertreated in Asia. As discussion of GSM with HCPs appears to be a factor influencing women's awareness and treatment status, a more active role by HCPs to facilitate early discussions on GSM and its treatment options is needed.

Topics: Aged; Atrophy; Dyspareunia; Female; Female Urogenital Diseases; Health Knowledge, Attitudes, Practice; Health Surveys; Humans; Indonesia; Malaysia; Methaqualone; Middle Aged; Postmenopause; Sexual Behavior; Singapore; Surveys and Questionnaires; Syndrome; Taiwan; Thailand; Vagina; Vulva; Women's Health

Cronkhite-Canada Syndrome (CCS) is a syndrome characterised by a constellation of signs including but not limited to onychodystrophy of the finger and toe nails, skin hyperpigmentation and alopecia. Endoscopic features showed hamartomatous polyps involving all segments of the gastrointestinal tract with the characteristic exception of being oesophageal sparring. These polyps show confirmation by the presence of eosinophils and mast cells at the lamina propria upon histological studies.

Topics: Alopecia; Humans; Intestinal Polyposis; Malaysia; Polyps; Syndrome

Jellyfish stings are the most frequently reported marine animal envenomation worldwide. However, data on jellyfish sting from Malaysia remains obscure due to inadequate research.. We investigated the epidemiology, clinical features and treatment of patients presenting at the emergency department of Langkawi Hospital between January 2012 and December 2014. Secondary data on the nature of the incident, patient demographics, clinical presentation, and treatment were retrieved from the patients' medical records. Descriptive statistics were presented for all patient variables.. A total of 759 patients presented with jellyfish stings during the 3-year study period, with highest number of visits in July, October, November, and December. The mean patient age was 26.7 years (SD: 12.14), 59.4% were men, 68.1% were foreigners or international tourists, and 40.4% were stung between 12.00 p.m. and 6:59 p.m. At least 90 patients presented with mild Irukandji or Irukandji-like syndromes. Most of the jellyfish stings occurred at Chenang Beach (590 reported cases), followed by Tengah Beach and Kok Beach. Most patients were treated symptomatically, and no deaths following a jellyfish sting was reported during the study period.. There is a need for public health interventions for both local and international tourists who visit Langkawi Island. Preventive steps and education on initial treatment at the incident site could elevate public awareness and decrease the adverse effects of jellyfish stings.

Topics: Adolescent; Adult; Animals; Bites and Stings; Emergency Service, Hospital; Female; Humans; Malaysia; Male; Public Health; Scyphozoa; Syndrome; Young Adult

Vena cava compression is a relatively rare initial manifestation of underlying malignancy. The superior vena cava syndrome, which is characterized by facial plethora, jugular venous distension, and arm swelling, is a well-known entity associated with bronchogenic carcinoma. Less common is the compression of the inferior vena cava. To the best of my knowledge, this is the first reported case of newly diagnosed gastric adenocarcinoma presenting initially as the inferior vena cava syndrome. The unique aspect about this case is that it highlights a rare presentation before diagnosis of gastric adenocarcinoma.. A 56-year-old Malaysian woman with a past medical history of iron deficiency anemia presented with lower extremity edema and progressive fatigue of 1 month's duration. She had significant worsening of leg swelling after standing for short periods of time. She also reported epigastric discomfort, which led to an additional workup, including computed tomography of the abdomen and pelvis. This revealed a 3cm×2.9cm mass in the stomach, extensive hepatic metastasis, and severe inferior vena cava compression. The patient was examined further with esophagogastroduodenoscopy, and a biopsy showed gastric adenocarcinoma.. This report describes a case of a patient with inferior vena cava syndrome as a unique presentation of previously undiagnosed stage IV gastric adenocarcinoma. Patients presenting with inferior vena cava syndrome should undergo prompt evaluation for underlying malignancies that have a predilection for hepatic metastasis. This case is important because earlier recognition of this syndrome can lead to earlier workup and thus detection of malignancy. Prompt initiation of treatment, including chemotherapy or vena cava stent placement, can result in improved patient outcome.

