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This paper collects information on the species resources of medicinal plants in Laos through various methods such as literature collation and analysis, sample line survey, visits and surveys, and initially obtains the medicinal plant resources in Laos, the use of folk herbs, and traditional medicine knowledge archives. It is found that Laos is rich with wild medicinal plant resources. There are 2 165 species (including varieties) belonging to 1 014 genera of 214 families, including 57 species belonging to 40 genera of 29 families of ferns, 32 species belonging to 17 genera of 8 families of gymnosperms, and 2 076 species belonging to 957 genera of 177 families of angiosperms. And, there are 108 kinds of medicinal materials currently circulatingin the market. Herbal resources is widely used in Laos, and many fresh herbs in the market have the special effects of relieving cough and promoting salivation, eliminating dampness, dispelling summer heat, nourishing yin and cooling blood.The medicinal materials for alleviating rheumatism and strengthening waist and knees in the market are with good prospects for development and utilization, so the development and management should be strengthened. China and Laos can conduct in-depth research and strengthen experience exchanges on traditional medicine experience.
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@#Species of the blood sucking nematode Haemonchus are a main problem in the small ruminant industry worldwide. Haemonchus worms were taken from 68 infected native goats slaughtered in three provinces of Laos in June and July 2019. Cuticular ridge patterns were used for the first time to identify adult female Haemonchus spp. and their vulvar morphs were characterized. The results showed that the variations in vulvar morphology of female Haemonchus spp. presented a knobbed morph as the dominant morphotype and predominant linguiform B subtype was also detected. In total, 270 selected female worms from each vulvar morph type were examined based on their cuticular ridge patterns in cross sections at positions of the esophageal-intestinal junction (EI), the 4 mm region from the anterior end (4 mm), and the mid-body (MB). Only Haemonchus contortus was identified and most worms had constant numbers of ridges at EI, 4 mm, and MB, namely 30, 26, and 22 ridges, respectively, accounting for 99.26%, 97.41%, and 97.04%, respectively, of worms detected, while the lowest variation in the number of ridges was at region EI which is recommended as the single best position. Based on synlophe and ITS2 sequence analysis, it was assumed that H. contortus might dominate in the sample areas with the possible numbers of ridges of H. contortus females in the ranges 29-30, 25-27, and 21-23 for positions EI, 4 mm, and MB, respectively. The cuticular ridge pattern was a useful character for identifying female Haemonchus species in this study and could be utilized as an affordable alternative method for epidemiological studies and as part of parasite control management in native goats of Laos.
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@#Objective: This study aimed to determine sensitivity, specificity, and accuracy of RDT used in 4 health care centres in Vientiane capital versus ELISA. Methods: A study was then conducted among 1,729 patients who underwent three different RDTs for surface antigen of hepatitis virus (Boson, CTK and Coretest) in two public central hospitals and two private clinics in Vientiane Capital, to compare sensitivity, specificity, and accuracy of RDTs versus ELISA. Results: The mean age (95%CI) of the patients was 28.7 years old and the sex ratio was balanced. 13.71% of the patients had positive HBsAg as detected by ELISA, while this was only 8.9% for RDTs. All three types of RDTs had a sensitivity of 54% and specificity of 97%. There was no difference in accuracy, sensitivity, specificity, positive and negative predictive values between RDTs. Conclusions: This study revealed higher prevalence of HBsAg among young adults who were present in health care facilities in Vientiane than previously described in Laos. All three RDTs studied had low sensitivity but high specificity; therefore, they are likely to miss many cases of Hepatitis B infection and should be replaced or backed up by more accurate methods.
