Prevalence and Factors Associated with Alcohol Use among Dayak Adolescents in Sarawak, Malaysia

@#Introduction: Alcohol is classified as a psychoactive substance, and its dependence is one of the three leading risk factors for death, disability, or disease. Early age alcohol use by the age of 15 is implied to be harmful due to interference in the brain development of adolescents, causing alcohol-related problems later in life. This study aims to determine the prevalence and factors associated with alcohol use among Dayak adolescents in Sarawak, Malaysia. Methods: This was a cross-sectional quantitative research approach. A total of 12 districts within the 12 divisions were selected by multistage stratified cluster sampling. Dayak housing area lists were obtained from district offices and the local councils. The respondents were selected systematically according to male and female respondent houses, and they were interviewed using an interviewer-administered questionnaire. Data were entered into Microsoft Excel and analysed through IBM SPSS Version 27.0. Results: Dayak adolescents’ mean age was 17.31 years. They were either low-risk (50.0 %), hazardous (31.0%), abstainers (11.0%), harmful (5.0%) or alcohol dependant (3.0%) drinkers. Age (p<.001), gender (p<.05), ethnicity (p<.001), religion (p<.05), employment (p<.001), level of education (p<.01), allowance (p<.001), family relationship (p<.05), and family size (p<.05) were the potential predictors of alcohol use disorder. Conclusion: Dayak adolescent alcohol drinking is prevalent and a public health problem, particularly among disadvantaged socio-economic families. The lower proportion of abstainers suggested that alcohol use among adolescents is on the rise. Hence, the results should be utilised to do targeted health promotion regarding harmful alcohol use among adolescents since early use of alcohol among adolescents may lead to more severe health and non-health outcomes in the future.

Gender-Stratified Factors Associated with Stigma Toward HIV/ AIDS among Rural Communities in Sarawak, Malaysia

@#Introduction: Many factors hinder the effective responses to the HIV/AIDS epidemic. Stigma is one of the major barriers to effective responses to the HIV/AIDS epidemic. It is often considered the main reason for the low response to access proper services for prevention, treatment, and care for HIV/AIDS. In this context, we assessed the perceived level of stigmatisation towards people with HIV/AIDS among rural communities in Sarawak and determined its associated factors. Methods: This cross-sectional community-based study was conducted among the adult population aged 18 years and above among rural communities in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the respondents. A total of 900 respondents were successfully interviewed using interviewer-guided questionnaires. Stepwise multiple linear regression with forward and backward selection method was used to determine the HIV/AIDS-related stigma. A p-value of ≤.05 was considered statistically significant. Results: Analysis revealed that females are more stigmatised than males (p<.05). Multivariate analysis showed that those who did not know someone had HIV and Chinese ethnicity were potential predictors in both male and female groups. Having no gainful job, and discussion of HIV/AIDS, household income less than MYR 500, history of HIV testing, knowledge on HIV transmission and exposure to HIV/AIDS information were factors that influenced HIV/ AIDS-related stigma among female respondents. On the other hand, age group 30 to 39, Bidayuh, Chinese ethnicity, and not knowing someone had HIV and media exposure on HIV were factors that influenced HIV/AIDS-related stigma among male respondents. Conclusion: HIV/AIDS-related stigma towards HIV/AIDS existed in rural communities. Enhanced health promotion related to HIV/AIDS activities in rural communities are needed to curb stigmatisation toward people with HIV/AIDS.

Perceived Body Image And Its Relationship With Body Mass Index, Self-Esteem, Body Change Strategy, And Social Network Usage Among Rural Adolescents In Sarawak, Malaysia

@#Body image is a complex and multifaceted construct with multiple associated factors determining its perception among adolescents. This study aimed to determine the perceived body image and its relationship with body mass index, self-esteem, body change strategy, and social network usage among rural adolescents. This study was a cross-sectional study design using a multistage random sampling technique to select adolescents aged 10 to 19 years. A total of 318 adolescents’ data were collected using a self-administered questionnaire. Data analysis was done using SPSS version 22.0 with a p-value of <0.05 was considered statistically significant. The mean (SD) age of adolescents was 14.6 (2.7) years with a male and female ratio of 1.09:1. The mean score (SD) of perceived body image was 3.63 (0.87). Multiple linear regression analysis revealed that gender, body mass index, and strategy to increase weight could predict perceived body image among adolescents. However, self-esteem did not correlate with perceived body image. Although, the body image dissatisfaction level was low among rural adolescents compared to other studies in Malaysia. However, it can still pose a threat to adolescents’ health if not addressed accordingly.