Topics: Adenocarcinoma; Anemia, Iron-Deficiency; Antineoplastic Combined Chemotherapy Protocols; Budd-Chiari Syndrome; Disease Progression; Edema; Endoscopy, Gastrointestinal; Fatigue; Female; Humans; Lower Extremity; Malaysia; Middle Aged; Neoplasm Staging; Paclitaxel; Stomach Neoplasms; Syndrome; Tomography, X-Ray Computed; Trastuzumab; Treatment Outcome; Vena Cava, Inferior

Tuberous sclerosis complex is an autosomal dominant neurocutaneous disorder affecting multiple organs. Tuberous sclerosis complex is caused by mutation in either one of the two disease-causing genes, TSC1 or TSC2, encoding for hamartin and tuberin, respectively. TSC2/PKD1 contiguous gene deletion syndrome is a very rare condition due to deletion involving both TSC2 and PKD1 genes. Tuberous sclerosis complex cannot be easily diagnosed since there is no pathognomonic feature, although there are consensus diagnostic criteria for that. Mutation analysis is useful and plays important roles. We report here two novel gross deletions of TSC2 gene in Malay patients with tuberous sclerosis complex and TSC2/PKD1 contiguous gene deletion syndrome, respectively.

Topics: Adult; Asian People; DNA Mutational Analysis; Female; Humans; Malaysia; Male; Sequence Deletion; Syndrome; TRPP Cation Channels; Tuberous Sclerosis; Tuberous Sclerosis Complex 1 Protein; Tuberous Sclerosis Complex 2 Protein; Tumor Suppressor Proteins

On 14 April 2014, the first laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported in Malaysia in a man in his mid-fifties, who developed pneumonia with respiratory distress, after returning from a pilgrimage to Saudi Arabia. The case succumbed to his illness three days after admission at a local hospital. The follow-up of 199 close contacts identified through contact tracing and vigilant surveillance did not result in detecting any other confirmed cases of MERS-CoV infection.

Topics: Antiviral Agents; Communicable Disease Control; Contact Tracing; Coronavirus; Coronavirus Infections; Disease Notification; Fatal Outcome; Humans; Malaysia; Middle Aged; Oseltamivir; Polymerase Chain Reaction; Population Surveillance; Respiratory Tract Infections; Reverse Transcriptase Polymerase Chain Reaction; Saudi Arabia; Syndrome; Travel

To examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending "high-risk" schools in Kuala Lumpur.. This is a cross-sectional study conducted upon 16-year-old adolescents attending three high-risk schools in Kuala Lumpur. A total of 373 students completed self-administered questionnaires on the sociodemographic variables and externalizing/internalizing syndromes. The number of truant-days per student during the study period was obtained from the school records.. The mean internalizing score, externalizing score and total problem score of those who were truant were found to be significantly higher (P < 0.05) than those who were non-truant. Multiple logistic regressions showed externalizing syndrome (odds ratio [OR] = 1.044; confidence interval [CI] = 1.012-1.078, P = 0.018) significantly predicts truancy but not the internalizing syndrome. Two other psychosocial factors, namely, having divorced parents (OR = 2.495, CI = 1.058-5.886, P = 0.037) and did not understand or were uncertain of the purpose of schooling (OR = 2.621, CI = 1.265-5.433, P = 0.010) were also showed to be stronger predictors of truancy compared to externalizing/internalizing syndromes.. Truancy has significant association to externalizing syndrome, in addition to other significant psychosocial variables like parental and schooling factors. This finding indicated the need for comprehensive assessment of students presenting with truant behavior, including the identification of associated psychological and behavioral problems which highlights the roles of mental health professionals in tackling truancy.

Topics: Absenteeism; Adolescent; Cross-Sectional Studies; Family; Female; Humans; Malaysia; Male; Prevalence; Psychology, Adolescent; Risk Factors; Schools; Students; Surveys and Questionnaires; Syndrome; Urban Population

