1.Compliance towards methadone maintenance therapy and its associated factors in Selangor primary care centers and Kuala Lumpur hospital.
W P Sharifa Ezat ; H Noor Azimah ; R Rushidi ; K Raminder ; I Ruhani
The Medical journal of Malaysia 2009;64(1):65-70
This paper seeks to determine the client's compliance level towards Methadone Maintenance Therapy (MMT) and identify its associated factors. A cross sectional study was conducted from June to September 2007 where 288 samples were interviewed. The outcomes were divided into good compliance and partial compliance categories. Overall client's compliance level is good at 86.1%. There are significant difference between mean age of groups (t = -2.041, p = 0.04); and significant associations of job's status (chi2 = 9.54, p = 0.008); client's confident score (t = -3.12, p = 0.023), client'ssocial function score (t = -2.308, p = 0.002) and client's social function level (chi2 = 5.43, p = 0.02) with compliance toward program. With multivariate analysis, only client's age, client's confidence score and client's job status were related to compliance status. It was concluded that there is high compliance rate among client's who received the program. Younger clients, low scores on client's confident and social function, and clients with unsteady jobs are at risk not to comply with treatment.
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Clients
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Drug addiction therapy - methadone
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2.Effect of Goreisan on Diarrhea Model Mouse Induced by Saline Purgative
Nobuyuki OKAMURA ; Kento TAKAYAMA ; Tomomi KAITA
Kampo Medicine 2009;60(5):493-501
Goreisan, a well-known hydrostatic modulating formulation, is used clinically in the treatment of edematous disorders. In this study, in order to clarify hydrostatic modulation in the intestine, we analyzed the effect of Goreisan in an experimental diarrhea model created with the single oral pretreatment of magnesium sulfate in mice. Ninjinto (166mg/kg, p.o.) did not lead to improvements in this model, whereas Goreisan (133mg/kg, p.o.) significantly abated the diarrhea.The warm Goreisan extraction (at 37°C, for 0.5hr) showed anti-diarrheal activity that was significantly stronger than the decoction. On investigating the anti-diarrheal activity of Goreisan by comparing the difference in crude drugs made from Atractylodis Rhizoma (Byakujutsu) and Atractylodis Lanceae Rhizoma (Sojutsu), no distinction between Byakujutsu-Goreisan and Sojutsu-Goreisan was recognized. Atractylodis Rhizoma, Polyporus, Poria, and Cinnamomi Cortex, which were administered singly, showed anti-diarrheal activities, but these were weak in comparison with Goreisan. Concoctions in which either Atractylodis Rhizoma, Polyporus, Poria, Alismatis Rhizoma, or Cinnamomi Cortex were omitted from Goreisan showed decreased anti-diarrheal activity as compared with Goreisan. The anti-diarrheal activity was clearly lower in the concoctions of warm extractions whereby the five kinds of crude drugs were extracted separately, compared with the warm extraction of Goreisan in which all crude drugs were extracted simultaneously.These findings suggest that the anti-diarrheal activity of Goreisan in this model was not dependent on a specific crude drug, it being optimal to extract the five kinds of crude drug simultaneously.
Diarrhea
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Models
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Chemical extraction
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cortex bone disorders
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lower case pea
3.Lack of insecticidal effect of mosquito coils containing either metofluthrin or esbiothrin on Anopheles gambiae sensu lato mosquitoes.
Nzira Lukwa ; Tonderai Chiwade
Tropical biomedicine 2008;25(3):191-5
Use of mosquito coils for personal protection against malaria and mosquito nuisance is advocated under mosquito and malaria control programmes. We performed field studies of mosquito coils containing either metofluthrin or esbiothrin in experimental huts situated in Kamhororo village, Gokwe district, Zimbabwe. All tests were performed on 3-5 day old reared female Anopheles gambiae sensu lato mosquitoes. The burning times were 9hr 20min for mosquito coils containing metofluthrin and 8 hr for those containing esbiothrin and the results were significantly different (p = <0.001). The mean knock down rate for mosquito coils containing metofluthrin was 90% and that for esbiothrin was 73.3% and the results were significantly different (p = 0.00). Mosquito coils containing metofluthrin had a mean repellence of 92.7% as compared to 85.4% for esbiothrin and the results were not significantly different (p=0.27). The protection time as required by EPA (1999) was 6 hr for mosquito coils containing metofluthrin and 5 hr for those containing esbiothrin. The mean insecticidal effect of mosquito coils containing metofluthrin was 84% as compared to 83% for those containing esbiothrin and the results were not significantly different (p = 0.56). Both mosquito formulations could not be classified as having insecticidal effect since none of them met the 95% mortality rate criteria.
Culicidae
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esbiothrin
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lower case pea
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seconds
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Anopheles gambiae
4.Clinical Evaluation of the Finger Tissue Blood Volume during Shuchi-Bushi Powder Administration
Kampo Medicine 2008;59(6):809-812
In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.
