Modern Aspects of Psychiatric Day Care
Wong Tai-Hwang, Lecturer, Department of Psychological Medicine, University of Malaya, Kuala Lumpur

Summary
Emergence of the socio-cultural theory of mental illness and introduction of chemotherapy enable the setting up of a special type of therapeutic milieu, namely day care centre or day hospital. This Paper reviews the functions, principles, methods and techniques involved. Via the different types of activities and the therapeutic interaction of staff and patients, selected psychiatric patients learn new behaviour patterns in a day centre while maintaining family and community contact.

Some Psychosocial Characteristics of Sexual Reassignment Requestors in Singapore - A Report on 23 Cases
F Y Long and M M Lee, Department of Psychology, Woodbridge Hospital, Singapore

Summary
A psycho-social study of 23 unmarried patients (21 males, 2 females) requesting sexual reassignment surgery shows that 82.6% were Chinese, 8.7% Indians, and 8.7% Eurasians. The mode age was 22 years. Most were engaged in occupations deemed appropriate for the opposite gender. Except 2 cases, all the males have had homosexual relationship in the receptor role. One female was lesbian. All denied any heterosexual experience. Most had cross-dressed either fully, partially or occasionally. 13 males have developed feminine breasts. The majority have at least secondary education. Birth complication, certain birth disorders, parental separation/death, adoption, etc. were noted but the patterns were still unclear for drawing definite conclusions. As a group, psychological testing suggested they were of "bright-normal" intelligence. Compared with Singapore Medical Students, they were significantly unstable in emotionality and needed to project a socially desirable image. Depression was generally noted. The male patients displayed strong feminine interests and adherence to female stereotype.

Biochemical Assessment of the Nutritional Status of Pre-School Children in Kuala Terengganu
Y H Chong, Head, Division of Nutrition, Institute for Medical Research, Kuala Lumpur

Summary
A baseline nutrition survey involving biochemical assessment, nutritional anthropometry and abbreviated clinical examination was conducted on 399 pre-school children of Malay origin in Bukit Payong, a rural district near the east coast town of Kuala Terengganu during September 1972.

The evidence derived from the biochemical evaluation considered in conjunction with nutritional anthropometry suggests that between 20-25% of the children examined were suffering from some moderate to severe degree of malnutrition which were related to deficiencies in protein, calories and vitamin A and to anaemia. The latter is presumed to be dietary in origin since the prevalence of both malaria and hookworm was minimal.

A Survey of Geriatric Cases in the Psychiatric Wards - University Hospital Admitted in July 1967 to December 1969
Mohsain Esa

Summary
A survey of the case records of 64 geriatric in-patients admitted to the psychiatric unit of the University of Malaya Hospital for the period June 1967 to December 1969 was done and the data compared with a control group. The results show that such factors as marital status, number of children, occupation and age group distribution show some significant differences but these could be accounted for by factors such as urbanization, education, traditional beliefs and distance from hospital, which probably influence this distribution. The duration of stay of the psychiatric patients was interesting in that it showed that there were two groups of patients admitted, those that were discharged by six weeks and those that remained longer than six weeks. The overall distribution of the different categories of diagnosis seemed to be similar to what other workers have found elsewhere.

Battered Child Syndrome in a Malaysian Hospital
Dr Woon Tai Hwang*, Mrs Carmel Chin** and Professor Lam Khuan Leng***, *Lecturer, Department of Psychological Medicine, University of Malaya, Kuala Lumpur, **Medical Social Worker, University Hospital, ***Associate Professor and Acting Head, Dept of Paediatrics, University of Malaya

Summary
Between 1968 and 1973, seven battered child syndromes were treated in the University Hospital, Kuala Lumpur. All the seven children were seen between 1971 and 1973. The clinical features include bruises, scalp haematoma, radiological evidence of fractures of skull and abdominal visceral injuries. The history of assault was available at admission in three cases while the suspicion was confirmed later in the other four. Three of them were under three years old. The families concerned frequently did not bring their children for medical and social follow-up. The importance of teamwork between the doctors and social workers, and hospitalization of the suspected child at the initial stage, were stressed. An appeal to medical practitioners and others for cooperaiton in detection of cases was made.

Bell's Palsy - A Retrospective Study
Dr Diong Ko Ing, 80, Main Road, Kampong Koh, Sitiawan, Perak

Summary
An opportunity was taken to make a retrospective study of a small endemic outbreak of Bell's Palsy in the district of Sitiawan. Though the study involved only 8 cases, some valuable observations were made. A viral agent was strongly implicated as the causal agent in the endemic, and the study showed that prednisolone has definitely a place in the treatment of Bell's Palsy. It hastens recovery and prevents denervation. Taverner and his colleagues used prednisolone only for selected cases and did not recommend the treatment for teenage patients as most would recover spontaneously. It would seem, however, that these young patients would be denied the benefit of the treatment, if they are not given at least a trial course of the treatment. It is the author's opinion that all patients with Bell's Palsy presenting within one month of the onset of the illness should be given a trial of the treatment.