Association Between Preventive Behaviour On Colorectal Cancer And Health Literacy Among The Adult Population In Sarawak, Malaysia

@#Health literacy has shown to have some influence in preventive behaviour, including on colorectal cancer. Such a relationship, however, is not well established in Malaysia, particularly Sarawak. This study is aimed to estimate the level of health literacy and preventive practice against colorectal cancer and factors associated with it. This was a cross-sectional study conducted in Sarawak, among adults aged 50 years and above. Data was collected by face to face interviews using a validated questionnaire. Descriptive statistics were used to determine the health literacy and preventive behaviour on colorectal cancer. Multiple linear regression was used to determine the factors associated with preventive behaviour on colorectal cancer and also to examine its relationship with health literacy. A p-value of ≤0.05 was considered as statistically significant. A total of 829 respondents were included in the analysis. Mean age (standard deviation) of the respondents was 55.78 (5.01) years. A large proportion had an educational background of upper secondary school and above (41%) and from Iban ethnicity (32.4%). Only 1.1% of them had a family history of colorectal cancer. Multiple linear regression analysis revealed that gender (p<0.01), ethnicity (p<0.05), functional health literacy (p<0.05), and knowledge on colorectal cancer (p<0.05) appeared to be significant predictors for preventive behaviour on colorectal cancer. Health literacy has a positive effect on preventive behaviour on colorectal cancer. The findings assist in designing and developing targeted informational campaigns to promote preventive behaviour, particularly among low health literate group.

Psychological Impact of Covid-19 Pandemic on Mental Health Among Medical Students in Malaysia

@#Introduction: The Coronavirus disease-2019 impacted the governments and public health systems worldwide, with the psychological impact including an increase in the level of stress, anxiety and depression. We determine the prevalence of depression, anxiety and stress using the Depression Anxiety Stress Scales (DASS-21), and to determine the psychological impact of COVID-19 pandemic amongst medical students in Sarawak, Malaysia using the revised Impact of Event Scale (IES-R). Methods: We analysed 355 medical student’s data obtained from an online survey. All the undergraduate medical students were the sample population. IBM SPSS version 22.0 was used for data analysis. A p-value of ≤.05 was considered statistically significant. Results: Analysis indicated that three-fourths of the students had no mental health issues. More than one-tenth of the students were moderately depressed (12.4%) and 4.3% severely depressed. A similar pattern of prevalence of anxiety was noted with 10% reported moderate anxiety, and 6.8% had severe anxiety. 15.8% of the students had mild stress, 4.2% moderately stressed, and 2% severely stressed. A hierarchical multiple linear regression analysis showed that hyperarousal appeared to be a predictor of depression (β=.466, p<.001), anxiety (β=.481, p<.001) and stress β=.508, p<.001). Along with hyperarousal, intrusion (β=.148, p<.05) predicts stress among the students. Conclusion: Our analysis revealed that hyperarousal symptoms related to the global pandemic of COVID-19 led to significant mental health issues among students. Therefore, urgent strategies to support the students’ psychosocial wellbeing and self-care and to strengthen their coping skills and resilience need to be implemented.

Prevalence and factors associated with undernutrition among Dayak children in rural areas of Sarawak, Malaysia

@#Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

Coping Strategies By Stroke Caregivers: Evidence From A Qualitative Study In Sarawak, Malaysia

