ABSTRACT
INTRODUCTION@#This study aimed to compare the incidence and mortality of ST-segment elevation myocardial infarction (STEMI) across the 3 main ethnic groups in Singapore, determine if there is any improvement in trends over the years and postulate the reasons underlying the ethnic disparity.@*MATERIALS AND METHODS@#This study consisted of 16,983 consecutive STEMI patients who sought treatment from all public hospitals in Singapore from 2007 to 2014.@*RESULTS@#Compared to the Chinese (58 per 100,000 population in 2014), higher STEMI incidence rate was consistently observed in the Malays (114 per 100,000 population) and Indians (126 per 100,000 population). While the incidence rate for the Chinese and Indians remained relatively stable over the years, the incidence rate for the Malays rose slightly. Relative to the Indians (30-day and 1-year all-cause mortality at 9% and 13%, respectively, in 2014), higher 30-day and 1-year all-cause mortality rates were observed in the Chinese (15% and 21%) and Malays (13% and 18%). Besides the Malays having higher adjusted 1-year all-cause mortality, all other ethnic disparities in 30-day and 1-year mortality risk were attenuated after adjusting for demographics, comorbidities and primary percutaneous coronary intervention.@*CONCLUSION@#It is important to continuously evaluate the effectiveness of existing programmes and practices as the aetiology of STEMI evolves with time, and to strike a balance between prevention and management efforts as well as between improving the outcome of "poorer" and "better" STEMI survivors with finite resources.
ABSTRACT
Quality standardization of complementary medicine is fundamental for industry and practice as it underpins the quality,safety and efficacy of Chinese herbal medicines.Current herbal standardizations are often based on the quantitative analysis of a single compound,which may not reflect the total characteristic,bioactive and toxic nature of the herbs or products.Therefore,there is a need to establish an internationally recognized methodology for quality standardization of Chinese herbal medicines.The analytical methods reviewed in this article are pharmacognosy,TLC,HPLC,LCMS,CE and chemo-metrics.This article also covers the developments and applications of these methods in quality standardization.Recent advances show that a combination of these methods creates an overall chemical profile of each herb.This iS supported by results reviewed in this article and obtained in our laboratory tests on medicinal herbs including Hypericum perforatum,Morinda officinalis and Centella asiatica.Significant variations in active components have been observed between herbal samples and products.It is proposed that the identification of active components,pharmacological activities and eventual clinical applications are required for a comprehensive quality standardization system.Our findings indicate that the combination of various chromatographic and chemometric methods will advance the methodology of quality standardization and enhance the overall confidence in herbal medicine for the health practitioner and the public.
ABSTRACT
Background and purpose: Sympatho-excitatory neurons which originate from Rostral Ventrolateral Medulla [RVLM] and project to spinal cord are necessary for the maintenance of resting sympathetic tone and integration of cardiovascular reflexes. Also, it is known that catecholamines, substance P and somatostatin are involved in blood pressure modulation in the brain stem. The aim of this study was answering to the question: Is somatostatin 2A receptor [SST2A] expressed in medullary C1 neurons which have preprotachykinin A [PPT-A] mRNA and are projected to spinal cord?
Methods and materials: This study was done on 12 male Sprague-Dawley rats. We used a complex of techniques such as retrograde labeling of spinally projecting neurons by injection of Cholera Toxin Beta [CTB] unit, In situ Hybridization [ISH] and Immunohistochemistry to identify PPT-A mRNA and SST2A receptor expression in C1 neurons of RVLM. For data description, mean +/- SEM as well as percentage were used
Results: Most spinally projecting neurons in RVLM [CTB+] are C1 neurons, i.e. they have Tyrosin Hydroxylase enzyme [TH+]. These neurons contain PPT-A mRNA or SST2A receptors, but no neurons were observed with the expression of both PPT-A mRNA and SST2A receptor
Conclusion: It seems that medulla C1 neurons, which project to spinal cord and express PPT-A mRNA or SST2A receptor, are two separate neuron types. They may have different modulatory effects on cardiovascular reflexes