Introduction: Opioid dependence is recorded as the most common drug of abuse in Malaysia. Currently, the preferred substitution therapy for most Government treatment centres is methadone used as substitution therapy for opioid dependence. There are, however patients who may benefit from being on the combined buprenorphine-naloxone formulation as substitution therapy instead. We discuss six cases of opioid dependence of varied backgrounds that were treated with buprenorphinenaloxone therapy and their outcomes. Discussion: All of the reported patients improved after the induction of buprenorphine- naloxone. Two of the cases highlighted the transfer of patients on methadone to buprenorphine-naloxone due to the adverse effect and interactions of methadone with other medications. During the transfer there were no major adverse reactions noted, and patients were safely able to continue with the maintenance therapy of buprenorphine- naloxone. Conclusion: Buprenorphine-naloxone is a safe and effective drug substitution therapy for opioid dependence. It has fewer interactions with other medications, and has similar efficacy to methadone. Being a partial agonist, it has a less sedating effect making patients more functional.
Buprenorphine, Naloxone Drug Combination

BACKGROUND: Some cosmetics used for treating acne are considered as cosmeceuticals. Consequently, patients with acne are now more likely to perceive such products as actual treatments. OBJECTIVE: We aimed to investigate the awareness and use of cosmetics for acne and to compare them with hospital treatments in terms of efficacy and safety. METHODS: We surveyed patients who presented at the National Medical Center for acne treatment. We collected data on demographics, hospital treatments, kinds of cosmetics for acne, awareness and use of cosmetics for acne, efficacy and adverse effects (cosmetics for acne vs. hospital treatments), and overall patient satisfaction. RESULTS: Of 101 enrolled participants, 94 (mean [SD] age, 25.6 [6.5] years; 59 women) were analyzed. Seventy-one (75.5%) patients used cosmetics for acne. Only 30% perceived that cosmetics for acne were insufficient to treat acne, whereas 45~55% deemed cosmetics for acne as applicable replacements for topical and oral treatments. The participants rated their improvement to be significantly better with hospital treatments than with cosmetics for acne (much improved: 45.1% vs. 2.8%, became worse: 1.4% vs. 8.5%, p<0.01). There were significantly fewer adverse events after hospital treatments than after use of cosmetics for acne. The overall satisfaction scores were significantly higher with hospital treatments than with cosmetics for acne. CONCLUSION: Patients with acne mistakenly believe that cosmetics for acne can replace topical and oral treatments. Dermatologists should disseminate information and educate patients about the proper treatments for acne. Moreover, it is desirable to exclude the word “acne” from the name of cosmeceuticals.
Acne Vulgaris ; Cosmeceuticals ; Demography ; Humans ; Patient Satisfaction

A 25 year and 7 month old man patient who had Angle's class II division 2 malocclusion combined with anterior crowding of upper & lower part was treated by bioprogressive mechanism. After setting out objectives through the use of V. T. O., we programmed a sequence of mechanic. The possible objectives of treatment in the class II division 2 malocclusion can be listed as follows. 1) Relief of crowding & irregularities. 2) Relief of anterior gingival trauma & correction of interincisal inclination. 3) Correction of buccal segment relationship We'd applied the class II intermaxillary elastics, Quad helix, utility arch wire and sectional arch wire in order to achieve anticipated objectives. As compared with pre & post treatment cephalogram, the result accomplished by this mechanics showed to us that interincisal angle was improved and favorable molar relationship was achieved.
Crowding ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination ; Humans ; Malocclusion* ; Mechanics ; Molar

Although surgery is the mainstay of local treatment for skin cancer, definitive radiation therapy (RT) has been also applied for patients who are unable to tolerate surgery. Definitive RT regimens usually consist of daily treatment for 4–7 weeks. Such protracted daily RT regimens, however, would not be feasible for non-compliant patients or patients who are unable to make multiple daily trips for weeks. Without treatment, however, skin cancers can continuously progress and cause distressing symptoms. A cyclical hypofractionated RT (QUAD Shot: 14 Gy in 4 fractions, twice-daily treatments with 6 hours interval on 2 consecutive days) can be a practical RT regimen for those patients. In this report, we present the successful treatment course of repeated QUAD Shots in a 79-year-old patient with neglected skin cancer that was disfiguring his face yet declined definitive surgery and protracted RT. We also evaluated and compared biologically equivalent doses between QUAD Shots and conventionally fractionated protracted RT regimens.
Aged ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination ; Humans ; Skin Neoplasms ; Skin

