Clinic ; Hospitals

In Papua New Guinea, measles remains a public health problem and the majority of measles cases occur in non-immunized children. In Goroka, measles vaccine coverage for the 9-month-old group was 44%. The parents or caregivers are important in measles prevention as children's immunization depends on their compliance. This study aimed to determine the factors that hinder caregivers from having their children vaccinated for measles prevention in the Goroka District, Eastern Highlands Province. A cross-sectional study was conducted in July-August 2003, using pre-constructed questionnaires and interviews. There was a total of 120 respondents who were caregivers or parents of children whose ages ranged from 6 to 12 months and who attended health care centres where immunization services were provided. The main reasons for not bringing their children to clinic for immunization were: limited access to health centres, especially to maternal and child health (MCH) clinics; too long a waiting time at the clinic; concern that too many injections were being given to their children; the side-effects of the vaccine; being sent away and asked to come back the next day for immunization; and a bad reception from health workers. Funerals or election-related events in the area also affected the attendance at the clinic. In order to improve the vaccine coverage, the use of a mobile MCH clinic should be re-established. Health workers should utilize the opportunities to pass on necessary information on immunization to caregivers, as well as being mindful to use communication that will prevent misunderstanding by the mothers. It is important for all health workers to recognize that their performance and attitude can greatly improve the overall vaccine coverage in Papua New Guinea.
Immunization ; Child ; Measles ; Health ; Clinic

Kampo formulae are selected according to a patient's symptoms. In certain cases the decoctions are modified with additional herbs to provide a suitable treatment. Knowledge of herbs and formulae used clinically in Kampo medicine is essential; however there is a lack of knowledge on how extensively certain herbs are applied. We have analyzed our Kampo outpatient clinic prescriptions for September 2004. The 20 most frequently applied formulae accounted for 60% of all prescriptions. Also, we analyzed our patients' medical backgrounds in relation to the most frequently used 20 prescriptions in September 2004, and the distribution of our patients for each prescription. The distribution of patients for each prescription differed significantly from the distribution of all patients. As a last point, we looked at which herbs were most frequently added to prescriptions. The most frequently added herb was Astragali Radix, followed by Coicis Semen and Aconiti Tuber. We consider this to be significant information for Kampo physicians and pharmacists.
Medicine, Kampo ; seconds ; Distributing ; Clinic ; Analysis

Kampo medicines have been used for treatment by an increasing number of doctors in recent years, and are becoming more frequently prescribed in combination with Western drugs. In the present study, we conducted a questionnaire of outpatients at the Kampo Clinic of Keio University Hospital in order to determine their perceptions and compliance regarding Kampo medicines.Ninety eight percent of patients used Kampo medicines in granular form, and approximately 30% of these patients reported difficulty in taking medicine due to reasons such as “bad taste”. Sixty percent of patients used Kampo medicines three times daily. Patients most often forgot to take afternoon doses, and so desired doses once daily. Furthermore, the same number of patients preferred Kampo medicines in tablet form as those who preferred Kampo medicines in granular form.The present findings clarified patients' perceptions toward Kampo medicines. Doctors and pharmacists must provide suitable treatment for patients by recognizing their perceptions of Kampo medicines.
Medicine, Kampo ; Clinic ; Use of ; percent ; therapeutic aspects

Background : Since 2002, Keio University Hospital's Kampo Clinic has promoted itself actively through the media, public presentations, faculty outreach and an internet home page. However, the relative value of these promotions is unknown. Additionally, the range and prevalence of presenting concerns, and the ages and the gender ratio of the patients served at Keio is unknown.Objective and Methods : To better understand and better serve the patients, the medical charts of every new patient who presented to Keio University Hospital's Kampo Clinic from November 2004 to November 2005 (n=791) were retrospectively analyzed for 1) referral source, 2) age, 3) gender, and, 4) disease category.Results : The internet webpage was by far the best source of new patient referrals. The out-of-hospital referral rate to the clinic was remarkably low. Women exceeded men by a 3 : 1 ratio. Most women were in their thirties but male patients were fairly evenly distributed across the age spectrum. Patients under 16 and over 70 were gender-balanced. The vast majority of patients presented with general medicine/pediatric, dermatological or gynecological problems.Conclusion : A patient-oriented internet home page provides a good source of new patient referrals. Given the low rate of referrals from outside hospitals and physicians, additional outreach directed at internal medicine, dermatology or obstetrics/gynecology physicians appears warranted.
Clinic ; Hospitals ; Medicine, Kampo ; seconds ; Universities

Kawakami village with a population of 4,700 is located in the easternmost corner of Nagano Prefecture. It borders on Gunma, Saitama, and Yamanashi Prefectures. In the village, there are only two medical facilities, our Kawakami Clinic and Kimura Branch Clinic. None of them have any inpatients' wards. Therefore, patients who need hospitalization without delay have to be transported in an ambulance car to the Saku Central Hpspital, a general hospital about 35 km from our clinic.In order to transport the emergency patients quickly, we began to used a helicopter on July 2005. A total of 75 cases who were transported by ambulance or helicopter from our clinic to the Saku Central Hospital from July 2005 to December 2006 were the subjects of the present study. The hour they were sent, their conditions, disease severity and transport from were examined, based on the reports filed by the committee which is supposed to judge disease severity, emergency degree and so on. It was found that 17 cases, which occupied 23% of the total number of transported cases, were transported by helicopter. Patients with internal diseases made up 76% and patients requiring surgical treatment 24%. Those patients with mild, moderate, serious and dangerous illnesses accounted for 12%, 41%, 29% and 18%, respectively. One case died three days after hospitalization. The other cases were discharged or transferred to other hospitals within two months. The rate at which we used the helicopter was low, so we could not say it was a common means of transport. In the cases of external trauma, it was difficult to decide which means of transport should be used, ambulance or helicopter.Further examination and discussion with the staff members of the emargency services and support hospital are needed to improve the emergency medical services as primary care.
Clinic ; Ambulances ; Central brand of multivitamin with minerals ; Review of ; Severity of illness, NOS

