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.

Coining is a technique used in treating many illnesses since ancient times. It is a form of dermabrasion therapy still widely practiced in China and South East Asia. This ancient treatment method is employed to rid the body of “heatiness” or “negative energies”. Coining is associated with serious complications, and has been confused with child abuse by physicians unfamiliar to Asian cultures. Despite the availability of more simple and effective treatment for fever, coining is still widely practiced among Asians.

Objective: To describe a quick and simple diagnostic approach to monocular diplopia. Background: Diplopia is a common visual complain in casualty departments, general practice clinics, neurologic clinics as well as ophthalmic clinics. Monocular diplopia, however, is uncommon. Many well established clinical examination methods are available to address diplopia. Some require special equipments which are not easily available or unfamiliar outside of ophthalmic clinic. We describe a simple two-minute diagnostic approach to monocular diplopia. Conclusion: Basic knowledge and understanding of simple clinical examination techniques enhances diagnostic skill and allow proper localization of underlying disorders.

Objective: To evaluate the wound healing potential of fractions from ethanol extract of Martyniaannua (M. annua) Linn leaves. Methods: Ethanol extract of M. annua Linn leaves was fractionate into three different fractions (MAF-A, MAF-B and MAF-C) which were screened for wound healing potential using two models: excision and incision on rats. The thin layer chromatography (TLC) profile of all fractions were analyzed and TLC of luteolin was also done. The Povidone-Iodine Ointment was used as reference for comparision. Excision and incision wounds were created on dorsal portion of rats for study. Wound contraction, biochemical parameters (protein level and hydroxyproline level) and histopathological study were performed in excision wound model whereas incision model was used for determination of tensile strength. Results: The wound contraction and tensile strength of skin tissues were observed significantly greater in MAF-C fraction treated group than other two fractions (P<0.01). In excision wound method (on day 18) protein content and hydroxyproline were found significantly higher in MAF-C group than control group (P<0.01). Histopathological study also showed better angiogenesis, matured collagen fibres and fibroblast cells as compared with the control group. Conclusions: In conclusion, our findings suggest that fraction MAF-C from ethanol extract of M. annua leaves is found most effective in wound healing.

This cross-sectional study investigates the association between energy intake and macronutrient composition of the diet with overweight and obesity among Malaysian women. One hundred and fifteen adult Malay women aged 20 to 59 years (mean age 37.2±7.6 years) were interviewed. Dietary intake was assessed using the food history method. Body weight status was assessed using weight, height, waist circumference and fat percentage measurements. When energy intake was assessed for accuracy, only 41% of the subjects (n=47) were normal energy reporters. Among the normal energy reporters, 55% were of normal weight whereas 32% and 13% were overweight and obese. Mean energy intake for normal weight, overweight and obese subjects was 1685±199 kcal/day, 1810±166 kcal/day and 2119±222 kcal/day, respectively. Energy intake increased with body mass index (BMI) category. Among the overweight and obese, energy intake was respectively higher by 125 kcal/day and 434 kcal/day as compared to their normal weight counterparts (p<0.001). There was also a significant, moderate and positive correlation between energy intake and BMI (r=0.635), waist circumference (r=0.545), and body fat percentage (r=0.534). When macronutrient composition of diet was analysed (% energy and g/1000 kcal), there was no significant difference in carbohydrate, protein or fat intake between the obese, overweight and normal weight subjects. There was also no significant correlation between macronutrient composition of the diet and body weight status. Based on these findings, we conclude that the subjects’ body weight status is likely to be influenced by energy intake rather than the macronutrient composition of the diet.

