The objective was to estimate the prevalence of intestinal protozoa among the aborigines and to determine the problems regarding the infection. The study was carried out in January 2006 in Pos Senderut, Pahang, Malaysia. Samples of faeces were collected from children and adults and these were fixed in PVA and trichrome staining was carried out. From the 130 individuals studied, 94 (72.3%) were positive with at least one intestinal protozoa. Nine intestinal protozoa namely Blastocystis hominis, Giardia lamblia, Entamoeba histolytica, Entamoeba coli, Endolimax nana, Entamoeba hartmani, Entamoeba polecki, Iodamoeba butschlii and Chilomastix mesnili were detected. The prevalent species were B. hominis (52.3%), followed by G. lamblia (29.2%), E. coli (26.2%) and E. histolytica (18.5%). The other species ranged from 1.5 to 10.8%. Among the positive samples, mixed infection with E. histolytica and G. lamblia was 3.8%, E. histolytica and B. hominis was 15.4%, G. lamblia and B. hominis was 17.7%. Triple infection of E. histolytica, G. lamblia and B. hominis was 3.1%. The infection was more prevalent in children below 10 years age group (45.4%) and lowest in the age above 60 years (3.8%). The high prevalence was attributable to poor environmental management, poor personal hygiene and lack of health education.
Protozoal ; upper case gee ; Upper case ee ; Upper case Bee ; Infection as complication of medical care

Background: Community pharmacists are strategically positioned to dispense Complementary and Alternative Medicine (CAM) products as part of their innate roles in the provision of accurate drug information to patients. This unique position of the pharmacist could be best realized if equipped with good knowledge and skills in regard to CAM products. Objectives: This study aimed to assess the readiness of community pharmacists in the provision of CAM productrelated information to patients by assessing the knowledge and determined the attitudes and practices of community pharmacists regarding CAM products in Eastern Visayas, Philippines. Methods: A descriptive mixed-method (qualitative and quantitative) survey design was utilized in this study. Community pharmacists (n=58) in Eastern Visayas, Philippines were the research participants in the study. The survey questionnaire constituted four sections: socio-demographic profile, attitudes, practices, and knowledge of community pharmacists on CAM products. Descriptive statistical analysis was performed using SPSS Version 20. Results: Results revealed that the majority of respondents are female (87.93%), age range in between 21-30 (62.07%), working full-time (79.31%), and bachelor’s degree holder (98.28%). More than half of the participants (53.45%) did not receive any education or training on CAM products during undergraduate studies. Community pharmacists displayed strong positive attitudes (mean=3.74) and had a moderate frequency of practice on CAM products (mean=3.20). The knowledge test revealed that only a few of the community pharmacists (31.03%) were considered knowledgeable. A significant relationship between years of work experience in community pharmacy and knowledge was found in this study. Conclusion Despite having strong attitude and moderate level of practice, community pharmacists in Eastern Visayas showed a low level of knowledge on CAM products. Demand for CAM products by patients encouraged community pharmacists to dispense and provide information. Readiness of community pharmacists in terms of knowledge provision of CAM product-related information to patients were found to be insufficient while a moderate level of practice towards CAM products was reported. Community pharmacists displayed a strong positive attitude towards CAM products. Overall, the community pharmacists are not ready to provide CAM information service in the context of the knowledge, attitude, and practices.
Complementary Therapies ; Medicine, Traditional ; Philippines

Malaria and dengue fever are among the most common mosquito-borne diseases worldwide; however, reports of coinfection are rare. We present a case of severe malaria and dengue coinfection in a 16-yearold female patient presenting with fever, thrombocytopenia, pleural effusion, myopericarditis, and acute respiratory distress syndrome. Dengue infection was confirmed by the presence of immunoglobin M antibodies and nonstructural protein 1, while malaria was confirmed by the presence of Plasmodium vivax in thick and thin blood smears. This is the first report of a dengue/malaria coinfection in Mexico.

INTRODUCTIONThis study aims to determine if the quantitative method of region-of-interest (ROI) analysis of lesion attenuation on CT may be a useful adjunct to the conventional approach of diagnosis by visual assessment in assessing tracer wash-out in hepatocellular carcinomas.