@#Caring for stroke survivors is inevitably a burden to caregivers. It is not uncommon for stroke survivors who are discharged from the hospital and found themselves at home without any help and care from the supposed caregivers. However, in instances where there are available and willing caregivers, a sudden and unpredictable task of caring for stroke survivors require the stroke caregivers to apply their coping strategies due to the demanding nature of looking after a survivor. This study aimed to determine coping strategies undertaken by stroke caregivers in caring for stroke survivors. This was an exploratory qualitative study and data was collected from the caregivers of stroke survivor using a semi-structured guided questionnaire. A total of 18 caregivers were included in the study. The data were collected from November 2015 until June 2016 at a selected community rehabilitation centre in Kuching, Sarawak. The qualitative data analysis revealed that the coping strategies undertaken by stroke caregivers include change of role in life, self-motivation, sharing with other people, crying, trying to forget things that happen, hoping survivors will get better, emotion suppression and self-blame. The study highlighted the experiences by the caregivers for caring for stroke patients and focused on the coping strategies undertaken by the caregivers. Better ununderstanding of these experiences does help the service providers to provide better support and resources for caregivers in caring for stroke survivors.

Factors predicting screen time related to physical and behavioural complaints in primary school children

@#problems from extended usage of electronic devices areissues among primary school children. This study is aimedto investigate the prevalence of physical and behaviouralcomplaints arising from the electronic device usage and toidentify the potential factors that predicted the complaints.Methods: This was a primary school-based cross-sectionalstudy using multistage cluster sampling, conducted at Baudistrict in Sarawak, Malaysia in 40 primary schools. Aquestionnaire was used to collect information of usagepattern in insufficient lighting, timing and position. Thephysical and behavioural complaints were traced. Dataanalysis was performed using SPSS version 22. A p-value <0.05 with 95% CI was considered as statistically significant. Results: About 52.8% of the 569 students used digitaldevices in a bright room, 69.8% in the day time and 54.4% insitting position. The physical complaints were headache(32.9%), neck, shoulder and back pain (32.9%) followed by byeye strain (31.8%). Regarding behavioural problems, 25.7% ofthe students had loss of interest in study and outdooractivities (20.7%), skipped meals (19.0%) andarguments/disagreements with parents (17.9%). After logisticregression analysis, the lying position (OR=1.71, 95% CI:1.096, 2.688) and darkroom lighting (OR=2.323 95% CI: 1.138,4.744) appeared to be potential predictors of the complaint.Conclusion: One-quarter of the students studiedexperienced physical complaints, and one-fifth hadbehavioural problems associated with the use of electronicdevices. Lying position and darkroom lighting are thepotential predictors of complaints. Therefore, we suggestthat the children should use electronic devices in the sittingposition with adequate room lighting.

Do Medical Students Know, Bother About, And Practise Preventive Measures In Malaysia?

@#Since December 2019, a novel coronavirus disease (COVID-19) creates a global threat. Medical students are more susceptible to be infected by the virus. This study aimed to assess COVID-19 related knowledge, attitude towards COVID-19, and preventive behaviours against COVID-19 among medical students within the first month of the onset of the outbreak in Malaysia. We collect data from medical students using an online Google survey form. Out of 696 students, 467 responded to the questionnaire. The analysis revealed that the mean percentage of knowledge was (85.04), attitude (84.12), and preventive practice (77.75) respectively. Hierarchical multiple linear regression analysis revealed that living with family (p<0.01) and knowledge of COVID-19 (p<0.001) appeared to be important predictors of attitude toward COVID-19. However, gender (p<0.001), living status (p<0.001), frequency of travel during movement control order (p<0.01), attitude towards COVID-19 (p<0.001) have appeared significant predictors for preventive practice against COVID-19. But knowledge of COVID-19 had no impact on preventive practice against COVID-19 (p>0.05). We found a high level of COVID-19 related knowledge, attitude, and preventive practice against COVID-19 among medical students. A sustained knowledge, attitude, and preventive behavioural strategy could play an ingredient in upholding the student’s learning and practice against any disease like COVID-19.

Barriers, Strength And Weakness Of Pre-Pregnancy Clinic Services In Sarawak: A Qualitative Analysis From Provider Perspectives

@#Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the open-ended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though pre-pregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.

