The concept of agricultural and environmental sustainability refers to minimizing the degradation of natural resources while increasing crop productions; assessment of inflow and outflow energy resources is helpful in highlighting the resilience of the system and maintaining its productivity. In this regard, the current study evaluated the amount of energy input–output of cotton productions and their environmental interventions. Data are randomly collected from 400 cotton farmers through face-to-face interview. Results suggested that the major energy is consumed by three culprits, i.e., chemical fertilizer, diesel fuel, and irrigation water (11,532.60, 11,121.54, and 4,531.97 MJ ha−1, respectively). Total greenhouse gas (GHG) emission is 1,106.12 kg CO2eq ha−1 with the main share coming from diesel fuel, machinery, and irrigation water. Stimulating data of energies, e.g., energy use efficiency (1.53), specific energy (7.69 MJ kg−1), energy productivity (0.13 kg MJ−1), and net energy gained (16,409.77 MJ ha−1). Further analysis using data envelopment analysis (DEA) showed that low technical efficiency, i.e., 69.02%, is the most probable cause of poor energy use efficiency. The impermanent trend in growth of energy efficiency has been witnessed with plausible potential of energy savings from 4,048.012 to 16,194.77 MJ ha−1 and a reduction of 148.96–595.96 kg CO2eq ha−1 in GHG emission. Cobb–Douglas production function is further applied to discover the associations of energy input to output, which inferred that chemical fertilizer, diesel fuel, machinery, and biocides have significant effect on cotton yield. The marginal physical productivity (MPP) values obliged that the additional use in energy (1 MJ) from fuel (diesel), biocides, and machinery can enhance cotton yield at the rate of 0.35, 1.52, and 0.45 kg ha−1, respectively. Energy saving best links with energy sharing data, i.e., 55.66% (direct), 44.34% (indirect), 21.05% (renewable), and 78.95% (nonrenewable), further unveiled the high usage of nonrenewable energy resources (fossil fuels) that ultimately contributes to high emissions of GHGs. We hope that these findings could help in the management of energy budget that we believe will reduce the high emissions of GHGs.

According to WHO, Malaysia has been classified as a concentrated epidemic country due to progression of HIV infection in the population of injecting drug users. The main objectives of current study are to determine the prevalence of HBV among HIV-positive individuals in a tertiary care hospital of Malaysia and to assess the predictors involved in the outcomes of HIV-HBV co-infected patients. A retrospective, cross-sectional study is conducted at Hospital Palau Pinang, Malaysia. The collection of socio-demographic data as well as clinical data is done with the help of data collection form. Data were analyzed after putting the collected values of required data by using statistical software SPSS version 20.0 and P > 0.05 is considered as significant. Results show that the overall prevalence of HBV was 86 (13%) including 495 (74.5%) males and 169 (25.5%) females among a total of 664 HIV-infected patients. It was observed that there is a high prevalence of HIV-HBV co-infection in males 76 (11.4%) as compared to females 10 (1.5%) (P = 0.002). The median age of the study population was 39 years. The statistical significant risk factors involved in the outcomes of HIV-HBV co-infected patients were observed in the variables of gender, age groups, and injecting drug users. The findings of the present study shows that the prevalence of HBV infection among HIV-positive patients was 13% and the risk factors involved in the outcomes of HIV-HBV co-infected patients were gender, age, and intravenous drug users.

HIV/AIDS remains the greatest public health concern in the world. With current scenario, HIV-AIDS is considered as a chronic disease due to the advent of highly active antiretroviral therapy that has significantly improved the status of infected population, making HIV a manageable illness. However, recent studies suggest that exposure to antiretroviral medications may have marked adverse effects, independent of HIV status. All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient. A better understanding of the adverse effects of antiretroviral agents is of interest not only for HIV specialists as they try to optimize therapy, but also for other physicians who care for HIV positive patients. Current article reviews a note on demerits of the therapy, major complications and metabolic abnormalities that occur as a consequence of highly active anti-retroviral therapy (HAART). Conclusion: It is critical that all health care providers and patients be trained to recognize the symptoms and signs of most of the adverse drug reactions early on. Proper protocols for management of the condition should be readily available. Adverse event surveillance at facilities offering HAART need to be formalized. Proper surveillance of side-effects will enable evidence-based decisions to be taken to avoid potentially fatal complications.