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Objective To analyze the advantages, disadvantages, opportunities and challenges for schistosomiasis elimination in Laos, so as to propose the corresponding healthy policies and suggestions. Methods A SWOT analysis was performed to analyze the strength, weakness, opportunity and threat for the schistosomiasis elimination program in Laos, and the corresponding policy suggestions were proposed. Results The national schistosomiasis elimination program of Laos receives governmental emphases and great supports. A strategy based on mass drug administration was proposed and a sentinel site-bases surveillance system has been built for schistosomiasis elimination in Laos; however, there are several challenges for the national schistosomiasis elimination program in Laos, including insufficient financial supports, inadequate professional capability, weak schistosomiasis control awareness in community populations and difficulty in vector control. Conclusions Persistent governmental leadership, increasing financial supports, strengthening professional team building and improving schistosomiasis control awareness in community populations are required to facilitate the progress towards schistosomiasis elimination in Laos.
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Background and Rational@#In Lao PDR, relapse of metamphetamine use following discharge from rehabilitation center is unacceptably high (~50%). Good preparedness and IEC provision to the rehabilitated addicts before discharge from the rehabilitation center is likely to be vital to prevent relapse. Effective IEC would probably help to reduce the rate of relapse.@*Methodology@#This was an open cluster-randomized-controlled trial to assess the newly developed IEC package among metamphetamine users. The intervention group received new IEC package (education message + brochure + telephone contact number + follow-up) while the conventional advice was given to control group. The study participants were followed up for 6 months by telephone (at 1, 3, 6 months). The primary endpoint was the relapse rate.@*Result@#One hundred and eighty-one addicts were enrolled in the trial (93 in intervention and 88 in control groups). Ninety-six subjects were male. The overall mean (SD) age of the participants was 26.5 (6.1) years and the overall median (range) duration of drug use was 5 (0.5 – 26) years and these figures were not significantly different between the groups (P=0.50 and P=0.97), respectively). The proportion of the participants who were lost to follow-up was 8%. Sixty percents of the study subjects completed 6-months follow up and this was not statistically different between the groups (P=0.93). The overall percentage of relapse was 39% (65/166) [36% (31/85) in intervention and 42% (34/81) in control groups, P=0.38). The median (range) duration of relapse was 30 (1 – 160) days and this was not significantly different between the groups (P=0.38). In a multiple logistic regression model, contact with drug users following discharge from the rehabilitation center was significantly associated with relapse [AOR = 73, 95%CI = 39 – 405, P<0.001] while having a permanent job following discharge was a protective factor for relapse [AOR = 0.03 (0.004 – 0.27), P=0.002].@*Conclusion@#The relapse rate of metamphetamine use was lower in the group with new IEC package than in control group but this was not statistically significant. Further study with a larger scale is strongly recommended
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Objective@#This study aimed to determine the incidences of dengue-like illness (DLI), dengue virus (DENV) infection, and serotypes and to identify socio-demographical and entomological risk factors of DLI in selected suburban and rural communities in the Lao People’s Democratic Republic and in Thailand.@*Methods@#A two-year longitudinal study was conducted in four villages during the inter-epidemic period between 2011 and 2013. Entomological surveys, semi-structured interviews of household heads and observations were conducted. Occurrences of DLI were recorded weekly using the World Health Organization’s dengue definition along with blood samples; results were compared with national surveillance dengue data. Risk factors of DLI were assessed using logistic regression.@*Result@#Among the 2007 people in the study, 83 DLI cases were reported: 69 in suburban Lao People’s Democratic Republic, 11 in rural Thailand, three in rural Lao People’s Democratic Republic and none in suburban Thailand. Four were confirmed DENV: two from suburban Lao People’s Democratic Republic (both DENV-1) and two from rural Thailand (both DENV-2). Although the number of detected DLIs during the study period was low, DLI incidence was higher in the study compared to the dengue surveillance data in both countries. DLI in suburban Lao People’s Democratic Republic was associated with age and occupation, but not with the number of pupae per person.@*Discussion@#This study highlights the importance of continuous clinical and vector surveillance for dengue to improve early detection of dengue and other mosquito-borne diseases in the region.
