Delayed neuropsychiatric sequelae is an important condition which commonly occur during recovery from acute carbon monoxide poisoning. Typical presentation would be apathy, disorientation, amnesia, hypokinesia, bizarre behavior, insomnia and neurological manifestations such as gait disturbance, hypertonia and tremor. We report here a case of a man presented with delayed neuropsychiatric sequelae one month after the carbon monoxide poisoning in his suicidal attempt. He presented with the typical presentation and diagnosis confirmed with the MRI findings. His MRI showed abnormal signal in subcortical hemisphere white matter of both temporo-fronto-parietal-occipital regions along the insula and both globus pallidus. He was treated with Olanzapine, Fluvoxamine, Chlorpromazine and Levodopa and his condition slowly improved. It is important for clinicians to recognize the symptoms and risk factors to develop delayed neuropsychiatric sequelae in patients who previously had carbon monoxide poisoning.
A study on 30 asthmatic children was conducted in Kuala Lumpur. The objective of this study was to study the relationship between respirable particulate (PM10), sulphur dioxide, ozone and various meteorological factors such as humidity, level ofrainfall and temperature with asthma attacks. This study was conducted from 1st September to 31 December 1994. Patients were selected from the Paediatric Unit, Kuala Lumpur Hospital. Questionnaires were used to obtain information from their parents on the history and severity ofasthmatic attacks ofthese patients. Questionnaires were also used to determine if the indoor sources contributed to the attack. Diary cards were used to collect information on the frequency of asthmatic attacks. Each patient's progress was followed through every week during the study period and the attacks were recorded. The data on air quality on the PM10, sulphur dioxide, nitrogen dioxide, carbon monoxide and ozone were collected hourly using the microcomputer system of air monitoring unit from the Universiti Pertanian Malaysia air quality monitoring station located at the City Hall, Kuala Lumpur. The meteorological parameters such as temperature, relative humidity and rain-fall levels were also monitored daily. The asthmatic attack percentage was obtained by dividing the number of attacks in a day with the total number of sample and multiplying by a hundred. Statistical tests indicated that there was a significant correlation between asthmatic attacks and the PM10 concentrations (r=0.73), nitrogen dioxide (r=0.57) and.carbon monoxide (r=0.53) throughout the study period. During the haze episode, more significant correlations between asthmatic attacks, PM10 concentra-tions (0.86), carbon monoxide (0.79) and nitrogen oxide (0.53) were found. Multiple regression statistical test showed that PM10 had the greatest influence on the asthmatic attack rate. The minute respirable particulate which entered the respiratory system of the asthmatics triggered attacks on these patients.
This study has been conducted in a new constructed building of NIOSH Malaysia located at Bandar Baru Bangi, Selangor. The goal of the case study is focusing on the level of Indoor Air Contaminants (IAC) including chemical contaminants within three consequent stages which are before furniture install, after furniture install and during one month occupancy. This study was divided the sampling area into two main facilities which are training and office setting. The contaminants has been measured consist of sixparameters such as Carbon Dioxide (CO2), Carbon Monoxide (CO), Total Volatile Organic Compounds (TVOC), Formaldehyde, Respirable Particulates (PM10) and Ozone. The result of Carbon Monoxide (CO), Total Volatile Organic Compound (TVOC), Respirable Particulates (PM10) and Ozone show an increasing trend across the three sampling stages. The Formaldehyde show an increasing trend in the first and second stages but were reduced significantly the last stage of sampling. These finding indicates that furniture and fittings installed might be a potential sources of indoor air contaminants. The management should be aware to their indoor air status to protect the occupant from the risk of unwanted exposure especially during the early stage of building occupancy.
