A pilot study on the efficacy of nasal rinsing during ablution in reducing acute respiratory tract infection (ARI) among male Hajj pilgrims.

OBJECTIVE: This study aimed to assess the effectiveness of nasal rinsing during ablution in reducing acute respiratory tract infection among male Hajj pilgrims. METHODS: A quasi-experimental trial study was conducted to compare the effectiveness of nasal rinsing between two groups. The intervention group was instructed to perform nasal rinsing during ablution, while the control group was not asked to do nasal rinsing. Both groups were provided progress diaries to record the symptoms of respiratory tract infection, including cough, rhinorrhoea, nasal blockage, fever, and sore throat, as well as thick phlegm, shortness of breath, epistaxis, and changes in sense of smell. The groups were also instructed to record any visits to clinics for their symptoms throughout their stay in Makkah for the Hajj ritual. RESULTS: The study showed that nasal rinsing significantly reduced the symptoms of cough, rhinorrhoea, and nasal blockage. The intervention group had an increased number of visits to healthcare facilities for treatment, when compared to those of the control group. There were no significant differences in the groups regarding the symptoms of fever and sore throat. CONCLUSION: Nasal rinsing can be included as part of intervention methods that include vaccination and the use of a face mask. Nasal rinsing can be easily practiced by the pilgrims, since it is a Sunnah act in ablution, which is an integral element of Muslims' daily life.

Ecogenomics reveals metals and land-use pressures on microbial communities in the waterways of a megacity.

Networks of engineered waterways are critical in meeting the growing water demands in megacities. To capture and treat rainwater in an energy-efficient manner, approaches can be developed for such networks that use ecological services from microbial communities. Traditionally, engineered waterways were regarded as homogeneous systems with little responsiveness of ecological communities and ensuing processes. This study provides ecogenomics-derived key information to explain the complexity of urban aquatic ecosystems in well-managed watersheds with densely interspersed land-use patterns. Overall, sedimentary microbial communities had higher richness and evenness compared to the suspended communities in water phase. On the basis of PERMANOVA analysis, variation in structure and functions of microbial communities over space within same land-use type was not significant. In contrast, this difference was significant between different land-use types, which had similar chemical profiles. Of the 36 environmental parameters from spatial analysis, only three metals, namely potassium, copper and aluminum significantly explained between 7% and 11% of the variation in taxa and functions, based on distance-based linear models (DistLM). The ecogenomics approach adopted here allows the identification of key drivers of microbial communities and their functions at watershed-scale. These findings can be used to enhance microbial services, which are critical to develop ecologically friendly waterways in rapidly urbanizing environments.

Diagnosis delay of breast cancer and its associated factors in Malaysian women.

BACKGROUND: Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia. METHODS: This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis. RESULTS: In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6% and delay of more than 6 months occurred in 45.5% of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95% confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95% CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95% CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95% CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95% CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95% CI: 1.15, 3.82). CONCLUSIONS: Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and treatment before the tumours enlarge and metastasis.