Comparison of rates of smoking across countries revealed that students are more likely to begin smoking in medical school than to give it up and increase their cigarette consumption rather than decrease it. A cross-sectional survey of all consenting medical students in a private medical university in north Malaysia was conducted in 2008 to determine the prevalence and smoking habits among them. A self administered questionnaire which was returned to the investigators in a sealed envelope was used. Results were tabulated and analysed with SPSS version 13.0 software. The response rate was 83.3% (508/610). The prevalence rate for current smokers was 5.3% (27/508) and for ever smokers 9.3% (47/508). Factors significantly associated with smoking were gender (p<0.001), age group (p<0.001) and family income (p=0.003). The odds of being a smoker was 14 folds high when a family member smoked and the odds of being an ever smoker was almost 6 folds more when a family member smoked. Friends were the most common influence to start smoking and the most common reason to stop smoking among ever smokers. The reasons for not smoking among the never smokers were health concerns and the distasteful smell of cigarettes. A module on how to help medical students to stop smoking should be included in the curriculum of every medical school. This will not only help them become good educators but will prevent them from picking up the habit. Educational intervention should also include family members who smoke.

A high frequency of bronchopulmonary infections complicating rheumatoid arthritis has been described in reports of case series. This study was undertaken to confirm and compare these finding in patients with RA and control. 117 patients with RA and 103 patients with OA/soft tissue rheumatism as controls. Study subjects were studied using their medical records available from hospitals‘ casenotes and GP data base. Details of all documented bronchopulmonary infections for the preceding year including lower and upper respiratory tract infections were recorded. Details of hospital admissions due to bronchopulmonary infection, antibiotic usage and functional capacity were also recorded. Mean age for RA was 56 and 59 for control. There were 34 males and 83 females in RA group, however, 14 males and 55 females in control group. There were at least 1 episodes of BPI in 66.7% (p<0.05) patients with RA and 48.5% in control. 69.2% (p<0.05) of subgroup patients with RA were noted to have poorer functional capacity compared to 50% in control. More RA patients with BPI (15%) (p<0.05) were admitted to hospital compared to control (3.8%). Significance findings were noted in terms of prevalence of BPI in RA patients compared to controls as well as patients with RA have severe course of BPI warranting hospitalization. RA patients with poorer functional capacity also noted to have high incidence of BPI.

Background: The aim of this study was to evaluate the prevalence and computed tomography (CT) appearances of accessory spleens in hospital-based patients, and to measure and make comparisons between accessory spleen size and density. Methods: A cross-sectional study was carried out in a diagnostic center in Erbil, Iraq during January–December, 2012. Biphasic abdominal CT images of 334 consecutive patients with different age groups were evaluated for the presence of an accessory spleen, and if identified, it was further analysed for shape, diameter, density, number, and location. Patients with inadequate CT techniques, splenectomy, hematological disorders, and widespread lesions in the abdomen were excluded from this study. Results: Of the 334 patients (198 female, 136 male), with a mean age of 47.2 years (SD 15.7), 82 accessory spleens were detected in 63 patients (18.8%). Their mean diameter was 14.7 mm (range 3–79 mm), 68% were round in shape and 75.6% were medial to the main spleen. Sixty percent of the cases showed a single accessory spleen and 40% had more than one (up to 4 detected). A significant difference in the mean diameter of accessory spleens between similar and different densities than the main spleen was observed (P = 0.018), 71 accessory spleens (mean diameter = 15.97 mm) displayed similar densities to the main spleen, while 11 (mean diameter = 7.09 mm) were hypodense or hyperdense to the main spleen. Conclusions: The prevalence of an accessory spleen is high, and should be considered by radiologists during abdominal CT scan reporting.

seconds ; therapeutic aspects ; Chronic Disease ; Back

Avoiding the adverse neonatal effects of perinatal asphyxia has been one of the common indications for cesarean deliveries in current obstetric practice. Expeditious delivery is dependent on decision to perform cesarean delivery and time lines achieved. A decision-delivery interval of 30 minutes, a concept initiated by the American College of Obstetricians and Gynecologists has open to debate as controversy reins about neonatal outcome when this time interval is considered in isolation. Time lines alone are probably not the only criteria to be employed, and may contribute to errors in interpretation by professional regulatory bodies and the society at large. Procedures prior to decision making like trial of labour, fetal scalp sampling and readily available resources for instituting emergent cesarean delivery invariably need to be considered. Though decision to delivery time is an integral component of critical conduct intervals in the acutely compromised fetus, a more pragmatic approach needs to be taken considering potential and known logistical and obstetric factors in line with good obstetric practice.