Carbon monoxide (CO) is a ubiquitous, an indoor and outdoor air pollutant. It is not a significant greenhouse gas as it absorbs little infrared radiation from the Earth. It is produced by the incomplete combustion of fossil fuels, and biomass burning. The CO data are obtained from Atmospheric Infrared Sounder (AIRS) onboard NASA’s Aqua satellite. The AIRS provides information for several greenhouse gases, CO2, CH4, CO, and O3 as a one goal of the AIRS instrument (included on the EOS Aqua satellite launched, May 4, 2002) as well as to improve weather prediction of the water and energy cycle. The results of the analysis of the retrieved CO total column amount (CO_total_column_A) as well as effective of the CO volume mixing ratio (CO_VMR_eff_A), Level-3 monthly (AIR*3STM) 1º*1º spatial resolution, ascending are used to study the CO distribution over the East and West Malaysia for the year 2003. The CO maps over the study area were generated by using Kriging Interpolation technique and analyzed by using Photoshop CS. Variations in the biomass burning and the CO emissions where noted, while the highest CO occurred at late dry season in the region which has experienced extensive biomass burning and greater draw down of CO occurred in the pristine continental environment (East Malaysia). In all cases, the CO concentration at West Malaysia is higher than East Malaysia. The southeastern Sarawak (lat. 3.5˚ - long. 115.5˚) is less polluted regions and less the CO in most of times in the year. Examining satellite measurements revealed that the enhanced CO emission correlates with occasions of less rainfall during the dry season.
OBJECTIVES: Assessment of nicotine withdrawal symptoms is an essential part of tobacco dependence treatment. This study aimed to evaluate the psychometric properties of a Malay translated version of the Minnesota Nicotine Withdrawal Scale (MNWS).
METHODS: The original scale was translated into Malay following the standard guidelines proposed for translation studies. The reliability and validity of the Malay version scale were evaluated on the basis of data collected from 133 participants. The Cronbach's alpha coefficient was calculated to assess the reliability. To validate the psychometric properties of the scale, factor analysis and construct validity were used. This study was conducted at the Quit Smoking Clinic at Penang General Hospital, Penang, Malaysia.
RESULTS: The translated scale has excellent reliability, with total Cronbach's alpha of 0.91. The test-retest reliability for the scale presented an excellent reliability and stability of the translated scale with Spearman's rank correlation coefficient (r = 0.876; P < 0.001). There was a significant positive correlation between the exhaled carbon monoxide level, Fagerstrom Test for Nicotine Dependence total score, and number of cigarettes smoked per day and the MNWS total score (r = 0.72, 0.68, and 0.68, respectively; P < 0.001). A principal-components analysis with orthogonal rotation yielded a unidimensional model that includes all the items of the MNWS.
CONCLUSIONS: The Malay version of the MNWS is a reliable and valid measure of withdrawal symptoms as well as the smoking urge, and it is applicable to clinical practice and research study.
Study site: Quit Smoking Clinic at Penang General Hospital, Penang, Malaysia.
Indoor air quality assessment in residential areas of Al-Hofuf city/Eastern region of Saudi Arabia is investigated through a multi-week multiple sites sampling survey. Critical air pollution indicators, including nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), carbon dioxide (CO2) and total volatile organic compounds (TVOC) as well as temperatures were measured and analyzed during the study period from January to May 2014. Three site-types - roadside, urban and rural - were selected and within each site type, six locations were selected to study the varying indoor/outdoor air quality. The results indicated that NO2 and CO concentrations increased at the starting hours of the day. SO2 concentrations were relatively low and constant. In addition, a strong association between outdoor and indoor air quality was found. Measurements showed that indoor/outdoor ratio for TVOC ranged from 0.8 to 0.99. For CO2, NO2 and SO2, this was 0.92-1.15, 0.5-0.7 and 0.52-0.9, respectively. Finally, the effects of activated carbon (AC) were investigated to assess the extent of the improvement in the indoor air quality. The analysis of data obtained indicated that using locally prepared AC from date stones was an effective way to reduce the indoor air pollution with an overall efficiency of 85.5, while the use of industrial granular AC reduced the air pollutants with an efficiency of less than 0.6. In addition, AC was exposed to an exhaust gas flow to evaluate its elimination potential for high concentrated pollutants. The obtained results demonstrated that AC was also functioning as an efficient absorbent with an overall removal efficiency of 77.8%, even when it was exposed to high concentrations.
