Suxamethonium Sensitivity - Yet Another Case
N Sivaneswaran, BS, K Inbasegaran, FFARACS, Department of Anaesthesiology, Hospital Besar, Johor Bahru

Summary
Abnormal variants of plasma cholinesterase are a rarity in this region and to date there is only one reported case of suxamethonium sensitivity in a Malaysian population. We now report a case of a Malaysian Chinese patient who received suxamethonium, developed prolonged apnoea and on investigation found to be a homozygote for the silent gene. His family was screened for abnormal variants of plasma cholinesterase. The results are discussed.

A Psychiatric Rating Scale for Schizophrenia in Singapore (Woodbridge Hospital Rating Scale for Schizophrenia)
Wing Foo Tsoi, FRANZCP, Ee Heok Kua, MRCPsych, Dept of Psychological Medicine, National University of Singapore, Sepoy Lines, Singapore 0316

Summary
This scale is constructed to meet the need for an efficient, rapid and economical method of measuring change in schizophrenic patients during the course of psychotropic medication (drug trial) in a multi-cultural, multi-lingual population of low educational level. Items are included only if (1) they can be elicited objectively, (2) they are important symptoms of schizophrenia and (3) they are frequent manifestation of the schizophrenic syndrome as recorded in Woodbridge Hospital. It could be used by a single rater but its reliability should be further improved if two raters are involved.

Insecticide Use for Malaria Control in Central Java, Indonesia : A Review
Y H Bang, PhD*, Arwati S, MD**, S Gandahusada, MD***, *WHO Vector Biology and Control Research Unit, P.O. Box 302, Jakarta, Indonesia, **Vector-Borne Disease Control, Sub-Directorate Communicable Disease Control, Ministry of Health, J1, Percetakan Negara 1, Jakarta, Indonesia, ***Division of Disease Ecology, Health Ecology Research Centre, National Institute of Health, Research and Development, Ministry of Health, J1, Percetakan Negara 1, Jakarta, Indonesia

Summary
DDT indoor residual sprayings in the Province of Central Java, Indonesia, for the past 28 years are reviewed in terms of Anopheles aconitus resistance to DDT and incidences of malaria. DDT resistance by An. aconitus has continued to increase and spread since its first detection in Central Java in 1962. In most areas malaria transmission is perennial, which appears to be not interrupted by DDT residual spraying of inner walls because of DDT resistance. In searching for alternatives to DDT, fenitrothion was the most effective residual compound among five insecticides tested in village-scale trials, giving control for about 13 weeks at 2 g/m2. Because the target species rests largely on the lower portions of walls, when applied at 2 g/m2 to only one horizontal swath between 10 and 85 cm from the ground, this compound was effective for over two months, about one-third less than that found in full coverage applications. For a single application this selective method reduced the amount of insecticide by 65 percent and manpower by 43 percent, and three applications, to compensate for less residual effectiveness, will reduce insecticide use by about 50 percent and manpower by 15 percent, compared to two applications with full coverage. Further field investigations on application of insecticides and the ecology of the DDT-resistant vector continue to be needed in Central Java to reduce further the cost of residual sprayings in malaria control programmes. This review also suggests the possibility of other selective spraying methods and anti-vector methods applicable at the village level by the community.

A Study of Characteristics of Women Seeking Induced Abortion
Chia Sze Foong, MCGP, 56, Jalan Sultanah, Batu Pahat, Johor

Summary
This is a study of 148 women seeking induced abortion by doctors. The typical woman in this study was married, with 2 or more children, Chinese, urban, 21 - 30 years and had completed primary education. She was motivated to defer pregnancy and to a lesser extent to limit family size by resorting to induced abortion.

Septic Induced Abortion - A Report of 100 Cases in Sarawak
Michael Teo Yu Keng, MRCOG, Tiong Tung Hui, MBBS, Bibiana Teo, MBBS, Miri General Hospital, Sarawak

Summary
Over a 28 month period in the Sarawak General Hospital, Kuching, there were 100 'confirmed' septic induced abortions and 75 'suspect' cases. Socio-demographic characteristics are studied. Seventy-five percent of induced abortions used some kind of foreign body per vaginam. Forty-one percent are in the age group of 20 - 25 years and the housewife together with the unemployed form 57 percent of the whole group. There were 2 maternal mortalities.

A Family Planning Study in Kuala Pilah, Peninsular Malaysia
Vimala Thambypillai, MPH, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur

Summary
Realising that family planning is not making a sufficient impact on the rural people as it is on the urban people, it was decided that it would be interesting to study the knowledge and attitude of a rural community towards family planning.

The study sample consisted of 200 Malay married women - 100 acceptors and 100 non-acceptors from Kuala Pilah District. The study commenced on 4 December 1978 and ended on 22 December 1978.

A healthy climate of knowledge and attitude exists among rural Malay women. Only 2 percent non-acceptors had not heard of any method of family planning, and 99 percent acceptors, and 85 percent non-acceptors discussed family planning with their husbands. There was also enough evidence to show that birth rate does decrease as literacy rate increases.

