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  1. Fulltext A survey of knowledge of sexually transmitted infections among patients at a public hospital in Pulau Pinang, Malaysia
    Anwar M, Sulaiman SA, Khan TM
    Med Princ Pract, 2010;19(4):312-8.
    PMID: 20516709 DOI: 10.1159/000312719
    OBJECTIVE: The aim of this study was to assess the patients' knowledge and awareness of sexually transmitted infections (STIs).
    SUBJECTS AND METHODS: A face-to-face interview was conducted among the patients visiting the Venereal Diseases Outpatient Department of the General Hospital of Pulau Pinang (Malaysia). A 19-item questionnaire was used. A total of 116 patients participated in the study and 107 patients had valid responses. The reliability and internal consistency of the questionnaire tool was estimated on the basis of Cronbach's alpha (= 0.81). The Statistical Package for Social Sciences (SPSS 13.0(R)) was used for data analysis. Student's t test and analysis of variance were used to analyse the knowledge differences among the groups.
    RESULTS: Of the 107 patients, 82 (76.6%) were diagnosed with syphilis; AIDS was the most commonly known STI among the patients. Of the 107 patients, 35 were sexually active and of these 23 (65.7%) had more than 1 sexual partner. The most popular source of knowledge was newspapers (51 patients, 47.7%), with hospitals (3 patients, 2.8%) being the least popular one. Overall mean score on knowledge questions was 12.21 out of the maximum of 33 points. Knowledge about causative organisms, risk groups, transmission, symptoms, prevention and treatment of STIs was inadequate. The knowledge level was significantly related to gender (p = 0.03), religion (p = 0.005), educational level (p = 0.000), marital status (p = 0.000) and income level (p = 0.036).
    CONCLUSION: This study demonstrated evidence of poor knowledge of STIs amongst the patients attending an STI service in the General Hospital of Pulau Pinang (Malaysia). Hence there is an immediate need for efforts towards improving patient knowledge of STIs.
    Study site: Venereal Diseases Outpatient Department, General Hospital Pulau Pinang, Malaysia
  2. Fulltext Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia
    Anwar M, Sulaiman SA, Ahmadi K, Khan TM
    BMC Public Health, 2010;10:47.
    PMID: 20113511 DOI: 10.1186/1471-2458-10-47
    BACKGROUND: Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.
    METHODS: Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.
    RESULTS: Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 +/- 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).
    CONCLUSIONS: It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.
  3. Evaluation of the management of sexually transmitted infections by private practitioners in pulau pinang, malaysia
    Anwar M, Sulaiman SA
    Malays J Med Sci, 2008 Oct;15(4):41-7.
    PMID: 22589637 MyJurnal
    To determine the current practices of private practitioners for the management of STIs in Pulau Pinang, Malaysia, evaluation of pharmacotherapy for STIs in private clinics and to ascertain the management of STIs compared to standard guidelines.

    METHODS: Data was collected by self-administered questionnaire for private practitioners, which gathered information on their socio-demographic as well as practice characteristics. Descriptive statistical analysis was performed by using SPSS for Windows version 13.0.

    RESULTS: Data was collected from 78 practitioners. Most of the treatment choices mentioned for the treatment of gonorrhea were inconsistent with the guidelines. About 51.2% of practitioners did not screen their patients for HIV/AIDS. Majority of private practitioners counseled their patients about HIV/AIDS on an irregular basis. A high percentage of 59% did not inform health authorities about STI cases and 32.1% mentioned that they did not use any guidelines.

    CONCLUSIONS: Management of STIs by private practitioners with respect to selection of antibiotics, patient counseling and case notification leaves a lot to be desired. Current management practices can adversely impact on HIV/AIDS transmission in the country. Interventions are needed to improve the management practices of private practitioners.

  4. Fulltext MicroRNAs and Target Genes As Biomarkers for the Diagnosis of Early Onset of Parkinson Disease
    Arshad AR, Sulaiman SA, Saperi AA, Jamal R, Mohamed Ibrahim N, Abdul Murad NA
    Front Mol Neurosci, 2017;10:352.
