Low dose estrogen progestin pill is better than cyclical progestin as medical management of abnormal uterine bleeding due to ovulatory dysfunction in premenopausal women

Background: In abnormal uterine bleeding due to ovulation dysfunction, unopposed estrogen causes persistent proliferative or hyperplastic endometrium and periods of amenorrhea followed by excessive bleeding. This is managed medically by cyclical use of some hormonal agents. The aim of the study was to compare the effectiveness and acceptability of cyclical progestin alone and low dose estrogen progestin pill as medical management of AUB-O in premenopausal women.Methods: The study composed of 57 premenopausal women with anovular type of bleeding. The study participants were randomly allocated to take either norethisterone 10 mg daily from 16th to 25th day of menstrual cycle or low dose estrogen progesterone pill, one pill daily from 1st day of menstrual cycle up to 24th day. These patients were followed up after three and six months to assess subjectively the persistence of abnormal uterine bleeding, patient’s satisfaction, need for hysterectomy and any side effects.Results: The symptomatic improvement was more apparent with estrogen progestin pill than cyclical norethisterone. More patients chose hysterectomy in the norethisterone group because they were not satisfied with medical management.Conclusions: Symptomatic improvement is more with low dose estrogen progestin pill than cyclical norethisterone in women with AUB-O. More women decline hysterectomy as they accept estrogen progestin pill.

Knowledge, Attitude and Practice Towards Dengue Prevention Among Students at Tan Sri Mustaffa Babjee College, Universiti Putra Malaysia

@#Introduction: The aim of this study was to assess the level of knowledge, attitude, and practice towards dengue prevention among students at Tan Sri Mustaffa Babjee College, Universiti Putra Malaysia. Method: An analytical cross-sectional survey was performed with 214 respondents from Tan Sri Mustaffa Babjee College residents using a simple random sampling method. A self-administered validated questionnaire was distributed to respondents through student email and Whatsapp phone application. The acquired data was then analyzed using Statistical Package for Social Sciences Software (SPSS) Version 27. Results: The majority of the students had moderate knowledge (17.14 ± 2.510), attitude (30.69 ± 4.065) and practice (7.97 ± 2.224) towards dengue prevention. The year of study was the only sociodemographic characteristic that had a significant association with knowledge (χ2 = 18.288, P = 0.013), attitude (χ2 = 18.526, P = 0.010) and practice (χ2 = 19.194, P = 0.014) of dengue prevention, while the factor of the study programme (χ2 = 31.599, P = 0.002) were found to have significantly associated with the level of knowledge. Conclusion: There was a significant association between dengue prevention knowledge and practice (χ2 = 11.838, P = 0.019), but no significant association between knowledge and attitude, as well as practice and attitude. College management should organize and regularly implement the dengue control activities that focus on both preventive action and expanding awareness of dengue prevention to ensure lifetime action and effective methods in controlling dengue.

Benzodiazepines Refusal During Dispensing Process Among Patients Diagnosed With Depression or Schizophrenia in Malaysia

@#Introduction: Benzodiazepines (BZDs) are commonly prescribed to psychiatric patients. However, there have been few studies evaluating BZD refusal among patients with psychiatric disorders during the dispensing process. Thus, this study aimed to determine 1) the factors associated with BZD refusal during the dispensing process and to determine 2) the association between BZD refusal and psychiatric medication adherence among patients diagnosed with depression or schizophrenia. Method: This study was conducted at the Specialist Clinic Pharmacy, Jerantut Hospital, Malaysia, from May 2018 to June 2018. BZD refusal status was determined after the dispensing process, and general information on BZD was determined using a questionnaire developed by the researchers. Medication adherence was assessed using the Malaysian Medication Adherence Scale (MALMAS). Results: Overall, 75 patients with psychiatric disorders participate in the study. Participants had been on BZD treatment for a mean of 32.8± 21.6 months. The BZD refusal rate was 38.7%. BZD refusal was significantly associated with several factors. A one-year increase in age resulted in increased odds of BZD refusal by 1.16 times (95% CI 1.05-1.27). Other factors were male gender (OR,9.14; 95% CI, 1.17-71.27), being single (OR,15.07; 95% CI, 1.12-184.28), the diagnosis of schizophrenia (OR,13.45; 95% CI, 1.75-10.33) and not having history of illicit drug use (OR,20.63; 95% CI, 2.49-171.0). Medication adherence was not associated with BZD refusal. Conclusion: BZD refusal was significantly associated with demographic factors such as increased age, male gender and being single and diagnosis factors namely schizophrenia diagnosis and not having history of illicit substance use. Thus, the need for BZD in these groups of patients should be reviewed regularly.

