Apalutamide for patients with metastatic castrationsensitive prostate cancer in East Asia: a subgroup analysis of the TITAN trial / 亚洲男科学杂志(英文版)

Ethnicity might be associated with treatment outcomes in advanced prostate cancer. This study aimed to evaluate the efficacy and safety of androgen deprivation therapy (ADT) combined with apalutamide in East Asians with metastatic castration-sensitive prostate cancer (mCSPC). The original phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial was conducted at 260 sites in 23 countries. This subgroup analysis included patients enrolled in 62 participating centers in China, Japan, and Korea. Radiographic progression-free survival (PFS), time to prostate-specific antigen (PSA) progression, and PSA changes from baseline were compared between groups in the East Asian population. The intent-to-treat East Asian population included 111 and 110 participants in the apalutamide and placebo groups, respectively. The 24-month radiographic PFS rates were 76.1% and 52.3% in the apalutamide and placebo groups, respectively (apalutamide vs placebo: hazard ratio [HR] = 0.506; 95% confidence interval [CI], 0.302-0.849; P = 0.009). Median time to PSA progression was more favorable with apalutamide than placebo (HR = 0.210; 95% CI, 0.124-0.357; P < 0.001). Median maximum percentages of PSA decline from baseline were 99.0% and 73.9% in the apalutamide and placebo groups, respectively. The most common adverse event (AE) was rash in the apalutamide group, with a higher rate than that in the placebo group (37.3% vs 9.1%). The most common grade 3 or 4 AEs were rash (12 [10.9%]) and hypertension (12 [10.9%]) for apalutamide. The efficacy and safety of apalutamide in the East Asian subgroup of the TITAN trial are consistent with the global results.

Efficacy and Safety of Ticagrelor Versus Clopidogrel in the Treatment of ACS Patients in East Asia ：A Meta- analysis / 中国药房

OBJECTIVE：To syst ematically evaluate the effectiveness and safety of ticagrelor versus clopidogrel in the treatment of acute coronary syndrome （ACS）patients in East Asia ，and to provide evidence-based references for clinical drug use. METHODS：Retrieved from Cochrane Library ，PubMed，Embase，CNKI，Wanfang database ，etc.，randomized controlled trials （RCTs）about ticagrelor （trial group ）versus clopidogrel （control group ）in the treatment of ACS patients in east Asia were collected. After literature screening and data extraction ，the quality of included literatures was evaluated by using biasrisk evaluation tool recommended by Co chrane system evaluation manual 5.1.0，and Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 5 RCTs were included ，with a total of 4 511 cases. Meta-analysis showed that the incidence of major adverse cardiovascular events [OR ＝0.85，95％CI（0.68，1.04），P＝0.12]，the incidence of death from cardiovascular causes [OR ＝0.76，95％CI（0.57，1.03），P＝0.08] and the incidence of stroke [OR ＝0.77，95％CI（0.48，1.24），P＝0.28]， without statistical significance. The incidence of major bleeding events [OR ＝1.54，95％CI（1.19，1.99），P＝0.001] and minor bleeding events [OR ＝1.80，95％ CI（1.40，2.32），P＜0.000 01] in trial group were significantly higher than control group. CONCLUSIONS：Ticagrelor is comparable to clopidogrel in reduce the major adverse cardiovascular events，death from cardiovascular causes and stroke in ACS patients in East Asian ，but it can increase the risk of major and minor bleeding events.

The COVID-19 pandemic in the ASEAN: A preliminary report on the spread, burden and medical capacities