    PMID: 29163029 DOI: 10.3389/fnmol.2017.00352
    Among the neurodegenerative disorders, Parkinson's disease (PD) ranks as the second most common disorder with a higher prevalence in individuals aged over 60 years old. Younger individuals may also be affected with PD which is known as early onset PD (EOPD). Despite similarities between the characteristics of EOPD and late onset PD (LODP), EOPD patients experience much longer disease manifestations and poorer quality of life. Although some individuals are more prone to have EOPD due to certain genetic alterations, the molecular mechanisms that differentiate between EOPD and LOPD remains unclear. Recent findings in PD patients revealed that there were differences in the genetic profiles of PD patients compared to healthy controls, as well as between EOPD and LOPD patients. There were variants identified that correlated with the decline of cognitive and motor symptoms as well as non-motor symptoms in PD. There were also specific microRNAs that correlated with PD progression, and since microRNAs have been shown to be involved in the maintenance of neuronal development, mitochondrial dysfunction and oxidative stress, there is a strong possibility that these microRNAs can be potentially used to differentiate between subsets of PD patients. PD is mainly diagnosed at the late stage, when almost majority of the dopaminergic neurons are lost. Therefore, identification of molecular biomarkers for early detection of PD is important. Given that miRNAs are crucial in controlling the gene expression, these regulatory microRNAs and their target genes could be used as biomarkers for early diagnosis of PD. In this article, we discussed the genes involved and their regulatory miRNAs, regarding their roles in PD progression, based on the findings of significantly altered microRNAs in EOPD studies. We also discussed the potential of these miRNAs as molecular biomarkers for early diagnosis.
  5. Fulltext Resource Utilization Pattern And Cost Of Tuberculosis Treatment In Penang, Malaysia
    Atif M, Sulaiman SA, Shafie AA, Asif M
    Value Health, 2014 Nov;17(7):A725-6.
    PMID: 27202579 DOI: 10.1016/j.jval.2014.08.051
  6. Fulltext Missing data Analysis in Longitudinal Studies: Findings from a Quality of Life Study in Malaysian Tuberculosis Patients
    Atif M, Toghrayee Z, Sulaiman SA, Shafie AA, Low HC, Babar ZU
    Value Health, 2014 Nov;17(7):A778.
    PMID: 27202884 DOI: 10.1016/j.jval.2014.08.361
  7. Fulltext Resource utilization pattern and cost of tuberculosis treatment from the provider and patient perspectives in the state of Penang, Malaysia
    Atif M, Sulaiman SA, Shafie AA, Asif M, Babar ZU
    BMC Health Serv Res, 2014 Aug 19;14:353.
    PMID: 25138659 DOI: 10.1186/1472-6963-14-353
    BACKGROUND: Studies from both developed and developing countries have demonstrated a considerable fluctuation in the average cost of TB treatment. The objective of this study was to analyze the medical resource utilization among new smear positive pulmonary tuberculosis patients. We also estimated the cost of tuberculosis treatment from the provider and patient perspectives, and identified the significant cost driving factors.
    METHODS: All new smear positive pulmonary tuberculosis patients who were registered at the chest clinic of the Penang General Hospital, between March 2010 and February 2011, were invited to participate in the study. Provider sector costs were estimated using bottom-up, micro-costing technique. For the calculation of costs from the patients' perspective, all eligible patients who agreed to participate in the study were interviewed after the intensive phase and subsequently at the end of the treatment by a trained nurse. PASW was used to analyze the data (Predictive Analysis SoftWare, version 19.0, Armonk, NY: IBM Corp.).
    RESULTS: During the study period, 226 patients completed the treatment. However, complete costing data were available for 212 patients. The most highly utilized resources were chest X-ray followed by sputum smear examination. Only a smaller proportion of the patients were hospitalized. The average provider sector cost was MYR 992.34 (i.e., USD 325.35 per patient) whereby the average patient sector cost was MYR 1225.80 (i.e., USD 401.90 per patient). The average patient sector cost of our study population accounted for 5.7% of their annual family income. In multiple linear regression analysis, prolonged treatment duration (i.e., > 6 months) was the only predictor of higher provider sector costs whereby higher patient sector costs were determined by greater household income and persistent cough at the end of the intensive phase of the treatment.
    CONCLUSION: In relation to average provider sector cost, our estimates are substantially higher than the budget allocated by the Ministry of Health for the treatment of a tuberculosis case in Malaysia. The expenses borne by the patients and their families on the treatment of the current episode of tuberculosis were not catastrophic for them.
    Study site: Chest clinic, Hospital Pulau Pinang, Malaysia
  8. Fulltext Treatment outcome of new smear positive pulmonary tuberculosis patients in Penang, Malaysia
    Atif M, Sulaiman SA, Shafie AA, Ali I, Asif M, Babar ZU
    BMC Infect Dis, 2014;14:399.
