Background: Helicobacter pylori (H. pylori) infection is known to be associated with peptic ulcer and gastric cancer. Detection of H. pylori infection is a significant part of peptic ulcer and gastric cancer prevention and management. 13 C-urea breath test (UBT) provides a good option for the pathogen detection due to its accuracy and safety. Objective: This review aims to evaluate the 13 C-UBT diagnostic accuracy studies conducted among Asian population and validate its use for the Asian population. Methods: Original articles were systematically searched in PubMed, Scopus, and Google Scholar using the PICOS strategy by applying relevant keywords. Only studies published in English and conducted in Asia were included. Our search returned 276 articles. After assessment, 11 articles which answered our research question and met the criteria set for systematic review and meta-analysis were accepted. A total of 15 study protocols were extracted from the 11 accepted articles. Findings: Majority of the studies were conducted in Hong Kong (six), followed by Taiwan (five), Japan (two), and one each in Singapore and Israel. All studies had used histology as part of its gold standard of reference. All but one study was performed on adult populations. The summary estimate for sensitivity was 97% (95% CI: 96, 98%), and specificity was 96% (95% CI: 95, 97%), with significant heterogeneity between studies. Adjusting for the dose (50 mg) and breath sample collection time (20 minutes) had improved both accuracy estimates and significantly reduced heterogeneity. Conclusion: This review supports the test-and-treat strategy for H. pylori infection management. Prevalence and cost-effectiveness studies are mandatory for health authorities to adopt this strategy into national policy.

INTRODUCTION Lung cancer is the most commonly diagnosed cancer worldwide and is the leading cause of cancer death. Smoking is a major contributor to the pathogenesis of lung cancer. Cytochrome P450 2A6 (CYP2A6) is responsible for the metabolic activation of most tobacco carcinogens. CYP2A6 genetic polymorphism can cause variations in the human metabolism of xenobiotics. We performed this meta-analysis to determine the association between whole-gene CYP2A6 deletion polymorphism (CYP2A6*4) and lung cancer risk. METHODS The PubMed, SAGE, Science Direct, the Cochrane Library and Ovid databases were searched for observational studies before October 2018. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). RESULTS Nine case-control studies involving 4385 lung cancer cases and 4142 controls were included in the analysis. The random-effects model was used to combine results from individual studies. The pooled odds ratio was 0.39 (95% CI: 0.27-0.56). There was no heterogeneity across studies (χ 2 =2.49, p=0.96, I 2 =0%). CONCLUSIONS Current evidence from the case-control studies suggests that the CYP2A6 whole-gene deletion polymorphism decreases the risk of lung cancer. Further research is needed to identify any potential confounding factors that may impact this association.

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Introduction: Tobacco is the only legal product that kills a large proportion of its consumers when used as intended by its manufacturer. The effect of nicotine as a driving substance on smoking has been established for decades. Still, very little is known on how the biopsychosocial determinants relationship affects levels of nicotine addiction in smokers, especially in the urban low-income population. The study aimed to validate measurement scales related to biopsychosocial factors that will be used in the future study to evaluate biopsychosocial components that influence nicotine addiction among urban poor smokers. Methods: Exploratory factor analysis (EFA) using the principal component analysis with varimax rotation and Kaiser normalization was used to assess the factor structure. Then, the confirmatory factor analysis (CFA) was conducted to assess the unidimensionality, validity, and reliability of the latent construct. Results: EFA showed extraction of factors according to their original scales with all factor loading and communality's values were above 0.5. During CFA, factor loading less than 0.6 was deleted. Convergent validity verified by computing the Average Variance Extracted (AVE) for every construct range between 0.528 – 0.801. The Fitness Indexes achieved the required level (RMSEA=0.05, CFI=0.937, Chisq/df=1.7). Meanwhile, the Discriminant Validity Index range between 0.75-0.89, which is higher than the correlation coefficient value. Internal consistency assessed from Composite Reliability range between 0.714-0.965. Conclusion: The measurement scales are valid and reliable to assess the intended constructs among low-income male smokers in the urban area.

Today around 80% of smokers worldwide live in low-and middle-income countries, and in most countries, regardless of country income group, tobacco use is more concentrated in low socioeconomic status (SES) populations. This meta-analysis was conducted to review current available evidences to determine the effectiveness of financial incentive strategies on smoking cessation among low-SES smokers. Database search using PubMed, Science Direct and Cochrane Library were used to search financial incentive intervention prior to October 2018. Appraisal of methodological quality was assessed using Cochrane Collaboration's tool. Six identified randomized control trials with 2450 and 2437 participants in intervention and control group respectively were included in the analysis. The random-effect model was used to combine results from individual studies. The pooled odds ratio (OR) was 2.16 (95% CI: 1.66-2.82) comparing financial incentive intervention with control. Heterogeneity was not significant across studies (Chi 2 = 8.17, p = 0.15, I 2 = 39%). Current evidences from the RCT researches suggest that financial incentives are promising potential strategy to encourage smoking cessation among low-SES smokers.