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Primary distal renal tubular acidosis (dRTA) caused by mutations of the SLC4A1 gene, which encodes for erythroid and kidney isoforms of anion exchanger, shows marked difference in inheritance patterns and clinical features in different parts of the world. While the disease shows autosomal dominant inheritance without any red cell morphological abnormalities in the temperate countries, it is almost invariably recessive, and often accompanies red cell morphological abnormalities or hemolytic anemia in the tropics, especially in Southeast Asia. Here, we report three patients with autosomal recessive (AR) dRTA, presenting with typical findings of failure to thrive and rickets, from two unrelated Lao families. The mutational analyses revealed that all three patients harbored the same homozygous SLC4A1 mutation, p.Gly701Asp. Adequate supplementation of alkali and potassium resulted in remarkable improvement of growth retardation and skeletal deformities of the patients. This is the first case report of Lao patients with AR dRTA caused by SLC4A1 mutations.
Subject(s)
Humans , Acidosis, Renal Tubular , Alkalies , Anemia, Hemolytic , Asia, Southeastern , Congenital Abnormalities , Failure to Thrive , Inheritance Patterns , Kidney , Laos , Potassium , Protein Isoforms , Rickets , WillsABSTRACT
PURPOSE: Medical professionals from Korea and Laos have been working together to develop a continuing professional development training program covering the major clinical fields of primary care. This study aimed to evaluate the effectiveness of the program from 2013 to 2014 using the Kirkpatrick model. METHODS: A questionnaire was used to evaluate the reaction of the trainees, and the trainers assessed the level of trainees' performance at the beginning and the end of each clinical section. The transfer (behavioral change) of the trainees was evaluated through the review of medical records written by the trainees before and after the training program. RESULTS: The trainees were satisfied with the training program, for which the average score was 4.48 out of 5.0. The average score of the trainees' performance at the beginning was 2.39 out of 5.0, and rose to 3.88 at the end of each section. The average score of the medical records written before the training was 2.92 out of 5.0, and it rose to 3.34 after the training. The number of patient visits to the district hospitals increased. CONCLUSION: The continuing professional development training program, which was planned and implemented with the full engagement and responsibility of Lao health professionals, proved to be effective.
Subject(s)
Humans , Education , Health Occupations , Hospitals, District , Korea , Laos , Medical Records , Physician Assistants , Primary Health Care , Program EvaluationABSTRACT
In the present study, we report on the occurrence of paramphistomes, Fischoederius cobboldi and Paramphistomum epiclitum, in Lao PDR with the basis of molecular data. Parasite materials were collected from bovines bred in Ban Lahanam area, Savannakhet Province, Lao PDR at Lahanam public market. Morphological observations indicated 2 different species of paramphistomes. The mitochondrial gene cox1 of the specimens was successfully amplified by PCR and DNA sequencing was carried out for diagnosis of 11 specimens. Pairwise alignment of cox1 sequences were performed and confirmed F. cobboldi and P. epiclitum infecting bovines in Laos. Although there were many limiting points, as the small number of worm samples, and the restricted access of the animal host materials, we confirmed for the first time that 2 species of paramphistomes, F. cobboldi and P. epiclitum, are distributed in Lao PDR. More studies are needed to confirm the paramphistome species present in Savannakhet and its hosts to clear the natural history of these parasites of ruminants in the region and measure the impact of this parasite infection in the life and health of the local people.
Subject(s)
Animals , Cattle , Diagnosis , Genes, Mitochondrial , Helminths , Laos , Natural History , Paramphistomatidae , Parasites , Polymerase Chain Reaction , Rumen , Ruminants , Sequence Analysis, DNAABSTRACT
InLao PDR, the National Malaria Control Program (NMCP) evaluates bednet coverage,often at the village level, using a coverage target of one net per 2.5 (or fewer)persons in a given population. However, in villages that meet the target, notall households necessarily meet the target or utilize all available bednets. Thisstudy explored households that fell short of the target and household utilizationof bednets in villages that met the target of bednet coverage set by the NMCP. Thepersons per net ratio (PPNR), which is defined as the population divided by thenumber of available bednets in a household/village, was used to determine whethera household/village met the NMCP target. Using a household survey, we collectedand analyzed the data of 635 households in 17 villages in Xepon district in2012. Households that fell short of the target (households with a PPNR of >2.5 or no bednet) existed in every village. The proportion of these households differedgreatly among the villages, ranging from 3.4–50%, with some households fallingfar short. Of the 635 households, 275 (43.5%) had at least one bednet that wasnot being used on the night preceding the survey and 131 (20.6%) had at leasttwo. In conclusion, in villages that met the NMCP target, a considerable numberof households fell short of the target. Available bednets were not fullyutilized in many of the surveyed households.