    PMID: 25037452 DOI: 10.1186/1471-2334-14-399
    According to the World Health Organization's recent report, in Malaysia, tuberculosis (TB) treatment success rate for new smear positive pulmonary tuberculosis (PTB) patients is still below the global success target of 85%. In this study, we evaluated TB treatment outcome among new smear positive PTB patients, and identified the predictors of unsuccessful treatment outcome and longer duration of treatment (i.e., > 6 months).
  9. Fulltext Tuberculosis deaths: are we measuring accurately?
    Atif M, Sulaiman SA, Shafie AA, Qamar Uz Zaman M, Asif M
    J Pharm Policy Pract, 2014;7(1):16.
    PMID: 25838918 DOI: 10.1186/2052-3211-7-16
    Death among tuberculosis patients is one of the major reasons for non-attainment of 85% treatment success target set by World Health Organization. In this short paper, we evaluated whether the overall mortality rate in pulmonary tuberculosis is being affected by other comorbid conditions. All new smear positive pulmonary tuberculosis patients (N =336), who started their treatment at the chest clinic of the Penang General Hospital, between March 2010 and February 2011, were followed-up until December 2011. Tuberculosis treatment outcomes were reported according to six treatment outcome categories recommended by World Health Organization. The outcome category 'died' was defined as 'a patient who died due to tuberculosis or other cause during tuberculosis treatment'. Our findings showed that out of 336 smear positive pulmonary tuberculosis patients, 59 (17.6%) died during treatment (mortality rate = 1.003 cases per 1000 person-days of follow-up). Among the deceased patients, the mean age was 55.8 years (SD =16.17) and 49 were male. According to the mortality review forms, 29 deaths were tuberculosis-related, while the remaining 30 patients died due to reasons other than tuberculosis. Cerebrovascular accident (n =7), septicaemia shock (n =4) and acute coronary syndrome (n =4) were the most common non-tuberculosis related reasons for mortality in the patients. If the 30 patients, for whom tuberculosis was incidental to death, are excluded from the final cohort, the proportion of patients in the 'died' outcome category could be reduced to 9.5%. The treatment outcome criterion (i.e., died) set by World Health Organization has limitations. Therefore, it requires improvement for more objective evaluation of the performance of the National Tuberculosis Program.
    Study site: Chest clinic, Hospital Pulau Pinang, Malaysia
  10. Fulltext Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: a follow-up study
    Atif M, Sulaiman SA, Shafie AA, Asif M, Sarfraz MK, Low HC, et al.
    Health Qual Life Outcomes, 2014;12:19.
    PMID: 24528499 DOI: 10.1186/1477-7525-12-19
    At present, much of the attention within tuberculosis (TB) management is spent on microbiological cure, and its impact on health-related quality of life (HRQoL) is either undervalued or seldom considered. The aim of this study was to evaluate the impact of TB treatment on HRQoL of new smear positive pulmonary tuberculosis (PTB) patients. Moreover, we also aimed to determine whether the selected socio-demographic and clinical variables were predictive of variability in the HRQoL scores over time.
  11. Fulltext Increasing the efficiency of detecting active tuberculosis cases in intermediate and high-burden tuberculosis countries: A way forward
    Atif M, Sulaiman SA
    J Basic Clin Pharm, 2012 Sep;3(4):330-1.
    PMID: 24826045 DOI: 10.4103/0976-0105.105333
  12. Determination of chest x-ray cost using activity based costing approach at Penang General Hospital, Malaysia
    Atif M, Sulaiman SA, Shafie AA, Saleem F, Ahmad N
    Pan Afr Med J, 2012;12:40.
    PMID: 22891098
    Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure.
  13. WHO guidelines for treatment of tuberculosis: the missing links
    Atif M, Sulaiman SA, Shafie AA, Ali I, Hassali MA, Saleem F
    Int J Clin Pharm, 2012 Aug;34(4):506-9.
    PMID: 22706597 DOI: 10.1007/s11096-012-9657-8
    Worldwide, the treatment of tuberculosis is based on evidence-based guidelines developed by the World Health Organization (WHO) for national tuberculosis programs. However, the importance of health related quality of life, the adequate management of side effects associated with antituberculosis drugs and the elaboration of tuberculosis treatment outcome categories are a few issues that need to be addressed in forthcoming WHO guidelines for the treatment of tuberculosis.
