BACKGROUND: In this study we sought to explore patients’ views regarding factors that helped them in smoking cessation.

METHODS:  In this cross-sectional study, 221 subjects who successfully stopped smoking were selected from two smoking cessation centers. We developed questionnaires which included 15 factors that may be associated with successful smoking cessation. Six months after successful smoking cessation, we administered the questionnaire to see what factors were associated with success in smoking cessation among the subjects. Validity of the study questionnaire was confirmed by 10 experts and its reliability was confirmed through a pilot study based on Cronbach’s alpha index (α=0.754).  Frequencies and percentages were used to describe demographic information of participants. Data was analyzed using the SPSS version 11.0 software.

RESULTS: Our study showed that worrying about getting ill in the future (95.4%), the side effects of smoking heard or observed (94.5%) were ranked the most important factors; while peer pressure (24.3%) and cost of cigarettes (17.2%) were the least important determinants of successful smoking cessation.

 CONCLUSION: In order to develop successful smoking cessation programs, public health professionals and health authorities need to focus on the key determinants of successful smoking cessation. This study highlights perspectives of former smokers who were successful in smoking cessation and thus incorporation of these factors in future intervention programs may prove beneficial, although randomized controlled trials and multicenter studies are needed

BACKGROUND: Since the World Trade Centre attacks on September 11, 2001, there is an increased awareness towards the importance of safety systems in high-rise buildings. From a medical perspective, evacuation and treatment of the victims in this situation is very challenging especially in dealing with multiple injuries. It is important to know the pattern of common injuries that may occur during high-rise evacuation drill for better emergency preparedness.

METHODS:  This is a descriptive study looking at the incidence of injuries during high rise evacuation drills. Participants that required medical attention during drills were included in the study.

RESULTS: There were 11 real patients treated in the medical station during drills. Of the total number of victims, 3 (27.3%) suffered from vasovagal attack, 3 (27.3%) asthmatic attack and 3 (27.3%) ankle sprain. Only 1 (9.05%) had severe hypertension and acute coronary syndrome respectively.

CONCLUSION: With this finding, it is important for standby medical team during high rise evacuation drills to anticipate the type of injuries and help them to prepare resuscitation equipment accordingly.

We report a case of bacterial endocarditis resulting from genital piercing in a male patient with known prior valvular heart disease. Body piercings have emerged as a fashion trend among teenagers and young adults. Concurrently, the number of complications related to body piercing has risen, alerting doctors and wearers to safety concerns. The potential risks of regional complications in male genital piercings (e.g. irritation, paraphimosis, priapism, rupture of the urethra, urethral stenosis, infections, and obstruction of urinary flow) are underestimated by the wearer. Bacterial endocarditis with genital piercing is a severe complication arising after the implantation of these accessories. Recognizing symptoms early and providing medical treatment is crucial to minimize morbidity and mortality of bacterial endocarditis.

SB is a Senior Research Scientist at the South Asian Cochrane Network and Centre, India which is a partner to the Effective Healthcare Research Consortium which receives a grant in aid for developing countries from UKAid (the Department for International Development, UK-DFID). SB has also previously received grants from ICMR, under its STS program. The Cochrane systematic review was funded by DFID and ICMR.

Spinal intramedullary glioblastoma localized in cervical spinal tract has rarely been reported in the literature. The most characteristic features are a rapid clinical and radiographic progression and a very poor prognosis. We report a case of a 37-year old man with a diagnosis of cervical spinal intramedullary glioblastoma, with a previous oncological history of a childhood head and neck (epypharyngeal) embryonal rabdomyosarcoma, treated with chemo-radiation therapy in our Department in 1982. The current presentation was with paresthesias/dysethesias on the left side without motor weakness; a brain and spinal MRI showed a contrast enhancing intramedullary lesion at the C2-C5 level, but no evidence of intra-cerebral disease. Biopsy of the intramedullary lesion by C2-C5 laminectomy was performed and cytological analysis revealed a glioblastoma. Radiation treatment was planned with a total dose of 54 Gy to be given in 27 fractions; unfortunately clinical deterioration at a total dose of 32 Gy was noted. Patient developed respiratory distress potentially related to the involvement of respiratory centers; patient died two days after the development of respiratory symptoms. There is little information about cervical spinal intramedullary glioblastoma in the literature and more studies are needed.

