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At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

Epidemiological situation of Japanese encephalitis in Nepal.

A human Japanese encephalitis (JE) case is considered to have elevated temperature (over 380 C) along with altered consciousness or unconsciousness and is generally confirmed serologically by finding of specific anti-JE IgM in the cerebro spinal fluid. No specific treatment for JE is available. Only supportive treatment like meticulous nursing care, introduction of Ryle's tube if the patient is unconscious, dextrose solution if dehydration is present, manitol injection in case of raised cranial temperature and diazepam in case of convulsion. Intra venous fluids, indwelling catheter in conscious patient and corticosteroids unless indicated should be avoided. Pigs, wading birds and ducks have been incriminated as important vertebrate amplifying hosts for JE virus due to viremia in them. Man along with bovines, ovines and caprines is involved in transmission cycle as accidental hosts and plays no role in perpetuating the virus due to the lack of viremia in them. The species Cx tritaeniorhyncus is suspected to be the principal vector of JE in Nepal as the species is abundantly found in the rice-field ecosystem of the endemic areas during the transmission season and JE virus isolates have been obtained from a pool of Cx tritaeniorhyncus females. Mosquito vector become infective 14 days after acquiring the JR virus from the viremic host. The disease was first recorded in Nepal in 1978 as an epidemic in Rupandehi district of the Western Development Region (WDR) and Morang of the Eastern Region (EDR). At present the disease is endemic in 24 districts. Although JE as found endemic mainly in tropical climate areas, existence and proliferation of encephalitis causing viruses in temperate and cold climates of hills and valleys are possible. Total of 26,667 cases and 5,381 deaths have been reported with average case fatality rate of 20.2% in an aggregate since 1978. More than 50% of morbidity and 60% mortality occur in the age group below 15 years. Upsurge of cases take place after the rainy season (monsoon). Cases start to appear in the month of April - May and reach its peak during late August to early September and start to decline from October. There are four designated referral laboratories, namely National Public Health Laboratory (Teku), Vector Borne Diseases Research and Training Center (Hetauda), B.P. Koirala Institute of Medical Sciences (Dharan) and JE Laboratory (Nepalgunj), for confirmatory diagnosis of JE. For prevention of JE infection; chemical and biological control of vectors including environmental management at breeding sites are necessary. Segregate pigs from humans habitation. Wear long sleeved clothes and trousers and use repellent and bed net to avoid exposure to mosquitos. For the prevention of the disease in humans, safe and efficacious vaccines are available. Therefore immunize population at risk against JE. Immunize pigs at the surroundings against JE. 225,000 doses of live attenuated SA-14-14.2 JE vaccine were received in donation from Boran Pharmaceuticals, South Korea for the first time in Nepal. Altogether 224,000 children aged between 1 to 15 years were vaccinated in Banke, Bardiya and Kailali districts during 1999. From China also, 2,000,000 doses of inactivated vaccine were received in 2000 and a total of 481,421 children aged between 6m to 10 yrs were protected from JE during 2001/2002. Ministry of Agriculture, Department of Livestock Services has vaccinated around 200,000 pigs against JE in terai zone during February 2001.

Adolescent↗
PubMedDate not supplied

A comparison of transdermal and oral HRT for menopausal symptom control.

BACKGROUND: To compare clinical efficacy, side effects and continuation rates using oral hormone therapy (HT), percutaneous gel, and transdermal patch. METHODS: Eighty-eight symptomatic menopausal women were allocated into 3 groups (oral, gel, patch); the patch group was further subdivided to be given either reservoir or matrix patch. After one year of follow up, symptomatic improvement, side effects and continuation rates were assessed and compared. Statistical analysis was performed using multiple analysis of variants and chi-square tests wherever appropriate, with p value < or = 0.05 considered significant. RESULTS: Percentage of patients showing complete relief from vasomotor symptoms at one year were 62%, 95%, and 100% among oral, gel, and patch groups, respectively. Similarly, above-mentioned percentages were 30%, 65%, and 68% for psychological disturbances; 64%, 100%, and 100% for genital symptoms; 40%, 90%, and 100% for urinary symptoms. Incidence of side effects, such as breakthrough bleeding [6 (60%), 6 (71%), and 5 (66%) among oral, gel, and patch groups at 6 months] and mastodynia [5 (14%), 6 (20%), and 5 (18%)] was comparable among three groups. Skin intolerance was significantly higher (92% of patients) in the reservoir patch group compared to the matrix patch (22% of patients) and gel (10% of patients) at first month. Continuation rate for one year was comparable among oral, gel, and matrix patch: 81%, 83%, and 88%, respectively. However, continuation rate was 50% among reservoir patch group. CONCLUSION: Transdermal HT performed significantly better than oral HT in menopausal symptom control. Reservoir patch was unsuitable in tropical climate where matrix patch and gel performed better.