  14. SF-36v2 norms and its' discriminative properties among healthy households of tuberculosis patients in Malaysia
    Atif M, Sulaiman SA, Shafie AA, Asif M, Ahmad N
    Qual Life Res, 2013 Oct;22(8):1955-64.
    PMID: 23239084 DOI: 10.1007/s11136-012-0337-x
    BACKGROUND: The aim of the study was to obtain norms of the SF-36v2 health survey and the association of summary component scores with socio-demographic variables in healthy households of tuberculosis (TB) patients.
    DESIGN: All household members (18 years and above; healthy; literate) of registered tuberculosis patients who came for contact tracing during March 2010 to February 2011 at the respiratory clinic of Penang General Hospital were invited to complete the SF-36v2 health survey using the official translation of the questionnaire in Malay, Mandarin, Tamil and English. Scoring of the questionnaire was done using Quality Metric's QM Certified Scoring Software version 4. Multivariate analysis was conducted to uncover the predictors of physical and mental health.
    RESULTS: A total of 649 eligible respondents were approached, while 525 agreed to participate in the study (response rate = 80.1 %). Out of consenting respondents, 46.5 % were male and only 5.3 % were over 75 years. Internal consistencies met the minimum criteria (α > 0.7). Reliability coefficients of the scales were always less than their own reliability coefficients. Mean physical component summary scale scores were equivalent to United States general population norms. However, there was a difference of more than three norm-based scoring points for mean mental component summary scores indicating poor mental health. A notable proportion of the respondents was at the risk of depression. Respondents aged 75 years and above (p = 0.001; OR 32.847), widow (p = 0.013; OR 2.599) and postgraduates (p < 0.001; OR 7.865) were predictors of poor physical health while unemployment (p = 0.033; OR 1.721) was the only predictor of poor mental health.
    CONCLUSION: The SF-36v2 is a valid instrument to assess HRQoL among the households of TB patients. Study findings indicate the existence of poor mental health and risk of depression among family caregivers of TB patients. We therefore recommend that caregivers of TB patients to be offered intensive support and special attention to cope with these emotional problems.
    Study site: Respiratory clinic, Hospital Pulau Pinang, Malaysia
  15. Duration of treatment in pulmonary tuberculosis: are international guidelines on the management of tuberculosis missing something?
    Atif M, Sulaiman SA, Shafie AA, Babar ZU
    Public Health, 2015 Jun;129(6):777-82.
    PMID: 25999175 DOI: 10.1016/j.puhe.2015.04.010
    BACKGROUND: Despite evidence of an association between tuberculosis (TB) treatment outcomes and the performance of national tuberculosis programmes (NTP), no study to date has rigorously documented the duration of treatment among TB patients. As such, this study was conducted to report the durations of the intensive and continuation phases of TB treatment and their predictors among new smear-positive pulmonary tuberculosis (PTB) patients in Malaysia.
    STUDY DESIGN: Descriptive, non-experimental, follow-up cohort study.
    METHODS: This study was conducted at the Chest Clinic of Penang General Hospital between March 2010 and February 2011. The medical records and TB notification forms of all new smear-positive PTB patients, diagnosed during the study period, were reviewed to obtain sociodemographic and clinical data. Based on standard guidelines, the normal benchmarks for the durations of the intensive and continuation phases of PTB treatment were taken as two and four months, respectively. A patient in whom the clinicians decided to extend the intensive phase of treatment by ≥2 weeks was categorized as a case with a prolonged intensive phase. The same criterion applied for the continuation phase. Multiple logistic regression analysis was performed to find independent factors associated with the duration of TB treatment. Data were analyzed using Predictive Analysis Software Version 19.0.
    RESULTS: Of the 336 patients included in this study, 261 completed the intensive phase of treatment, and 226 completed the continuation phase of treatment. The mean duration of TB treatment (n = 226) was 8.19 (standard deviation 1.65) months. Half (49.4%, 129/261) of the patients completed the intensive phase of treatment in two months, whereas only 37.6% (85/226) of the patients completed the continuation phase of treatment in four months. On multiple logistic regression analysis, being a smoker, being underweight and having a history of cough for ≥4 weeks at TB diagnosis were found to be predictive of a prolonged intensive phase of treatment. Diabetes mellitus and the presence of lung cavities at the start of treatment were the only predictors found for a prolonged continuation phase of treatment.
    CONCLUSIONS: The average durations of the intensive and continuation phases of treatment among PTB patients were longer than the targets recommended by the World Health Organization. As there are no internationally agreed criteria, it was not possible to judge how well the Malaysian NTP performed in terms of managing treatment duration among PTB patients.