Objective: To provide preliminary descriptions of the spread, burden and related medical capacity characteristics of the ASEAN countries. Methods: We utilized the data from four main official databases, including WHO reports, the Statistics and Research of the Coronavirus Disease, and the Southeast Asia Program of the Center for Strategic and International Study. The spread of the COVID- 19 pandemic, current burden and the COVID-19 medical response capacities were extracted before April 11, 2020. Results: As of April 13, 2020, the ASEAN countries reported 19 547 COVID-19 positive cases with 817 deaths (case-facility rate of 4.2%). Thailand was the first country in the region that reported having the COVID-19 cases, while Laos was the last to report confirmed COVID-19 cases. Durations for the number of deaths to double were between 8-12 days. For the testing and treatment capacities, the number of PCR tests provided to the populations was the highest in Vietnam, followed by Singapore, Malaysia, and Thailand. Meanwhile, the percentage of the population being tested was the highest in Brunei (2.31%), followed by Singapore (1.30%). Conclusions: A wide range of interventions were taken into practice in response to the outbreak with an effort of curbing the rise of this pandemic. However, special care should not be overlooked as the pandemic is placing a huge impact on the population and becomes increasingly unpredictable. To tackle the spread of the pandemic in the region, the ASEAN countries should work together as one community to provide better responses to future pandemics and other transboundary public health challenges.

The COVID-19 pandemic in the ASEAN: A preliminary report on the spread, burden and medical capacities

Objective: To provide preliminary descriptions of the spread, burden and related medical capacity characteristics of the ASEAN countries. Methods: We utilized the data from four main official databases, including WHO reports, the Statistics and Research of the Coronavirus Disease, and the Southeast Asia Program of the Center for Strategic and International Study. The spread of the COVID- 19 pandemic, current burden and the COVID-19 medical response capacities were extracted before April 11, 2020. Results: As of April 13, 2020, the ASEAN countries reported 19 547 COVID-19 positive cases with 817 deaths (case-facility rate of 4.2%). Thailand was the first country in the region that reported having the COVID-19 cases, while Laos was the last to report confirmed COVID-19 cases. Durations for the number of deaths to double were between 8-12 days. For the testing and treatment capacities, the number of PCR tests provided to the populations was the highest in Vietnam, followed by Singapore, Malaysia, and Thailand. Meanwhile, the percentage of the population being tested was the highest in Brunei (2.31%), followed by Singapore (1.30%). Conclusions: A wide range of interventions were taken into practice in response to the outbreak with an effort of curbing the rise of this pandemic. However, special care should not be overlooked as the pandemic is placing a huge impact on the population and becomes increasingly unpredictable. To tackle the spread of the pandemic in the region, the ASEAN countries should work together as one community to provide better responses to future pandemics and other transboundary public health challenges.

From the "Out of Africa Theory" Study to the Application of "DNA Biogeographic Ancestry Inference" in Criminal Investigation / 法医学杂志

Genetic markers, such as single nucleotide polymorphism （SNP）, insertion/deletion （InDel）, were discovered and widely used with the development of whole genome sequencing and bioinformatics technology. The origin and genetic structure of the modern population had been gradually revealed from the perspective of genetics. The study on biogeographic ancestry inference in the field of forensic genetics emerged and developed rapidly, providing clues and scientific basis for the determination of investigation direction and for the narrow of the scope of investigation in the process of case investigation. This paper briefly reviews the research progress, inference methods and development trends of DNA ancestry inference technology.

Genetic Polymorphism of Y Chromosome Haplogroup D-M174 in East Asian Populations / 法医学杂志

Objective To explore the genetic polymorphism of Y chromosome D-M174 haplogroup and sub-haplogroups in East Asia. Methods The samples of 1 426 unrelated male individuals from East Asia were collected, and then 7 Y chromosome haplogroup D-M174 and the Y-SNP of its sub-haplogroups were detected with mini-sequencing. The 22 Y-STR genotypes were detected with DNA Typer™ Y26 kit. The haplogroup was analyzed using direct counting method, heatmap, phylogenetic cluster and network graph cluster, and then distribution of genetic polymorphism and the clustering relation between populations and samples of Y chromosome D haplogroup were discussed. Results Haplogroup D-M174 were distributed mostly among Tibetans （40.96%）and Japanese （35.71%）, while less or none were distributed among the surrounding areas of Tibet and other areas. Conclusion The geographical distribution of Y chromosome D-M174 haplogroup in East Asian populations has significant characteristics.