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In Lao PDR, the National Malaria Control Program (NMCP) evaluates bednet coverage, often at the village level, using a coverage target of one net per 2.5 (or fewer) persons in a given population. However, in villages that meet the target, not all households necessarily meet the target or utilize all available bednets. This study explored households that fell short of the target and household utilization of bednets in villages that met the target of bednet coverage set by the NMCP. The person per net ratio (PPNR), which is defined as the population divided by the number of available bednets in a household/village, was used to determine whether a household/village met the NMCP target. Using a household survey, we collected and analyzed the data of 635 households in 17 villages in Xepon district in 2012. Households that fell short of the target (households with a PPNR of > 2.5 or no bednet) existed in every village. The proportion of these households differed greatly among the villages, ranging from 3.4–50%, with some households falling far short. Of the 635 households, 275 (43.5%) had at least one bednet that was not being used on the night preceding the survey and 131 (20.6%) had at least two. In conclusion, in villages that met the NMCP target, a considerable number of households fell short of the target, and the available bednets were not fully utilized in many of the surveyed households.
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Background and rationale@#In the Lao PDR, shortage of blood for transfusion for use in hospitals is an important and challenging problem, which has not been adequately resolved. This is due to the very low number of voluntary blood donation by the general population. Many factors may contribute to the low number of voluntary blood donation of Lao people, which we do not all know and understand.@*Results@#Eight hundred and ninety-eight subjects were enrolled in the study and interviewed (449 cases and 449 controls). The median (range) age of the respondents was 26 years (17 – 40). Factors significantly associated with voluntary blood donation were males (OR = 1.71; 95% CI = 1.31-1.23, P= 0.001), being single (OR = 2.01; 95% CI = 1.52-2.65, P<0.001), having a positive attitude toward voluntary blood donation (OR = 3.17; 95% CI = 2.37-4.22, P<0.001), convenience in traveling to and short distance from home to blood donation centre (OR = 2.35; 95% CI = 1.73-3.20, P=0.01), (OR = 1.67; 95% CI = 1.25-2.22, P=0.001), respectively, and having received information on blood donation from any channels (OR = 1.88; 95%CI = 1.38-2.55, P<0.001). Another important but not statistically significant reinforcing factor for voluntary blood donation was blood donation during important occasion (birthday, marriage anniversary and valentine’s day).@*Conclusion@#This study suggested that (1) voluntary blood donation campaign should be carried out continuously and focus on young people at educational institutions and (2) it is very vital that mobile blood donation teams continue their activities regularly in order to ensure that blood demand in hospital can be achieved.