Fibromyalgia syndrome (FMS) is a common but controversial condition. There appears to be different levels of belief of its existence and awareness. We set out to explore the variations of perceptions and awareness of this condition among rheumatologists from Malaysia and Singapore.. 48 rheumatologists from Malaysia (28) and Singapore (20) were approached to participate in this survey by answering a specific questionnaire regarding their belief in FMS. 23 respondents from Malaysia and 20 from Singapore completed the questionnaire.. 91 percent of Malaysian rheumatologists and 95 percent of the Singaporean believe that FMS is a distinct clinical entity and that this condition is considered an illness rather than a disease. 87 percent and 90 percent of rheumatologists from Malaysia and Singapore, respectively, believe that FMS is a mixture of medical and psychological illness. However, not many of those in the university setting include FMS in their undergraduate teaching. 87 percent and 80 percent of the respondents from Malaysia and Singapore, respectively, also ordered blood tests to exclude other serious pathologies, and 100 percent of the respondents from both countries also prescribed some form of drugs to their FMS patients.. This study confirmed that there was a variation of perceptions and knowledge of FMS among rheumatologists from Malaysia and Singapore. The majority of rheumatologists recognise that FMS is a distinct clinical entity, and is diagnosed by excluding other well-defined clinical diseases through a combination of clinical evaluation and screening tests.

Topics: Awareness; Fibromyalgia; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Perception; Practice Patterns, Physicians'; Rheumatology; Singapore; Surveys and Questionnaires; Syndrome

Running amok is considered a rare but dangerous act of violence which has been investigated predominantly on a case by case basis. German-wide data on amok cases covering the decades 1980 - 1989 and 1991 - 2000 were used to perform the first epidemiological study world-wide on the stability of socio-demographic, criminological and psychiatric variables of amok behaviour.. A content analysis study on nation-wide press reports of amok cases included a total of 104 subjects who were identified by combined homicidal-suicidal acts of violence and fulfilled structured criteria originally defined according to former Malayan amok events.. Amok cases in both decades were comparable except for the significant increase of weapon use, especially of firearms. Total prevalence showed a tendency to decline from 1 : 5.5 million to 1 : 8.5 million men per year, females were involved in rare single cases only. The male offenders showed a bimodal age distribution with a mean of 35 years. They were professionally well qualified, but had a 5 - 7fold higher risk of unemployment than the normal population. Motives and reasons for running amok were serious but not unusual, they varied widely and addressed all areas of daily life. Most offenders were characterized by abnormal personality patterns such as passive, aggressive, impulsive and paranoid and were in possession of firearms and previously convicted. Psychiatric diseases such as psychosis, paranoia, depression or personality disorders were present in more than 50 % of cases; further 20 % were intoxicated. The presence of psychiatric disorders influenced patterns of violent behaviour in individual subjects. Victims were predominantly unknown to the offenders. Close to one third of the amok runners committed suicide or were killed by legal authorities.. Amok represents a temporarily stable syndrome of extreme violent behaviour even in modern industrialized societies. Subjects exhibit a complex combination of serious causative motives, social burden and psychiatric diseases which do not explain common causes of amok rather than the origin of amok behaviour in individual cases. Amok joins the wide spectrum of human homicidal-suicidal acts which show similarities in many aspects.

Topics: Adult; Alcoholic Intoxication; Female; Firearms; Germany; Homicide; Humans; Malaysia; Male; Mental Disorders; Personality; Suicide; Syndrome; Unemployment; Violence

We present two siblings from a consanguineous Malaysian family with multiple skeletal abnormalities, anterior segment anomalies of the eye and early lethality. These features are consistent with a syndrome first described by Al-Gazali and we provide further delineation of the syndrome.

Topics: Adult; Anterior Eye Segment; Bone and Bones; Consanguinity; Female; Humans; Infant, Newborn; Malaysia; Male; Siblings; Syndrome

The unprecedented inclusion of culture-bound syndromes in DSM-IV provides the opportunity for highlighting the need to study such syndromes and the occasion for developing a research agenda to study them. The growing ethnic and cultural diversity of the U.S. population presents a challenge to the mental health field to develop truly cross-cultural approaches to mental health research and services. In this article, the authors provide a critique of previous analyses of the relationship between culture-bound syndromes and psychiatric diagnoses. They highlight the problems in previous classificatory exercises, which tend to focus on subsuming the culture-bound syndromes into psychiatric categories and fail to fully investigate these syndromes on their own terms. A detailed research program based on four key questions is presented both to understand culture-bound syndromes within their cultural context and to analyze the relationship between these syndromes and psychiatric disorders. Results of over a decade of research on ataques de nervios, a Latino-Caribbean cultural syndrome, are used to illustrate this research program. The four questions focus on the nature of the phenomenon, the social-cultural location of sufferers, the relationship of culture-bound syndromes to psychiatric disorders, and the social and psychiatric history of the syndrome in the life course of the sufferer.

