ABSTRACT
@#Malaysia is one of the countries that have signed the WHO Framework Convention on Tobacco Control (FCTC). The WHO FCTC is a form of evidence-based agreement that recognises the right of all people to attain the highest standard of health. Policies established by the government were in line with the WHO requirements to gazette the nationwide smoking ban so that enforcement measures can be taken to control smoking activities in public places. The purpose of this scoping review is to give an overview of the extent of knowledge, attitude, and the perception of the public on smoking ban policies implemented in Malaysia. The keyword search strategy was as follows: smoking AND policy AND Malaysia AND (knowledge OR attitude OR perception) for publications between the year 2015-2021, conducted through several databases including Medline (search results of 5 publications), Web of Science (search results of 9 publications) and Scopus (search results of 19 publications). A total of 12 articles were considered relevant to answer the research objectives. We found that the level of knowledge, attitude, and perception of the public towards the smoking ban policy in Malaysia was still defective and inadequate. Therefore, it is hoped that the results of this multifactorial relationship study could cultivate governance in administration and governmental policies to imbue competency and efficiency.
ABSTRACT
Background: Anal fissures are often encountered in surgical practice with surgery the gold standard management for chronic anal fissures. Recently the widespread use of pharmacologic agents for chronic fissures has increased. In our study we compare topical 2% diltiazem with lateral sphincterotomy with respect to symptoms such as relief of pain, ulcer healing, and side effects of treatments.Methods: A prospective comparative study, a total of 80 patients were randomized into 2 groups 40 each. Group A patients were subjected to open internal lateral sphincterotomy and group B to 2% topical diltiazem. The patients in both groups were followed up at 1st, 4th, 14th weeks and 6 months in OPD and were assessed for pain, sphincter tone and complications.Results: In group A (lateral anal sphincterotomy), patients achieved a good pain relief with a mean pain score of 1.98 by one week post procedure whereas group B (2% diltiazem) had taken 14 weeks to achieve similar pain relief (pain score of 1.5). At the end of 6 months, healing of fissure was noted in 100% of group A and in 90% of group B. 4 patients (10%) had recurrences in group B. Flatus incontinence was reported in 2 patients (5%) in group A although transient.Conclusions: Lateral anal sphincterotomy is superior to 2% diltiazem especially in healing of fissure, pain relief, quality of life and recurrence. Pharmacologic agents should be reserved for patients who are unfit or unwilling for surgery or can be used as a bridge therapy till sphincterotomy can be planned.
ABSTRACT
Anal fissures are often encountered in surgical practice in both sexes. It is a distressing disease impacting quality of life and causes profound morbidity among those affected. If left untreated, it may lead onto perianal abscess or even malignancy in long standing cases. Surgery is the gold standard management for chronic anal fissures. Recently the widespread use of pharmacologic agents for chronic fissures has increased. The management of chronic anal fissures has migrated to an era of multifaceted approach. This narrative review looks into various studies spanning over a period of 16 years. Various articles were shortlisted and analyzed for efficacy of various treatment methods, their impact in hospital stay, quality of life improvement, recurrence rate and complications among various treatment methods. We concluded from this review, that open lateral internal sphincterotomy is still the gold standard method of treatment for chronic anal fissure. Among pharmacological agents, 2% diltiazem has the best effectiveness with good compliance rate. Modern surgical techniques like VY plasty can be reserved for special situations. We do not recommend the practice of manual anal dilatation.
ABSTRACT
The immunomodulatory effect of aqueous extract of Acacia catechu commonly known as Katha or Karangali was studied at two doses of 5 mg/kg and 50 mg/kg orally. The effect was studied in neutrophil adhesion test, mice lethality test, carbon clearance assay, cyclophosphamide induced neutropenia, serum immunoglobulin levels and the heamagglutination test. Acacia catechu extract showed an increase in the neutrophil adhesion to the nylon fibres, produced a significant increase in the phagocytic index and a significant protection against cyclophosphamide induced neutropenia indicating its effect on cell mediated immunity. On the other hand, Acacia catechu extract produced a significant increase in the serum immunoglobulin levels, increase in the haemagglutination titre values and decreased the mortality ratio in mice, suggesting its effect on the humoral arm of the immune system. From the above results, it was concluded that the aqueous extract of Acacia catechu has a significant effect on both cell mediated and humoral immunity.