Gonadal Dysgenesis, 46,XY ; Gonadal Dysgenesis

Breast cancer is one of the most common malignancy in women and is the leading cause of cancer related death worldwide. Reactive oxygen species (ROS) play an important role in the development of tumours. Several mechanisms leading to oxidative stress have been proposed in cancer patients. In this study we aimed to measure and compare the levels of zinc, superoxide dismutase, catalase, vitamin C, vitamin E, and malondialdehyde in breast cancer patients and age matched healthy controls. Methods: In this comparative cross sectional study, 30 confirmed breast cancer cases and 30 age and sex matched controls were enrolled after taking their consent. Blood sample was collected in EDTA vial, and the parameters of oxidative stress were evaluated by spectrophotometric and atomic absorption spectrophotometric methods. Results: Zinc and MDA level were significantly higher (p<0.001) in cases (106.4 µg/dl and 7.12 nmol/ml) compared to controls (89.8µg/ dl and 3.99nmol/ml). In contrast, there were lower catalase, vitamin C and E levels in cases (28.7±14.56, 0.92±0.35 and 0.68±0.13 mg/dl) compared to controls (37.1±14.7,1.62±0.59 and 1.02±0.22 mg/dl) and were statistically significant (p<0.05 and p<0.001). Whereas, superoxide dismutase was lower in cases compared to controls, but was not statistically significant. Conclusion: Zinc was found to be higher in our study as it is a pivotal element in all rapidly growing tissues. Enhanced lipid peroxidation observed in the circulation of breast cancer patients in our study can be attributed to over production of ROS and deficiency of antioxidant defences. Oxidative stress in cancer cells may trigger excessive consumption of antioxidants as a compensatory mechanism which lead to its lower concentration.

Accidental or suicidal fatalities of paraquat (Gramoxon) poisong are occasionally seen in the emergency room or intensive care unit in this country. In most cases, respiratory symptoms and eventual death by respiratory distress occur within several days. The most striking pathologic change is fibrosis of the lung due to widespread proliferation of fibroblastic cell. We experience a 21-year-old woman with huge bulla on left lung and diffuse fibrosis in other site, who ingested paraquat 10 months ago. After thoracoscopic removal of bulla, the patient survive without progression of pulmonary complication till now.
Emergency Service, Hospital ; Female ; Fibroblasts ; Fibrosis ; Humans ; Intensive Care Units ; Lung ; Paraquat ; Pulmonary Fibrosis* ; Strikes, Employee ; Young Adult

BACKGROUND: To evaluate the efficacy of Fibrin glue to decrease recurrence in video-assisted thoracoscopic surgery(VATS) for a treatment of spontaneous penumothorax. MATERIAL AND METHOD: All medical records of 17 patients who underwent a thoracoscopic wedge resections of bullae with stapling device with Fibrin glue in our institute between May 1998 and December 1999 were reviewed. variables analyzed include affected sites primary indication of VATS. duration from admission to discharge duration of postoperative stay duration of chest tube drainage recurrence and complication. There were 16 men and 1 woman. RESULT: There was no evidence of hemodynamic instability or arterial blood gas abnormalities encountered during the procedure. Mean age at the time of the VATS was 26.9 years (range 15 to 61 years) The mean duration from admission to discharge was 7.8 days and mean postoperative stay was 5.1days mean chest tube indwelling period was 4..0 days. There was no recurrence of pneumothorx. CONCLUSION: Thoracoscopic wedge resections with introduction of fibrin glue are safe and effective and requires only a short hospital stay. We believe that this thoracoscopic technique will further simplify the surgical treatment of pneumothorax.
Chest Tubes ; Drainage ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Hemodynamics ; Humans ; Length of Stay ; Male ; Medical Records ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted

The objective of this study was to find out the role of varicocele surgery in oligospermic infertile patients. It was a prospective and descriptive study carried out in Surgical Unit-I, Abbasi Shaheed Hospital and Karachi Medical and Dental College (KMDC), Karachi from April 2004 to March 2014. In this study, all patients of infertility due to low sperm count having bilateral varicocele were included while those patients having azoospermia or patients with unilateral varicocele were excluded. All patients were clinically assessed for bilateral varicocele and confirmed by ultrasonography of scrotum and relevant investigations were done. Patients were prepared for varicocele surgery and ligation of pampiniform plexus done. Semenanalysis were done during follow up and results were analyzed on SPSS version 14. Total fifty seven patients (n=57) were included in which age range was 20 to 30 years in 33.3%, 31 to 40 years in 42.1%, 41 to 50 years in 19.3% and 51 years to onwards in 05.3% patients only. Chronic smoking was found in 68.4% patients while 31.6% were nonsmokers. Normal testes was found in 77.19% while 22.81% had smaller (atrophied) testes. Very low sperm count was in 15.79%, 50.88% had low sperm count and 33.33% had near normal sperm count. All patients were operated for bilateral varicocele and discharged. Follow-up semen analysis showed improvement and semen analysis became normal in 19.3% after six months, 21.05% after nine months and 36.84% after one year of surgery while 22.81% had no improvement even after one year of surgery. Thus, patients with bilateral varicocele having low sperm count showed improvement in sperm count after varicocele surgery and so infertile patients may become fertile after varicocele surgery.