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Background and rationale@#Diabetes mellitus (DM) remains an important health problem worldwide, including in Laos. Most deaths among DM type-2 patients result from complications due to poor control of glycemia. Eating and drinking behaviors are vital factors for glycemia control in DM patients and study of their knowledge, attitude and practice for eating-drinking behavior may help us to understand the problem and plan engagement and how to promote appropriate changes in patients’ behavior.@*Methodology@#A descriptive, cross-sectional study was conducted to explore knowledge, attitude and practice on eating-drinking of DM type-2 patients who visited the Outpatient Department of Mahosot Hospital from February to March 2012. A questionnaire was designed and pre-tested before interviewing patients following their consent. Patients were selected into the study using systematic random sampling.@*Results@#Two hundred DM type-2 patients (60% females) were interviewed. The overall mean (SD) age of the patients was 58 (9.2) years; 35.5% of them had at least a family member with DM. The mean (SD) duration the patients knew that they had DM was 6.1 years (SD = ±5.8). On the day of interview, 42% and 32.5% of the patients had blood glucose levels that were high (130-180 mg/dL) and very high (>180 mg/dL), respectively. Twenty-two percent of the respondents had a good level of DM diet knowledge while 59% of them had a moderate level and the remainder (19%) had a low level. Most of interviewees (98.5%) had correct knowledge on food restriction (rice, flour, sugar, and lipid) and 93.5% knew that food control, exercise, and taking antidiabetics regularly are the best ways to control blood sugar. Less than 50% of the respondents knew that DM patients have to restrict the quantity of rice to eat and that patients with complications must control their diets strictly. Although 68.5% and 31.5% of the patients had a good and moderate level, respectively, of attitude on DM nutrition, some of them still had beliefs that are not medically recommended. For example, 15.5% of patients thought that they could stop their medication by themselves, 28% said that DM patients can live normally regardless of blood sugar control, and 49.5% believed that DM was a bad karma. Approximately 1/4 of the interviewees reported that they mostly did not eat on time, 30.5% did not restrict their food, 41% just ate what they needed and 41.5% said that they ate any fruits that they liked.@*Conclusion@#Although most of DM patients had correct knowledge on DM diets, some of them had attitudes and practice on food consumption, including poor blood sugar control, that are at odds with current medical advice. Engagement methods are needed to inform patients of optimal dietary practice in order to prevent DM complications.
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Background and rationale@#Intensive Care Units (ICU) are wards where very sick patients are admitted and they are usually connected to invasive devices such as respirator, urine catheter etc. Patients in ICU are more likely (5 – 10 times) to have hospital-acquired infections than those admitted to other wards of the same hospitals. Very little is known about hospital-acquired infections in Laos, including the species of bacterial contaminating ICU. Information on this issue is essential for a hospital to plan on how to manage the environment and set stricter measures to avoid nosocomial infections in the ICU.@*Methodology@#This was a research survey conducted to determine the types and quantity of bacterial contamination in ICUs of a hospital in Vientiane. Open plate technique was applied by placing 256 media plates in 8 rooms of paediatric (n=3) and adult (n=5) ICUs. Controls were closed plates. Plates were sent to and bacteria were identified at National Centre of Laboratory and Epidemiology, Vientiane, Laos.@*Results@#Eight pathogens were identified and the most predominant bacteria found was Coagulase negative Staphylococcus spp. (56.0%), followed by Bacillus spp. (19.7%), Acinetobacter spp. (12.5%), Micrococcus spp. (8.4%), Escherichia coli (1.9%), Klebsiella pneumoniae (0.8%), Providencia rettgeria (0.4%) and Proteus mirabilis (0.3%). Escherichia coli, Klebsiella pneumoniae and Providencia rettgeri were not found in adult ICUs and Proteus mirabilis was not found in paediatric ICUs. The overall mean (95%CI) colonies of pathogens found in paediatric and adults ICUs was 83.04 CFU/dm2 (43.21 - 149.42 CFU/dm2) and 48.54 CFU/dm2 (21.96 - 135.00 CFU/dm2), respectively.@*Conclusion@#This study suggested that there were many bacteria contaminated in the ICUs of this hospital with a considerable quantity. Therefore, the hospital should have a better strategic plan to manage its environment and improve sterilization in the ICUs in order to reduce hospital-acquired infections among patients.
