ABSTRACT
An audit on diabetic management was done in seven Perak general practice (GP) clinics in December 2001. The results showed inadequacies in nine out of eleven criteria assessed. Remedial measures were implemented. A second audit in March 2003, at the completion of the audit cycle, showed improvements in all the criteria used. All clinics established a diabetic register compared to 28.6% in the first audit and 57.1% of the clinics set up a reminder mechanism compared to 0% in the first audit. In the process of care, recording of weight, height, blood pressure; feet examination, fundoscopy, blood sugar monitoring and urine for albumin improved at the end of the audit cycle. In the only outcome criteria, the blood sugar control improved from 21.8% to 31.3%.
Subject(s)
Diabetes Mellitus/therapy , Family Practice/standards , Medical Audit , Blood Glucose , Blood Pressure , Delivery of Health Care , Diabetes Mellitus/nursing , Hospitals, Teaching , Humans , Malaysia , Quality Assurance, Health CareABSTRACT
Famciclovir is a novel guanosine nucleoside analogue with activity against herpes viruses and hepatitis B virus (HBV). Several preliminary reports have described efficacy of famciclovir in patients with recurrent hepatitis B after orthotopic liver transplantation (OLT). This report describes the largest study to date of long-term famciclovir treatment in patients with de novo or recurrent hepatitis B post-OLT. One hundred thirty patients with detectable serum HBV DNA after OLT received oral famciclovir 500 mg tid on a compassionate-use basis. Safety analyses included all treated patients; efficacy was assessed in all patients and a subgroup of 73 patients with complete baseline HBV DNA and alanine aminotransferase (ALT) data who had received > or =6 months of treatment. Efficacy parameters included serum levels of HBV DNA, ALT, and anti-HBe or anti-HBs seroconversion rates. Of the 70 patients treated for > or =6 months who could be evaluated for response/non-response to famciclovir, 52 (74%) were responders, defined as patients who experienced a 70% decrease or more in HBV DNA levels from baseline, or who became HBV DNA-negative, for at least two consecutive visits. In famciclovir responders, HBV DNA levels decreased by a median of 91% after 12 weeks of treatment, 95% after 6 months and >99% after 18 months of treatment. Marked differentiation between responders and non-responders could be made soon after the onset of treatment. Among anti-HBe positive patients with evidence of HBV replication, 12/13 were responders. Patients with high baseline ALT levels experienced more rapid suppression of HBV DNA during therapy with famciclovir. Famciclovir therapy was safe and well tolerated; serious adverse events were reported infrequently. Famciclovir treatment may be beneficial in patients with hepatitis B infection post-OLT.
Subject(s)
2-Aminopurine/therapeutic use , Antiviral Agents/therapeutic use , DNA, Viral/isolation & purification , Hepatitis B/drug therapy , 2-Aminopurine/adverse effects , 2-Aminopurine/analogs & derivatives , Adolescent , Adult , Aged , Alanine Transaminase/blood , Antiviral Agents/adverse effects , Child , DNA, Viral/genetics , Famciclovir , Female , Hepatitis B/blood , Hepatitis B/etiology , Hepatitis B Surface Antigens/blood , Hepatitis B e Antigens/blood , Hepatitis B virus/genetics , Hepatitis B virus/isolation & purification , Humans , Liver Transplantation/adverse effects , Male , Middle Aged , Time Factors , Treatment OutcomeABSTRACT
We conducted a placebo controlled, double-blind trial on the effect of a single dose of zaprinast (M&B 22,948, an orally active mast cell stabilizer) on exercise-induced asthma in 15 children. We demonstrated no prophylactic effect on the whole group. A trend towards effectiveness was shown when the results for children whose asthma was not steroid dependent were analysed alone.