    KEYWORDS: Duration of continuation phase; Duration of intensive phase; Duration of tuberculosis treatment; Malaysia; Penang; Smear-positive pulmonary tuberculosis
  16. Fulltext Development and validation of RP-HPLC-UV method for the determination of Glipizide in human plasma
    Atif M, Khalid SH, Onn Kit GL, Sulaiman SA, Asif M, Chandersekaran A
    J Young Pharm, 2013 Mar;5(1):26-9.
    PMID: 24023449 DOI: 10.1016/j.jyp.2013.01.005
    A simple, sensitive and selective HPLC method with UV detection for determination of Glipizide in human plasma was developed. Liquid-liquid extraction method was used to extract the drug from the plasma samples. Chromatographic separation of Glipizide was achieved using C18 column (ZORBAX ODS 4.6 × 150 mm). The mobile phase was comprised of 0.01 M potassium dihydrogen phosphate and acetonitrile (65:35, v/v) adjusted to pH 4.25 with glacial acetic acid. The analysis was run at a flow rate of 1.5 mL/min with an injection volume was 20 μL. The detector was operated at 275 nm. The calibration curve was linear over a concentration range of 50-1600 ng/mL. Intra-day and inter-day precision and accuracy values were below 15%. The limit of quantification was 50 ng/mL and the mean recovery was above 98%. Freeze-thaw, short-term, long-term and post-preparative stability studies showed that Glipizide in plasma sample was stable. The method may be successfully applied to analyze the Glipizide concentration in plasma samples for bioavailability and bioequivalence studies.
  17. Fulltext Tracing contacts of TB patients in Malaysia: costs and practicality
    Atif M, Sulaiman SA, Shafie AA, Ali I, Asif M
    Springerplus, 2012;1:40.
    PMID: 23961366 DOI: 10.1186/2193-1801-1-40
    Tuberculin skin testing (TST) and chest X-ray are the conventional methods used for tracing suspected tuberculosis (TB) patients. The purpose of the study was to calculate the cost incurred by Penang General Hospital on performing one contact tracing procedure using an activity based costing approach. Contact tracing records (including the demographic profile of contacts and outcome of the contact tracing procedure) from March 2010 until February 2011 were retrospectively obtained from the TB contact tracing record book. The human resource cost was calculated by multiplying the mean time spent (in minutes) by employees doing a specific activity by their per-minute salaries. The costs of consumables, Purified Protein Derivative vials and clinical equipment were obtained from the procurement section of the Pharmacy and Radiology Departments. The cost of the building was calculated by multiplying the area of space used by the facility with the unit cost of the public building department. Straight-line deprecation with a discount rate of 3% was assumed for the calculation of equivalent annual costs for the building and machines. Out of 1024 contact tracing procedures, TST was positive (≥10 mm) in 38 suspects. However, chemoprophylaxis was started in none. Yield of contact tracing (active tuberculosis) was as low as 0.5%. The total unit cost of chest X-ray and TST was MYR 9.23 (2.90 USD) & MYR 11.80 (USD 3.70), respectively. The total cost incurred on a single contact tracing procedure was MYR 21.03 (USD 6.60). Our findings suggest that the yield of contact tracing was very low which may be attributed to an inappropriate prioritization process. TST may be replaced with more accurate and specific methods (interferon gamma release assay) in highly prioritized contacts; or TST-positive contacts should be administered 6H therapy (provided that the chest radiography excludes TB) in accordance with standard protocols. The unit cost of contact tracing can be significantly reduced if radiological examination is done only in TST or IRGA positive contacts.
  18. Fulltext Influence of fuel moisture content and reactor temperature on the calorific value of syngas resulted from gasification of oil palm fronds
    Atnaw SM, Sulaiman SA, Yusup S
    ScientificWorldJournal, 2014;2014:121908.
