Diabetes is often associated with dysfunction in activities of daily living (ADL), especially among older adults.Hospitalisation of older adults is often followed by decline in functional status affecting their quality of life and well-beingafter discharge. The objective of this study was to determine the functional independence in carrying out basic activitiesof daily living, its relationship with quality of life, and the factors influencing the quality of life in hospitalised olderadults with diabetes. This cross sectional study was carried out on 104 diabetic patients (mean age: 67.5 ± 9.2 years) whowere receiving in-patient treatment. Face-to-face interviews were carried out to determine functional independence usingModified Barthel Index (MBI) as well as quality of life using the World Health Organization’s Quality of Life instrument(WHOQOL-BREF). Results showed that only 37.5% (n = 39) respondents were catergorised as being fully-independent.Among the domains in MBI, using the stairs recorded the lowest score followed by mobility. The physical domain in qualityof life also recorded the lowest score compared to other domains of quality of life. There were significant (p < 0.05),positive correlations between the overall MBI scores and all domains of quality of life; physical (rs = 0.70), psychology(rs = 0.50), social (rs = 0.33) and environmental (rs = 0.25). Hierachical multiple regression analysis showed MBI scoreshad significant influence on all domains of quality of life, with the largest influence on the physical domain i.e. 36% [F(1,92) = 82.14, p < 0.01, R2 = .36]. As a conclusion, hospitalisation reduces the functional independence in carrying outbasic activities of daily living as well as the physical aspect of quality life in older adults with diabetes. Therefore, it isimportant to provide rehabilitation in activities of daily living while the elderly diabetics while undergoing in-patienttreatment in order to maintain quality of life after discharge.

ABSTRACT Electronic cigarettes (e-cigarettes) have been in demand among young generations as a modern way of smoking since last decade. E-cigarette devices generate the vapour through the heating process and the inhalation of vapour through the mouth which is known as vaping directly exposed the oral cavity to potentially toxic chemicals in the vapour. The e-cigarette vapour has been reported with potential systemic and oral health impacts though it is to a lesser extent than the conventional cigarette. The toxicity of the chemicals in e-cigarette vapour has been highlighted by various in-vitro studies and currently being explored by many researchers. Nicotine content in e-cigarette vapour not only causes addiction but has deleterious effects on the oral mucosa. E-cigarette vapour is commonly associated with oral health-related problems such as irritation to the oral mucosa, periodontal disease, and possibly the initiation of dental caries. As a marketing strategy, e-cigarette has been promoted as a safer way of smoking habit and use as a smoking cessation tools. Non-scientific assertions regarding e-cigarettes are causing public misunderstanding, leading people to assume that they are safe while the truth is yet unclear. This narrative review aims to emphasise the hazard of e-cigarette vapour and the outcome to oral health by summarising the evidence gathered from previous studies and the potential role of e-cigarette for smoking cessation aids considering the widespread usage of e-cigarettes and public concerns.
E-Cigarette Vapor--adverse effects ; Oral Health

Objective: To characterise a collection of pili-carrying and none pili-carrying pneumococcal isolates of clinical origin for serotypes, antibiotic resistance and genotype. Methods: In total, 42 clinical isolates were collected between October 2017 and December 2019. Those isolates were analysed for antimicrobial susceptibility, serotype distribution, detection of pneumococcal virulence and pilus genes. Multilocus sequence typing was performed only for piliated isolates, followed by phylogenetic analysis. Results: The common isolation sites among the pneumococcal isolates were tracheal aspirate (28.6%), blood (26.2%), and sputum (23.8%). Fifty percent isolates were resistant to erythromycin, tetracycline (50.0%) and trimethoprim-sulfamethoxazole (43.0%). The most frequent were serotypes 19F (28.6%), 6A/B (23.8%) and 19A (14.3%). Piliated isolates were detected in a small proportion (33.3%); 64.3% were multidrug-resistant. ST320 was the prevalent sequence type among the piliated isolates and genetically related to the Pneumococcal Molecular Epidemiology Network clones Taiwan 19F -14 (CC271). In the phylogenetic analysis, some piliated isolates showed a close association having similar ST320, carrying serotype 19A and both pilus genes indicating their clonal spread. Conclusions: Pneumococcal lineages of piliated isolates have been globally disseminated and pili could have played a role in the spread of antibiotic resistant clones.