The pornography use and its addiction among emerging adults in Malaysia: Perceived realism as a mediator

Past studies have demonstrated a link between pornography use and addiction to pornography, the underlying mechanism of the association is still unclear. This study intended to examine the mediating role of perceived realism of pornography in the association between pornography use and addiction among emerging adults in Malaysia. This study recruited 222 self-identified pornography users (M age = 21.05; SD Age = 1.68; 75.1% male respondents) via the purposive sampling method. The correlation results indicated positive associations among pornography use, addiction to pornography, and perceived realism of pornography. Further, the perceived realism of pornography significantly mediated the association between pornography use and addiction to pornography after controlling for gender. Thus, this study has provided a fundamental understanding on the perceived realism role of pornography in explaining the association between its use and addiction. Although it is unlikely to stop illegal pornography use, the results pointed out a need to guide emerging adults in pornography use via media literacy programmes.

Transradial percutaneous coronary intervention in acute ST elevation myocardial infarction and high-risk patients: experience in a single centre without cardiothoracic surgical backup

INTRODUCTION

Primary transradial percutaneous coronary intervention (TRI) is shown to be efficacious in stable patients with acute coronary syndrome. We aimed to evaluate the application of primary TRI for acute ST elevation myocardial infarction (STEMI), including among high-risk patients from our registry.

METHODS

This was a single-centre case series comprising 138 patients who underwent primary TRI for STEMI between May 2007 and June 2008. TRI was attempted with a 6-Fr guiding catheter in all patients regardless of Killip class status. Outcome measures were success rates of primary TRI, door-to-balloon time, procedure duration and volume of contrast used. All patients were followed up for major adverse cardiac events in-hospital, at 30 days and six months.

RESULTS

A total of 138 patients had primary TRI attempted for STEMI. Four patients failed primary TRI and required a femoral approach. The remaining 134 patients underwent primary TRI. The mean patient age was 56.4 years. Most patients with acute STEMI presented in Killip class I and II (91.8 percent). Only 8.2 percent were in Killip class III or IV on admission. 50 percent of patients presented with anterior STEMI. The median door-to-balloon time for this group was 92 (interquartile range [IQR] 77-121) minutes, with a median procedure time of 39 (IQR 29-51) minutes. The success rate of primary TRI was 97.1 percent.

CONCLUSION

Success rate, procedural and radiation time for TRI are comparable to those achieved via the femoral approach. Primary TRI is therefore a feasible and effective approach for acute STEMI, even in high-risk patients.

Anterior mediastinal masses: an anaesthetic challenge

A patient with a large anterior mediastinal mass with minimal respiratory symptoms presented for a diagnostic biopsy of the mass. A pre-operative thoracic computed tomographic scan demonstrated narrowing of the distal trachea, and right and left main stem bronchi. An awake intubation was done. Thiopentone and muscle relaxant were given and surgery commenced. High airway pressure developed and ventilation became difficult, although oxygenation remained satisfactory throughout. Anaesthetic implications are discussed. We recommend that patients with more than 50% obstruction of the airway at the level of the lower trachea and main bronchi have their femoral vessels cannulated in readiness for cardiopulmonary bypass.