Spatial and Temporal Distributions Pattern of Dengue Fever Cases: A Ten Years Trends in Kuantan, Pahang

@#Introduction: Dengue fever (DF) is a prominent vector-borne disease spread by mosquitos of the Aedes genus (mainly Aedes aegypti, and even Aedes albopictus), a tropical regions vector. The purpose of this research was to establish the spatial and temporal distribution patterns of DF cases in the study area between 2010 and 2020. Methods: The correlation between the Kuantan sub-district and dengue haemorrhagic fever (DHF) incidence is examined in this study using spatial analysis. The correlation was calculated using spatial autocorrelation, Moran’s Index (Moran’s I) and Spatial Autocorrelation of Local Indicators (LISA). Moran’s index is a worldwide indicator used to determine whether or not disease transmission has geographical autocorrelation in disease transmission. Results: The results indicated that between 2011 and 2020, the monthly Moran’s I of dengue transmission in Kuantan was estimated to range between -0.685 and 0.338. The lowest reading of Moran’s index was -0.685 in May 2015, whereas the highest reading was 0.338 in May 2019. This reflects the strong spatial autocorrelation of dengue transmission in Kuantan over the last decade. The LISA analysis revealed significant spatial autocorrelations on DF cases in Kuantan for three (3) out of six (6) sub-districts (50%) with a significance level of 2%. This suggests that there are spatial autocorrelations in Kuala Kuantan, Beserah and Penor sub-district that influence the distribution of DHF transmission. Conclusion: The results reveal that the spatial autocorrelation analysis method can be a tool for relevant researchers to understand the pattern of DF transmission study and establish the direction for further study.

Detección de Klebsiella pneumoniae productora de carbapenemasa en un hospital del norte del Perú / Detection of carbapenemase-producing Klebsiella pneumoniae in a hospital in northern Peru

Objetivo. Comunicar el primer reporte de Klebsiella pneumoniae productora de carbapenemasas. El estudio: Diagnóstico microbiológico empleando métodos fenotípicos: sinergia del doble disco, Test de Hodge modificado, inmunocromatografia y la inactivación del carbapenémico. Hallazgos: Se confirmaron cuatro aislamientos (orinas 3 y sangre 1) de K. pneumoniae productoras de carbapenemasas que además presentaron una CMI de 4 y > = 8 para el ertapenem y > = 16 µg/mL a imipenem y meropenem. Conclusiones: los métodos fenotípicos estandarizados son de utilidad en la confirmación de carbapenemasas y con ello una alternativa para la mejor toma de opciones terapéuticas y vigilancia epidemiológica

Objetive. Communicate the first report of Klebsiella pneumoniae producing carbapenemases. The study: Microbiological diagnosis using phenotypic methods: d o u b l e d i s c s y n e r g y, m o d i f i e d H o d g e t e s t , i m m u n o c h r o m a t o g r a p h y a n d c a r b a p e n e m i c inactivation. Findings: Four isolates (urine 3 and blood 1) of carbapenemase-producing K. pneumoniae were confirmed, which also presented a MIC of 4 and> = 8 for ertapenem and> = 16 µg / mL at imipenem and meropenem. Conclusion: Standardized phenotypic m e t h o d s a r e u s e f u l i n t h e c o n f i r m a t i o n o f carbapenemases and with it an alternative for the best taking of therapeutic options and epidemiological surveillance

Potasio elevado, sin T picuda / High pot but no T

Introducción. La identificación y el tratamiento de pacientes con hiperpotasemia son necesarios para prevenir el desarrollo de arritmias. La pseudohiperpotasemia se debe más comúnmente a la hemólisis de la muestra y a menudo es reconocida por los laboratoristas que posteriormente informan los resultados de las pruebas con advertencias de precaución. Los autores presentan un caso de pseudohiperpotasemia en un paciente con leucemia linfocítica crónica. Reporte de caso: los factores técnicos y el método de transporte son una causa potencial de pseudohiperpotasemia. La pseudohiperpotasemia se ha asociado también con hiperleucoctosis, en poblaciones de pacientes con cáncer, más comúnmente en Leucemia linfocítica crónica en adultos, pero también con leucemia linfoblástica aguda en niños. Esto pone al paciente en riesgo de tratamientos innecesarios y potencialmente peligrosos. Conclusión: Los médicos deben considerar la pseudohiperpotasemia como la causa subyacente de los niveles elevados de potasio en pacientes con leucocitosis maligna que no presentan signos o síntomas de hiperpotasemia sistémica.