Factors Determining Attempt-To-Quit Smoking Among Adult Current Smokers In Sarikei, Sarawak, Malaysia

@#Achieving smoking cessation is an arduous process, where smokers try different methods or approaches to achieve cessation. Quit smoking attempts play an important role in smoking cessation.Thus, this study was conducted to determine the factors associated with attempt-to-quit smoking among the currentsmokers in Sarawak.This cross-sectional study was conducted among adult smokers in Sarikei, Sarawak by face-to-face interview using an adapted and validated questionnaire. Non-probability sampling method was used to select the study place. An adult smoker was selected systematically from each selected household. A total of 482 smoker households were identified with a response rate of 92.3%. Data was analysed using IBM SPSS Version 22.0. A p-value of <0.05 was considered statistically significant. The mean (SD) age of the smokers was 36.3(13.3) years. However, the mean (SD) age of smoking initiation was 18.5(4.8) years. Majority of the smokers were male (91.5%), with the male to female ratio being 1:0.1. Mean (SD) score on The Fagerström Test for Nicotine Dependence was 4.75(2.4), while motivation to quit smoking score was 3.04(1.0). Majority of the smokers (83.1%) hadever seen pictorial health warnings on cigarette packs. More than half of the smokers (54.8%) had ever tried to quit smoking. Binary logistic regression analysis revealed that marital status, religion, ethnicity, pictorial health warnings on cigarette packs and motivation to quit smoking appeared to be the significant predictors of attempt-to-quit smoking (p<0.05). Understanding the attempts to quit smoking will assist inclinical expectations. Thus, a smoking cessation programme should be designed in line with these factors, to aid quit smoking attempts.

Factors Affecting Smoking Menthol Brand Cigarette Among The Adult Population In Sarawak, Malaysia

Menthol brand cigarette has been found to be linked with early initiation of smoking and addiction of nicotine. This study was designed to find out the factors associated with smoking menthol brand cigarettes among adult population in Sarawak. This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability purposive sampling method was adopted to select the villages. All the households of the villages were visited, and an adult member was selected randomly from each household irrespective of sex. After missing value imputation, 1000 data sets were analysed using statistical software SPSS 19.0 version. Analysis showed that 28.8% of the respondents were current smokers, and 7.8% were past smokers. Among the smokers, 56.3% were habituated with menthol brand cigarette. Logistic regression analysis revealed that age at initiation of smoking before 15 years of age (OR=11. 68, 95% CI: 4.25, 32.10), smoking within five minutes of wake up from sleep (OR=3. 20, 95% CI: 1.35, 7.54), nature of job as business (OR=4. 81, 95% CI: 2.13, 10.86) and service holders (OR= 3.85, 95% CI: 2.07, 7.16) and family size 5 and above (OR=2. 22, 95% CI: 1.25, 3.94) appeared to be important determinants of smoking any menthol brand cigarette (p<0.05). Menthol is a prominent design feature to attract and retain younger smokers. It does not necessarily make the transition from experimenting with cigarettes, but to encourage early smokers to become a confirmed smoker. So, anti-tobacco public health programme should focus on age-specific community approach.

Assessment of pharmacological activities of two medicinal plant of Bangladesh: Launaea sarmentosa and Aegialitis rotundifolia roxb in the management of pain, pyrexia and inflammation

BACKGROUND: The current study aims at evaluating the analgesic, anti-pyretic and anti-inflammatory properties of methanolic extract of the stem, bark and leaves of Launaea sarmentosa and Aegialitis rotundifolia roxb. RESULTS: The AELS and AEAR extract presented a significant (***p < 0.001) dose dependent increase in reaction time in writhing method and showed inhibition of 63.1% and 57.1% respectively at the doses of 400 mg/kg body weight while standard drug showed (P < 0.001) inhibition of 69.23%. In tail immersion method, AELS and AEAR showed maximum time of tail retention at 30 min in hot water i.e. 6.93 sec and 6.54 sec respectively at highest doses of 400 mg/kg body weight than lower dose while standard pentazocine showed reaction time of 7.62 sec. The AELS and AEAR extract also exhibited promising anti-inflammatory effect as demonstrated by statistically significant inhibition of paw volume by 32.48% and 26.75% respectively at the dose of 400 mg/kg body weight while the value at the dose of 200 mg/kg body weight were linear to higher dose at the 3rd hour of study. On the other hand, Standard indomethacin inhibited 40.13% of inflammation (***P < 0.001). In Cotton-pellet granuloma method, AELS and AEAR extract at the dose of 400 mg/kg body weight exhibited inhibition of inflammation of 34.7% and 29.1% respectively while standard drug showed (P < 0.001) inhibition of 63.22%. Intraperitoneal administration of AELS and AEAR showed dose dependent decrease in body temperature in brewer's yeast induced hyperthermia in rats at both doses. However, AELS significantly decreased body temperature (***p < 0.001) at 400 mg/kg compared to control. CONCLUSIONS: Present work propose that the methanolic extract of Launaea sarmentosa and Aegialitis rotundifolia roxb possesses dose dependent pharmacological action which supports its therapeutic use in folk medicine possibly mediated through the inhibition or blocking of release of prostaglandin and/or actions of vasoactive substances such as histamine, serotonin and kinins.