Frequent haze occurrences in Malaysia have made the management of PM10 (particulate matter with aerodynamic less than 10 μm) pollution a critical task. This requires knowledge on factors associating with PM10 variation and good forecast of PM10 concentrations. Hence, this paper demonstrates the prediction of 1-day-ahead daily average PM10 concentrations based on predictor variables including meteorological parameters and gaseous pollutants. Three different models were built. They were multiple linear regression (MLR) model with lagged predictor variables (MLR1), MLR model with lagged predictor variables and PM10 concentrations (MLR2) and regression with time series error (RTSE) model. The findings revealed that humidity, temperature, wind speed, wind direction, carbon monoxide and ozone were the main factors explaining the PM10 variation in Peninsular Malaysia. Comparison among the three models showed that MLR2 model was on a same level with RTSE model in terms of forecasting accuracy, while MLR1 model was the worst.
Tobacco and nicotine derivatives uses are multiple in nature. These include conventional cigarettes (CCs), heated tobacco products (HTPs), and electronic cigarettes (ECs). This study aims to determine the practices, nicotine dependency profile, association with exhaled carbon monoxide (eCO) level, and pulmonary function (PF) among adult product users and non-smokers. This cross-sectional study involved smokers, nicotine users, and non-smokers from two public health facilities in Kuala Lumpur from December 2021 to April 2022. Data on socio-demography, smoking profile, nicotine dependency level, anthropometry, eCO monitor, and spirometer measurements were recorded. Out of 657 respondents, 52.1% were non-smokers, 48.3% were CC only smokers, poly-users (PUs) (27.3%), EC-only users (20.9%), and HTP-only users (3.5%). EC use was prevalent among the younger aged, tertiary educated, and females; HTP use was prevalent among those of an older age and CC users was common among lower educated males. The highest median eCO (in ppm) seen were as follows: in CC users only (13.00), PUs (7.00), EC users (2.00), HTP users (2.00), and the least was observed among non-smokers (1.00), which is significantly different across the groups (p <0.001). Comparison of practice between the different product users showed significant differences in age of product initiation (p <0.001, youngest in CC users in PUs), duration of product use (p <0.001, longest in exclusive CC users), cost per month (p <0.001, highest in exclusive HTP users) and attempt to quit product (p <0.001, CC use in PUs had the highest attempt to quit), while there is no significant difference in Fagerström score across the groups. Among EC users, 68.2% successfully switched from smoking CCs to ECs. The findings suggest that EC and HTP users are exhaling less CO. The use of these products in a targeted approach may manage nicotine addiction. Switching practice was higher among current EC users (from using CCs), hence emphasizing the need of switching encouragement and total nicotine abstinence later on. Lower eCO levels in the PU group, (as compared to CC-only users) and high quit attempt rate among in CC use in PUs may indicate attempt of PUs in reducing CC use through alternative modalities such as ECs and HTPs.
Smoking deception is often ignored, but is important in health care. In this trial it was assessed at both study entry and outcome. At study entry, 1,044 males at a primary care clinic were asked smoking status and tested for breath carbon monoxide (CO). Of self-reported non-smokers, 57/402 (14%) were actually smokers, as were 59/251 (24%) of self-reported ex-smokers. The self-reported smokers (n=387) entered a randomized, controlled trial where the intervention comprised four questions on knowledge and beliefs about smoking, standardized verbal advice against smoking, and a leaflet. At follow-up, subjects were also questioned about beliefs. Follow-up was difficult, but 191/387 (49%) attended at three or six months. Of 27 who claimed to have quit, 6 (22%) were deceivers and 21 were confirmed quitters. Cessation did not differ between intervention and control groups. Overall confirmed cessation at six months was 16/387 (4.1 %). Confirmed quitters were significantly lighter smokers than deceivers and still smokers. There were non-significant trends between the outcome groups whereby deceivers had least knowledge and most lay beliefs, and quitters had most knowledge and fewest lay beliefs. The lay beliefs may prevent some smokers from quitting.
Study site: open-access outpatients
clinic (KPM) attached to the teaching hospital
(HUSM) of Universiti Sains Malaysia