Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly under-notified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea while improving surveillance and notification of the disease.

Two methods of identifying smokers with high nicotine dependence, the heaviness of smoking index (HSI) and number of cigarettes per day (CPD) were compared with the Fagerstrom test for nicotine dependence (FTND). The HSI, CPD and the FTND were administered to 316 adult Malaysian male, daily smokers aged between 25-64 years old in the Malaysian NCD Surveillance-1 Survey using a two-stage stratified random sampling of enumeration blocks and living quarters, via an interview based on a validated questionnaire. The cut-off point for classification of high nicotine dependence on the HSI was a score of four or higher, and for the heavy smoking category, smoking more than 20 cigarettes per day. Classification using each method was compared with classification by the FTND (score of six or more) as the reference standard. Sensitivity, specificity and kappa statistics for concordance between both measures and the FTND were evaluated. The HSI gave a similar prevalence rate of high nicotine dependence as the FTND. There was substantial agreement between the HSI and the FTND (kappa=0.63.), with moderate sensitivity (69.8%) and high specificity (92.5%). However, prevalence of high nicotine dependence using the CPD was 7% lower than the FTND. The heavy smoking category also showed fair agreement with the FTND (kappa=0.45) and moderate sensitivity (67.0%), but specificity was high (86.9%). The findings indicate that the HSI can be used as an alternative to the FTND in screening for high nicotine dependence among daily smokers in large population-based studies, while CPD may not be a suitable alternative to the FTND. Keywords: Fagerström test for nicotine dependence -heaviness of smoking index -heavy smoking -Malaysians

Although much has been researched on the external contextual forces as barriers to women’s career development, there is a need to assess the role of women’s internal forces (personal cognitive) in determining their aspirations for advancement in career. The study aims at investigating the direct linkages among several personal cognitive factors in shaping up the career aspirations of working women. AMOS-based ‘structural equation modelling’ was performed and the results revealed a significant influence of occupational self-efficacy, proactive personality, work role salience and gender role attitude as cognitive factors in explaining the aspirations of working women for advancement in career. The findings present important implications for women as individuals, families, supervisors and organizations.

The purpose of this article was to investigate the impact of career-related support in work and non-work domains on the aspirations of women for progression in career. Using multistage sampling technique, the data were collected from 438 female employees working in private sector banks and insurance companies in Punjab, a state in north India. AMOS-based structural equation modelling was performed, and the results revealed that family/spousal support in non-work domain and supervisory and organisational support in work domain significantly predicted the career aspirations of working women, whereas the impact of collegial support was not observed. Supervisor support was found to be the most significant source of support followed by family/spousal support and then organisational support. The present study is a pioneer work, which has empirically examined the role of various forms of contextual supports in work and non-work domains in determining the desired aspirations of working women in India. The study proposes that collective efforts on the part of women themselves, their families, supervisors, colleagues and organisations are required to enhance working women’s propensity to aspire and realise their aspirations for advancement in career.

Assistant environmental health officers (AEHO) are health care providers (HCPs) who act as enforcers, educators and trusted role models for the public. This is the first study to explore smoking behaviour and attitudes toward tobacco control among future HCPs. Almost 30% of AEHO trainees did not know the role of AEHOs in counselling smokers to stop smoking, but 91% agreed they should not smoke before advising others not to do so. The majority agreed that tobacco control regulations may be used as a means of reducing the prevalence of smoking. Future AEHOs had positive attitudes toward tobacco regulations but lacked understanding of their responsibility in tobacco control measures.

No abstract

Not many drugs in anaesthesiology have gained so much attention as ketamine got for so many years. It has been used worldwide for the last five decades through various routes and for various indications. In its early year of its manufacture, it was considered a wonder or magic drug though the popularity declined with observation of so many side effects coming to the fore through various clinical trials. However, recently its non-anaesthetic properties and anaesthetic profile has re-kindled a newer interest in its pharmacological profile. Here we stand at a new juncture where a possible confluence of its old and recent utilities can make it a drug for future thus revolutionizing its clinical usage in many scenarios. The current narrative review aims to highlight these aspects through a short journey from its pharmacological profile to its older and recent indications.

Actual vaccination coverage in Kuala Lumpur was much higher than the estimated coverage previously reported, reflecting the expected success of the Department of Health immunization campaign. Estimated values of live births are insufficient to accurately determine vaccine status and should be avoided.