MATERIALS AND METHODSFrom a surgical database of 289 patients from 2 institutions, all patients with complete surgical, pathological and preoperative multiphasic CT scans available for review were selected. For each phase of scanning, HU readings of lesion obtained (Lesion(arterial), Lesion(PV) and Lesion(equilibrium)) were analysed using receiver operating curves (ROC) to determine the optimal method and cut-off value for quantitative assessment of tumour wash-out (Lesion(arterial - equilibrium), Lesion(PV - equilibrium) or Lesion(peak - equilibrium)).

RESULTSNinety-four patients with one lesion each met the inclusion criteria. The area under the curve (AUC) values for Lesion(arterial - equilibrium) (0.941) was higher than the AUC for Lesion(pv - equilibrium) (0.484) and for Lesion(peak - equilibrium) (0.667). Based on ROC analysis, a cut-off of 10HU value for Lesion(arterial - equilibrium) would yield sensitivity and specificity of 91.5% and 80.9%, respectively. ROI analysis detected 9/21 (42.9%) of lesions missed by visual analysis. Combined ROI and visual analysis yields a sensitivity of 82/94 (87.2%) compared to 73/94 (77.7%) for visual analysis alone.

CONCLUSIONUsing a cut-off of 10 HU attenuation difference between the arterial and equilibrium phases is a simple and objective method that can be included as an adjunct to visual assessment to improve sensitivity for determining lesion wash-out on CT.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; surgery ; Confidence Intervals ; Databases, Factual ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Preoperative Period ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; instrumentation ; Young Adult

OBJECTIVE: To determine whether topical applications of thiosulfinate-enriched Allium sativum extract (TASE) can accelerate acute cutaneous wound healing (WH) in a murine model. METHODS: Keratinocyte viability and in vitro wound closure were assessed in keratinocyte cultures. Effects of topical TASE (0.5 μg/mL of allicin in 97% ethanol) on acute cutaneous WH were determined in a murine model of acute cutaneous wound. Twelve mice were alternately assigned to the vehicle- and TASE-treated groups (n=6 per group). Expression levels of mRNA for keratinocyte differentiation marker-related proteins (filaggrin, loricrin and involucrin) and lipid synthetic enzymes (elongation of very long chain fatty acids protein 4 (ELOVL4), fatty acid synthase (FA2H), 3-hydroxy- 3-methyl-glutaryl-coenzyme A reductase (HMGCoA), and serine palmitoyltransferase (SPT)) were assessed using real-time quantitative polymerase chain reaction on day 3 and 8 after wounding, while transepidermal water loss (TEWL) rates were measured in wounded areas. RESULTS: TASE accelerated WH both in vivo (40% vs. 22% reduction in wound area, P<0.01) and in vitro (90% vs. 65% reduction in wound area, P<0.01). Moreover, topical applications of TASE upregulated the expression levels of epidermal mRNA for ELOVL4, HMGCoA, SPT, filaggrin, loricrin and involucrin (P<0.05 vs. vehicle-treated controls) on day 3 after wounding. Likewise, TASE significantly lowered TEWL rates in comparison with vehicle alone on day 8 (33.06±2.09 g/(m CONCLUSIONS Topical applications of TASE stimulated keratinocyte proliferation and formation of epidermal permeability barrier function, leading to acceleration of acute cutaneous WH. Topical products containing TASE could be used to manage acute cutaneous WH.

BACKGROUND: Community-managed health programs (CMHPs) were designed to promote community self-determination in addressing health needs, but there is a need to evaluate how CMHPs can lead to better outcomes while accommodating changes in the national health system, which requires analysis of current CMHP interventions, institutional and community readiness, and points of interface with other health facilities.

OBJECTIVE AND METHODS: This preliminary study aimed to guide an eventual effort to develop a framework to ensure CMHPs sustainably improve health outcomes. A preliminary analysis of results from a community participatory research was done in which baseline health characteristics, related social determinants, level of involvement of CMHPs with the local government health system, and quality of life were documented through surveys, focus group discussions and key informant interviews, both in a community with an established CMHP (Murcia, Negros Occidental, Philippines), and a control area without a similar NGO sector (Isabela, Negros Occidental).

RESULTS: There was higher NGO and local government involvement among respondents in Murcia, use of traditional medicine, and sense of awareness of the need to improve the water quality in Murcia, with noted persistence of sanitation concerns, pinpointing the need to assess community participation and the efficiency of CMHPs.

CONCLUSION: Further study is needed in measuring community participation while considering its underlying cultural and socioeconomic contexts, in order to facilitate planning and implementation of strategies that intend to address community-recognized health needs while sustainably improving health outcomes.

Human ; Community Participation ; Health ; Philippines