The sale of tobacco-based cigarettes has declined in western countries, and ‘Big Tobacco’ is trying to make up the deficit in profits from the developing world. The recent introduction of e-cigarette, in which they have invested both their hopes and their finances, has been a boon to them as it serves to confuse smokers and non-smokers about the real issues relating to the toxicity, dangers, and the promotion of nicotine addiction especially among youths who have not previously smoked cigarettes. E-cigarettes cause inflammation and damage to epithelial cells in human airways and increased risk of infection. E-cigarette vapour contains more carcinogens like formaldehyde and acetaldehyde compared to a regular cigarette. Longterm vaping is associated with an incremental lifetime cancer risk. E-cigarettes are neither safe nor effective in helping smokers quit; there is enough evidence to caution children, adolescents, pregnant women, and women of reproductive age about e-cigarette’s potential for long term consequences to foetal and adolescent brain development that sub-serve emotional and cognitive functions. The nicotine effects that cause modification of late CNS development constitute a hazard of adolescent nicotine use. The American Heart Association (AHA), Food and Drug Administration (FDA), World Health Organisation (WHO) and two-thirds of the major nations in the world discourage the promotion of e-cigarettes as an alternative to proven nicotine-addiction treatments. Doctors, health care workers, and medical students should be armed with the facts about e-cigarettes, its dangers, and the legal status concerning its use, in order to be able to offer proper counselling to patients and adolescents, in particular, with special reference to the Malaysian context.
A settlement of Temiars, an aboriginal tribe residing in the north-eastern jungles of the Malay Peninsula, was selected for a study of their cardiorespiratory fitness. A step-test was used to elicit the Vo2max, V E max and HR max in a group of 19 boys aged 12 to 18 years and 6 men aged 19 - 40 years. The mean VO2max of the boys was found to be 45.9 +/- 6.9 ml-kg-1-min-1 compared with 45.6 +/- 5.4 ml-kg-1-min-1 for the men. The mean V E max, HR max and blood lactate levels were found to be 65.5 +/- 11.31/min and 69.2 +/- 23.71/min; 194 +/- 8 beats/min and 186 +/- 10 beats/min; and 79.8 +/- 13.4 mg% and 97.7 +/- 33.4 mg% respectively. These results are comparable to those obtained in urban populations as well as those found in other primitive communities. Telemetric monitoring of the routine daily physical activity of the men revealed that these jungle dwellers rarely tax their oxygen transport systems in their daily living and their cardiorespiratory functions were similar to communities who do not specifically train for physical fitness.
Orogastric lavage has been performed since 200 years ago for intoxicated patients. Due to the risk that outweighs benefits it has fallen out of favour for the last decade. A teenage girl presented to Emergency Department with history of ingestion of a bottle of pesticide within the time frame before gastric emptying. The girl was resuscitated, intubated and orogastric lavage was performed. Fifty cc of the toxic substance was siphoned and antidote of the toxin was administered. She was admitted to the Intensive Care Unit, subsequently recovered and discharge five days later. Definitive airway management, proper technique, correct selection of patients and adequate monitoring are paramount to the success of orogastric lavage.
The case history, treatment and follow-up of a thirteen-year-old girl with obsessive-compulsive neurosis of six months duration are reported. Results show that behaviour modification techniques were effective though a second course of treatment was required. Her illness and its treatment by behaviour therapy in relation to the Malaysian Chinese culture is discussed.