Two New Species of the Genus Candelariella from China and Korea

Candelariella is a widespread lineage of lichenized ascomycetes with ambiguous relationships among species that have not solved completely. In this study, several specimens belonging to Candelariella were collected from China and South Korea, and the internal transcribed spacer region was generated to confirm the system position of the newly collected specimens. Combined with a morphological examination and phylogenetic analysis, two new areolate species, Candelariella rubrisoli and C. subsquamulosa, are new to science. Detail descriptions of each new species are presented. In addition, C. canadensis is firstly reported from China mainland.

Meta-analysis of coffee intake and all cancer mortality in East Asian population / 预防医学

Objective @#To explore the association between coffee intake and all cancer mortality in East Asian populations. @*Methods @#We searched literatures which assessed the relationship between coffee intake and cancer mortality in Asian populations published by December 10th,2018 from China National Knowledge Infrastructure,Wanfang Database,VIP Database and PubMed. We conducted category and dose-response meta-analyses using Stata 15.0. @*Results @#A total of 335 relevant articles were retrieved; five articles were finally included in the meta-analyses,of which four were carried out in Japanese population and one in Singaporean Chinese population. The total sample size of the five articles was 361 802,and the number of deaths from cancer was 17 664. The results showed that coffee intake reduced the risk of all cancer mortality in East Asian populations（RR=0.93,95%CI：0.87-0.99）. There was no statistical significant association between coffee intake and all cancer mortality in East Asian men（RR=0.94,95%CI：0.77-1.15）. Among East Asian women,coffee consumption reduced the risk of all cancer mortality by 12%（RR=0.88,95%CI：0.81-0.95）. All cancer mortality risk decreased with the increase of coffee intake,and reached the lowest point at one and a half cups of coffee per day（RR=0.92,95%CI：0.86-0.98）. @*Conclusion @#Coffee intake reduced the risk of all cancer mortality in East Asian populations,which was obviously found in East Asian women. Drinking one and a half cups of coffee a day had the lowest risk of all cancer mortality.

An Electronic Questionnaire Survey Evaluating the Perceived Prevalence and Practices of Lactose Intolerance in 1 to 5 Year Old Children in South East Asia / 대한소아소화기영양학회지

PURPOSE: Lactose intolerance (LI) is perceived to be frequent in Asia and has been reported to have considerable impact on dietary intake, nutritional status and the quality of life. We aimed to gather information from healthcare professionals on the perceived incidence, diagnosis and management of LI in 1 to 5 year old children in Southeast Asia. METHODS: An anonymous electronic survey was sent randomly among healthcare professionals registered in the database of the pediatric societies in Thailand, Indonesia, and Singapore between June and October 2016. RESULTS: In total, 259 health care professionals responded of which 45.5% (n=118) were from Thailand, 37.4% (n=97) from Indonesia and 16.9% (n=44) from Singapore. Of the participants who responded (n=248), primary LI prevalence among children 1 to 3 years of age was estimated to be less than 5% by 56.8%. However, about 18.9% (n=47) answered they did not know/unsure. Regarding secondary LI, 61.6% of respondents (n=153) estimated the prevalence to be less than 15%. But again, 10.8% (n=27) answered they did not know or unsure. Rotavirus gastroenteritis was ranked as the top cause for secondary LI. There was considerable heterogeneity in the diagnostic methods used. The majority of respondents (75%) recommended lactose-free milk to manage primary and secondary LI. CONCLUSION: More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required.

Melioidosis en paciente del sudeste asiático / Melioidosis in a Southeast Asian patient

La melioidosis es una enfermedad infecciosa causada por una bacteria gram-negativa intracelular facultativa, Burkholderia pseudomallei, que se encuentra en el suelo y el agua. Es de importancia para la salud pública en las zonas endémicas, sobre todo el sudeste asiático. Se han descrito casos fuera de las regiones endémicas en su mayoría adquiridos por los visitantes a estas áreas. Se presenta el caso de un paciente masculino con sintomatología respiratoria, elementos de sepsis y contracción volumétrica, en el que se diagnosticó diabetes mellitus de debut, neumonía adquirida en la comunidad y finalmente se aisló en hemocultivo la Burkholderia pseudomallei. Se comenzó tratamiento recomendado acorde al antibiograma, observándose evolución satisfactoria del paciente(AU)

