Effect of the consumption of natural products on some biochemical parameters of a type 2 diabetic population.

PURPOSE: The use of phytotherapy is common worldwide and especially in Algeria. This practice was transmitted orally and ritually to treat chronic diseases. Safe extracts of edible plants can provide a resource of structurally diverse molecules that can effectively interfere with multifactorial diseases, such as diabetes mellitus. The objective of this work is to study the biochemical parameters of diabetic populations who consume medicinal plants. METHODS: This study involved 100 T2D subjects, recruited over a five-month period via a questionnaire containing anthropometric information: sex, age, age of diabetes, type of diabetes, plants consumed. Recruited patients were recalled for further examination of the biochemical record (fasting glucose, glycated hemoglobin, total cholesterol, triglycerides, creatinine, ASL and ASP). RESULTS: We found that diabetic patient associated with prescribed medical treatment uses the medicinal plants. This use is strongly predominant by women in both populations with 76% of them using herbal medicine. 58% of diabetics under herbal medicine had slightly unbalanced diabetes with HbA1c > 7. The difference between the total cholesterol, ASL and ASP parameters of the two populations was not significant. The study of correlation showed that the consumption of plant had an effect on the type of correlation between biochemical parameters of diabetic patients. CONCLUSIONS: The consumption of medicinal plants did not affect the values of the measured biochemical parameters, while the correlation between these parameters can be modified.

Indonesian dengue burden estimates: review of evidence by an expert panel.

Routine, passive surveillance systems tend to underestimate the burden of communicable diseases such as dengue. When empirical methods are unavailable, complimentary opinion-based or extrapolative methods have been employed. Here, an expert Delphi panel estimated the proportion of dengue captured by the Indonesian surveillance system, and associated health system parameters. Following presentation of medical and epidemiological data and subsequent discussions, the panel made iterative estimates from which expansion factors (EF), the ratio of total:reported cases, were calculated. Panelists estimated that of all symptomatic Indonesian dengue episodes, 57·8% (95% confidence interval (CI) 46·6-59·8) enter healthcare facilities to seek treatment; 39·3% (95% CI 32·8-42·0) are diagnosed as dengue; and 20·3% (95% CI 16·1-24·3) are subsequently reported in the surveillance system. They estimated most hospitalizations occur in the public sector, while ~55% of ambulatory episodes are seen privately. These estimates gave an overall EF of 5·00; hospitalized EF of 1·66; and ambulatory EF of 34·01 which, when combined with passive surveillance data, equates to an annual average (2006-2015) of 612 005 dengue cases, and 183 297 hospitalizations. These estimates are lower than those published elsewhere, perhaps due to case definitions, local clinical perceptions and treatment-seeking behavior. These findings complement global burden estimates, support health economic analyses, and can be used to inform decision-making.

Introducing Vi polysaccharide typhoid fever vaccine to primary school children in North Jakarta, Indonesia, via an existent school-based vaccination platform.

OBJECTIVES: To report results on coverage, safety and logistics of a large-scale, school-based Vi polysaccharide immunization campaign in North Jakarta. METHODS: Of 443 primary schools in North Jakarta, Indonesia, 18 public schools were randomly selected for this study. Exclusion criteria were fever 37.5 degrees C or higher at the time of vaccination or a known history of hypersensitivity to any vaccine. Adverse events were monitored and recorded for 1 month after immunization. Because this was a pilot programme, resource use was tracked in detail. RESULTS: During the February 2004 vaccination campaign, 4828 students were immunized (91% of the target population); another 394 students (7%) were vaccinated during mop-up programmes. Informed consent was obtained for 98% of the target population. In all, 34 adverse events were reported, corresponding to seven events per 1000 doses injected; none was serious. The manufacturer recommended cold chain was maintained throughout the programme. CONCLUSIONS: This demonstration project in two sub-districts of North Jakarta shows that a large-scale, school-based typhoid fever Vi polysaccharide vaccination campaign is logistically feasible, safe and minimally disruptive to regular school activities, when used in the context of an existing successful immunization platform. The project had high parental acceptance. Nonetheless, policy-relevant questions still need to be answered before implementing a widespread Vi polysaccharide vaccine programme in Indonesia.

The technical procedure and the value of fine needle aspiration biopsy of the nasopharynx.

Malignant lesions in the nasopharynx are not infrequently missed by conventional endoscopic biopsy, even if repeated. To improve the diagnostic yield of nasopharyngeal examination, we have developed a technique for fine needle aspiration biopsy of the nasopharynx. Histological correlation was possible in 121 cases in which cytology was reported as malignant. Malignancy was confirmed in 92 cases. In the remaining 29 cases histological examination revealed only benign or atypical changes. However, all these patients had clinical evidence of a malignant growth in the nasopharynx, and 21 of them had, in addition, enlarged cervical nodes. Fine needle aspirates from these nodes showed malignant cells similar to those of the primary site. The failure to obtain representative biopsies for histology could be explained by the deep situation of tumors below the surface epithelium. We believe that fine needle aspiration is more useful and reliable than conventional surgical biopsy in the diagnosis of nasopharyngeal carcinoma and that it improves the diagnostic yield of endoscopic examination.

The costs of public primary health care services in rural Indonesia.

Described are the results of a cost study of national rural health services carried out in Indonesia between November 1986 and March 1987. Detailed costings of government inputs to all public health services below the district hospital level were made for 41 subdistricts in five provinces that were representative of the different regions of the country. The total costs of services as well as the average costs for specific service functions were estimated for the whole country as well as for the different provinces. The results indicate a low overall level of government spending on rural primary health care. Regional differences in this respect were not significant, suggesting that the government policy of encouraging regional balance in allocations has been successful. The average costs for most services were much greater than the charges made to patients, and this provided information on the current level of government subsidies. There was a large variability in the average costs, indicating that the existing system is inefficient, that some districts were able to attain much higher levels of efficiency than others within the existing constraints, and that improvements in this respect are possible.

PIP: Described are the results of a cost study of national rural health services carried out in Indonesia between November 1986-March 1987. Detailed costings of government inputs to all public health services below the district hospital level were made for 41 subdistricts in 5 provinces that were representative of the different regions of the country. The total costs of services as well as the average costs for specific service functions were estimated for the whole country as well as for the different provinces. The results indicate a low overall level of government spending on rural primary healthcare. Regional differences in this respect were not significant, suggesting that the government policy of encouraging regional balance in allocations has been successful. The average costs for most services were much greater than the charges made to patients, and this provided information on the current level of government subsidies. There was a large variability in the average costs, indicating that the existing system is inefficient, that some districts were able to attain much higher levels of efficiency than others within the existing constraints, and that improvements in this respect are possible. (author's)

The cost of public primary health care services in rural Indonesia

Described are the results of a cost study of national rural health services carried out in Indonesia between November 1986 and March 1987. Detailed costings of government inputs to all public health services below the district hospital level were made for 41 subdistricts in five provinces that were representative of the different regions of the country. The total costs of services as well as the average costs for specific service functions were estimated for the whole country as well as for the different provinces

The results indicate a low overal level of government spending on rural primary health care. Regional differences in this respect were not significant, suggesting that the government policy of encouraging regional balance in allocations has been successful. The average costs for most services were much greater that the charges made to patients, and this provided information on the current level of government subsidies. There was a large variability in the average costs, indicating that the existing system is inefficient, that some districts were able to attain much higher levels of efficiency than others within the existing constraints, and that improvements in this respect are possible(AU)