Factors associated with unsuccessful quitters in stop smoking services in Perlis, Malaysia.

INTRODUCTION: Tobacco smoking is one of major risk factor of non-communicable disease worldwide. As a prevention strategy, stop smoking services has been advocated at primary care. However, evidence suggests that worldwide there is high rate of unsuccessful quitters. In Malaysia, such evidence has come from small studies or single site study, and evidence on factors associated with failure to quit is scarce. This study aimed to identify the factors associated with unsuccessful quitters among smokers in Stop Smoking Services provided by government health clinics at North Peninsular of Malaysia. MATERIALS AND METHODS: This was a retrospective study record review using data from the Stop Smoking Services registry and patient file card between January 2017 and Jun 2019. Independent variables included in this analysis are sociodemographic data, comorbidity, number appointments attended, duration of smoking, age of starting smoking, previous attempt to quit, fagerstrom score and type of treatment. The outcome of interest, is unsuccessful quitters defined as those who continued to smoke at 6 months after attending the service. A total of 427 sample randomly cases selected from 490 eligible sample was analysed. Logistic regression was used to model factors associated with unsuccessful quitters. RESULTS: The study suggested that clients who attended 0-3 clinic sessions (AdjOR 6.57; 95% CI: 4.14, 10.43) and being single, unmarried (AdjOR: 2.78; 95%CI: 1.07, 7.18) was associated with increased risk of being unsuccessful quitters among smokers in Northern state of Malaysia CONCLUSION: The number of clinic sessions attended and marital status were factors associated with unsuccessful quitters among smokers in the State of Perlis, of Malaysia.

Rural child malnutrition and unsuccessful outcome of food basket programme: does ethnicity matter?

Objectives: The objectives of this study were to determine the prevalence of malnutrition among five-year-olds and factors associated with unsuccessful outcome of a Food Basket Programme (FBP) in a rural district of Kelantan, Malaysia.Design: Administrative health records from selected health clinics were reviewed. Study sample includes indigenous population or Orang Asli of Malaysia. Unsuccessful outcome was defined according to failure to complete the programme according to growth gain and on-time. Multiple logistics regression was used to assess the associated factors of unsuccessful outcome of FBP.Results: This study showed that the prevalence rates of malnutrition among children below five years old were 34.2% underweight, 16.4% thinness, 32.5% stunting and 3.0% overweight, with Orang Asli children faring the worse. Orang Asli children were also five times more likely to be unsuccessful in the FBP (p < .001).Conclusion: Malnutrition is still prevalent among children below five years old in this rural setting and Orang Asli children are vulnerable to have an unsuccessful outcome from the Food Basket Programme. Further research is necessary to further explain this association to inform policy, specifically for Orang Asli children.

Porous (PVDF-HFP/PANI/GO) ternary hybrid polymer electrolyte membranes for lithium-ion batteries.

A poly(vinylidene co-hexafluoropropylene) (PVDF-HFP) membrane is functionalized with polyaniline (PANI) and graphene oxide (GO) nanoparticles. The obtained PVDF-HFP polymer electrolyte membranes (PEMs) have been characterized and implemented in lithium-ion batteries. As a result, the PVDF-HFP/PANI membrane shows the highest ionic conductivity (IC) of 1.04 × 10-3 mS cm-1 compared to pristine PVDF-HFP and PVDF-HFP/PANI/GO ternary membrane; however, PANI addition decreases the tensile strength of the PVDF-HFP membrane from 4.2 MPa to 2.8 MPa. Therefore, GO is introduced to recover the reduced mechanical strength of the PVDF-HFP/PANI membrane. The obtained PVDF-HFP/PANI/GO ternary membrane shows a remarkable improvement in tensile strength of up to 8.8 MPa; however, slight reduction is observed in the ionic conductivity of 6.64 × 10-4 mS cm-1. Furthermore, the PVDF-HFP/PANI/GO ternary membrane exhibits outstanding thermal and mechanical stabilities, improved morphology, highest electrolyte uptake (367.5%) and an excellent porosity of around 89%. Moreover, the PVDF-HFP/PANI/GO ternary PEM has been successfully applied in a lithium-ion battery, which can retain over 95% capacity after 30 cycles. Therefore, the proposed PVDF-HFP/PANI/GO ternary membrane can be a promising candidate as a separator in future lithium-ion batteries.