Introduction. The identification and treatment of patients with hyperkalemia is necessary to prevent the development of arrhythmias. Pseudohyperkalemia is most commonly due to specimen haemolysis and is often recognised by laboratory scientists who subsequently report test results with cautionary warnings. The authors present a case of pseudohyperkalemia in a patient with chronic lymphocytic leukaemia. Report case: the technical factors and method of transport are a potential cause of pseudohyperkalemia. Pseudohyperkalemia has been associated with hyperleukoctosis, in cancer patient populations, more commonly in CLL in adults, but also acute lymphoblastics leukemia in children. This places the patient at risk of unnecessary and potentially dangerous treatments. Conclusion: Physicians should consider pseudohyperkalemia as the underlying cause of elevated potassium levels in patients with malignant leucocytosis who do not have signs or symptom of systemic hyperkalemia.

Serie de Redacción Científica: Estudio de Cohortes / Scientific Writing Series: Cohort studies

Objetivo. El estudio de cohortes es un diseño de tipo observacional. Este diseño solo incluye participantes que tienen el mismo riesgo de estar expuestos, para luego comparar quienes de los expuestos y no expuestos presentarán el desenlace de interés durante el mismo periodo de tiempo. La temporalidad entre la exposición y el resultado de interés en un estudio de cohorte está bien definida porque se tiene certeza de que la exposición antecede al resultado de interés. Los estudios de cohorte pueden ser prospectivos, retrospectivos o una combinación de ambos. Una de las principales ventajas es su naturaleza longitudinal, lo que permiten estimar la incidencia y el riesgo relativo como asociación de interés. Algunas variables pueden variar en el tiempo por lo que es importante, utilizar técnicas de modelamiento de datos avanzados como los modelos de efectos fijos y aleatorios

Objetive. The cohort study is an observational design. This only includes participants who have the same risk of being exposed, then compares who is exposed and unexposed presents the outcome of interest during the same period. The temporality between the exposure and the outcome of interest in a cohort study is well defined because it is certain that the exposure antecedent to the outcome of interest. Cohort studies can be prospective, retrospective, or a combination of both. One of the main advantages is its longitudinal nature, making it possible to estimate the incidence and relative risk as an association of interest. Some variables may vary over time, so it is essential to use advanced data modeling techniques such as fixed and random effects models.

Bienestar espiritual de adultos jóvenes del municipio Libertador San Martin, Entre Ríos, Argentina / Spiritual welfare of young adults of the municipality Libertador San Martin, Entre Ríos, Argentina / Bem - estar espiritual dos adultos jovens no município Libertador San Martin, Entre Ríos, Argentina

O b j e t i v o: d e s c r i b i r e l b i e ne s t a r e s p i r i t u a l d e l o s a d u l t o s j ó v e ne s d e l m u n i c i p i o d e L i b e r t a d o r S a n M a r t í n , P r o vi n c i a d e E nt re Rí o s ( A r g e nt i n a ) . M ét o d o : s e u t i l i z ó l a e s c a l a d e b i e ne s t a r e s p i r i t u a l J A R E L , co m p u e s t a p o r 2 1 p reg u nta s e i nt eg r a d a p o r t res f a c t o res : F e y c re e n c i a s re l igi o s a s , V id a y a u t o r res p o n s a b i l id a d , y S a t i s f a cc i ón co n l a v i d a . S e e n c u e s t a r o n a 250 personas entre 20 y 40 años. Resultados: la mayoría de la población encuestada pertenecía al sexo femenino (62 %), era menor de 30 años (65 %) y soltera (57 %) con estudios universitarios en curso (50 %). Se encontró que la creencia en un ser superior hacía p a r t e d e l a e s p i r i t u a l i d a d e n un 8 7 , 6 % d e l o s e n c u e s t a d o s ; a s u v ez , e l 9 6 , 4 % refirió tener algún grado d e s a t i s f a cc i ón co n s u v i d a y e l 9 5 , 2 % , e l a c e p t a r f á c i lm e n t e l a s s i t u a c i o ne s pr o bl e má t i c a s . C o n c l u s ió n : las características principales del bienestar espiritual de los adultos jóvenes son la creencia en un p o d e r s u p e r i o r y l a c a p a c i d a d d e r e c i b i r y d a r a m o r , s i e n d o l a s e s f e r a s d e l o s f a c t o r e s co n m e j o r e v a l u a c i ón . E l f a c t o r m e j o r p e r c i b i d o f u e S a t i s f a cc i ó n co n l a v i d a , y s e i d e n t i f i c a r o n m a y o r e s n i v e l e s d e b i e ne s t a r e s p i r i t u a l e n l o s p a r t i c i p a n t e s d e má s d e 3 0 a ñ o s , e x t r a n j e r o s , co n h i j o s , q u i e ne s co n v i v í a n co n a m ig o s y f a m i l i a r e s , y o s t e n t a b a n e s t u d i o s un i v e r s i t a r i o s . E s e v i d e n t e q u e l a e s p i r i t u a l i d a d e s una característica esencial del cuidado de enfermería y se sugiere realizar estudios que indaguen y establezcan la existencia o no del nivel de bienestar espiritual con las conductas de autocuidado y los p a t r o ne s d e a f r o n t a m i e n t o d e l o s pr o bl e m a s e n l a p o bl a c i ón a d u l t a .