Oral Health Knowledge among Healthcare Professionals and Their Challenges in Dealing with Patients’ Oral Health Problems (Pengetahuan Kesihatan Pergigian di Kalangan Pengamal Penjagaan Kesihatan Profesional dan Cabaran dalam Mengendalikan Masalah Pergigian Pesakit) / Jurnal Sains Kesihatan Malaysia

@#The important role of non-dental healthcare professionals (HCPs) in promoting oral health is well-accepted and has received increased attention in recent years. However, greater efforts are needed to train them in ensuring better competency in delivering this role. The aim of the present study is to assess oral health and care knowledge among HCPs by further exploring possible challenges faced by them in managing oral health problems, particularly in regard to patients in a public primary healthcare clinic. In the case of the current research, a focus group discussion was carried out with ten HCPs who are directly involved with patients from different units within the health clinics. In particular, the questions developed for the focus group discussion were divided into two parts: (1) knowledge on oral health and its link to general health, and (2) issues and challenges faced by HCPs in handling patients with oral health problems in their daily routine. The session was recorded on a digital audio tape, the responses were then transcribed, followed by the grouping of the scripts which were then qualitatively analysed. The results revealed that majority of the participants appeared to have good knowledge of general and basic oral health; however, only very few of them were aware of the relationship between oral health problems with systemic conditions. Meanwhile, one of the main challenges faced by HCPs in handling patients with oral health problems is their limited knowledge of oral health problems. Specifically, the main challenges refer to the management of medically compromised patient requiring dental treatment as well as the difficulty in changing the mindset of patients regarding oral health issues, especially in terms of seeking dental treatment. In conclusion, it has been clearly observed that HCPs involved in the present study have good knowledge of general health and oral health but limited knowledge related to oral health to systemic health. Furthermore, they tend to face numerous challenges when dealing with patients, especially due to their limited knowledge of oral health facts and drug prescription for oral problems. Therefore, there is an urgent need of additional training for both HCPs and dental teams for the purpose of enabling both parties to provide coordinated and comprehensive service to patients with oral health problems at the primary healthcare clinics.

Percutaneous Cement Vertebroplasty & Kyphoplasty: A Minimally Invasive Solution for Osteoporotic Vertebral Fracture

Introduction: Osteoporotic fracture is common among theelderly people. It occurs following minor trauma like slipping onthe floor or due to jolt while travelling in a vehicle on an unevenroad. It is usually associated with severe crippling local painwhich aggravates on movement, sitting or standing.Objective: Our goal in this study is to find out the outcome ofpercutaneous cement vertebroplasty & kyphoplasty forosteoporotic vertebral fracture.Methodology: This cross sectional study was carried out atDepartment of Neurosurgery, BMSSU, Dhaka from January2017 to June 2018 where 28 patients data were evaluated onthe basis of their history, clinical examination. Among thecases Per. Vertebroplasty was 23 and Balloon kyphoplastywas 5. 60% patients were female and 40% patients were male.The entered data were cross-checked and confirmed.Results: Percutaneous vertebroplasty is a minimally invasiveprocedure with very good results for the treatment of severepain due to vertebral compression fracture. It providessignificant pain relief with the potential for improving functionaloutcome.Conclusion: Percutaneous vertebroplasty and balloonkyphoplasty not only relives pain instantly but can also restorevertebral height.