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Rationale and Background: Diarrhea remains an important cause of morbidity and mortality among Lao children, particularly those aged < 5 years. Child caretakers’ behaviors on the prevention of diarrhea are key determinants affecting child morbidity and mortality. Study of factors associated with caretakers’ behavior on diarrhea prevention is therefore needed to identify correct and appropriate solutions in the community. Methodology: This was cross-sectional research to identify factors associated with child caretakers’ behavior on diarrhea prevention among children aged 0 - 5 years in rural Champasack Province, Lao PDR. The study population was caretakers of children aged 0 – 5 years who lived together in the same household (n = 280). The study was performed between June 2010 – June 2011 using predesigned and pretested questionnaire. Results: Eighty-one percent of respondents were females with a mean (SD) age of 32.4 (10.2) years and 50% of them were rice farmers. Sixty-five percent of the caretakers had high level (score 24 – 30) of perceived risk of getting diarrhea with a mean (SD) score of 24.7/30 (3.26). The mean (SD) score of disease severity perception of the respondents was 26.03/30 (2.47) and 82.5% of them had high level of perception. Eighty percent of those interviewed perceived benefits of following advice about diarrhea prevention behaviors at high level, about half perceived obstacles in following advice in diarrhea prevention behaviors at high level (52.14%) and 60.71% had a high level of diarrhea prevention behaviors. In a multiple linear regression analysis, factors associated with caretakers’ behaviors on prevention of diarrhea were educational attainment (no education) (Mean diff = -0.156; 95%CI = -1.487 to -0.327; P-value < 0.001), perceived severity of diarrhea (Mean diff = 0.328; 95%CI = 0.160 to 0.361; P-value < 0.001), and perceived benefits of following advice in diarrhea prevention behaviors (Mean diff = 0.2763; 95%CI = 0.255 to 0.500; P-value < 0.001). Conclusion: Despite a high level of child caretakers perception of risk of getting diarrhea, disease severity, and benefit of following advice in diarrhea prevention behavior, there remains a need to provide health education on hygiene and sanitation to prevent diarrhea among children, aimed at reducing morbidity and mortality among Lao children which is still high at the moment.
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Rational and Background: Epidemiological surveillance by Khammouane Provincial Health Centers has been inadequate with incomplete and untimely data collection, and insufficient information dissemination. However, difficulties and gaps in the surveillance system have not been identified. Study of the administrative factors and processes affecting performance of epidemiological surveillance by health center workers would help to identify problems and therefore identify appropriate solutions. Methodology: This was a descriptive, cross-sectional study involving two groups: (1) 143 health workers from 74 health centers who were interviewed using a questionnaire and (2) 9 heads of epidemiology teams from 9 districts of Khammouane Provinces, Lao PDR who were interviewed in-depth. Results: Fifty-nine percent of the respondents were female with mean (SD) age of 35.6 (8.5) years. The mean (SD) years of working in epidemiology was 4.1 (4.2) years. The overall mean (SD) score of performance in epidemiological surveillance by the health center workers was 3.30/5 (0.94). The mean (SD) score of administrative factors affecting the performance in epidemiological surveillance was 2.68/5 (0.80). Previous training in epidemiology and educational level were positively correlated with epidemiology surveillance performance (r=0.25, P<0.05) and (r=0.27, P<0.05). Manpower, material, and budget were related with work performance (r=0.54, P<0.01), (r=0.34, P<0.01), and (r=0.22, P<0.01), respectively. In a multivariate analysis, planning (P<0.01), organization (P<0.01), and staff training (P<0.01) were independently correlated with the epidemiological surveillance performance. Conclusion: The level of the performance of epidemiological surveillance by Khammouan Health Center staff was moderately satisfactory. Regular monitoring of the work performance by the Provincial and District Health is required to identify problems and solutions. At least 1-2 workshops on epidemiological surveillance should be organized in order to enhance knowledge and understanding of disease surveillance by the health center staff aimed at improving their work performance.
