A satisfaction survey of opioid-dependent patients with methadone maintenance treatment.

The aim of this study was to examine opioid-dependent patients' satisfaction with the methadone maintenance treatment (MMT) program in Malaysia and identify predictors of satisfaction. We used an interviewer-administered questionnaire developed and validated by Rankin Court, New South Wales, Australia. Of 502 patients approached in 11 MMT centers in Malaysia, 425 agreed to participate giving a response rate of 85%. In terms of overall satisfaction, a high percentage of respondents (85%) were satisfied with the MMT services. A logistic regression analysis showed that only "centres" and marital status were associated with overall satisfaction and that being single (OR 3.31; 95% CI 1.52 to 7.20) or married (OR 4.06; 95% CI 1.76 to 9.38) was associated with higher odds of overall satisfaction compared to being divorced or separated. An analysis of the responses pertaining to the most desired changes required at the center found dosing hours, waiting area and staff shortages to be common. The findings acquired from this survey will be useful to attain a clearer perspective on what aspects of the MMT service need to be reviewed for the improvement of service delivery.

Effects of Hibiscus sabdariffa L. on serum lipids: a systematic review and meta-analysis.

ETHNOPHARMACOLOGICAL RELEVANCE: Prevention of cardiovascular disease by modifying its major risk factors, including serum cholesterol levels, is an important strategy. Hibiscus sabdariffa L. has been promoted for reducing cholesterol levels, but its reported impact on cholesterol levels has been inconsistent. The study aimed to assess systematically the evidence and quality of current research on the effect of Hibiscus sabdariffa L. on blood lipids and its adverse effects. MATERIALS AND METHODS: Electronic databases were searched up to June 2013 for relevant randomised controlled trials (RCTs). Journals and conference proceedings were also searched. The quality of the selected trials was assessed using the Cochrane Risk of Bias Assessment Tool. The efficacy results of similar studies were pooled if they used the same comparator. Outcomes examined were levels of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides. RESULTS: Six studies involving 474 subjects met our inclusion criteria. These studies varied in terms of the types of interventions, comparators used, and duration of trials. Overall, Hibiscus sabdariffa L. did not produce any significant effect on any of the outcomes examined, when compared with placebo, black tea or diet. With short-term use it is well tolerated. CONCLUSIONS: The available evidence from RCTs does not support the efficacy of Hibiscus sabdariffa L. in lowering serum lipids. Further rigorously designed trials with larger sample sizes are warranted to confirm the effects of HS on serum lipids.

A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency.

We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI). We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.