ABSTRACT
<b>Introduction</b><br> 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.<br><b>Methods</b><br> 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.<br><b>Results</b><br> 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.<br><b>Conclusions</b><br> 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.
ABSTRACT
Garré's osteomyelitis is generally considered to be synonymous with chronic osteomyelitis with proliferative periostitis and occurs most commonly in the first molar region of the mandible. We report a case of Garré's osteomyelitis caused by the infected tooth-germ of a wisdom tooth. A 12-year-old boy had a swelling of the right cheek and his right mandibular second molar was covered by gingiva with pus retention. X-ray examination showed a radiolucent area around the impacted tooth-germ of the wisdom tooth and extracortical new bone at the angle of the mandible. After preoperative treatment with antibiotics, the tooth-germ and extracortical bone were removed. The antibiotics treatment was continued for 18 days postoperation. No recurrence of pain or swelling has been observed thereafter.
ABSTRACT
The research project titled “Developing Technical Approaches for the Master Plan of the Health Sector International Cooperation ” has been conducted for the duration of three years from 2002 by the support of grants-in-aid for research on international medical cooperation from the Japanese Ministry of Health, Labor and Welfare. Based upon comprehensive and detailed review on the development studies (DS) in the health sectors so far completed, and throughout extensive and detailed examinations on the various DS related issues at the organized workshops with the parties concerned, the following propositions were made for the orientation and possible improvement of future DS in the health sectors; 1) a master plan in the individual DS to be defined in association with the level of strategy with which the study deals, 2) the instruction of surveys and methods to be more crystallized, 3) appropriate survey methods with reproducibility to be employed, 4) qualitative researches to be complimentarily exercised with quantitative researches 5) the ownership of DS to be cultivated by adoption of participatory methods.
ABSTRACT
Between June 1998 and January 2000, "The Master Plan Study on Strengthening Primary Health Care Services (JICA PHC Study)" was executed in the Republic of Malawi. The purpose of the study was to formulate a central region master plan and a national master plan to improve the primary health care (PHC) system, and to transfer essential research, analytical skills, and methodologies to Malawian counterparts. The health investigations covered the referral system, human resources, health finance, policy and management, the health management information system, community participation, logistics systems and health facilities and supplies. As a result of the study, childhood malnutrition, maternal health, and the inappropriate role of informal drug-sellers, in the PHC system were found to be key health issues, and on the basis of these problems the national master plan was formulated with six prioritized proposed projects. In this report, the following challenges to the execution of effective and efficient study were discussed and recommended through the review of health development studies conducted in five developing countries including Malawi; 1) the study purpose and the concept of a master plan should be clarified, 2) the study outcome should be evaluated and utilized effectively, 3) terms of reference for the study should be reviewed and improved, 4) a better relationship with counterparts and donors should be developed, and 5) a capacity of participants in the study such as consultants should be built up.