    PMID: 24578617 DOI: 10.1155/2014/121908
    Biomass wastes produced from oil palm mills and plantations include empty fruit bunches (EFBs), shells, fibers, trunks, and oil palm fronds (OPF). EFBs and shells are partially utilized as boiler fuel while the rest of the biomass materials like OPF have not been utilized for energy generation. No previous study has been reported on gasification of oil palm fronds (OPF) biomass for the production of fuel gas. In this paper, the effect of moisture content of fuel and reactor temperature on downdraft gasification of OPF was experimentally investigated using a lab scale gasifier of capacity 50 kW. In addition, results obtained from equilibrium model of gasification that was developed for facilitating the prediction of syngas composition are compared with experimental data. Comparison of simulation results for predicting calorific value of syngas with the experimental results showed a satisfactory agreement with a mean error of 0.1 MJ/Nm³. For a biomass moisture content of 29%, the resulting calorific value for the syngas was found to be only 2.63 MJ/Nm³, as compared to nearly double (4.95 MJ/Nm³) for biomass moisture content of 22%. A calorific value as high as 5.57 MJ/Nm³ was recorded for higher oxidation zone temperature values.
  19. Fulltext Study on tar generated from downdraft gasification of oil palm fronds
    Atnaw SM, Kueh SC, Sulaiman SA
    ScientificWorldJournal, 2014;2014:497830.
    PMID: 24526899 DOI: 10.1155/2014/497830
    One of the most challenging issues concerning the gasification of oil palm fronds (OPF) is the presence of tar and particulates formed during the process considering its high volatile matter content. In this study, a tar sampling train custom built based on standard tar sampling protocols was used to quantify the gravimetric concentration of tar (g/Nm3) in syngas produced from downdraft gasification of OPF. The amount of char, ash, and solid tar produced from the gasification process was measured in order to account for the mass and carbon conversion efficiency. Elemental analysis of the char and solid tar samples was done using ultimate analysis machine, while the relative concentration of the different compounds in the liquid tar was determined making use of a liquid gas chromatography (GC) unit. Average tar concentration of 4.928 g/Nm3 and 1.923 g/Nm3 was obtained for raw gas and cleaned gas samples, respectively. Tar concentration in the raw gas sample was found to be higher compared to results for other biomass materials, which could be attributed to the higher volatile matter percentage of OPF. Average cleaning efficiency of 61% which is comparable to that of sand bed filter and venturi scrubber cleaning systems reported in the literature was obtained for the cleaning system proposed in the current study.
  20. Fulltext Impact of connecting tuberculosis directly observed therapy short-course with smoking cessation on health-related quality of life
    Awaisu A, Haniki Nik Mohamed M, Noordin NM, Muttalif AR, Aziz NA, Syed Sulaiman SA, et al.
    Tob Induc Dis, 2012 Feb 28;10:2.
    PMID: 22373470 DOI: 10.1186/1617-9625-10-2
    BACKGROUND: With evolving evidence of association between tuberculosis (TB) and tobacco smoking, recommendations for the inclusion of tobacco cessation interventions in TB care are becoming increasingly important and more widely disseminated. Connecting TB and tobacco cessation interventions has been strongly advocated as this may yield better outcomes. However, no study has documented the impact of such connection on health-related quality of life (HRQoL). The objective of this study was to document the impact of an integrated TB directly observed therapy short-course (DOTS) plus smoking cessation intervention (SCI) on HRQoL.
    METHODS: This was a multi-centered non-randomized controlled study involving 120 TB patients who were current smokers at the time of TB diagnosis in Malaysia. Patients were assigned to either of two groups: the usual TB-DOTS plus SCI (SCIDOTS group) or the usual TB-DOTS only (DOTS group). The effect of the novel strategy on HRQoL was measured using EQ-5D questionnaire. Two-way repeated measure ANOVA was used to examine the effects.
    RESULTS: When compared, participants who received the integrated intervention had a better HRQoL than those who received the usual TB care. The SCIDOTS group had a significantly greater increase in EQ-5D utility score than the DOTS group during 6 months follow-up (mean ± SD = 0.98 ± 0.08 vs. 0.91 ± 0.14, p = 0.006). Similarly, the mean scores for EQ-VAS showed a consistently similar trend as the EQ-5D indices, with the scores increasing over the course of TB treatment. Furthermore, for the EQ-VAS, there were significant main effects for group [F (1, 84) = 4.91, p = 0.029, η2 = 0.06], time [F (2, 168) = 139.50, p = < 0.001, η2 = 0.62] and group x time interaction [F (2, 168) = 13.89, p = < 0.001, η2 = 0.14].
    CONCLUSIONS: This study supports the evidence that an integrated TB-tobacco treatment strategy could potentially improve overall quality of life outcomes among TB patients who are smokers.
    Study site: Five chest clinics, Hospitals in Pulau Pinang, Bukit Mertajam, Seberang Jaya, Sungai Bakap, and Institut Perubatan Respirotori, Malaysia
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