Melioidosis is an infectious disease caused by a facultative intracellular gram-negative bacterium, Burkholderia pseudomallei, found in soil and water. It is of importance for public health in endemic areas, especially Southeast Asia. Cases have been described outside the endemic regions, mostly acquired by visitors to these areas. The case is presented of a male patient with respiratory symptoms, elements of sepsis and volumetric contraction, in which the diagnosis of onset diabetes mellitus and community-acquired pneumonia, while Burkholderia pseudomallei was finally isolated in hemoculture. The recommended treatment was started according to the antibiogram, observing the patient's satisfactory evolution(AU)

Application and mechanism of dipeptidyl peptidase-4 inhibitor in East Asia type 2 diabetic patients / 中华内分泌代谢杂志

Dipeptidyl peptidase 4 (DPP-4) inhibitors are novel oral hypoglycemic agents, which have been used to inhibit degradation of endogenously released glucagon-like peptide-1 ( GLP-1 ) via inhibiting DPP-4 activity, consequently increasing level of GLP-1 in circulation, enhancing the effect of incretin hormone, and finally leading to improve glucose control. Meta-analysis showed that DPP-4 inhibitors exhibit better glucose-lowering effect in Asians compared with that in Caucasian. The racial differences of hypoglycemic effect could be mainly ascribed to the differences in the frequency of pancreatic-related gene mutations, the severity ofβ-cell dysfunction, the level of GLP-1, and the intake of carbohydrates in patients with diabetes mellitus.

The Study on the Lives and Health Conditions of Internees in Santo Thomas Camp of Philippines: Based on McAnlis's The War in Manila (1941–1945) / 의사학

When Japan invaded the Philippines, two missionary dentists (Dr. McAnlis and Dr. Boots) who were forced to leave Korea were captured and interned in the Santo Thomas camp in Manila. Japan continued to bombard and plunder the Philippines in the wake of the Pacific War following the Great East Asia policy, leading to serious inflation and material deficiency. More than 4,000 Allied citizens held in Santo Thomas camp without basic food and shelter. Santo Thomas Camp was equipped with the systems of the Japanese military medical officers and Western doctors of captivity based on the Geneva Conventions(1929). However, it was an unsanitary environment in a dense space, so it could not prevent endemic diseases such as dysentery and dengue fever. With the expansion of the war in Japan, prisoners in the Shanghai and Philippine prisons were not provided with medicines, cures and food for healing diseases. In May 1944, the Japanese military ordered the prisoners to reduce their ration. The war starting in September 1944, internees received 1000 kcal of food per day, and since January 1945, they received less than 800 kcal of food. This was the lowest level of food rationing in Japan's civilian prison camps. They suffered beriberi from malnutrition, and other endemic diseases. An averaged 24 kg was lost by adult men due to food shortages, and 10 percent of the 390 deaths were directly attributable to starvation. The doctors demanded food increases. The Japanese Military forced the prisoner to worship the emperor and doctors not to record malnourishment as the cause of death. During the period, the prisoners suffered from psychosomatic symptoms such as headache, diarrhea, acute inflammation, excessive smoking, and alcoholism also occurred. Thus, the San Thomas camp had many difficulties in terms of nutrition, hygiene and medical care. The Japanese military had unethical and careless medical practices in the absence of medicines. Dr. McAnlis and missionary doctors handled a lot of patients focusing mainly on examination, emergency treatment and provided the medical services needed by Philippines and foreigners as well as prisoners. Through out the war in the Great East Asia, the prisoners of Santo Thomas camp died of disease and starvation due to inhumane Japanese Policy. Appropriate dietary prescriptions and nutritional supplements are areas of medical care that treat patients' malnutrition and disease. It is also necessary to continue research because it is a responsibility related to the professionalism and ethics of medical professionals to urge them to observe the Geneva Convention.