Topics: Cross-Cultural Comparison; Cultural Diversity; Culture; Ethnicity; Female; Humans; Koro; Malaysia; Male; Medicine, Traditional; Mental Disorders; Middle Aged; Research Design; Syndrome; Terminology as Topic; United States; West Indies

Since 1994, white spot syndrome virus (WSSV) has been detected in cultured shrimp Penaeus monodon in Peninsular Malaysia. The gross signs, target organs and histo-cytopathology for the viral infection were studied and it was found to infect most organs and tissues including oocytes, but not hepatopancreatocytes and epithelial cells of the midgut, which were regarded as refractory tissues. Based on a time-sequence of ultrastructural cytopathology, 4 cytopathic profiles and 6 phases of viral morphogenesis were described. The virions were elliptical to short rods with trilamilar envelopes that measured 305 +/- 30 x 127 +/- 11 nm. Viral nucleosomes were often present singly in infected nuclei and were associated with the early stages of viral replication. The structure of WSSV pathognomonic white, cuticular lesions was examined at the microscopic and ultrastructural levels and the mechanism of their formation appeared to be related to the disruption of exudate transfer from epithelial cells to the cuticle via cuticular pore canals.

Topics: Animals; Aquaculture; DNA Viruses; Malaysia; Microscopy, Electron; Penaeidae; Syndrome; Virion

To describe the clinical features, management and outcome of children with cyclic vomiting syndrome (CVS) from South-East Asia.. Retrospective review of all children who fulfilled the diagnostic criteria of CVS and who were seen at Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur and Paediatric Unit, Penang Hospital, Penang, Malaysia from 1987 to 1997.. Eight children with CVS were seen at the two units during the study period, five girls and three boys. All had cyclical, self-limited episodes of nausea and vomiting with symptom-free intervals. The mean age of onset was 5.9 years. The clinical features were similar to other series described in the literature. Only two of the eight children were described as 'perfectionist'. Two children identified stress as precipitating factors. Therapy to reduce the number of emeses during acute attacks and to prevent subsequent attacks had been ineffective.. There are similarities and differences in CVS from South-East Asian children as compared to those described in the literature.

Topics: Age of Onset; Child; Child, Preschool; Female; Humans; Malaysia; Male; Nausea; Retrospective Studies; Sleep Stages; Syndrome; Vomiting

Asperger's Syndrome is a distinct variant of autism, with a prevalence rate of 10 to 26 per 10,000 of normal intelligence, and 0.4 per 10,000 in those with mild mental retardation. The syndrome now has its own clinical entity and diagnostic criteria. It is being officially listed in the ICD-10 under pervasive developmental disorder. Two such cases are described in this article. Case One lacked the ability to relate to others, was excessively preoccupied with the late actor P. Ramlee and demonstrated a peculiar behaviour of holding on to toothbrushes in his early childhood. Cognitively, he was unable to synthesise words into meaningful sentences. Similarly, Case Two was unable to relate well to others and was preoccupied with the planets and its constellations. Though he appeared intelligent with an IQ score of 101, he was unable to follow instructions at school. Both children had motor clumsiness and fulfilled the criteria for the diagnosis of Asperger's Syndrome.

Topics: Autistic Disorder; Child; Child Development Disorders, Pervasive; Humans; Language Development Disorders; Malaysia; Male; Psychiatric Status Rating Scales; Social Behavior; Stereotyped Behavior; Syndrome

Thirty-seven cases of latah are examined within the author's Malay extended family (N = 115). Based on ethnographic data collected and a literature review, cases are readily divisible into two broad categories: habitual (N = 33) and performance (N = 4). The first form represents an infrequent, culturally conditioned habit that is occasionally used as a learned coping strategy in the form of a cathartic stress response to sudden startle with limited secondary benefits (i.e., exhibiting brief verbal obscenity with impunity). In this sense, it is identical to Western swearing. Performers are engaged in conscious, ritualized social gain through the purported exploitation of a neurophysiological potential. The latter process is essentially irrelevant, akin to sneezing or yawning. It is concluded that latah is a social construction of Western-trained universalist scientists. The concept of malingering and fraud in anthropology is critically discussed.