In vivo antipyretic, antiemetic, in vitro membrane stabilization, antimicrobial, and cytotoxic activities of different extracts from Spilanthes paniculata leaves

BACKGROUND: The study was conducted to evaluate the in vitro antimicrobial activity, cytotoxic, and membrane stabilization activities, and in vivo antiemetic and antipyretic potentials of ethanolic extract, n-hexane and ethyl acetate soluble fractions of Spilanthes paniculata leaves for the first time widely used in the traditional treatments in Bangladesh. RESULTS: In antipyretic activity assay, a significant reduction (P < 0.05) was observed in the temperature in the mice tested. At dose 400 mg/kg-body weight, the n-hexane soluble fraction showed the effect (36.7 ± 0.63°C ) as like as the standard (dose 150 mg/kg-body weight) after 5 h of administration. Extracts showed significant (P < 0.001) potential when tested for the antiemetic activity compared to the standard, metoclopramide. At dose 50 mg/kg-body weight, the standard showed 67.23% inhibition, whereas n-hexane and ethyl acetate soluble fractions showed 37.53% and 24.93% inhibition of emesis respectively at dose 400 mg/kg-body weight. In antimicrobial activity assay, the n-hexane soluble fraction (400 µg/disc) showed salient activity against the tested organisms. It exerts highest activity against Salmonella typhi (16.9 mm zone of inhibition); besides, crude, and ethyl acetate extracts showed resistance to Bacillus cereus and Bacillus subtilis, and Vibrio cholera respectively. All the extracts were tested for lysis of the erythrocytes. At the concentration of 1mg/ml, ethanol extract, and n-hexane and ethyl acetate soluble fractions significantly inhibited hypotonic solution induced lysis of the human red blood cell (HRBC) (27.406 ± 3.57, 46.034 ± 3.251, and 30.72 ± 5.679% respectively); where standard drug acetylsalicylic acid (concentration 0.1 mg/ml) showed 77.276 ± 0.321% inhibition. In case of heat induced HRBC hemolysis, the plant extracts also showed significant activity (34.21 ± 4.72, 21.81 ± 3.08, and 27.62 ± 8.79% inhibition respectively). In the brine shrimp lethality bioassay, the n-hexane fraction showed potent (LC50 value 48.978 µg/ml) activity, whereas ethyl acetate fraction showed mild (LC50 value 216.77 µg/ml) cytotoxic activity. CONCLUSIONS: Our results showed that the n-hexane extract has better effects than the other in all trials. In the context, it can be said that the leaves of S. paniculata possess remarkable pharmacological effects, and justify its folkloric use as antimicrobial, antipyretic, anti-inflammatory, and antiemetic agent. Therefore, further research may be suggested to find possible mode of action of the plant part.

Identification of differentially expressed genes in gauze-exposed omentum of dogs using differential display RT-PCR

Molecular mechanisms governing peritonitis caused by the presence of aseptic gauze have remained unclear. To identify the genes involved, sterile gauze-exposed omentum was collected at 0, 6, 12, 24, and 48 h intervals, and analyzed by differential display RT(reverse transcription)-PCR. Among over 1,200 bands, 230 bands were found differentially expressed. These bands represented the fragment sizes of approximately 200 to 1,500 bp. The eight fragments were expressed differentially in the treatment group but not in the control. The sequences of two bands were similar to those of genes associated with the inflammatory process and a band was related to repair and regeneration process. Another one was related with spermatogonia and the rest four were unknown. Additionally, amplicons corresponding to the full-length sequences of two inflammatory gene fragments were synthesized by rapid amplification of cDNA end PCR. One showed 99% similarity to the major histocompatibility complex class II dog leukocyte antigen-DR beta chain and the other was canis familiaris proteasome beta type 3. Results of the present study suggested that sterile gauze induced the differential expression of genes in the omentum involved in inflammation and healing process.