East Asian Subgroup Analysis of a Randomized, Double-Blind, Phase 3 Study of Docetaxel and Ramucirumab Versus Docetaxel and Placebo in the Treatment of Stage IV Non-small Cell Lung Cancer Following Disease Progression after One Prior Platinum-Based Therap / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: REVEL demonstrated improved overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) with docetaxel+ramucirumab versus docetaxel+placebo in 1,253 intent-to-treat (ITT) stage IV non-small cell lung cancer patients with disease progression following platinum-based chemotherapy. Results from the East Asian subgroup analysis are reported. MATERIALS AND METHODS: Subgroup analyses were performed in the East Asian ITT population (n=89). Kaplan-Meier analysis and Cox proportional hazards regression were performed for OS and PFS, and the Cochran-Mantel-Haenszel test was performed for response rate. RESULTS: In docetaxel+ramucirumab (n=43) versus docetaxel+placebo (n=46), median OS was 15.44 months versus 10.17 months (hazard ratio [HR], 0.762; 95% confidence interval [CI], 0.444 to 1.307), median PFS was 4.88 months versus 2.79 months (HR, 0.658; 95% CI, 0.408 to 1.060), and ORR was 25.6% (95% CI, 13.5 to 41.2) versus 8.7% (95% CI, 2.4 to 20.8). Due to increased incidence of neutropenia and febrile neutropenia in East Asian patients, starting dose of docetaxel was reduced for newly enrolled East Asian patients (75 to 60 mg/m², n=24). In docetaxel+ramucirumab versus docetaxel+placebo, incidence of neutropenia was 84.4% versus 72.7% (75 mg/m²) and 54.5% versus 38.5% (60 mg/m²). Incidence of febrile neutropenia was 43.8% versus 12.1% (75 mg/m²) and 0% versus 7.7% (60 mg/m²). CONCLUSION: Results of this subgroup analysis showed a trend favoring ramucirumab+docetaxel for median OS, PFS, and improved ORR in East Asian patients, consistent with ITT population results. Reduction of starting dose of docetaxel in East Asian patients was associated with improved safety.

Adverse effects on health posed by consumption of Areca nut (Areca catechu L., family: Palmaceae).

This review paper discusses the impact of areca nut (Betel nut) on human health. Small pieces of betel nut are generally use with betel leaf after meals in a day or on any festival. Areca nut seed contains bioactive components like alkaloids and tannins. It is known as salivary stimulating, digestive agents and act as antimicrobial effect against oral bacteria. Along with the few beneficial effects, it has some adverse effects on the human body. Need to enhance the awareness activities regarding the health concern due to consumption of areca nut.

National nursing and midwifery legislation in countries of South-East Asia with high HIV burdens.

This paper analyses nursing and midwifery legislation in high HIV-burden countries of the World Health Organization (WHO) South-East Asia Region, with respect to global standards, and suggests areas that could be further examined to strengthen the nursing and midwifery professions and HIV service delivery. To provide universal access to HIV/AIDS prevention, care and treatment, sufficient numbers of competent human resources for health are required. Competence in this context means possession and use of requisite knowledge and skills to fulfil the role delineated in scopes of practice. Traditionally, the purpose of professional regulation has been to set standards that ensure the competence of practising health workers, such as nurses and midwives. One particularly powerful form of professional regulation is assessed here: national legislation in the form of nursing and midwifery acts. Five countries of the WHO South-East Asia Region account for more than 99% of the region’s HIV burden: India, Indonesia, Myanmar, Nepal and Thailand. Online legislative archives were searched to obtain the most recent national nursing and midwifery legislation from these five countries. Indonesia was the only country included in this review without a national nursing and midwifery act. The national nursing and midwifery acts of India, Myanmar, Nepal and Thailand were all fairly comprehensive, containing between 15 and 20 of the 21 elements in the International Council of Nurses Model Nursing Act. Legislation in Myanmar and Thailand partially delineates nursing scopes of practice, thereby providing greater clarity concerning professional expectations. Continuing education was the only element not included in any of these four countries’ legislation. Countries without a nursing and midwifery act may consider developing one, in order to facilitate professional regulation of training and practice. Countries considering reform to their existing nursing acts may benefit from comparing their legislation with that of other similarly situated countries and with global standards. Countries interested in improving the sustainability of scale-up for HIV services may benefit from a greater understanding of the manner in which nursing and midwifery is regulated, be it through continuing education, scopes of practice or other relevant requirements for training, registration and licensing.