to desc ri be the spiritual well - being of young adults in the muni ci pality of Li bertador San M a r t í n , P r o v i n c e o f E nt r e R í o s ( A r g e n t i n a ) . M e t h o d : t h e J A R E L S p i r i t u a l W e l l b e i n g S c a l e w a s u s e d , w h i c h i s c o m p o s e d o f t w e n t y - o n e i t e m s a n d t h r e e f a c t o r s : F a i t h a n d r e l i g i o u s b e l i e f s , L i f e a n d s e l f - r e s p o n s i b i l i t y a n d S a t i s f a c t i o n w i t h l i f e . 2 5 0 p e o p l e b e t w e e n t w e n t y a n d f o r t y - y e a r s o l d w e r e s u r v e y e d . R e s u l t s : t h e p o p u l a t i o n s u r v e y e d w e r e m o s t l y w o m e n ( 6 2 % ) , u n d e r 3 0 ( 6 5 % ) , s i n g l e ( 5 7 % ) a n d w i t h u n i v e r s i t y s t u d i e s i n p r o g r e s s ( 5 0 % ) . I t w a s f o u n d t h a t t h e b e l i e f i n a s u p e r i o r b e i n g w a s p a r t o f t h e s p i r i t u a l i t y o f 8 7 . 6 % o f p e o p l e s u r v e y e d ; i n t u r n , 9 6 . 4 % r e p o r t e d h a v i n g s o m e d e g r e e o f s a t i s f a c t i o n w i t h t h e i r l i v e s a n d 9 5 . 2 % r e p o r t e d e a s i l y a c c e p t i n g p r o b l e m a t i c s i t u a t i o n s i n t h e i r l i v e s . C o n c l u s i o n : T h e m a i n c ha r a c t e r i s t i c s o f the spiritual well - being of young adults are belief in a higher power and the capacity to receive and g i v e l o v e , b e i n g t h e s p h e r e s o f t h e f a c t o r s w i t h t h e b e s t e v a l u a t i o n . T h e b e s t p e r c e i v e d f a c t o r w a s S a t i s f a c t i o n w i t h l i f e , a n d h ig h e r l e v e l s o f s p i r i t u a l w e l l - b e i n g w e r e i d e n t i f i e d i n t h o s e o v e r 3 0 y e a r s o l d , f o r e i g n e r s , w i t h c h i l d r e n , w h o l i v e w i t h f r i e n d s a n d f a m i l y , a n d i n t h o s e w h o h o l d u n i v e r s i t y s t u d i e s . I t is evident that spirituality is an essential c harac teris tic of nurs ing care and it is suggested to conduc t studies in the adult popul ati on that investigate and establish the level of spiritual well - being with self - c a r e b e h a v i o r s , a n d p a t t e r n s o f c o p i n g w i t h p r o b l e m s