SUMMARY: In the current study we explored the occurrence of adverse drug reactions (ADRs) to antiretroviral therapy among human immune-deficiency virus (HIV)/AIDS patients. We concluded an observational retrospective study in all patients who were diagnosed with HIV infection and were receiving highly active antiviral therapy from Jan. 2007 to Dec. 2012 at Hospital Pulau Pinang, Malaysia. Patient socio-demographic details along with clinical features and susceptible ADRs were observed during the study period. Out of 743 patients, 571 (76.9z) were men, and 172 (23.1z) were women. Overall 314 (42.2z) patients experienced ADRs. A total of 425 ADRs were reported, with 311 (73.1z) occurring in men and 114 (26.8z) in women, with a significant statistical relationship (P value (P) ＝ 0.02, OR ＝ 1.21). Overall 239 (56.2z) ADRs were recorded among Chinese, 94 (22.1z) in Malay, and 71 (16.7z) in Indian patients, which had a statistically significant association with ADRs (P ＝ 0.05, OR ＝ 1.50). Out of a total 425 among ADRs, lipodystrophy was recorded in 151 (35.5z) followed by skin rashes in 80 (18.8z), anemia in 74 (17.4z), and peripheral neuropathy in 27 (6.3z) patients. These findings suggest a need of intensive monitoring of ADRs in HIV treatment centres across Malaysia.

Background: Self-medication is an important issue for health authorities around the world. It is also a common practice among university students.Objective: This study aimed to assess the prevalence of and reasons for self-medication among university students.Methods: A descriptive, cross-sectional community based survey design was adopted for the current study. All the students enrolled in Hail University, Saudi Arabia were selected to include in the study. Data was collected from February to April 2020 using a validated questionnaire and were analyzed using IBM SPSS Statistics, Version 22.0. Using convenient sampling technique, the total sample size calculated was 370 participants. A descriptive analysis was performed. Chi-square test and binary logistic regression was used for analyzing the data where statistical significance was set at p ≤ 0.05.Results: A total of 373 participants completed the questionnaire. The response rate was 84%. The overall prevalence of self-medication among the students was 98.2%. Of the 373 participants, 40.8% were men, and 59.2% were women. Furthermore, 56% were in fields other than health sciences, 23.1% were in preparatory foundation courses, and 20.9% were from the health and medical sciences. The most frequent medical condition that led to self-medication was headaches (92.85%), followed by coughs (37.5%), colic (31.9%) and influenza (30.3%). On univariate analysis, it is revealed that for both abdominal colic [OR 0.54 (0.34–0.86), p = 0.01] and constipation [OR 0.57 (0.32–1.02), p 0.05], female gender was observed significantly with low prevalence than male. However, for influenza, the self-medication prevalence [OR 1.86 (1.19–2.91), p = 0.006] observed was significantly higher in female participants than male. A significant association (p = 0.011) between the self-medication factors and gender was shown in the current study results.Conclusion: An alarming prevalence of self-medication among the students was recorded. Health care providers can increase awareness of the issue by educating individuals about the harmful effects of irresponsible self-medication.

Background: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes. The current study was conducted to determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients. Methods: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form. Results: Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smokers, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with extrapulmonary TB. Male gender (OR= 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR= 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR= 0.74, 95% CI 0.58-0.95), urban residents (OR= 1.46, 95% CI 1.33-1.61), employed individuals (OR= 1.21, 95% CI 1.09-1.34), alcoholics (OR= 4.91, 95% CI 4.04-5.96), drug abusers (OR= 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR= 1.27, 95% CI 1.16-1.40) all showed significant association with smoking habits. This study found that 3236 (75.0 %) patients were successfully treated in the smokers' group, while 4004 (79.7 %) patients were non-smokers. The proportion of deaths (6.6%, n=283), defaulters (6.6%, n=284) and treatment interruptions (4.7%, n=204) was higher in the smokers' group.Conclusions: Smoking has a strong influence on TB and is a major barrier towards treatment success (OR= 0.76, 95% CI 0.69-0.84, p< 0.001). Therefore, the findings indicate that smoking cessations are an effective way to decrease treatment failure and drug resistance.

Background Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes. The current study was conducted to determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients. Methods A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form. Results Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smokers, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with extrapulmonary TB. Male gender (OR = 1.43, 95% CI 1.30–1.58), Chinese ethnicity (OR = 1.23, 95% CI 1.02–1.49), Sarawak indigenous ethnicity (OR = 0.74, 95% CI 0.58–0.95), urban residents (OR = 1.46, 95% CI 1.33–1.61), employed individuals (OR = 1.21, 95% CI 1.09–1.34), alcoholics (OR = 4.91, 95% CI 4.04–5.96), drug abusers (OR = 7.43, 95% CI 5.70–9.60) and presence of co-morbid condition (OR = 1.27, 95% CI 1.16–1.40) all showed significant association with smoking habits. This study found that 3236 (75.0%) patients were successfully treated in the smokers’ group, while 4004 (79.7%) patients were non-smokers. The proportion of deaths (6.6%, n = 283), defaulters (6.6%, n = 284) and treatment interruptions (4.7%, n = 204) was higher in the smokers’ group. Conclusions Smoking has a strong influence on TB and is a major barrier towards treatment success (OR = 0.76, 95% CI 0.69–0.84, p < 0.001). Therefore, the findings indicate that smoking cessations are an effective way to decrease treatment failure and drug resistance.

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