Love and sexual relationships in a globalized world / Relacionamentos amorosos e sexuais em um mundo globalizado / Rapports amoureux et sexuels dans un monde globalisé / Relacionamientos amorosos y sexuales en un mundo globalizado

With the development of globalized exchanges, sexual and/or sentimental relationships between developed and developing countries are becoming more and more frequent. Through the comparative study of relationships between Occidental and Thai or Malay people, we will see how Occidental and Oriental actors use hierarchies of gender, class and race to try to valorise their economic, cultural, social and symbolic capital. In Thailand, lower-class women seek access to financial stability while in the neighbouring country, upper-class women aspire to freedom from local culture. For Occidental men, what hides behind their desire of the “other” is a rejection of "Occidental values", especially sexual equality, and a return to values considered more "stable", "traditional", and "hierarchical". We will see how love interactions in a globalized context are an instrument to valorise the different forms of capital, in Bourdieu‟s sense, and a way to redefine social hierarchies.

Com o desenvolvimento dos intercâmbios globalizados, as interações sexuais e/ou amorosas entre os países desenvolvidos e em desenvolvimento se tornaram mais frequentes. Por meio de um estudo comparativo das relações entre Ocidentais e Tailandeses e Malaios, veremos como sujeitos Ocidentais e Orientais usam as hierarquias de gênero, classe e raça para valorizar seus capitais econômico, cultural, social e simbólico. Se na Tailândia, as mulheres oriundas das classes desfavorecidas buscam uma certa segurança financeira, no país vizinho, as mulheres das classes abastadas desejam a liberdade em relação à cultura local. Para os homens ocidentais, o desejo pelo "outro" esconde uma rejeição dos "valores ocidentais", particularmente a igualdade entre os sexos, e o desejo de retomar valores considerados mais "estáveis", "tradicionais" e "hierárquicos". Nós veremos como as interações amorosas globalizadas valorizam diferentes formas de capital, no sentido de Bourdieu, redefinindo hierarquias sociais.

Avec le développement des échanges mondialisés, les interactions sexuelles et/ou amoureuses entre les pays développés et en développement deviennent plus fréquentes. A travers l‟étude comparative des relations entre Occidentaux et Thaïlandais ou Malaisiens nous verrons comment, par le biais des hiérarchies de genre, de classe et de "race", les acteurs occidentaux et orientaux tentent de revaloriser leur capital économique, culturel, social et symbolique. Si en Thaïlande les femmes issues des classes défavorisées peuvent espérer une certaine assurance financière, dans le pays voisin les femmes d'un milieu aisé souhaitent accéder à davantage de liberté face à l'emprise de la culture locale. Ce désir de l'autre cache souvent chez les Occidentaux un rejet des dites "valeurs occidentales", notamment l'égalité des sexes, et une volonté de retour vers des valeurs considérées "stables", "traditionnelles" et "hiérarchisées".

Con el desarrollo de los intercambios globalizados, las interacciones sexuales y/o amorosas entre el Occidente y los países en desarrollo se tornan más frecuentes. Por medio de los estudios comparativos de las relaciones entre Occidentales y Tailandesas o Malayas vemos como, por la perspectiva de las jerarquías de genero, de clase y de “raza”, lo actores occidentales y orientales tienden a valorar sus capitales económicos, culturales, sociales y simbólicos. Si en Tailandia las mujeres oriundas de las clases desfavorecidas pueden esperar una cierta seguridad financiera, en el país vecino, las mujeres de las clases abastadas desean el acceso a la libertad frente a la cultura y de la religión locales. Este deseo por el otro esconde, frecuentemente, por parte de los Occidentales un rechazo de los dichos “valores occidentales”, particularmente a la igualdad entre los sexos, y una voluntad de retornar a valores considerados más “estables”, “tradicionales” y "jerárquicos”. Vemos así como las interacciones amorosas globalizadas son un instrumento de valorización de diferentes maneras de capital, no sentido de Bourdieu, y una manera de redefinir las jerarquías sociales.