Administration, Cutaneous↗
PubMed2006

Malaria--Great Exuma, Bahamas, May-June 2006.

Malaria in humans is caused by four distinct protozoan species of the genus Plasmodium (P. falciparum, P. vivax, P. ovale, and P. malariae). These parasites are transmitted by the bite of an infective female Anopheles mosquito. In the Caribbean region, malaria has been eliminated from all islands except Hispaniola, the island consisting of Haiti and the Dominican Republic. Elimination of malaria elsewhere resulted from a combination of integrated control measures, socioeconomic development, and close public health surveillance. However, even Caribbean islands where malaria is no longer endemic remain at constant risk for reintroduction of the disease because of their tropical climate, presence of competent malaria vectors, and proximity to other countries where malaria is endemic. This susceptibility was underscored by the recent outbreak of malaria on the island of Great Exuma in the Bahamas; during May-June 2006, a total of 19 malaria cases were identified. Four of the cases, in travelers from North America and Europe, are described in this report; such cases of imported malaria can signal the presence of a malaria problem in the country visited and thus assist local health authorities in their investigations. On September 19, after 3 months with no report of new cases, CDC rescinded its previous recommendation that U.S.-based travelers take preventive doses of the antimalarial drug chloroquine before, during, and after travel to Great Exuma.

Adult↗
PubMed1991

[Antitetanus immunity in mother-child pairs].

A study on tetanus toxoid immunity in mothers and their children by passive hemagglutination using "Vacci T Pasteur" was conducted in two stages: an initial study of 100 mothers and their newborns was conducted with no particular selection criteria used. Tetanus toxoid titers were measured on serum directly for the mothers and on whole blood using filter paper for the children; a second study of 100 mothers and children was conducted using defined criteria for enrollment. Blood was drawn directly from the veins of both the mother and child in this study. Titers were measured for both mother and child on serum. In both studies it was verified that the pregnant women has good vaccination coverage. However, the study of immunity levels among the newborns showed different results in the two studies. The authors discuss the reasons for these differences and formulate recommendations for an use of these tests during sero-epidemiologic studies in tropical climates.

Adolescent↗
PubMed1991

Pyomyositis secondary to group A beta hemolytic streptococcus.

Pyomyositis is a primary bacterial infection of skeletal muscle not formed by local extension from superficial tissues. It is relatively frequently seen in tropical climates but reportedly rarely seen in temperate climates such as North America. In this report, we present a 67-year-old man with a primary Group A beta hemolytic Streptococcal infection of the quadriceps muscle of the left leg.

Aged↗
PubMed1991

[The differential diagnosis of malignant soft tissue tumors: pyomyositis].

The case of a seven-year-old boy with an enlarging woody-hard mass in the upper thigh is described and the related literature is reviewed. In absence of conclusive signs of inflammation on both clinical and radiological findings a malignant soft tissue tumour was initially suspected. On operation the mass was found to contain multiple loculated abscesses, and turned out to be a subacute staphylococcal myositis (pyomyositis). Such lesions are quite common in subtropical and tropical climates, and a review of the literature indicates that the incidence of this formerly rare entity is increasing in temperate climates. A variety of factors play a role in pathogenesis, and a history of previous aseptic trauma can be found in about 50% of all cases. The most frequent location is the proximal lower limb or buttock. The clinical history and physical findings are often non-specific. Plain radiographs are non-diagnostic; ultrasound, CT and/or MRI may in some cases be equivocal and angiography sometimes is even misleading. It is important to keep this differential diagnosis in mind, especially in children.

Angiography, Digital Subtraction↗
PubMedDate not supplied

[Pleural complications of pneumonia in children].

Four-year experiences are reported concerning the treatment in tropical climate of 37 children with pneumonia complicated with pleural empyema. Most children were aged below 3 years. Among clinical manifestations dysponoea, fever and toxaemia were in the foreground. The pathogen most frequently demonstrated in blood and pleural exudate was Staphylococcus aureus. In all cases antibiotics were given, hydration and diet with high protein content were given, pleurocentesis was done for decompression. Despite intensive hospital treatment every 7th child died.

Child, Preschool↗
PubMedDate not supplied

Retroperitoneal infectious myositis.

A case of retroperitoneal infectious myositis is described. The symptoms of infectious myositis may be confused with those of other more frequent soft tissue pathologies (haematoma and sarcomata). This infection is more frequent in countries with a tropical climate. The most frequent aetiological agent is Staphylococcus aureus. This paper reports on the diagnostic and therapeutic problems of this disease as recently observed at the Division of Surgical Oncology of the National Cancer Institute in Genoa.

Adult↗