Knowledge, Attitude, Exposure, and Future Intentions toward Exclusive Breastfeeding among Universiti Sains Malaysia Final Year Medical and Dental Students / 가정의학회지

BACKGROUND: Breastmilk is the best nourishment for an infant for the first 6 months of life. Health professionals like medical doctors and dentists can help promote and support exclusive breastfeeding. We aimed to assess knowledge, attitudes, exposure, and future intentions toward exclusive breastfeeding among final year medical and dental students at Universiti Sains Malaysia, Kelantan, Malaysia. METHODS: A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest. RESULTS: Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding. CONCLUSION: Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.

Effects of carbon source and additives on biomass, exopolysaccharide production and morphology of Pleurotus ostreatus in submerged cultivation

Aims@#To investigate the influence of carbon sources and additives/surfactants on the mycelium growth and exopolysaccharides (EPS) production, including the morphology during submerged cultivation of Pleurotus ostreatus in the minimal-medium as the base medium. @*Methodology and results@#Pleurotus ostreatus was cultivated in different types of carbon sources to investigate the effects of carbon sources to mycelium growth and changes of mycelium morphology which directly affects the synthesis of EPS. In addition, additives or surfactants can increase the bioavailability of less soluble substrates in the cultured medium for the mycelium growth and indirectly affects the EPS production. In this study, the cultivation of P. ostreatus in the minimal-medium by using glucose as the carbon source with the addition of lecithin at 1% (w/v) gave the highest EPS production 4.53 ± 0.30 g/L, an increase of about 89.53% when compared to the cultivation without the addition of lecithin. Addition of lecithin changes morphology of the pellets outer layer and under microscope showing a dense hyphal network surrounding the pellets with the sizes of micro pellets almost 0.5-1.5 mm which contributed to the increase of EPS production after 14 days cultivation at 26 °C @*Conclusion, significance and impact of study@#The choice of the carbon source should not only be for high productivity rate of mycelium growth and EPS production, but a cheaper alternative source should also be considered. In conclusion, high mycelium biomass and EPS production was achieved either by changes of the morphology through the type of carbon source and addition of additives such as lecithin.

Virtual screening for potential COX-inhibiting constituents from Mimosa pudica.

Developing a new agent in the anti-inflammatory and analgesic field, plants secondary metabolites can be a good source for the Non-Steroidal Anti-inflammatory Drugs (NSAID) drug development. For this purpose we subjected the active compounds of Mimosa pudica Linn. to reveal its potentiality by molecular docking analysis to find out its potent compound against COX which was done by GOLD docking analysis. Docking studies by GOLD showed that vitexin of Mimosa pudica had the highest fitness score against the COX-1 which is 60.43 and 63.49 for COX-2 enzyme. Vitexin of Mimosa pudica detected with significant fitness score and hydrogen bonding against COX-1 and COX-2 which may be a potent analgesic compound.

Características de los ensayos controlados y aleatorizados pediátricos en países no industrializados / Characteristics of pediatric randomized drug trials in developing countries

Los ensayos controlados y aleatorizados y la investigación en general deberían correlacionarse mejor con las necesidades de salud de los niños a nivel mundial.

Monitoring Antimicrobial Susceptibility of Neisseria gonorrhoeae Isolated from Bangladesh during 1997-2006: Emergence and Pattern of Drug-resistant Isolates.