Historical Study of the Etymological Form and Translational Process of Gout (Tongfeng) / 의사학

This study aims to address questions regarding the translation of 'gout' into 'tongfeng' in East Asia. To this end, the formation process of the origins, 'gout' from Western medicine and 'tongfeng' from Oriental medicine, and the translational process were investigated through the relevant records and literature dating from the 16th century on. Symptoms associated with gout were originally mentioned in ancient Egypt and various terminologies were used to refer to gout, such as podagra, cheiragra and gonogra. The word 'gout', which is derived from Latin, was used for the first time in the 13th century. The reason for this linguistic alteration is thought to be the need for a comprehensive term to cover the various terms for gout in symptomatic body parts, since it can occur concurrently in many joints. However, it took hundreds of years before gout was independently established as a medical term. In oriental medicine, terms describing diseases with features similar to gout include bibing, lijiefeng, baihufeng and tongfeng. Among them, the concept of 'tongfeng' has been established since the Jin and Yuan dynasties. The cause, prevention and various treatments for tongfeng were proposed throughout the Ming and Qing dynasties. The early translation of gout and tongfeng in East Asia, respectively, is estimated to have occurred in the 18th century. The first literature translating gout in China was 'An English and Chinese Vocabulary in the Court Dialect (yinghua yunfu lijie)'. From the publication of this book until the late 19th century, gout was translated into an unfamiliar Chinese character 'Jiu feng jiao', likely because the translation was done mostly by foreign missionaries at the time, and they created a new word on the basis of Western medicine instead of researching and translating similar diseases in oriental medicine. In Japan, the first book translating gout was 'A Pocket Dictionary of the English and Japanese Language (Eiwa taiyaku shuchin jisho)', Japan's the first English-Japanese translation dictionary. In this book, gout was translated into tongfeng, a word adopted from oriental medicine. These differences from China are thought to be caused by Rangaku doctors, who, influenced by oriental medicine in the Jin and Yuan dynasties, played an important role in translating medical terminology at that time.

Levels and trends of smokeless tobacco use among youth in countries of the World Health Organization South-East Asia Region.

BACKGROUND: At least two rounds of the Global Youth Tobacco Survey (GYTS) have been completed in most of the countries in the World Health Organization South‑East Asia region. Comparing findings from these two rounds provides trend data on smokeless tobacco (SLT) use for the first time. METHODS: This study uses GYTS data from Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor‑Leste during 2006–2013. GYTS is a nationally representative survey of 13–15‑year‑old students using a consistent and standard protocol. Current SLT use is defined as using any kind of SLT products, such as chewing betel quid or nonbetel quid or snuffing any other products orally or through the nasal route, during the 30 days preceding the survey. Prevalence and 95% confidence intervals were computed using SAS/SUDAAN software. RESULTS: According to most recent GYTS data available in each country, the prevalence of current use of SLT among youth varied from 5.7% in Thailand to 23.2% in Bhutan; among boys, from 7.1% in Bangladesh to 27.2% in Bhutan; and among girls, from 3.7% in Bangladesh to 19.8% in Bhutan. Prevalence of SLT was reported significantly higher among boys than girls in Bhutan (boys 27.2%; girls 19.8%), India (boys 11.1%; girls 6.0%), Maldives (boys 9.2%; girls 2.9%), Myanmar (boys 15.2%; girls 4.0%), and Sri Lanka (boys 13.0%; girls 4.1%). Prevalence of current SLT use increased in Bhutan from 9.4% in 2009 to 23.2% in 2013, and in Nepal from 6.1% in 2007 to 16.2% in 2011. CONCLUSION: The findings call for countries to implement corrective measures through strengthened policy and enforcement.