This study was aimed to assess the dissolution of 4 chloramphenicol capsule products of 4 Vietnamese pharmaceutical enterprises. The results showed that most of them have a very low drug release degree. The cause may be resulted from making capsule without making particles, too raw powder, using too much insoluble excipient, too high rate of insoluble excipient. The dissolution test should be considered an item of chloramphenicol capsule specification
Chloramphenicol ; Adjuvants, Pharmaceutic ; Capsules ; drugs

Experimental studies were carried out concerning the disintegration of 10 preparation of tablet, capsules with various group of medicinal products, produced and distributed by the Pharmaceutical Enterprise X including tablets of paracetamol, tablet of indomethacine, tablet of isoniazid, tablet of metronidazol, tablet of quinin sulfate, tablet of papaverin hydrochloride, tablet of theophylin and tablet of chloroquin phosphate. Results showed that 9 preparations (90%) satisfied the criterions of disintegration
Pharmaceutical Preparations ; Adjuvants, Pharmaceutic ; Capsules ; drugs ; tablets

Processing of Chinese medicinals with vinegar is one of the characteristic processing techniques. Vinegar is vital for the quality of vinegar-processed decoction pieces. However, there have been no specified standards for adjuvants. Through consulting relevant literature and monographs, we comprehensively reviewed the historical evolution of processing with vinegar in records, selection and application of vinegar, and summarized the relevant standards and current status of vinegar as an adjuvant in China. According to the records in literature, vinegar is effective in activating blood, moving qi, dispersing blood stasis, removing toxin, promoting appetite, and nourishing the liver. Traditionally, rice vinegar is chosen in processing. Nowadays, the vinegar made from rice under solid-state fermentation should be chosen. At present, only food standards can be taken for reference for vinegar in the processing. Integrative and specific inspection indicators are lacking, so the standards for adjuvants need to be improved urgently. In addition, the inadequacy in quality control and management is also a major problem to be solved. Through literature research, we reviewed the historical evolution and research advance in vinegar to provide a reference for the standardization and further research of vinegar used in the Chinese medicinal processing.
Acetic Acid ; Adjuvants, Pharmaceutic ; Drugs, Chinese Herbal ; Oryza ; Quality Control

OBJECTIVETo evaluate the efficacy of 3 commonly used protocols for management of acute exacerbation of asthma in children.

METHODSTotally 113 asthmatic children were randomized into 3 groups. In group A (53 cases), the children were treated with inhalation of nebulized budesonide suspension plus salbutamol and ipratropium bromide twice daily for 5 days; in group B (41 cases), budesonide plus salbutamol and ipratropium aerosol was administered, and in group C (29 cases), dexathmisone plus aminophylline injection was given once daily for 5 days. All the children received basic treatment with fluid infusion, antibiotics or/and anti-virus medications.

RESULTSThe children in both groups A and C showed effectively controlled asthma attack, with significant differences in the therapeutic effects (P>0.05). In contrast, only a few children showed improvement in group B, suggesting the ineffectiveness of the treatment.

CONCLUSIONNebulized medicine is one of the best means for management of acute asthma exacerbation in children, and inhalation of budesonide suspension plus salbutamol and ipratropium bromide can effectively relieve the asthmatic symptoms in these children with good compliance and convenient administration.

Acute Disease ; Adolescent ; Aerosols ; Albuterol ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Budesonide ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Female ; Humans ; Infant ; Ipratropium ; administration & dosage ; therapeutic use ; Male ; Treatment Outcome

Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.
Adenine ; Adult ; Carbamates ; Dental Arch ; Deoxycytidine ; Drug Combinations ; Humans ; Incisor ; Jaw ; Macroglossia ; Mouth ; Open Bite ; Organophosphonates ; Palatal Expansion Technique ; Prognosis ; Quinolones ; Thiazoles ; Tongue ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination

Twenty years have passed since a prenatal screening for Down syndrome and neural tube defect was applied to obstetric field. The Quad test (AFP, hCG, uE3, Inhibin-A) of the second trimester and the combination test (PAPP-A, hCG, NT) of the first trimester became popular now. The recent trend of prenatal screening is to combine these two screening tests together in order to increase a detection rate of Down syndrome. Three types of screening methods are introduced as follows; integrated test, sequential test and contingent test. In addition to combination of each test, an incorporation of characteristic ultrasound findings of Down syndrome is suggested for its risk calculation. The absence of fetal nasal bone would be a very useful marker especially in the first trimester screening test. According to a change of way calculating risk of Down syndrome, obstetrician's role will be more increased not by passive participation, but by active participation using ultrasound in risk calculation.
Adenine ; Carbamates ; Deoxycytidine ; Down Syndrome ; Drug Combinations ; Female ; Humans ; Mass Screening ; Nasal Bone ; Neural Tube Defects ; Organophosphonates ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Quinolones ; Thiazoles ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination