The number of elderly diabetic patients has continued to increase year by year. Home-visit nursing care is beneficial to homebound elderly diabetic patients and there is a large number of senior citizens utilizing this form of health service. We conducted a questionnaire survey of home-visit nursing care of elderly diabetic patients. Those queried were participants in the diabetes workshop. Eighty-five of them responded to our questionnaire.The results showed that 87% of the respondents experienced care of diabetic patients and acute complications of hypoglycemia and hyperglycemia as well. It was also found that many home helpers extended assistance in drug compliance, indicating that home helpers play an important role in the medical care of elderly diabetic patients.On the other hand, many problems became apparent such as lack of observation of foot care, lack of knowledge of methods of treating hypoglycemia, and inadequate observation of drug compliance due to the limited availability of home visit time.Training and collaboration of local home-visit nursing care personnel are considered necessary in the future in order to improve on the home care of elderly diabetic patients.
Elderly ; Care given by nurses ; Questionnaires ; Home ; Surveys

Patient compliance with presciibed drug regimens may be improved by finding out incom-pliant patients and exhorting them to take their medicines, but it's not an easy task. We telephoned those who had not shown up at the pharmacy within 7 days after the preparation of their drugs to come and receive the dispensed drugs. When the dispensed drugs had to be disposed of after a long misplacement, we prepared a “patient compliance report” to inform the attending physicians about noncompliance by attaching it to the patient's visit history. Further, of when they visited the hospital again we gave guidance about drug compliance at the window to those whose dispensed drugs had been disposed.
We contacted 63 patients by telephone during the 3-month period from January to March 1995 of the patients who left their drugs at the pharmacy, and found 30.6% of them had some compliance problems. Telephone calls were effective for reducing the proportion of the patients whose dispensed drugs were disposed of to 0.03% from 0.11%, the percentage worked our during the 5-month period from August to December 1994 during which no telephone call was made. We reported 19 drug disposal cases to the physicians by means of the “patient compliance report”. All the physicians appreciated it as they were brought to a realizatopn of the drug compliance rate of their patients.
As there were some patients who did not know that their drugs were prescribed, we considered how to cope with the left dispensed drugs would not be a question of the pharmacy alone. It should be handled as a problem of the whole hospital from the stage ofconsultation to payment.

Introduction
 During the course of primary health care activities in Khammouane province of Lao PDR by non- profit organization, international support and partnership for health, an exceedingly high infant mortality rate was recognized in some villages. As thiamine deficiency was strongly suspected for the main cause of the high mortality, the household survey with an emphasis on nutritional aspect and the measurement of thiamine level in the blood of mothers as well as their breast-milk were carried out for the confirmation.
Methods
 The survey was conducted at Sibounhouane sub-district (Group 1) with the highest infant mortality and Hatkhamhieng sub-district (Group 2) with the lowest mortality. Fifty families of the two groups, each consisting of randomly selected 25 families with less than one year old infant(s) were interviewed by using prepared questionnaire. The body weight of both mother and infant was measured and blood and milk were taken from the mother.
Results
 The ethnic minorities of the group 1 consisted of Lao Lum (44%) and Lao Theung (56%), whereas only Lao Lum in the group 2. The economical indicators and the mother's educational level in the group 1 were inferior to those in the group 2. There was no significant difference in the methods of preparing staple glutinous rice, likely to flux thiamine and intake of thiaminases between the two groups. High infant mortality rate was documented in the group 1 whose clinical symptoms were mostly consistent with those of infantile beriberi. The concentration of thiamine in the blood and milk of mothers in both groups were considerably lower and significant reduction of thiamine level was observed in the group 1 than the group 2. Nevertheless, both groups of those infants tended to be inadequately fed with the foods except for breast-milk during their early infantile phase.
Conclusions
 The low concentration of thiamine in the blood and milk of mothers was strongly suggestive that infantile beriberi due to thiamine deficiency was the principal cause of the infant mortality in the study region. We hereby surmise that thiamine deficiency could be extensively prevalent in Lao PDR than the currently studied areas because of their traditional preparing methods of staple dietary rice, postpartum food taboos and intake of thiaminases. For the prevention of infant death due to severe thiamine deficiency, necessary measures including the exchange of information among the institutions concerned, adequate thiamine supplementation and nutritional counseling have to be urgently adopted.

AIMTo study the chemical composition of Tripterygirm wilfordii Hook. f.

METHODSColunm chromatography was used to separate the chemical constituents. UV, IR, MS, HRMS, 1HNMR, 13CNMR (COM and OFR), 1H-1H COSY, 1H-13C COSY, NOESY and COLOC spectra were used to determine the structures of the isolated constituents.

RESULTSTwo sesquiterpene alkaloids were isolated and their structures were elucidated as wilforgine and wilfordlongine on the basis of spectral evidence.

CONCLUSIONWilfordclonine is a new sesquiterpene alkaloid.

Lactones ; chemistry ; isolation & purification ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Pyridines ; chemistry ; isolation & purification ; Tripterygium ; chemistry