O b j e t i v o: d e s c r e v e r o b e m - e s t a r e s p i r i t u a l d e j o v e n s a d u l t o s n o m un i c í p i o d e L i b e r t a d o r S a n M a r t í n , n a P r o ví n c i a d e E nt re Rí o s , n a A r g e nt i n a . M ét o d o : t r a ta - s e d e u m es t u d o d e a n ál i s e q u a nt i ta t i v a t r a n s v e r s a l . F o i u t i l i z a d a a E s c a l a d e " b e m - e s t a r e s p i r i t u a l J A R E L " , co m p o s t a d e 2 1 p e r g un t a s a b r a n g e n d o t r ê s f a t o r e s : a f é e c r e n ç a s r e l igi o s a s , v i d a e a u t o r e s p o n s a b i l i d a d e , e s a t i s f a ç ã o co m a v i d a . A e s c a l a foi aplicada em 250 pessoas com idades entre 20 e 40 anos. Resultados: a maioria dos participantes e r a m d o g ê ne r o f e m i n i n o ( 6 2 % ) , m e n o r e s d e 3 0 a n o s ( 6 5 % ) , s o l t e i r o s ( 5 7 % ) e co m e s t u d o s un i v e r s i t á r i o s e m a n d a m e n t o ( 5 0 % ) . V e r i f i co u - s e q u e a c r e n ç a e m u m s e r s u p e r i o r f a z i a p a r t e d a e s p i r i t u a l i d a d e e m 8 7 , 6 % d o s p a r t i c i p a n t e s ; p o r s u a v ez , 9 6 , 4 % d e l e s r e l a t a r a m t e r a l g u m g r a u d e s a t i s f a ç ã o co m a v i d a e 9 5 , 2 % , a c e i t a m f a c i lm e n t e a s s i t u a ç õ e s d i f í c e i s . C o n c l u s ã o: a s pr i n c i p a i s c a r a c t e r í s t i c a s d o b e m - e s t a r espiritual dos participantes são a crença em um poder superior e na capacidade de receber e dar a m o r , s e n d o e s t e s o s a s p e c t o s co m m e l h o r a v a l i a ç ã o . O m e l h o r f a t o r p e r c e b i d o f o i a s a t i s f a ç ã o co m v i d a . O s n í v e i s m a i s a l t o s d e b e m - e s t a r e s p i r i t u a l f o r a m i d e n t i f i c a d o s n o s p a r t i c i p a n t e s co m m a i s d e 3 0 a n o s d e i d a d e , e s t r a n g e i r o s , co m f i l h o s , p a r t i c i p a n t e s q u e m o r a v a m co m a m ig o s e f a m i l i a r e s e co m e s t u d o s un i v e r s i t á r i o s . D e s v e l a - s e n o e s t u d o q u e a e s p i r i t u a l i d a d e é u m a c a r a c t e r í s t i c a e ss e n c i a l d o c u i d a d o d e e n f e r m a g e m . S u g e r e - s e a r e a l i z a ç ã o d e o u t r o s e s t u d o s q u e a b r a n j a m a e x i s t ê n c i a o u n ã o d o n í v e l d e b e m - e s t a r e s p i r i t u a l , s u a r e l a ç ã o co m o s co m p o r t a m e n t o s d e a u t oc u i d a d o e o s p a d r õ e s d e e n f r e n t a m e n t o d e pr o bl e m a s n a p o p u l a ç ã o a d u l t a

Expression of Ki67 and CerbB-2 in Gall Bladder, Oesophageal, Small Intestinal and Colorectal Adenocarcinomas: A Study from a Tertiary Care Hospital in Western U.P.

Introduction: Gall bladder cancer is the commonestbiliary tract malignancy with poor prognosis. Oesophagealadenocarcinomas are aggressive with very poor survival.Adenocarcinomas of small intestine are rare, in comparisonto colorectal carcinomas. We studied the expression of twocommonly studied immunohistochemical markers Ki67 andCerbB-2 in gall bladder and gastrointestinal carcinomas, tofind out their prognostic significance.Material and Methods: Histopathologically confirmed casesof adenocarcinomas of gall bladder (19 cases), oesophagus(3 cases), small intestine (3 cases) and colorectal region (8cases) were included. Formalin fixed paraffin embeddedtissue blocks were retrieved and sections were studiedimmunohistochemically for expression of Ki67 and CerbB-2.Tumors of all stages and grades were studied.Results: Our study revealed a significantly high Ki67in neoplastic glands of gall bladder, oesophageal, smallintestinal and colorectal adenocarcinomas as comparedto the non neoplastic areas. The Ki67 labelling index washigher in moderately and poorly differentiated areas as wellas mucinous and signet ring type adenocarcinomas. Therewas no relation with stage/depth of tumor invasion. CerbB-2was significantly overexpressed in gall bladder and colorectaladenocarcinomas. Expression was higher in advanced stageand greater depth of invasion. There was no associationwith tumor grade or type. In esophageal and small intestineadenocarcinomas, expression was not related to either tumorstage or grade.Conclusion: A panel of Ki67 and CerbB-2 in gastrointestinaland biliary tract malignancies may correlate well with differentprognostic indicators in these malignancies, like tumor stage,histologic type and grade.

Spatial analysis of the distribution of reported dengue incidence in the National Capital Region, Philippines

@#<p style="text-align: justify;"><strong>BACKGROUND AND OBJECTIVE:</strong> With an aim of developing an effective disease monitoring and surveillance of dengue fever, this study intends to analyze the spatial distribution of dengue incidences in the National Capital Region (NCR), across four years of reported dengue cases.<br /><strong>MATERIALS AND METHODS:</strong> Data used was provided by the Department of Health (DOH) consisting of all reported dengue cases in NCR from 2010-2013. For mapping and visualization, a shapefile of NCR was made readily available by www.philgis.org. Both Moran's I and Kulldorff's spatial scan statistics (SaTScan) were used to identify clusters across the same time period.<br /><strong>RESULTS AND CONCLUSION:</strong> The analyses identified significant clustering of dengue incidence and revealed that the northern cities of NCR, such as Caloocan, Malabon, Navotas and Valenzuela, exhibited high spatial autocorrelation using local Moran's I and Kulldorff's SaTScan. A temporal analysis of the results also suggested movement in increased dengue incidence through time, from the northwest cities to the northeast cities. Presence of spatial autocorrelation in dengue incidence suggests possible enhancements of early detection schemes for dengue surveillance. Moreover, the results of these analyses will be of interest to both policymakers and health experts in providing a basis for which they can properly allocate resources for the prevention and treatment of dengue fever.</p>

Studies on genetic diversity for grain yield and physiological parameters in maize (Zea mays L.).

The D2 statistics is useful tool to assess genetic diversity among genotypes. It also provides qualitative measures of association between geographical and genetic diversity based on generalized distances. In the present study data on forty nine genotypes were subjected to D2 analysis, which revealed the presence of substantial amount of genetic variability among them. The pattern of distribution of genotypes into various clusters was random, suggesting that geographical and genetic diversity were not related. The experimental material was partitioned into eight clusters. Flag leaf area per plant contributed maximum towards genetic diversity followed by days to 50 per cent tasseling.

Effect of different musical tempo on post-exercise recovery in young adults.

The role of music in increasing the exercise performance is well recognised. There is very little information about effect of music on time taken for post exercise recovery. We examined the effect of music and different musical tempo on post exercise recovery time, following treadmill work. 30 volunteers (15 male, 15 female) subjected to isotonic exercise (submaximal treadmill work) on three consecutive days. They were allowed to rest in silence on the first day, rest by hearing slow music on second day and rest with fast music on third day. Parameters such as Pulse rate, blood pressure, rating of perceived exertion (RPE) were measured at predetermined intervals. Repeated measures ANOVA test showed that with slow music, recovery time of systolic blood pressure (SBP) (7.9±2.5), diastolic blood pressure (DBP) (5.5±3.4) pulse rate recovery (PR) (8.0±2.3) and recovery from exertion (RPE) (7.7±2.5) were significantly faster when compared to both no music and fast music. The individual music preference made no significant difference in the relaxation time. The study concluded that music hastens post exercise recovery and slow music has greater relaxation effect than fast or no music, recovery time being independent of the gender and individual music preference.

Challenge of Personalized Medicine in the Genomic Era

"Personalized medicine," the goal of which is to provide better clinical care by applying patient's own genomic information to their health care is a global challenge for the 21st century "genomic era." This is especially true in Korea, where provisions for clinical genetic services are inadequate for the existing demand, let alone future demands. Genomics-based knowledge and tools make it possible to approach each patient as a unique biological individual, which has led to a paradigm-shift in medical practice, giving it more of a predictive focus as compared with current treatment oriented approach. With recent advancements in genomics, many genetic tests, such as susceptibility genetic tests, have been developed for both rare single gene diseases and more common multifactorial diseases. Indeed, genetic tests for presymtomatic individuals and genetic tests for drug response have become widely available, and personalized medicine will face the challenge of assisting patients who use such tests to make appropriate and wise use of genetic risk assessment. A major challenge of genomic medicine lies in understanding and communicating disease risk in order to facilitate and support patients and their families in making informed decisions. Establishment of a health care system with provisions for genetic counseling as an integral part of health care service, in addition to genomic literacy of health care providers, is vital to meet this growing challenge. Realization of the promise of personalized medicine in the era of genomics for improvement of health care is dependent on further development of next generation sequencing technology and affordable sequencing test costs. Also necessary will be policy development concerning the ethical, legal and social issues of genomic medicine and an educated and ready medical community with clinical practice guidelines for genetic counseling and genetic testing.