Prevalence and sociodemographic determinants of tobacco use in four countries of the World Health Organization: South-East Asia region: Findings from the Global Adult Tobacco Survey.

INTRODUCTION: Tobacco use is a leading cause of deaths and Disability Adjusted Life Years lost worldwide, particularly in South‑East Asia. Health risks associated with exclusive use of one form of tobacco alone has a different health risk profile when compared to dual use. In order to tease out specific profiles of mutually exclusive categories of tobacco use, we carried out this analysis. METHODS: The Global Adult Tobacco Survey (GATS) data was used to describe the profiles of three mutually exclusive tobacco use categories (“Current smoking only,” “Current smokeless tobacco [SLT] use only,” and “Dual use”) in four World Health Organization South‑East Asia Region countries, namely Bangladesh, India, Indonesia and Thailand. GATS was a nationally representative household‑based survey that used a stratified multistage cluster sampling design proportional to population size. Prevalence of different forms of usage were described as proportions. Logistics regression analyses was performed to calculate odds ratios (OR) with 95% confidence intervals. All analyses were weighted, accounted for the complex sampling design and conducted using SPSS version 18. RESULTS: The prevalence of different forms of tobacco use varied across countries. Current tobacco use ranged from 27.2% in Thailand to 43.3% in Bangladesh. Exclusively smoking was more common in Indonesia (34.0%) and Thailand (23.4%) and less common in Bangladesh (16.1%) and India (8.7%). Exclusively using SLT was more common in Bangladesh (20.3%) and India (20.6%) and less common on Indonesia (0.9%) and Thailand (3.5%). Dual use of smoking and SLT was found in Bangladesh (6.8%) and India (5.3%), but was negligible in Indonesia (0.8) and Thailand (0.4%). Gender, age, education and wealth had significant effects on the OR for most forms of tobacco use across all four countries with the exceptions of SLT use in Indonesia and dual use in both Indonesia and Thailand. In general, the different forms of tobacco use increased among males and with increasing age; and decreased with higher education and wealth. The results for urban versus rural residence were mixed and frequently not significant once controlling for the other demographic factors. CONCLUSION: This study addressed the socioeconomic disparities, which underlie health inequities due to tobacco use. Tobacco control activities in these countries should take in account local cultural, social and demographic factors for successful implementation.

Health spending, macroeconomics and fiscal space in countries of the World Health Organization South-East Asia Region.

The paper examines the issues around mobilization of resources for the 11 countries of the South-East Asia Region of the World Health Organization (WHO), by analysing their macroeconomic situation, health spending, fiscal space and other determinants of health. With the exception of a few, most of these countries have made fair progress on their own Millennium Development Goal (MDG) targets of maternal mortality ratio and mortality rate in children aged under 5 years. However, the achieved targets have been very modest – with the exception of Thailand and Sri Lanka – indicating the continued need for additional efforts to improve these indicators. The paper discusses the need for investment, by looking at evidence on economic growth, the availability of fiscal space, and improvements in “macroeconomic-plus” factors like poverty, female literacy, governance and efficiency of the health sector. The analysis indicates that, overall, the countries of the WHO South-East Asia Region are collectively in a position to make the transition from low public spending to moderate or even high health spending, which is required, in turn, for transition from lowcoverage–high out-of-pocket spending (OOPS) to highcoverage–low OOPS. However, explicit prioritization for health within the overall government budget for low spenders would require political will and champions who can argue the case of the health sector. Additional innovative avenues of raising resources, such as earmarked taxes or a health levy can be considered in countries with good macroeconomic fundamentals. With the exception of Thailand, this is applicable for all the countries of the region. However, countries with adverse macroeconomic-plus factors, as well as inefficient health systems, need to be alert to the possibility of overinvesting – and thereby wasting – resources for modest health gains, making the challenge of increasing health sector spending alongside competing demands for spending on other areas of the social sector difficult.