On the other hand, however, only 19 percent respondents approved of family planning practice before the first child. Also there is a dearth of information on family planning in the rural areas and not much was being done in utilising the two popular forms of mass-media - the radio and the television as a means of disseminating information on family planning.

The study concludes with a recommendation that there is a need for sustained effort at improving knowledge and disseminating information, and nursing and nurturing the right attitudes towards family planning. It suggests that community leaders, women's clubs and private organisations be mobilised to participate more fully in promoting family planning.

Prevalence of Squints and Visual Defects in Malaysian Primary One School Children
G H Teoh, FRCS, C S Yow, FRCS, Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur

Summary
Six hundred and fifty standard one school children in 3 Petaling Jaya schools were examined. 7.1 percent were found to have significant refractive errors and fourteen cases of squints were detected giving a prevalence of 2.2 percent. The majority of squints were of the divergent type. The prevalence and different patterns among the Malaysian and Caucasian populations are discussed.

Oral Contraceptives Postdatism as a Complication
Michael Teo Yu Keng, MRCOG, Bibiana Teo Siew Eng, MBBS, Miri General Hospital, Sarawak

Summary
Women who conceived within 4 months of cessation of oral contraceptives have five times more postdatism (term plus 14 days or more) compared to the non pill users. Also postdatism is severe if they conceive within 4 months of cessation of oral contraceptives. In pill users, routine induction at term plus 14 days would result in unacceptably high induction rate, iatrogenic prematurity and possibly high caesarean rates. This is the conclusion of a prospective study of 186 pill users of which 37 were postdate out of 1496 pregnancies.

Infantile Hypertrophic Pyloric Stenosis - A Rarity in Malaysia?
A Zulkiflee Laidin, FRCS, Rubaiyat Proehoeman, MD, Mahmud Mohd Nor, FRCS, Fakulti Perubatan, Universiti Kebangsaan Malaysia, Kuala Lumpur

Summary
Sixty seven infants were admitted over a 10-year period from 1972 to 1981 : 50 males and 17 females. A higher incidence of hypertrophic pyloric stenosis exists in West Malaysia than was previously recognised. However, it remains at less than one tenth of the Western figures. Among the three major races, the condition was commonest in Indians and least in Malays. Most cases presented between the ages of 3 to 8 weeks. Prolonged history of vomiting of more than 3 weeks occurred in 43.3 percent cases, usually among Malay and Indian patients. All patients were treated surgically with 1 death (1.5 percent). The usual postoperative complication was vomiting which occurred in 22.4 percent. Early presentation, adequate preoperative resuscitation and improved anaesthetic and morbidity.

Experiences in the Diagnosis and Prevention of Mental Retardation of Environmental Origin in Singapore
F M Paul, National University of Singapore, Sepoy Lines, Singapore 0316

Summary
Consideration is given to the recognition and prevention of various types of mental retardation due to hazards of environmental origin. Observations are presented on congenital syphilis, congenital toxoplasmosis, congenital rubella, Singapore kernicterus, Japanese B encephalitis, and tuberculous meningitis. Appropriate preventive measures have resulted in a significant reduction in Singapore of these conditions, and hence in a decreased frequency of environmentally determined mental retardation and related disabilities.

Percutaneous Transhepatic Cholangiography - It's Place in Obstructive Jaundice
Chew Peng Hong, MRCP, Leong Lin Chuong, MBBS, Philip Ting Toh Ming, MBBS, Sunil Kumar Nath, DMRD, Lau King Howe General Hospital, Sibu, Sarawak

Summary
The case notes of twelve jaundiced patients, on whom percutaneous transhepatic cholangiography (PTC) were performed, are reviewed. PTC was carried out to differentiate the patients with intrahepatic cholestasis from those with extra-hepatic biliary obstruction, and to identify the site and nature of the block.

In eleven cases, the biliary trees were visualised, with the sites of obstruction in those present demonstrated and confirmed at subsequent laparotomies. There was no serious side effect from the procedure. PTC in our hands has proved an invaluable aid in the investigation of the icteric patients.

The Prevalence of Intestinal Parasites Among Children at the General Hospital, Kuala Lumpur, Malaysia
Hamimah I, MPHTM, Zahedi M, MSc, Ainiyah A J, Department of Parasitology and Medical Entomology, Medical Faculty, Universiti Kebangsaan Malaysia, Kuala Lumpur

Summary
A prevalence study for intestinal parasites among 305 infants and young children was conducted at the Paediatric wards of the General Hospital, Kuala Lumpur, Malaysia. 40.8 percent of children were infected with at least one type of intestinal parasites : 39 percent were found to be infected with intestinal helminths and 4.26 percent with intestinal protozoa. Ascaris formed 17.38 percent of the infestation followed by Trichuris (14.75 percent) and hookworm (2.95 percent); 0.3 percent of the cases had Strongyloides stercoralis; 2.30 percent and 2.62 percent of the children had Entamoeba histolytica and Giardia lamblia respectively. Indian children were the predominant group found infected, followed by the Chinese and Malays. A significant drop in infestation rate of soil-transmitted helminths was detected among the Malays.

The significance of the changing pattern in the epidemiology of soil-transmitted helminths is discussed. A brief review of literature is also presented.