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Rational and Background: Advertisements are forms of communication used to encourage or persuade an audience to continue or to take some new action, usually to purchase. Product and service adverts on Lao television have significantly increased recently. However, very little is known about the frequency of health- related adverts on Lao television and whether they are containing Lao appropriate public health messages. Study of the frequency and potential impact of health-related adverts might help us to better understand the situation and contribute to solving health-related problems of Lao people. Methodology: This was a descriptive study to describe the adverts on Lao television during three months (February – April 2011). All Lao television adverts broadcasted during three months were tape-recorded and information was extracted on a pre-designed form. All adverts were analyzed and classified as health-related and non health-related. The time of adverts was also calculated. Data were entered into excel sheet and analyzed using STATA 10.0. Results: During three months, 34 adverts were observed on all three Lao television channels. Of these, 28 (82%) were health-related and 6 (18%) were not. Of 28 health-related adverts, 10 (36%) were classified as good for Lao public health, 3 (11%) were considered as dangerous to health, and 15 (53%) were of uncertain classification. All three adverts regarded as ‘bad’ to health were advertising beverages containing alcohol or caffeine. The average advert durations were 1.5 minutes and 1 minute for those advertising alcohol- and caffeine- containing beverage. Over three months, 3,702 spots of these three adverts were on air with an average total exposure time of 82.5 hours, which was longer than those considered as ‘good’ for health (2,068 spots over 32.9 hours). Some products were exaggeratedly advertized which might mislead the audience and negatively affect their health. Conclusion: More than 80% of all Lao TV adverts were health-related, but 2/3 were classified as potentially harmful to health. The frequency and total duration of health-related adverts, which were considered to be harmful to health, were higher and longer, respectively, when compared to those considered to be good for health. This study suggests that Lao people are exposed to adverts that are contrary to the interests of Lao public health. Strict measures to ensure that advertisements are accurate and do not mislead people, persuading them to buy things that are not in the interests of Lao public health, are required.
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Rational and Background: The University of Health Sciences (UHS) is the only health institution training medical doctors in the Lao PDR. The curriculum of the Faculty of Medicine has been developed and improved but no formal evaluation has been performed. Feedbacks on the current learning-teaching situation by medical students are essential and important as they are directly exposed to the real learning-teaching situation. Methodology: This was a descriptive study of feedback from the sixth year medical students (academic year 2010-2011) on the current learning-teaching situation of the Faculty of Medicine, UHS, using a pre-designed, pre-tested and self-administered questionnaire between January – February 2011. Results: Of a total of 162 students, 161 participated in the survey. Only 50% of the respondents reported that they ‘really like’ to study medicine at enrollment. This figure was consistent with the proportion of the students who said that they had successfully passed the entrance examination (56%). However, 86% of the interviewees stated that they ‘like medicine’ after six years of study. Only 44% of the students reported that they had regularly paid attention to the lectures. Approximately half of them mentioned that the basic sciences they had learnt at the beginning of their medical training were useful for medicine and 94% suggested adding anatomy and physiology to the first year class. The majority (78%) of students complained that they had had too little practical experience in the laboratories and hospitals. Forty-two and 54 % suggested that the students should have worked in the hospitals from the second and third years of their training, respectively. More than half (60%) said that the number of lecturers was insufficient, 36% stated that the lecturers are sufficiently knowledgeable, 20% stated that the lecturers were knowledgeable and adequately passed on their knowledge to the students, and 63% of them reported that the lectures were not always updated. Most of the respondents (84%) said that the number of the students in the class was too big and crowded and this negatively affected the learning-teaching atmosphere. Two third of the interviewers said that educational materials and equipment were not adequate, 86% mentioned that textbooks in the University library were not sufficient and lacking while the internet room did not respond to the need of the students (94% said that the internet room opened late in the morning but closed too early, there are not enough computers, and internet speed was too slow). Eighty-three percent of the students complained that the laboratories and hospitals were too small and did not respond to the need of the students. Conclusion: This study clearly demonstrated that the current learning-teaching of the Faculty of Medicine, University of Health Sciences needs to be evaluated, revised, and improved urgently in order to ensure that the newly graduated doctors are fully knowledgeable and qualified. Copyright: ! 