ABSTRACT
The Project for Improving Maternal and Newborn Care through Midwifery Capacity Development by Japan International Cooperation Agency (JICA) was initiated for capacity building through pre-and post-service midwifery training.<BR> Firstly, we have shared the concept of ideal midwifery care based on the definition of evidence-based medicine (EBM) with our counterparts, which involves the integration of the best research evidence with clinical expertise and patient values. In addition to evidence-based midwifery care, we tried to provide individualized woman-centered care. <BR> After sharing these concepts in our project sites, we tried to modify the lectures on the basic concepts of midwifery care in the Health Center Midwifery Training program, and care providers’ attitudes based on EBM in the Basic Emergency Obstetric and Neonatal Care Training program.<BR> Our trial is an essential first step towards the further reduction of maternal mortality in Cambodia.
ABSTRACT
We report a rare case of intraductal lipid-rich carcinoma of the breast with a component of glycogen-rich carcinoma. An impalpable tumor that was revealed by mammography and magnetic resonance imaging was excised. Histologic examination showed vacuolated neoplastic cells in the mammary ducts, and electron microscopy confirmed lipid droplets in the cytoplasm. The coexistence of glycogen-rich carcinoma was shown. Lipid-rich carcinoma that is coexistent with glycogen-rich carcinoma is rare, and most lipid-rich carcinomas are invasive. Intraductal lipid-rich carcinoma is difficult to detect without echography or mammography.
Subject(s)
Breast , Cytoplasm , Glycogen , Immunohistochemistry , Magnetic Resonance Imaging , Mammography , Microscopy, ElectronABSTRACT
Dizziness and vertigo are frequent complaints in the clinic, but standardized treatments have not yet been established. Here we report three cases of dizziness and vertigo successfully treated with takushato. Case 1 involved a 38-year-old woman who experienced dizziness, which had made her feel as if she was sea sick for 2 years, and which was worsening. After taking takushato for a month, her dizziness improved.Because she complained of an abnormal pharyngeal sensation, her prescription was changed to hangekobokuto in combination with takushato, and her dizziness almost disappeared 2 months after her first visit. Case 2 involved a 61-year-old woman who had had dizziness and vertigo for 4 months. Although no abnormality was observed on MRI, she developed labile vertigo a few days later. After taking takushato for a month, she felt no dizziness or vertigo at all. Case 3 involved a 67-year-old woman in whom labile vertigo had developed even while supine for 2 months, and although receiving medication for a diagnosis of benign paroxysmal positional vertigo, did not improve. Triple dose takushato was remarkably effective, and improved her otological findings. Takushato is one hopeful option for the medical treatment of refractory dizziness and vertigo.
ABSTRACT
We have limited evidence as to the clinical indications for Kampo medicines, especially as they relate to gastrointestinal function. Thus, we investigated the efficacy of the Kampo medicine hangekobokuto (HKT) on patients with functional dyspepsia (FD), with special reference to its clinical indications for gastrointestinal function, including gastric emptying and bowel gas volume.Gastric emptying rate (GER) in FD patients was significantly facilitated by HKT. HKT also improved the gastrointestinal symptoms of the patients. Among these, patients who had inchuusharen, or a symptom of globus sensation, and a representative indication for HKT, showed significant improvement of both their GER and gastrointestinal symptoms compared with patients who did not have inchuusharen. As for bowel gas, the bowel gas volume calculated from a plain abdominal radiogram (gas volume score, GVS) in FD patients decreased significantly, after administration of HKT. Patients who had fukuman, or a feeling that one's stomach is full or bloated, and another representative indication for HKT, showed significant decrease of their GVS to normal levels, compared with patients who did not present with fukuman.These results suggest that the presence of clinical indications, such as inchuusharen or fukuman, are strongly related to HKT efficacy in patients with FD, and that these are useful, scientifically validated markers for the efficient use of HKT.