The Relevant Intervention Strategies for Improving Medication Adherence of Diabetic Patients

Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent’s health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent’s related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.

Prevalence and Determinants of Smoking Behaviour among the Secondary School Teachers in Bangladesh

Despite country’s tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the school personnel is alarming. To determine the prevalence of smoking and to examine the determinants of smoking behaviour among the secondary school teachers in Bangladesh. A two-stage cluster sampling was used with a selection of schools on Probability Proportional to Enrolment (PPE) size followed by stratified random sampling of government and private schools and then all the teachers present on the day of the survey were selected for the study. The 66-item questionnaire included smoking behaviour, knowledge, attitude, second-hand smoking, tobacco free school policy, cessation, media advertisement and curriculum related topics. Seven additional questions were included to assess the socio-demographic characteristics of the teachers. Data analysis was performed using SPSS 17 software. A total of 60 schools were selected with school response rate of 98.3%. An anonymous self-administered questionnaire was filled in by all teachers present at the day of the survey. The sample consisted of 559 teachers with response rate of 99.5%. The prevalence of smoking was 17% (95% CI: 14%, 20.4). About half of the teachers (48.4%) smoke daily followed by 25.3% smoke 1-2 days in last 30 days. The mean duration smoking of was 13.7(95% CI: 11.6, 15.9) years. Logistic regression analysis revealed that male teachers smoke 37.46(95% CI: 5.078, 276.432) times higher than their female counterparts. The graduate teachers were 2.179(95% 1.209, 3.926) times more likely to be smoke than master’s degree holder teachers. Smoking by friends appeared to be the strongest predictor for teachers smoking behaviour (OR 4.789, 95% CI: 1.757, 13.050). However, no statistically significant association was found between type of school, second-hand smoking and curriculum related factors and smoking behaviour of the teachers (p>0.05). Prevalence of smoking among the teachers is high in Bangladesh. Effective smoking prevention program should take into account within the dominant of socio-environmental influence to reduce smoking behaviour. The school curriculum items had less impact in preventing smoking behaviour.

Tetralogy of fallot in Down syndrome [Trisomy 21] - an uncommon association

Down Syndrome [trisomy 21] is the common disorder among chromosomal anomalies. This is frequently associated with congenital acyanotic heart disease. Tetralogy of fallot is an uncommon event in the trisomy 21. Tetralogy of fallot presents with cyanosis usually in the later part of infancy, but cyanosis is present since birth if Tetralogy of Fallot is accompanied with Down Syndrome

Guided bone regeneration with beta-tricalcium phosphate and poly Llactide-co-glycolide-co-epsilon-caprolactone membrane in partial defects of canine humerus

This study was performed to evaluate the effect of betatricalcium phosphate and poly L-lactide-co-glycolide-coepsilon- caprolactone (TCP/PLGC) membrane in the repair of partial bone defects in canine proximal humerus. Three adult mixed-breed dogs were used during the experimental period. The length of the defect was quarter of the full length of humerus, and width of the defect was quarter of middle diameter of the lateral aspect of humerus. The humeri of each dog were divided into treatment (TCP/ PLGC) and control groups. The defect was covered with TCP/PLGC membrane in treatment group. To evaluate regeneration of the bone, computerized tomography (CT) and histopathologic examination were performed. The radiopaque lines were appeared at the original defect sites in TCP/PLGC group but below the original site in control at 4th week. Radiopacity and thickness of the defect sites, and radiopaque lines were more increased at 8th week than those of 4th week. Histopathologic findings revealed fibrous connective tissue migration into the defect and the migration inhibited the structure of new cortex to be placed in the original level in control whereas new cortex growth was found in the level of original line in TCP/ PLGC group. However, the new cortical bone in the TCP/ PLGC group was thinner and less organized than the adjacent intact cortex, and the amount of new cancellous bones were also scanty. The result suggested that TCP/ PLGC membrane is a good guided bone regeneration material to restore the original morphology of humerus in partial defect.