Gonorrhoea is one of the most common sexually transmitted infections (STIs) in developing countries, and the emergence of resistance to antimicrobial agents in Neisseria gonorrhoeae is a major obstacle in the control of gonorrhoea. Periodical monitoring of antimicrobial susceptibility of N. gonorrhoeae is essential for the early detection of emergence of drug resistance. In total, 1,767 gonococcal strains isolated from males and females (general population and those with high-risk behaviour) from different parts of Bangladesh were studied during 1997-2006. Minimum inhibitory concentrations of penicillin, tetracycline, ciprofloxacin, ceftriaxone, spectinomycin, and azithromycin for the isolates were determined by the agar dilution method. Isolates resistant to three or more antimicrobial agents are considered multidrug-resistant. The prevalence of plasmid-mediated penicillinase-producing N. gonorrhoeae (PPNG) and plasmid-mediated tetracycline-resistant N. gonorrhoeae (TRNG) was determined. Nine percent of the isolates were resistant to ciprofloxacin in 1997 compared to 87% in 2006. Multidrug-resistant N. gonorrhoeae have emerged in 1997, and 44% of the strains (n=66) isolated during 2006 were multidrug-resistant. Forty-two percent of the isolates in 2006 were both PPNG- and TRNG-positive compared to none in 1997. The rapidly-changing pattern of gonococcal antimicrobial susceptibility warrants the need for an antimicrobial susceptibilitymonitoring programme, and periodical analysis and dissemination of susceptibility data are essential to guide clinicians and for successful STI/HIV intervention programmes.

Antagonism of levcromakalim by glibenclamide [glyburide] in the uterus of rat in vitro

This study was conducted in the department of Pharmacology, Shaikh Zayed, Post Graduate Medical Institute, Lahore. In the present study the Antagonistic [Inhibitory] effect of Glibenclamide [Glyburide] an oral anti-hyperglycemic agent, on relaxant effect of Levcromakalim [a Potassium Channel Opener] on the non Pregnant isolated rat uterus was studied. Twenty Five albino rats [Sprague Dawley Strain] were sacrificed. The rats were injected with diethyl stilbestrol [estrogen] intra muscularly, 24 hours before the experiments to facilitate the contractile effect of oxytocin on isolated rat uterus. The dose of oxytocin [Mean +/- SEM] 4.360 +/- 0.644ng was required to produce sub-maximial contraction of the uterus. The dose of Levcromakalim [Mean +/- SEM] 3.041 +/- 0.364ug was required to decrease / inhibit 50% contraction of uterus induced by oxytocin. In the presence of Glibenclamide, the dose of Levcromakalim was required [Mean +/- SEM] 7.41 +/- 0.834ug [<0.05] to reduce 50% contraction of the uterus produced by oxytocin

immune response of chickens vaccinated with live and killed nd vaccines

Immune response of chicken, vaccinated with live and killed ND vaccines, was studied. The HI titre of chicks, one weeks post vaccination with killed vaccine, were found to be stimulated. Two weeks after booster dose however, the HI titres were generally low for live vaccines as compared to the killed vaccine. The chicks vaccinated with killed ND vaccine demonstrated higher resistance to intraoccular challenge. The protection rate later decreased and was more or less the same in all the chicks vaccinated with either live or killed vaccines. All the control chicks were found to be free from ND antibodies and there was100% mortality in them after challenge. The over all results indicated killed ND vaccines to be more protective

Factors affecting the maximum yield of non protein nitrogen from skeletal muscles

Attempt was made to study the factors that affect maximum yield of nonprotein nitrogen from various skeletal muscles. The results showed that sonification was the most effective method out of the various extraction procedures used for the extraction of NPN, while the use of tungstic acid as protein precipitant was most suitable. The pH studies showed that pH 2 gave the optimal yield of NPN. Results of the coloured sample dilutions showed exponential relationship between optical densities and the concentrations of NPN used. The results are discussed in terms of the factors affecting maximum yield of NPN along with the significance of the term half optical density dilution

Independence of force velocity relationship of skeletal muscles to denervation at higher temperatures

Effect of chronic denervation and temperature was studied on the force velocity relationship of rat diaphragm muscle. The muscles were denervated for 15 - 20 days and force of contraction and velocity of shortening were calculated according to Hill [1938] using isotonic contraction data. The results showed that the force velocity relationships were not altered at 35°C to 25°C. However, a change in this parameter was observed in the denervated muscles at 15°C. It is suggested that the velocity of shortening is independent of changes in the series elasticity of the denervated muscle at higher temperatures