Kikuchi-Fujimoto disease is a self-limiting disease that usually presents with lymphadenopathy and fever.  We present the case of a young girl who presented with complaints of cervical lymphadenopathy and fever. A lymph node biopsy was performed which was suggestive of Kikuchi disease. Our patient was treated symptomatically and did well. Awareness and knowledge of this disorder is essential for physicians and health care workers to ensure appropriate care and treatment of such cases.

The clinical facts and radiologic findings are very important in the diagnostic evaluation of jaw swellings, and must be considered along with histologic findings. Osteoblastoma is a rare, benign, bone-forming tumor that is histologically related to the more common osteoid osteoma. We report a case of osteoblastoma in a 45-year-old female with pain and swelling in the right mandibular posterior region. Radiological imaging disclosed a well-circumscribed lesion in which some parts were calcified. Histologic examination showed large irregular bony trabeculae present within loose and highly cellular connective tissue stroma with few myxoid areas. Areas with clusters of plump osteoblasts and few osteoclasts were also seen. Surgical excision was performed as treatment. This case report is an attempt to help the dental community in developing familiarity with the clinical presentation and at the same time advocating the development of a high index of suspicion in recognizing such cases.

BACKGROUND: The INSURE method (INtubation- SURfactant- Extubation) is effective in decreasing the need for mechanical ventilation and reducing ventilation-related adverse events. The aim of this study was to determine the risk factors for failure of the INSURE method.

METHODS: A prospective descriptive analytical study was conducted in a tertiary level neonatal intensive care unit (NICU) between March 2012 and December 2012. All preterm neonates who received intratracheal surfactant were enrolled in this study and allocated to INSURE failure and INSURE success groups depending on whether they needed intubation and mechanical ventilation or not.

RESULTS: Of the 147 neonates, 45 (30.6%) required intubation within the first 72 hours of intratracheal surfactant administration and, therefore, were included in the failure group. The mean birth weight and gestational age in the failure group were 1342±545 grams and 28.7±2.9 week, respectively, and were significantly lower than the success group (1688±472 grams and 31±2.2 week, respectively; p<0.001). The Apgar scores at 1 and 5 minutes were significantly lower in the failure group than the success group (5.7±2.1 and 7.5±1.3 vs. 7.6±1.5 and 8.8±1, respectively; p<0.001). Respiratory distress syndrome (RDS) score was 8.8±1 in the failure group and 7.1±1.3 in the success group (p<0.001). The need for repeated doses of surfactant in the failure group was more than the success group (odds ratio (OR)=8.24, 95% confidence interval (CI): 3.10- 21.86). The patent ductus arteriosus (OR=3.42, 95% CI: 1.46-8.01; p=0.003) and intra ventricular hemorrhage (OR=4.56, 95% CI: 1.90-10.93; p<0.001) were significantly more common in the failure group.

CONCLUSION: Preterm infants with lower birth weight and gestational age and higher RDS score are at higher risk of INSURE method failure.

We are highlighting a rare presentation of small lymphocytic lymphoma (SLL) presenting as a huge lung mass without mediastinal lymph node involvement. At initial presentation, the differential diagnosis did not include a lymphoma. Our patient was diagnosed only after two CT- guided biopsies of the lung mass. Immunohistochemistry was consistent with the diagnosis of SLL. Hence, non-Hodgkin’s lymphoma (NHL) can be considered as a differential diagnosis for a lung mass with clinical suspicion of malignancy to prevent the delay in diagnosis and treatment.