Blood from 2100 women attending the antenatal clinic of the Port Moresby General Hospital (PMGH) and the 9 Mile urban clinic of Port Moresby was tested for syphili using the laboratory-based Venereal Disease Research Laboratory (VDRL) syphilis serology test and two clinic-based syphilis tests, Abbot Determine and Abbot Syfacard-RR (Rapid Plasma Reagin (RPR) card test). The Abbot Determine and the Syfacard-R tests were compared with the VDRL test, the gold standard in this study. The validation test results of Determine versus VDRL were as follows: sensitivity 92.0%; specificity 94.6%; the predictive value of a positive test 42.6%; and the predictive value of a negative test 99.6%. The validation tests for RPR versus VDRL were as follows: sensitivity 56.3% specificity 96.5%; predictive value of a positive test 41.2%; and the predictive value of a negative test 98.1%. The RPR test costs 3.5 kina (about one US dollar) a test, the VDRL less than 1 kina a test whilst the Determine test kit costs about 5 kina a test. When laboratory time, salaries and other supplies are costed the Determine test is expected to cost relatively much less. Our recommendation is that the Determine test be made available in areas of the country where VDRL is unavailable or where logistics do not allow for test results to be available early enough to make a difference to the care of th pregnant woman and her fetus.
VDRL test ; Rapid plasma reagin ; predictive ; Clinic ; Rapid

Between June 2001 and December 2002, 152 antenatal patients at Port Moresby General Hospital who were Venereal Disease Research Laboratory (VDRL) serology positive and 150 unselected antenatal patients who tested negative were studied to determine the gestational age at which the tests were performed, the time it took for results to become available, the proportion of patients who received treatment, the sociodemographic characteristics associated with VDRL positivity and the effect of VDRL positivity on maternal and perinatal outcomes. The prevalence rate of VDRL positive among antenatal clinic attenders in Port Moresby at that time was 4.4%. Of the 152 VDRL-positive patients in this study 97% were also Treponema pallidum haemagglutination (TPHA) positive. Significantly more of the positive patients were of highlands origin, lived in settlements, had previous marriages, had lower parities, delivered preterm babies, had stillbirths, had growth-restricted babies and had babies with lower Apgar scores at both 1 and 5 minutes. The mean birthweight was significantly lower among the positive patients. Significantly more of the positive patients were married to spouses with occupations which were regarded as 'risky' for sexually transmitted infections. There was no difference between the two groups with respect to patient's education, marital status, husband's education, gestational age at delivery and the number of days the baby spent in the Special Care Unit. The study concluded that the current antenatal screening does not provide adequate coverage for our patients. If the current availability of clinic-based strip tests provided by a non-government organization can be continued by the Ministry of Health we should be able to overcome this problem.
VDRL test ; Clinic ; Mores ; seconds ; Port - alcoholic beverage

The whole spectrum of patients infected with hepatitis C virus (HCV) who visited hospitals has not been fully clarified. It is also unknown whether such patients have visited the hospitals regularly thereafter for a long period. We studied 844 consecutive patients with liver diseases who visited our outpatient clinic located in the southern region of Ibaraki Prefecture. Five hundred eighty-three patients were HCV-infected. Among them, three patients were HBsAg-positive and another patient was IgM anti-HAV positive. Thus, 579 patients (68.6%) were considered to have HCV solely as a hepatotropic virus.Of these HCV patients, 60 were asymptomatic carriers and 15 others were unclassified because of the absence of either biopsy or imaging test records of the liver. As to the rest of the HCV patients, acute hepatitis was diagnosed in one patients, chronic hepatitis in 332 patients, cirrhosis in 130 patients and cancer of the liver in 41 patients.About half of the patients undergoing liver biopsy showed F1 in the degree of liver fibrosis. The rate of virological response to interferon mono-therapy in patients infected with genotype 2 was worse than the national average. The poor response was considered to be due to high viral load. It was suggested that the distribution of patients with each genotype was uneven in this region. After five years, the rate of patients still visiting our clinic were 68.1% for those with chronic hepatitis, and 50% for the healthy carriers. We deemed that it was important to clarify whether patients not visiting our clinic are followed up closely in other hospitals.
Hepatitis C virus ; Liver ; Clinic ; Infection as complication of medical care ; biopsy characteristics

This paper applies a qualitative perspective and method to a highly quantitative dataset. Data on 4275 consecutive patients with sexually transmitted diseases (STDs) who reported to the Daru General Hospital STD Clinic between 1980 and 1992 are critically examined. Prevailing public health approaches to the epidemiology of STDs presume a linguistic, social, cognitive and geographical fixity to both STDs and the people whom they afflict in ways that are empirically unsound. Some of the problems of and some of the problems with the presentation and treatment of gonorrhoea, syphilis and donovanosis are discussed. Because Daru is characterized by high levels of sexual violence, low levels of condom usage and a deeply entrenched sex industry, this total of 4275 is surely a dramatic under-accounting. In particular it misses the embodied, highly gendered nature of disease. Male and female STD Clinic patients appear to think about, feel and report their problems in greatly different ways.
STD brand of sodium tetradecyl sulfate ; Clinic ; SOCIAL ; Public health service ; Study of epidemiology