A preliminary study on the effect of pharmacist counseling on awareness of and willingness to quit smoking in Malaysian population

Objectives This paper presents an outcome of pharmacist counseling among Malaysian smokers for their awareness of and willingness to quit smoking. Method It was a cross-sectional study during a 3-day public health campaign at a shopping complex. Each self-referred participant was asked to complete a questionnaire apart from the question regarding improvement, and if any in their awareness and willingness to quit smoking, were asked to respond after counseling. Pharmacists counseled each participant about smoking cessation strategies and smoking related diseases. The data were analyzed by χ ² test. Results Among respondents, 25.5% had been smoking for more than 10 years, 31% for 5–10 years, 25.4% for 2–5 years and 18.3% for 1–2 years. The participants declaring no awareness about smoking were 22.9%, with little awareness 44.3%, having moderate awareness 25.7% and with considerable awareness were 7.1%. After counseling, 4.1% revealed unawareness, 17.8% little awareness, 43.8% moderate and 34.2% had considerable awareness on the above aspects. The post counseling awareness on smoking was observed to be significantly higher (P< 0.01). Among smokers studied, 67% showed willingness to quit smoking. Conclusion Increase in awareness of and willingness to quit smoking reflects that pharmacist counseling seems to be helpful in cessation of smoking.     

A life-threatening infection: Fournier's gangrene

Fournier's gangrene is a life-threateningdisorder in which infection of the perineum andscrotum spreads along fascial planes, causingsoft tissue necrosis. If urgent surgery isdelayed, the disease will soon result in septicshock, multiorgan failure, and death. In thisstudy, we present 21 patients with Fournier'sgangrene who were treated in period between1994 and 2001. Patients' charts were reviewedretrospectively and are discussed in the lightof literature.All patients received aggressive surgicaldebridment. Penicillin or Ceftriaxone,aminoglicoside and metronidazole wereadministered intravenously. Of the 21 patients,5 had scrotal carbuncle, 1 had urethralstricture, 1 had chronic indwelling urethralcatheterization, 2 had perirectal abscess, and1 had hemorrhoidectomy. In eleven patients wecouldn't identify any cause. Twelve patientshad diabetes mellitus, and two had chronicalcoholism. Escherichia coli was isolatedin 12 purulent tissue cultures, and Bacteroides fragilis in eight. Seventeenpatients survived, whereas four died.Fournier's gangrene is considered a surgicalemergency. Early surgical intervention isessential, as the gangrene can spread rapidlyat rates reaching 2 mm per hour. So thatFournier's gangrene is an abrupt, rapidlyprogressive, gangrenous infection of theexternal genitalia and perineum and is a realurologic emergency.     

Rare variants of Cutaneous Leishmaniasis: whitlow, paronychia, and sporotrichoid

Cutaneous Leishmaniasis is endemic in certain areas of Pakistan, with the wet form of the disease being the most prevalent. It has a number of morphological variants, which are dependent on the immune status of the host, the subspecies of the Leishmania, and also, to some extent, on the site of involvement. We describe here a case of Leishmaniasis showing two very rare variants, whitlow and paronychial lesions, occurring concurrently with sporotrichoid spread. The patient responded to intramuscular sodium stibogluconate with resolution of the skin lesions.     

Molecular genetics of colorectal cancer: An overview

Colorectal cancer (CRC) is a major cause of morbidity and mortality from cancers in the United States. Recent studies have revealed the paradigm in which sequential genetic changes (mutations) result in the progression from normal colonic tissues to frank carcinoma. In particular, the study of hereditary colorectal cancer and polyposis syndromes such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer has contributed enormously to the understanding of the pathogenesis of CRC. Here we describe some of the common genetic pathways in CRC and the mechanisms of action for some of the key genes involved in the formation of CRC. The understanding of the genetic pathways and functions in CRC may lead to the development of novel therapeutic approaches for treating this deadly disease.     

Treatment of pneumothorax in newborns: Use of venous catheter versus chest tube

BACKGROUND: The traditional treatment for pneumothorax is tube thoracostomy. Chest tube placement often involves complications, particularly in newborns. The aim of this study is to introduce the method of air drainage with venous catheter and to compare two different methods, chest tube placement and venous catheter insertion, in the treatment of pneumothorax in newborns. METHODS: We treated 72 newborn patients with pneumothorax over a 4-year period in neonatal intensive care units at two different medical centers. We randomly divided the patients into two groups. In group I, we treated the patients with chest tube placement technique. We used 18-gauge venous catheter connected to an underwater system to drain air in group II patients. The duration of the procedure, the period of time that the chest tube or catheter was left in place, and the complications associated with the two different procedures were statistically compared. RESULTS: The time required to perform the venous catheter procedure was significantly shorter than that for chest tube placement (P < 0.05). The duration of the device in place was also significantly shorter in group II than group I (P < 0.05). Only two minor complications were recorded in patients who underwent venous catheter placement, and this group's complication rate was significantly lower than the rate in the chest tube group (P < 0.05). CONCLUSION: Insertion of a venous catheter is a safe alternative to chest tube placement as a method of draining air from newborn patients with pneumothorax. This is an easy and quick bedside procedure and is particularly useful for newborn patients that require immediate air drainage.     

Angry wives, abusive husbands: relationship between domestic violence and psychosocial variables

BACKGROUND: A small number of studies conducted in Pakistan have shown high rates of domestic violence. None of the studies, however, discussed associated psychosocial factors. We interviewed a group of women to look at violence and associated psychosocial factors. We wanted to see if self-esteem, quality of relationships, social support, stressful life events, psychiatric symptoms, and different measures of anger were associated with domestic violence. METHODOLOGY: In a cross-sectional survey of women presenting to primary care physicians, we used Women's Experience with Battering and Domestic Abuse Checklist to measure domestic violence. The Relationship Assessment Scale, Oslo Social Support Scale, State Trait Anger Inventory, and Evaluative Belief Scale were used to look at the correlates of violence. We used the information in a regression model to identify independent predictors of violence in this sample. RESULTS: More than half of the women reported experiencing battering and/or violence. Women in abusive relationships reported unhappiness with their intimate relationships and had high scores on 1 subscale of anger. Living in extended families was protective against violence. CONCLUSIONS: We were able to replicate findings that women in abusive relationships are not satisfied with the relationships with their partners. Living in extended families was protective against violence. Community studies may provide a better design to look at the association between abuse and poverty, literacy, self-esteem, and social support.     

Lymphoepithelioma-Like Carcinoma of the Urinary Bladder: A Case Report and Discussion of Differential Diagnosis

Lymphoepithelioma-like carcinoma (LELC) of the urinary bladder is very rare. It is mandatory to make differential diagnosis among lymphoma, chronic cystitis and LELC because of different therapeutic approach. A bladder tumor was found in a 90-year-old patient suffering from hematuria. After transurethral resection, undifferentiated tumor with prominent lymphoid infiltration was seen on light microscopy. Immunohistochemical examination demonstrated positive staining of tumor cells with cytokeratin (CK), epithelial membrane antigen and CK-20. We presented the case because of its rarity and related literature was reviewed.