Objective:To compare intestinal parasitoses between urban and rural children in developing countries and its related factors. Methods:Children of 1-6 years old in the urban and rural areas who had not taken antihelmenthic drugs in the last 6 months were randomly selected. Various factors were taken as variables in a preformed questionnaire. Results:Among the total 52 children, 24 were in urban and 28 were in rural group. Male/female ratio of the rural group was 1:1 and that of the urban group was 1.4:1. Average income was 12 000 taka and 4 000 taka per month in urban and rural areas, respectively. None of the rural group used sanitary latrine, whereas every one in urban group used sanitary latrine. Majority (71%) of the mothers in rural group were below the primary level of education. Majority (75%) of fathers were educated above higher secondary level in urban group. In the rural group 18 (64%) fathers had not received any education. Enterobius vermicularis was observed only in 1 (4%) stool samples of urban children but in rural group it was found in 7 (25%) of the stool samples. Enterobius vermicularis was the main parasite isolated from both groups. Exclusive breast feeding practice of less than 6 months was observed in 20 (83%) children of urban group but in rural group that of less than one year was found in 22 (78%) children. Conclusions:Intestinal parasitic infestation is mostly found in rural children. Urban children almost have no intestinal parasitoses. It has the relation with the poor sanitation, low standard of living, less parental income and education, and early weaning. Unnecessary universal deworming of the urban and rural children in developing countries should be discouraged in order to use the money economically and effectively. It can be carried out in rural children and their living standard should be improved.

Acute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy.

There has been a change in the lifestyles of populations, including reduced physical activity and consumption of foods high in calories. Overweight and obesity are now replacing the more traditional public health concerns such as under-nutrition and infectious diseases as some of the most significant contributors to ill health. Determination of the body mass index (BMI) profile and nutritional status of adults of two rural coastal villages in Northern Malaysia was part of a community diagnosis in a community survey. Height and weight were measured and BMI calculated. Blood pressure was measured using a manual sphygmomanometer according to WHO guidelines. A standardized questionnaire was used to interview the villagers concerning their health. Out of the total population, 504 were above 20 years of age. Data was available for 441 persons for analysis. There were 210 (47.6%) males and 231 (52.4%) females. The prevalence of underweight was 9.8% (n=43), overweight 25.9% (n=114) and obesity 17% (n=75). The problem of over-nutrition was significantly higher among females, especially housewives. (p< 0.05). Those in ages 41-70 years were the majority with problems of over-nutrition (p=<0.05). More than half (52.9%; n=39) of those who were obese had hypertension (p=<0.05). Results show that a higher number of women especially housewives were obese and more than half of those obese subjects had hypertension. A more thorough nutritional profile using waist, hip and body fat measurement as well as an assessment of the dietary intake and activity regime of these villagers is needed. Interventions need to be carried out before more serious complications of obesity become rooted in this community.
Nutritional status ; Obesity ; Body Mass Index ; Lower case en ; lower case pea

Basic fibroblast growth factor (bFGF) is angiogenic and effective in down-regulating excess collagen production. The aim of this study is to evaluate the effectiveness of vitamin E (Tocotrienol Rich Fraction) in altering the level of bFGF, a cytokine involved in the scar formation process. In this model, normal human fibroblasts were treated with various concentrations of vitamin E at different time frames. The levels of bFGF were determined by Enzyme-Linked Immunosorbant Assay (ELISA). This study demonstrated that Tocotrienol Rich Fraction (TRF) stimulated bFGF production by fibroblast and postulate that vitamin E may decrease aberrant scar formation.