Minute of time
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lower case pea
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Tissues
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lower case aitch
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Powders
5.Quazepam Improves Health-related Quality of Life and Nocturia in Elderly Japanese Patients with Chronic Insomnia
Journal of Rural Medicine 2008;4(1):1-6
Aim and background: Chronic insomnia in elderly patients significantly affects their health and quality of life (QOL). Nocturia also worsens sleep condition. The aim of this study was to evaluate the improvement effects of quazepam, a long-term acting benzodiazepine, on insomnia and nocturia in elderly patients. Method: Forty-one elderly outpatients (mean age 77.1 ± 5.6 yr) suffering from chronic insomnia while on regular a short- or ultra-short-acting hypnotic treatment were enrolled. We prescribed 7.5-15 mg of quazepam, which was administered regularly by the subjects before bedtime. A questionnaire was used to compared changes in quality of sleep and frequency of nocturia for before treatment and at 2 and 4 weeks after initiation of treatment. QOL was also examined using the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36). Results: Thirty-seven subjects (90.2%) completed the study. All subscales of the sleep quality questionnaire improved significantly (p<0.001) after 2 weeks, as did the total scores (p<0.001) after 4 weeks. Frequency of nocturia decreased significantly from 3.6 ± 1.7 times to 1.5 ± 0.8 (p<0.001) and 1.2 ± 1.0 times (p<0.001) after 2 and 4 weeks, respectively. Every SF-36 subscale also showed significant improvement after 4 weeks. The total SF-36 scores of the group showing a decrease in the frequency of nocturia (>/= 2 times) improved significantly compared with that with a frequency of < 2 times (p=0.016). Conclusion: Quazepam significantly improves sleep, QOL and nocturia in elderly patients that respond poorly to short-acting or ultra-short-acting hypnotics.
Nycturia
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Elderly
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week
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Sleep
6.Hospital outcomes of adult respiratory tract infections with extended-spectrum b-lactamase (ESBL) producing Klebsiella pneumonia.
Li-Cher Loh ; Nor Izran Hanim bt Abdul Samad ; Rosdara Masayuni bt Mohd Sani ; Sree Raman * ; Tarmizi Thayaparan * ; Shalini Kumar
Malaysian Journal of Medical Sciences 2007;14(2):36-40
Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in ‘ESBL’ than in ‘non-ESBL’ group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians.
Extended-spectrum beta lactamase
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Hospitals
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Adult
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Respiratory
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lower case pea
7.Body mass index and nutritional status of adults in two rural villages in Northern Malaysia.
Narayan K.A. ; Abdul Rashid Khan
Malaysian Journal of Nutrition 2007;13(1):9-17
There has been a change in the lifestyles of populations, including reduced physical activity and consumption of foods high in calories. Overweight and obesity are now replacing the more traditional public health concerns such as under-nutrition and infectious diseases as some of the most significant contributors to ill health. Determination of the body mass index (BMI) profile and nutritional status of adults of two rural coastal villages in Northern Malaysia was part of a community diagnosis in a community survey. Height and weight were measured and BMI calculated. Blood pressure was measured using a manual sphygmomanometer according to WHO guidelines. A standardized questionnaire was used to interview the villagers concerning their health. Out of the total population, 504 were above 20 years of age. Data was available for 441 persons for analysis. There were 210 (47.6%) males and 231 (52.4%) females. The prevalence of underweight was 9.8% (n=43), overweight 25.9% (n=114) and obesity 17% (n=75). The problem of over-nutrition was significantly higher among females, especially housewives. (p< 0.05). Those in ages 41-70 years were the majority with problems of over-nutrition (p=<0.05). More than half (52.9%; n=39) of those who were obese had hypertension (p=<0.05). Results show that a higher number of women especially housewives were obese and more than half of those obese subjects had hypertension. A more thorough nutritional profile using waist, hip and body fat measurement as well as an assessment of the dietary intake and activity regime of these villagers is needed. Interventions need to be carried out before more serious complications of obesity become rooted in this community.
Nutritional status
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Obesity
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Body Mass Index
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Lower case en
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lower case pea
8.Validation of nutritional screening tools against anthropometric and functional assessments among elderly people in Selangor.