Topics: Adaptation, Psychological; Adolescent; Adult; Aged; Culture; Ethnicity; Exhibitionism; Family; Female; Fraud; Habits; Hallucinations; Humans; Malaysia; Male; Malingering; Mental Disorders; Middle Aged; Reflex, Startle; Syndrome

Topics: Base Sequence; Capsid; Dengue; Dengue Virus; Humans; Malaysia; Molecular Sequence Data; Sequence Homology, Nucleic Acid; Syndrome; Viral Core Proteins; Viral Nonstructural Proteins

A study was carried out to determine the health effects of rice husk dust in Malaysian rice millers. The study population consisted of 122 male Malay workers from three rice mills, with 42 controls of similar age, sex, ethnic group, and agricultural work background. Interviews using standardised questionnaires, physical examination, total and differential white cell counts, chest radiographs, and lung function tests were performed on each of the millers and the controls. Environmental dust monitoring was also carried out in the three rice mills. Clinical, haematological, and radiological findings suggest that a distinct clinical syndrome seems to be associated with exposure to rice husk dust. The manifestations of this "rice millers' syndrome" include acute and chronic irritant effects affecting the eyes, skin, and upper respiratory tract; allergic responses such as nasal catarrh, tightness of chest, asthma, and eosinophilia; and radiological opacities in the chest, probably representing early silicosis or extrinsic allergic alveolitis.

Topics: Adolescent; Adult; Dust; Eye Diseases; Food-Processing Industry; Humans; Lung; Lung Diseases; Malaysia; Male; Middle Aged; Occupational Diseases; Oryza; Radiography; Respiratory Hypersensitivity; Syndrome

Turner's concepts of structure and anti-structure are applied to the culture-bound syndromes to demonstrate that they are dialectical aspects of cultural reality, The Malay cases of amok, latah and possession hysteria are discussed as instances of anti-structural behaviors that dramatize role-reversals and role-enhancement. The performers of these behaviors are not subjected to the Malay code of moral conduct. The supernatural ethos in Malay culture plays an important role in shaping tolerance towards them. Although this tolerance has been gradually eroded as a result of the introduction of Western psychiatry, the anti-structural status of these syndromes has not faded away but has assumed new meanings in terms of psychopathology.

Topics: Cultural Characteristics; Cultural Evolution; Culture; Female; Humans; Malaysia; Male; Mental Disorders; Morals; Motivation; Psychological Theory; Sex Factors; Social Control, Informal; Syndrome

Marchiafava-Bignami disease, a rare affliction of alcoholic males, is described in a severely malnourished Malaysian Indian male who took no alcohol. It is the second report of the disease in an Asian and represents one of the few cases which have occurred in non-alcoholics. Besides the pathognomonic demyelination of the central portion of the corpus callosum, there were striking demyelinative plaques in the subcortical white matter. In addition, neuropathological features of Wernicke's disease were found suggesting that severe malnutrition with thiamine deficiency was probably the cause of his demise.

Topics: Alcoholism; Australia; Brain Diseases; Corpus Callosum; Humans; Malaysia; Male; Psychoses, Alcoholic; Syndrome; Wernicke Encephalopathy

The phenomenon of amok is reviewed in order to demonstrate the heuristic value of an ethno-behavioral model of culture-bound syndromes. The notion that culture-bound syndromes share underlying common disease forms is rejected. Instead, the ethno-behavioral model postulates that culture-bound syndromes consist of culturally specific behavioral repertoires legitimated by culturally sanctioned norms and concepts, but with both behavior and norms acquired in accordance with basic principles of human learning universal to all cultures. Consistent with this model, amok is shown to be a common behavioral pathway for multiple precipitants (which may or may not include disease pathology), but with a distinct form and conceptualization which can be traced to the social learning practices and beliefs of the Malay.

Topics: Attitude to Health; Culture; Ethnicity; Humans; Language; Malaysia; Mental Disorders; Social Behavior; Social Conformity; Social Environment; Stress, Psychological; Syndrome