Clinical Results of Segmental spinal instrumentation in Unstable Fracture and Fracture / 대한정형외과학회잡지

Segmental Spinal Instrumentation (S.S.I.) is considered to the effective operative procedure in unstable fracture and fracture-dislocation of the thoracolumbar spine, providing improved correction effect, high rate of fusion and immediate rigid fixation which obviates the need for postoperative immobilization. Retrospective study was carried out of 24 cases of fracture or fracture-dislication of the thoracolumbar spine, There were treated with Harrington rod instrumentation and sublaminar wiring (8 cases) and Luque rod instrumentatiom and sublaminar wiring (16 cases) in Soonchnhyang University, from January 1986 to June 1988. We have analyzed the results of treatment, which were as follows ; 1. Thoracolumbar junction (T12 Ll) was most commomly involved segment (63%) and falling from a height was most common cause of injuries. 2. The most common type by Denis classification was burst fracture (38%). 3. About improvement of neurologic status by injury site and type of instrumentation, thoracolumbar junction (38.5%) and lumbar spine (35%) were better prognosis than thoracic spine (8.75%). 4. In commparison with kyphotic deformity and displacement, Harrington rod (66.4%) was better than Luque rod (58.9%) in postoperative correction. Also in total correction, Harrington rod was better than Luque rod in spite of more or less large amount of loss of correction. words : Thoracolumbar spine, Unstable fracture-dislocation, Segmental spinal instrumentation (S.S.I.)

Segmental Spinal Instrumentation in the Management of Fracture and Fracture-Dislocation of the Thoraco-Lumbar Spine / 대한정형외과학회잡지

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.

The Effect of Acupuncture and Mobilization on Lumbago / 全日本鍼灸学会雑誌

Joint mobilization (i. e. intracapsular passive exercise) is now attracting clinicians' attention as manipulative therapy for pain of intervertebral joint disorder.<br>In the present paper, introducing a part of a mobilization technique for the lumbar and sacroiliac joint and our mobilization evaluating method, we report a comparative study on the efficacy of acupuncture and mobilization therapy using our “lumbago evaluation chart”.<br>METHOD<br>Fifteen lumbago outpatients (6 males and 9 females with average age of 41.6±16.28 years) of our physiotherapy department, who showed no remarkable radiographic changes, were divided into three groups: Acupucnture alone, mobilization alone, and both acupuncture and mobilization were, performed for A, B, and C group respectively. Their responses were compared on the evaluation chart.<br>The patients were asked to rate the severity of pain and disability on a four grade basis. Five movements were chosen from A. D. L. and the results were rated as “easy”, “difficult” and “impossible”. The following were measured for lumbar flexibility: the distance between the finger-tip and the floor; the maximum backward bending of the upper body; S. L. R.; the distance between the S₁ and an upper point on the skin (10cm in an erect posture) at the maximal flexion the distance between the top of the iliac crest and an upper point (10cm in an erect posture) at the maximal lateral flexion.<br>Tenderness was measured with an algesiometer (maximum 10kg). CHILLS were rated on a three-grade basis. All the measured values were rated so that the maximum number of the total points in the evaluation chart was 100. Another chart (a mobilization test chart) was made, in which the severity of STIFFNESS and PAIN was rated on the following basis: None=0, Minimal=1, Severe=2, and the maximum total was 50.<br>RESULT<br>1) As for the score of “TENDERNESS and CHILLS”, C group was significantly different from both A and B group at 10% level by t-test. As for the total score, C group was significatly different from A and B group at the 0.5% level.<br>2) C group showed high rated improvement in the score of “PAIN”, “TENDERNESS”, and “STIFFNESS” after treatment.<br>3) Tenderness was often detected at VU₅₂ Zhishi and VU₄₀ Weizhong, and lumbar vertebrae stiffness was often seen in the lower part.<br>CONCLUSION<br>1) An evaluation chart for lumbago was developed to rate the symptoms.<br>2) Lumbago pationts without remarkable x-ray findings underwent acupuncture alone, mobilization alone, or both acupuncture and mobilization. The score of the evaluation chart has shown that combined use of acupuncture and mobilization is more effective than solitary use of each therapy in relieving pain.