Suzana Shahar ; Siti Saifa Hussain
Malaysian Journal of Nutrition 2007;13(1):29-44
This cross sectional study was conducted to determine the validity of three screening tools, Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Risk Screening Tool for Community (MRST-C) and Malnutrition Risk Screening Tool for Hospital (MRST-H) among elderly people at health clinics. The screening tools were validated against anthropometric and functional assessments. The anthropometric assessments that were carried out included body weight, height, arm span, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A set of questionnaire on manual dexterity, muscular strength, instrumental activities daily living (IADL) and cognitive status was used to assess functional abilities. A total of 156 subjects were recruited from rural (38 subjects) and urban (118 subjects) health clinics at Sabak Bernam and Cheras respectively. Subjects’ age ranged from 60 to 83 years old, with 44.2% were men and 55.8% women. The prevalence of muscle wasting among the subjects assessed from MUAC and CC were both 7.0%. MNA-SF had the highest correlation with BMI (r = 0.497, p<0.001), followed by MUAC (r = 0.398, p<0.001), CC (r = 0.473, p<0.001), cognitive assessment (r = 0.229, p<0.001) and handgrip strength (r = 0.209, p<0.001). Whilst MRST-C had the highest correlation with IADL score (r = -0.320, p<0.001) and MRST-H had the highest correlation with the lock and key test (r = -0.325, p<0.01). Sensitivity was the highest for MNA-SF (93.2%), followed by MRST-H (52.5%) and MRST-C (25.8%). Specificity was the highest for MRST-H (97.3%), followed by MRST-C (90.8%) and MNA-SF (79.4%). Positive predictive value (PPV) for MRST-H, MNA-SF and MRST-C was 55.5%, 18.2% and 14.1%, respectively. In conclusion, among the screening tools being validated, MNA-SF is considered the most appropriate tool to be used in health clinics for identification of elderly individuals who are at high risk of malnutrition.
Lower case are
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SF Brand of Topical Fluoride
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Carbon ion
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upper case aitch
9.Utility of MRI in prostate cancer
Masami NIWA ; Hideto ANDO ; Itaru HIRAMATSU ; Eriko ITO ; Tuneo WATANABE ; Masao FUJIMOTO ; Daisuke MISAWA ; Nobuhito ONOGI ; Takuya KOIDE ; Manabu OKANO
Journal of the Japanese Association of Rural Medicine 2007;56(4):624-631
For diagnosis of prostate cancer, MRI was performed in 91 patients prior to prostate biopsy, and prostate cancer was detected in 37 patients. The ability of MRI diagnosis compared with biopsy was accuracy 0.84, sensitivity 0.95, and specificity 0.76.In 26 patients (14 patients with prostate cancer) from whom MR images were obtained by diffusion weighted imaging, ADC value and PSA value showed a reverse correlation significantly.The ADC value was 0.97±0.23-3mm2/sec in the cancer area, 1.51±0.20-3mm2/sec in the normal peripheral zone, and 1.47±0.12-3mm2/sec in the normal central zone. The ADC value in the cancer area was smaller than that in the normal peripheral area or in the normal central zone significantly (p<0.001).The relation between ADC value and Gleason score did not show any correlation. However, when the Gleason score was under 6, ADC value was 1.11±0.20-3mm2/sec, and when it was over 7, ADC value was 0.81±0.19-3mm2/sec which showed a lower value than the ADC value with Gleason score under 6 significantly (p<0.05).MRI was effective for visualization of prostate cancer. We concluded that pre-biopsy MRI in prostate cancer would allow not only systemic-biopsy but also accurate targeting-biopsy, and it would improve the diagnosric ability of biopsy.
Cancer of Prostate
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biopsy characteristics
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Magnetic Resonance Imaging
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GLEASON GRADING FOR PROSTATIC CANCER
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lower case pea
10.The epidemiology of malaria in the Papua New Guinea highlands: 4. Enga Province.
Ivo Mueller ; Moses Ousari ; Simon Yala ; Rex Ivivi ; Albert Sie ; John C Reeder
Papua and New Guinea medical journal 2006;49(3-4):115-25
Of all Papua New Guinea provinces, Enga has the largest proportion of people living at altitudes that preclude malaria transmission. However, the first systematic surveys in 1979 showed that malaria was endemic in lower-lying valleys to the north and east of the province. A series of new surveys conducted in both wet and dry seasons showed that these areas remain the main malaria focus in Enga. However, over the last 25 years the risk of malarial infections has increased substantially in areas < 1200 m (from 10% to 37-41%). In these low-lying areas people acquire substantial antimalarial immunity and most infections are asymptomatic. However, people in villages in these areas had significantly lower mean haemoglobin levels (13.0 vs 14.0 g/dl, p < 0.001) than in areas above 1200 m, where overall prevalence rates (0-9%) have not changed much. In areas between 1200 and 1600 m epidemics with parasite prevalence rates in excess of 20% have been found to occur. Malaria was a significant cause of febrile illness only in endemic areas or during outbreaks. Although rarely used, sleeping under a bednet was associated with a significant reduction in risk of malaria infection (adjusted OR = 0.45, p = 0.01). On the other hand, sleeping in garden houses away from the main villages increased the risk of malaria infection (adjusted OR = 1.6, p = 0.03). Malaria control in outlying, malarious areas of Enga province could therefore be based on the distribution of long-lasting impregnated bednets, while at the same time addressing the additional risks posed by the high mobility of many of these populations through targeted health education.
Malaria
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meter
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Risk
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Papua New Guinea


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