An approach for IPM program to control sucking pests infesting garden bean plants (Phaseolus vulgaris L.) in Egypt.

An approach to eatablish IPM program for some sucking pests infesting garden beans plants was carried out in two successive seasons of 2004 and 2005 under field conditions in Alexandria, Egypt. The sucking pests included the aphid, Aphis craccivora Koch (Homoptera: Aphididae), the white fly, Bemisia tabaci Genn. (Homoptera: Aleyroidae) and the spider mite, Tetranychus urticae Koch Pymetrozine, thiamethoxam, carbosulfan, abamectin, azadirachtin and the detergent (Masrol 410) were tested for their efficacy in this study. Thiamethoxam, carbosulfan, and pymetrozine proved to be highly effective against Aphis craccivora Koch, while abamectin, azadirachtin, and the detergent (Masrol 410) provided a moderate effect. Moreover, thiamethoxam, pymetrozine, and abamectin showed remarkable efficacy against adults and immature stages of the whitefly, Bemisia tabaci. However, azadirachtin provided a moderate effect, while carbosulfan and detergent (Masrol 410) had no effect altogether on whiteflies. In addition, abamectin induced the highest toxicity effect against the red spider mite, Teteranychus urticae followed by azadirachtin and the detergent that provided moderate effects. IPM program could be achieved by using abamectin, pymetrozine and azadirachtin in a sequence pattern throughout the whole season. Furthermore, the performance of the used agrochemicals on certain nutritional elements of beans pods vr. Branco , i.e. nitrogen, phosphorus, potassium, iron, and magnesium were also studied with varied results.

Abamectin, pymetrozine and azadirachtin sequence as a unique solution to control the leafminer Liriomyza trifolii (Burgess) (Diptera: Agromyzidae) infesting garden beans (Phaseolus vulgaris L.) in Egypt.

Field trails were conducted to determine the performance of three different sequences as a unique solution for the control of the leaf miner Liriomyza trifolii (Burgess) (Diptera: Agromyzidae) infesting garden beans (Phaseolus vulgaris L.) during the two successive seasons of 2004 and 2005. Furthermore, during the evaluation period, the side effect against the ectoparasite Diglyphus isaea (Walker) (Hymenoptera: Eulophidae) was put into consideration. Meanwhile, the comparative evaluation of the pesticides alone showed that abamectin and azadirachtin were highly effective against Liriomyza trifolii, while carbosulfan, pymetrozine and thiamethoxam provided to be of a moderate effect. Moreover, carbosulfan showed harmful effect to the larvae of the ectoparasite Diglyphus isaea (Walker), while abamectin and azadirachtin gave a moderate effect. Thiamethoxam and the the detergent (Masrol 410) had slight effect in this respect. The highly effective sequence among the sequences was abamectin, pymetrozine and azadirachtin, against Liriomyza trifolii (Burgess), with slight harmful effect on Diglyphus isaea (Walker). However the sequence of azadirachtin, pymetrozine and abamectin had a moderate effect on Liriomyza trifolii (Burgess) and exhibited a slight toxic effect on Diglyphus isaea (Walker). In contrast, the sequence of carbosulfan, thiamethoxam and pymetrozine was the least effective and represented a slight effect on Diglyphus isaea (Walker). From this study, it was concluded that abamectin, pymetrozine and azadirachtin sequence has proved to be a unique solution for the control of the leaf miner Liriomyza trifolii (Burgess) infesting garden beans (Phaseolus vulgaris L.) in Egypt.

