METHODS: Cross-sectional study of ambulant children with epilepsy on long-term AEDs for >1 year seen in three tertiary hospitals in Malaysia from April 2014 to April 2015. Detailed assessment of pubertal status, skin pigmentation, sunshine exposure behavior, physical activity, dietary vitamin D and calcium intake, anthropometric measurements and bone health blood tests (vitamin D, alkaline phosphatase, calcium, phosphate, and parathyroid hormone levels) were obtained on all patients. Vitamin D deficiency was defined as 25-hydroxy vitamin D [25(OH)D] levels ≤35 nmol/L and insufficiency as 25(OH)D levels of 36-50 nmol/L.
RESULTS: A total of 244 children (146 male) participated in the study. Ages ranged between 3.7 and 18.8 years (mean 12.3 years). 25(OH)D levels ranged between 7.5 and 140.9 nmol/L (mean 53.9 nmol/L). Vitamin D deficiency was identified in 55 patients (22.5%), and a further 48 (19.7%) had vitamin D insufficiency. Multivariate logistic regression analysis identified polytherapy >1 AED (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.07-4.36), age >12 years (OR 4.16, 95% CI 1.13-15.30), Indian ethnicity (OR 6.97, 95% CI 2.48-19.55), sun exposure time 30-60 min/day (OR 2.44, 95% CI 1.05-5.67), sun exposure time <30 min/day (OR 3.83, 95% CI 1.61-9.09), and female (OR 2.61, 95% CI 1.31-5.20) as statistically significant (p < 0.05) risk factors for vitamin D deficiency.
SIGNIFICANCE: Despite living in the tropics, a high proportion of Malaysian children with epilepsy are at risk of vitamin D deficiency. Targeted strategies including vitamin D supplementation and lifestyle advice of healthy sunlight exposure behavior should be implemented among children with epilepsy, particularly for those at high risk of having vitamin D deficiency.
METHOD: The dispensing system is based on an Arduino circuit breadboard where an ATmega328p microcontroller was pre-installed. To sense the proximity, a light-dependent resistor (LDR) is used where the laser light is to be blocked after the placement of human hands, hence produced a sharp decrease in the LDR sensor value. Once the LDR sensor value exceeds the lower threshold, the pump is actuated by the microcontroller, and the sanitizer dispenses through the nozzle.
RESULTS AND DISCUSSION: A novel design and subsequent fabrication of a low-cost, touchless, automated sanitizer dispenser to be used in public places, was demonstrated. The overall performance of the manufactured device was analyzed based on the cost and power consumption, and environmental factors by deploying it in busy public places as well as in indoor environment in major cities in Bangladesh, and found to be more efficient and cost-effective compared to other dispensers available in the market. A comprehensive discussion on this unique design compared to the conventional ultrasonic and infra-red based dispensers, is presented to show its suitability over the commercial ones. The guidelines of the World Health Organization are followed for the preparation of sanitizer liquid. A clear demonstration of the circuitry connections is presented herein, which facilitates the interested individual to manufacture a cost-effective dispenser device in a relatively short time and use it accordingly. Conclusion: This study reveals that the LDR-based automated hand sanitizer dispenser system is a novel concept, and it is cost-effective compared to the conventional ones. The presented device is expected to play a key role in contactless hand disinfection in public places, and reduce the spread of infectious diseases in society.