Trimethoprim-Sulphamethoxazole in the Treatment of Infections in Obstetrical and Gynaecological Practice - A Bacteriology and Clinical Study
Dr Ng Keng Hing*, Dr Wong Wai Ping*, Dr Chai Kim Hai**, *Department of O & G, **Department of Bacteriology, University of Malaya, Kuala Lumpur

Summary
It would appear that the combination of sulphamethoxazole and trimethoprim is most effective in the treatment of obstetricl and gynaecological infections. Good and moderate responses were seen in 94% of patients. The bacteriological investigations confirmed the high sensitivity of organisms isolated (82% sensitive) to the drugs. The percentage of success suggest it might be more effective than penicillin and streptomycin, treating these patients. A comparison of these different drug combinations has been reported. Toxicity to the drug was minimal in our study (3.6%).

Oral Prostagladin E2 and Amniotomy for Induction of Labour
Nafisah Adeeb, Thomas Ng Khoon Fong, Department of O & G, General Hospital, Kuala Lumpur

Summary
This is a preliminary communication of an on-going study of the efficacy, safety and acceptability of oral prostagladin E2 in association with amniotomy for the induction of labour. Out of the initial series of 43 cases, vaginal delivery was achieved in 38 on prostagladin E2 alone, 2 with the addition of oxytocin infusion. Three Caesarean sections were performed, one for borderline disproportion and two for foetal distress. The mean induction delivery interval was 11 hours for primigravidae and 6 hours 9 minutes for multigravidae. There were no untoward maternal or foetal side-effects.

The Cardiorespiratory Fitness and Energy Expenditure of the Temiars
Chan Onn Leng*. Margaret T Duncen*, J W Sundsten*, T Thinakaran**, Mohd Nor Bin Che' Noh**, V Klissouras***, *Faculty of Medicine, University of Malaya, Kuala Lumpur, **Ministry of Culture, Youth and Sports, Kuala Lumpur, ***Department of Ergophysiology, McGill University, Montreal

Summary
A primitive settlement of Temiars was selected for a study of their physical work capacity in their natural environment. Twenty boys and 10 men were subjected to exhaustive exercise on a step-ergometer and their maximal oxygen consumption, heart rate and blood lactate levels were observed. The boys aged between 12-18 years, were found to have a mean maximal oxygen uptake of 45.9 ± 6.7 ml/min/kg body weight, a mean maximum heart rate of 94.4 ± 4 beats per min., and a mean lactate level of 75 ± 18 mg%; whilst the men showed a higher maximum oxygen consumption of 53.2 ± 2 ml/min/kg, a lower maximum heart rate of 187 ± 32.4 mg%. These results are comparable ot those found in city dwellers and those studied in other primitive populations. The health of the subjects was good and their dietary intake sufficient in calorie intake. There was little evidence of obesity although their staple diet was tapioca root, but telemetric monitoring of their routine daily activity revealed that jungle dwellers seldom tax their oxygen transport system to induce any adaptive changes.

A Comparative Study of Eldoncards for Blood Grouping ABO and RHo (D) with the Tile Method of Typing
K B Kuah*, C S Lim**, *Consultant O & G, **Laboratory Technician, The Clinic, Maternity & Nursing Home, 15, Jalan 14/20, Petaling Jaya, Selangor

Summary
303 blood samples from antenatal patients are typed for ABO-D grouping. Each sample is typed by Eldoncards as well as the conventional tile method. Eldoncards are found to be as reliable as the conventional tile method of typing.

Imperforate Vaginal Septum with Haematocolpos
Dr Ooi Kah Chuan, Dr Wong Wai Ping, Department of O & G, University of Malaya, Kuala Lumpur

Summary
The main clinical features of 7 cases of vaginal septum with haematocolpos are presented. The aetiology of the membranous obstruction is discussed. Diagnosis is not difficult if the diagnosis is kept in mind and a simple vaginal examination is done. Treatment consists of an adequate excision of the obstructing membrane.

A Simple Technique of Intra-Uterine Transfusion of Foetus in University Hospital, Kuala Lumpur
Ng King Kwi*, Ng Keng Hing**, *Department of Radiology, University Hospital, Kuala Lumpur, **Department of O & G, University of Malaya, Kuala Lumpur

Summary
The indications of intra-uterine transfusion are briefly discussed. A simple technique of intra-uterine transfusion used in University Hospital, Kuala Lumpur is described. Radiation hazards of the procedure to foetus are small. In view of the serious prognosis of erythroblastosis, the procedure justifies this small risk.

A Case of Modified A Antigen in Acute Leukaemia
Albert Antoni*, John Case**, *Blood Bank Supervisor, **WHO Consultant in Blood Banking, Blood Services Centre, General Hospital, Kuala Lumpur

Summary
Details of the blood grouping reactions obtained on the blood of a patient suffering from myeloblastic leukaemia are presented and it is concluded that these signify the modification of a normal A antigen associated with the disease process. Though without serious implications in this case, conscious bias in the recording of agglutination reactions caused a misinterpretation of the patient's grouping in the first instance, and there could be some situations in which such erroneous recording could invite adverse consequences.