Risk factors for mental disorder hospitalization after the Persian Gulf War: U.S. Armed Forces, June 1, 1991-September 30, 1993.

Effects of Persian Gulf War (August 2, 1990-July 31, 1991) and Gulf War occupation on post-War hospitalization risk were evaluated through Cox proportional hazards modeling. Active-duty men (n = 1,775,236) and women (n = 209,760) in the Army, Air Force, Navy, and Marine Corps had 30,539 initial postwar hospitalizations for mental disorders between June 1, 1991 and September 30, 1993. Principal diagnoses in the Defense Manpower Data Center hospitalization database were grouped into 10 categories of ICD-9-CM codes. Gulf War service was associated with significantly greater risk for acute reactions to stress and lower risk for personality disorders and adjustment reactions among men. Personnel who served in ground war support occupations (men and women) were at greater risk for postwar drug-related disorders. Men who served in ground war combat occupations were at higher risk for alcohol-related disorders. Longitudinal studies of health, hospitalization, and exposure beginning at recruitment, are needed to better understand how exposure to combat affects the mental health of military personnel.

Prediction of stature from hand measurements.

A sample of 166 normal adult males and females was taken from different colleges of Assiut representing those living in upper Egypt. Each subject has been studied for measurements of stature (S), hand length (HL) and hand breadth (HB). The data were statistically analysed in order to assess the relationship between stature and hand measurements. The correlation matrix of the study indicates close similarity of the relationship between stature and hand measurements in both sexes and in both sides. A generalized multiple regression equation has been designed to estimate stature from values of hand length and hand breadth regardless of sex or side in the form: S = 34.5 + 5.77 HL + 2.7 HB +/- 5.1. This equation may be helpful to obtain approximate stature when there is difficulty in obtaining a direct measurement or where there is a chance print of a criminal or an amputated hand or arm.

Does the developmental plasticity hypothesis have application to Irish Travellers? Findings from the all Ireland Traveller Health Study birth cohort 2008-2011.

There is little record of birth weight of Irish Travellers, a minority group in Ireland. Travellers are known to have higher rate of adult chronic disease and to be exposed to life-long disadvantage. The aim of this study was to establish whether the birth weight and infant mortality rate patterns in Ireland's Travellers were consistent with the developmental plasticity hypothesis. A 1-year follow-up birth cohort study was conducted with linkage data from maternity hospital records of Traveller infants born on the island of Ireland over a 12-month period to self-identifying Traveller and general Irish population mothers from the Lifeways Cross-Generation Cohort Study. The main outcome measure was the rate of birth weight <3000 g in a cohort of Traveller children. There were 987 confirmed Traveller births, 500 of whose mothers consented to linkage to their records. A social gradient was observed in the distribution of birth weight in the general population and Traveller infants constituted the highest proportion of all social classes in the birth weight range of 3 kg or less (16.3%). There was a high rate of persistent smoking among Traveller mothers (53%). After adjustment for smoking and alcohol consumption in pregnancy, the birth weight differential persisted (OR 3.5, 95% CI 1.4-8.1). Infant mortality rate at 12.0/1000 births (95% CI 5.5-19.7) was almost four times that of the general population. This analysis confirms Travellers had a greater than expected incidence of low birth weight and high infant mortality with high rates of premature adult chronic diseases from all causes already demonstrated previously.

Thoracic intradural disc herniation.

Intradural disc herniation is a well-recognized entity in the lumbar region, where over 90% of all intradural herniations are seen.1 By contrast, fewer than 5% occur in either the cervical or thoracic regions.1 We describe a case of a sudden onset neurological deficit caused by an intradural thoracic disc herniation at the T11-T12 level, the intradural nature of which was not diagnosed on preoperative MRI. To the best of our knowledge this is the first description of an intradural disc herniation at this level.

The use of an adjustable valve to treat over-drainage of a cyst-peritoneal shunt in a child with a large sylvian fissure arachnoid cyst.