2012 Hang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Rationale and Background: Risk factors associated with Type 2 diabetes mellitus (DM) may differ between population groups and ethnicities. In Lao PDR (Laos), no studies have been conducted to investigate the potential risk factors for Type 2 DM. Methodology: A case-control study was conducted among 150 patients with Type 2 DM who were matched for age and sex with 300 patients presenting at OPD with non-DM diseases, at Setthathirath Hospital between November 30, 2007 and April 30, 2008. Results: Most of the study patients (97.5%) were Lao Loom with an overall mean (95%CI) age of 57.6 (56.6- 58.5) years. The mean (95%CI) daily expense (Lao Kip) was significantly higher in cases [38,700 (35,213- 42,186)] compared to controls [31,400 (29,667-33,132)] (P0.05). Although the frequency of the patients who did regular physical exercise was not statistically different between the cases (31%) and the controls (27%) (P=0.48), the mean (95%CI) body mass index was significantly higher in the cases [28.3 (27.7-28.9)] compared with the controls [24.9 (24.5-25.4)] (P<0.001). A history of family members with DM was significantly higher among the type 2 DM cases (31%) compared with the controls (16%) (P<0.001), [OR= 2.3; 95%CI = 1.4 - 3.7)]. The history of NSAID/Steroid and traditional-herbal use was associated with type 2 DM [OR = 2.6; 95%CI = 1.3 - 5.0) and OR = 2.7; 95%CI = 1.7 - 4.6), respectively]. Conclusion: Higher expenditure, sweet soft drink consumption, BMI, a history of family members with DM, and history of NSAID/steroid or traditional herb use were risk factors associated with type II DM among Lao patients. Further studies are required in order to confirm the findings of this study especially in different hospitals and parts of Laos. Copyright: ! 2012 Xaysanavong et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ABSTRACT
Hand, Foot and Mouth Disease (HFMD) is a common childhood exanthema caused by viruses of the Enterovirus (EV) genus of the Picornaviridae family. The commonest species infecting humans is Human Enterovirus-A (HEV-A) within which group the most frequent serotypes are coxsackievirus A16 (CVA16) and enterovirus 71 (EV71). Other enteroviruses (CV-A2, -A4, -A5, -A6, -A8, -A9, -A10, -A12, -A16, -B3 and –B5) may also be associated with HFMD outbreaks, sporadic cases or asymptomatic infection. HFMD is a highly infectious disease, transmitted through direct contact with respiratory droplets, feces or blister fluid of infective patients or through contact with contaminated environments such as water, food or fomites. The clinical syndromes and severity of cases are diverse, but usually mild and self-limiting. Infants and children under 5 years old are commonly susceptible to the virus. The symptoms of HFMD include fever with blister like lesion or sores in the mouth, on hand, feet and sometimes on the buttocks. In some children with enteroviral disease, neurological complications may occur following a febrile illness but without mucocutaneous manifestations. Severe complications include encephalitis, pneumonia, myocarditis, brainstem encephalitis and acute flaccid paralysis. Epidemics of severe disease have caused great concern in SE and E Asia. High mortality and severe sequelae can be anticipated when the disease is complicated by neurogenic pulmonary edema. Children who have fever for more than three days with a temperature of 38.5°C and a history of lethargy might be at risk of neurological involvement. There are currently neither specific antiviral agents to treat nor vaccines to prevent the infection. Treating severe EV71 brainstem encephalitis patients with intravenous immunoglobulin is recommended by many experts but its efficacy is still doubtful. It is very important to establish a surveillance system to predict future outbreaks and to develop public health measures to control them. If there is an outbreak of HFMD in a school or child care center, classes with 2 or more sick children should be suspended. If there are sick children in many classes, the whole school is recommended to close for 5 to 7 days. During closure, those responsible for the school should ensure that thorough cleaning is carried out before reopening. In addition, parents are advised to ensure that their children adopt a high-standard of personal hygiene and to keep infected children at home until recovery. Copyright: ! 2012 Phommasone K and Dubot-Pérès A. This is an open-access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited