Effectiveness of pictorial health warning on cigarette packages: A cross-sectional study in Sarawak, Malaysia

Introduction: Specific health warning placed on the tobacco product packages is considered as an effective and low-cost method for increasing the knowledge and awareness among the community. Thus, a study was conducted to assess the perception of pictorial health warnings (PHWs) against smoking among the adult rural population of Sarawak. Methods: Cross-sectional data were collected from 10 villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Nonprobability sampling method was adopted to select the villages. All the households of the selected villages were visited and an adult member was selected randomly from each house irrespective of the sex. After missing value imputation, 1000 data were analysed using statistical software IBM SPSS 20.0 version. Results: Analysis showed that 28.8% of the respondents were current smokers, 7.8% were past smokers and the rest were non-smokers. Six items of pictorial health warnings were evaluated with five point Likert’s scales for attractiveness, fearfulness and adequacy of the information. Analysis revealed that the majority of the respondents had perceived awareness on PHWs, but the smokers believed that this was not adequate to make them quit smoking. Only one-fifth (19.7%) of them reported that current pictorial health warnings were sufficient to motivate people to quit smoking. Conclusion: Though the PHWs on cigarette packages are appealing, it is not sufficient as a reason to stop smoking. Thus, an approach using an integrated anti-tobacco public health programme should be focused into the specific targeted community.

Factors Influencing Smoking Initiation Among The Secondary School Students In Bangladesh: Findings From A Cross Sectional Study

Smoking among school children is becoming a serious problem in developing countries, including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling of government and private schools and then a random start in classes VIII, IX and X of each school targeting the students aged 13 years and above. Data collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=823), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors of smoking initiation (p0.05). Promotion of smoking resistance skills among children and teens through comprehensive approaches designed to enhance general personal competence by teaching an array of personal and social life skills is recommended.

Evaluation of Aspirin and Clopidogrel resistance in patients with Acute Coronary Syndrome by using Adenosine Diposphate Test and Aspirin Test.

OBJECTIVES: To evaluate Aspirin and Clopidogrel resistance/non-responders in patients with acute coronary syndrome (ACS) by using adenosine diposphate and aspirin tests. METHODOLOGY: In the study patients with ACS loaded with 300 mg of clopidogrel and 300 mg aspirin and patients on stable daily dose of 75 mg of clopidogrel (more than 3 days) underwent PCI. Response to clopidogrel and Aspirin was assessed by Adenosine Diphosphate (ADP) Test (20 µmol/L) and Aspirin Test (Acetyl Acid) (ASP) 20 µmol/L, respectively, using the Multiplate Platelet Function Analyzer (Dynabyte Medical, Munich, Germany). RESULTS: Sixty four patients were included in this study out of which 57 were with ACS and 7 scheduled for percutaneous coronary intervention (PCI) electively. The proportion of Aspirin good responders and adequate responders were 76.56% and 18.75%, respectively while adequate response and good response to Clopidogrel accounted for 29.7 and 48.4%, respectively Hyperlipidaemia was only co-morbidity associated with higher AUC ADP value (p: 0.046). Hypertriglyceridaemia and serum calcium were weakly correlated with higher AUC ADP serum calcium r=0.08, triglyceride r=0.12. Patients admitted for scheduled PCI and on stable dose of 75mg clopidogrel exhibited lower AUC ADP value as compared to those admitted with acute coronary syndrome given loading dose of 300mg of Clopidogrel. Post loading dose measurement of anti-platelet therapy among ACS patients using the Multiplate Platelet Function Analyzer showed comparable results with other methods. Conclusions : As determined by Multiplate Platelet Function Analyzer, Aspirin resistance/non-responders in this study in acute coronary syndrome patients accounted for 4.69% while Non-responders in Clopidogrel was 21.9%.

An anatomical study on pyramidal lobe of thyroid gland in Bangladeshi people.

The study was done to see the incidence of pyramidal lobe of thyroid gland including its position, attachment, length and incidence of its association with levator glandulae thyroidae in Bangladeshi population. Sixty postmortem tissue blocks containing thyroid gland and its related neighbouring structures were collected from 48 male and 12 female cadavers of different age groups and fixed in 10% formol-saline solution. Gross and fine dissection was carried out to study the incidence of presence of pyramidal lobe, its attachments, length, breadth and association with levator gladulae thyroidae. In the present study, findings were compared with those of Western and Bangladeshi researchers. It was evident that, fifty percent of the thyroids possesses pyramidal lobe. Incidence was more in male (52.1%) than in female (41.7%). It also appeared from the observations that, this lobe was commonly situated on the left side. In the majority of cases (56.66%), base of the pyramidal lobes were attached to the upper border of the isthmus with or without encroachment on the adjacent part of the left lobe. The range of length and breadth of the pyramidal lobe was from 1.8 to 35mm and 1.3 to 19mm respectively. In 73.33% cases, pyramidal lobe was associated with levator glandulae thyroideae and in only 26.66% cases pyramidal lobe was found independently.

A giant Condyloma accuminata.

Condyloma accuminata is not a rare disease in our country. But such a giant Condyloma accuminata is very uncommon case that we reported here. It is a type of venereal wart that commonly grows in genital region, caused by the HPV (Human papilloma virus). It is considered one of the most common sexually transmitted disease in western countries. The patient presented with cauliflower like fungating growth over the genitalia for 15 years with pain and burning sensation over the lesion for 1 month. Patient had multiple sexual partners for about 20 years. Clinically the patient was diagnosed as Condyloma accuminata. The wart was excised under spinal anesthesia and confirmed by histopathology.

Fracture of the penis with urethral rupture.

We report a rare case of penile fracture with incomplete urethral rupture in a 25 years old male who sustained the injury during sexual intercourse. He presented with a tense haematoma on the ventral aspect of the penile shaft, associated with urethral bleeding. Per urethral catheterization was possible though it was painful. Exploration and repair of the penile fracture and urethra were performed within 16 hrs. The patient made an uneventful recovery with good erectile and voiding function. This case illustrates the value of early surgical repair of the fracture in order to prevent complications. The true incidence of penile fracture is not known even in the Western countries because it is under reported or hidden for social embracement and even it is reported to physicians it remains undiagnosed or mismanaged. Very rarely it is associated with urethral rupture.

Overlapping of Sturge Weber syndrome and Klippel Trenaunay Weber syndrome.

Sturge-Weber Syndrome (SWS) occurs sporadically with a frequency of approximately 1 in 50,000. SWS is a mesodermal phakomatosis. Klippel-Trenaunay Weber syndrome (KTWS) is another very rare phakomatosis. Overlap between SWS & KTWS is very rarely encountered. We report a 19 months old boy with features of both SWS and KTWS. The reported case had seizures, port wine haemangioma of the right side of the body, glaucoma of both eyes, subcortical calcification which were consistent with the Sturge Weber Syndrome; on the other hand he had also hypertrophy of the right side of the including the face and limbs, angiomatous skin naevus, varicosities consistent with the KTWS.

Actividades citotóxicas y antibacterianas de las raíces de Capparis zeylanica Linn / Antibacterial and Cytotoxic Activities of Capparis zeylanica Linn Roots

Se analizaron extractos crudos y un ácido graso, ácido octadec-7-en-5-ynoic (1), de la corteza de la raíz de Cappariszeylanica Linn. (familia de las Capparidaceae) para observar sus actividades antibacterianas frente a la bacteria Gram positiva y Gram negativa. Entre los extractos crudos, el extracto de cloroformo mostró una buena actividad frente a todos los organismos de prueba. El ácido graso (1) aislado del extracto de cloroformo mostró actividades antibacterianas frente a todos los organismos de prueba, a excepción de E. coli. Las actividades se compararon con un antibiótico estándar: la kanamicina. Las concentraciones inhibitorias mínimas (CIH) de 1, determinadas mediante la técnica de dilución en serie, fueron 64 mg/ml frente a Bacillus subtilis y Shigella dysenteriae. Las actividades citotóxicas del extracto crudo y del ácido graso (1) se observaron mediante el bioensayo de gambas en salmuera yel valor de LC50 del compuesto fue 6,27 mg/ml (AU)

Crude extracts and a fatty acid, octadec-7-en-5-ynoic acid (1), from the root bark of Capparis zeylanica Linn. (Fam. Capparidaceae) were screened for their antibacterial activities against Gram positive and Gram negative bacteria. Among the crude extracts, chloroform extract showed good activity against all test organisms. The fatty acid (1) isolated from chloroform extract exhibited antibacterial activities against test organisms except E. coli. The activities were compared to a standard antibiotic- kanamycin. The minimum inhibitory concentrations (MICs) of 1, determined byserial dilution technique, were found to be 64 mg/ml against Bacillus subtilis and Shigella dysenteriae. The cytotoxic activities of crude extract and fatty acid (1) were observed by brine shrimp biassay and LC50 value of the compound was found to be 6.27 mg/ml (AU)

Flood control management-towards an environment friendly approach

In many practical cases, huge amount of money is spent in elimination of vegetation in the river reach for the purpose of riparian safety. The conservation of vegetation must be supplemented by adequate riparian safety. An analytical model is developed in this paper to take care of submerged as well as unsubmerged vegetation and this concept is incorporated in the hydraulic simulation. The conclusion is highly important for the planners regarding flood control as it is seen that random removal of vegetation is not the solution. Clear suggestion towards planned vegetation (which means selection of the vegetation with appropriate shape and roughness in the vertical direction of plant) is made