INTRODUCTION: The cyst-peritoneal shunt is a recognised surgical alternative in the management of sylvian fissure arachnoid cysts. Shunt overdrainage is well described in literature on ventriculo-peritoneal shunts, but not often appreciated as a complication of cysto-peritoneal shunts. CASE REPORT: A 5-year-old boy presented with a symptomatic left sylvian fissure arachnoid cyst. This was initially treated by craniotomy and membrane fenestration in the carotid cistern. Recurrence led to insertion of a valveless cyst-peritoneal shunt 5 months later. Initial progress was followed by persistent headaches 18 months after shunt insertion. CT scan revealed a significant reduction in the cyst size, enlargement of the ipsilateral lateral ventricle, collapse of the contra-lateral ventricle and midline shift towards the side of the shunt. These findings were interpreted as over-drainage of the cyst-peritoneal shunt. RESULT: A Codman Medos adjustable valve was inserted, with the intention of gradually increasing the pressure until the midline shift was restored and the contra-lateral ventricle was reconstituted. This was achieved with the valve set at 90 mm H(2)O, verified by CT scan. Radiological improvement was associated with dramatic symptomatic improvement. CONCLUSION: Over-drainage of cyst-peritoneal shunts is often not appreciated, especially when the main manifestation is headaches. As it is difficult to predict the required valve pressure setting, it may be advisable to consider the use of an adjustable valve.

Targeting the subthalamic nucleus for deep brain stimulation: technical approach and fusion of pre- and postoperative MR images to define accuracy of lead placement.

OBJECTIVES: To define the role of magnetic resonance imaging (MRI) and intraoperative electrophysiological recording in targeting the subthalamic nucleus (STN) in Parkinson's disease and to determine accuracy of electrode placement. PATIENTS AND METHODS: We implanted 54 electrodes into the STN in 27 patients. Target planning was done by coordinate guidelines and visualising the STN on MRI and defined in relation to the mid-point of the AC-PC line. Intraoperative microelectrode recording was used. We adjusted electrode positions for placement in the centre of the STN electrical activity and verified this on postoperative MRI in 16 cases, which were fused to the preoperative images to measure actual error in electrode placement in the three axes. RESULTS: Based on coordinate calculation and MRI localisation, the mean of the target was 11.5 mm lateral, 2.5 mm posterior and 4.1 mm inferior to the mid-point of the AC-PC line. Fifty good electrophysiological recordings of the STN (average length 4.65 mm) were achieved and target point adjusted in 90% of lead placements. The mean of the final target after electrophysiological correction was 11.7 mm lateral, 2.1 mm posterior, and 3.8 mm inferior to the mid-point. The distance from the centre of the electrode artefact to the final target used after electrophysiological recording on the fused images was 0.48 mm, 0.69 mm, and 2.9 mm in the x, y, and z axes, respectively. No postoperative MRI related complication was observed. CONCLUSION: Both direct visualisation of the STN on MRI and intraoperative electrophysiological recording are important in defining the best target. Individual variations exist in the location of the STN target. Fewer tracks were required to define STN activity on the side operated first. Our current stereotactic method of electrode placement is relatively accurate.

Anaplastic oligodendroglioma with metastasis to the spinal cord.

A case of intramedullary spinal metastasis presenting 14 months after excision of the primary anaplastic cerebral oligodendroglioma is presented. To the best of our knowledge, less than 10 cases of spinal metastasis have been reported in the world literature.

Multiple brain metastases from malignant melanoma with long-term survival.

We present a case of multiple malignant melanoma metastases in the brain who is leading a normal life 16 years after the brain secondaries were managed by surgical resection, stereotactic radiation and chemotherapy. The primary lesion in the left upper arm was excised 4 years prior to the brain metastases. His most recent MRI shows him to be disease free. To the best of our knowledge, this is longest survival reported of any patient with multiple brain metastases from malignant melanoma.