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By R. Ningal. Brewton-Parker College.

These are the reason for poorer outcome of gastric cancer patients in our country than others order ayurslim 60 caps overnight delivery, eg ayurslim 60caps otc. The poor prognosis of these patients emphasizes the need to improve the survival rate with considerable efforts in future trusted 60caps ayurslim. Public health measure influencing the nutrition of population and changing some of traditional eating patterns of daily diet, eg. As there were no early cases of gastric cancer, attemptes on early case detection are required for the future. The mass survey system, used in Japan, is costly and it is not feasible in Myanmar at the moment. At present the best way to solve the problem is to give informations about the nature of the disease to the general practitioners and health education to the public. The dyspeptic patients, or those suffering from epigastric pain not relieved by antacids should be refered to consultation clinics without delay. Careful examination and assessment should be performed in suspicious cases using contrast x ray, Scopy and biopsy. By this way, the number of early referral cases of gastric cancer will increase in future. Because of the limited period of the present study, long term follow up was not possible on gastric cancer patients. I hope that effort of early detection of gastric cancer patients with the resultant increase in curative respectability rate, better staging incooperation with the pathologists and better understanding of the nature of gastric cancer will undoubtedly improve the prognosis of gastric cancer patients in our country in future. Routine examinations, virological, and bacteriological investigations were done in the laboratories of Virology and Bacteriology Research Divisions of the Department of Medical Research. Maternal education, behaviour scale, sanitation scale of family and paternal occupation were important contributing factors in the occurrence of acute infantile diarrhoea. A total of 3640 cases of diarrhoea and 3279 age- and sex-matched controls were studied; about 60% of the patients were aged less than 1 year and 60% were male. In all the study centres, the pathogens most strongly associated with disease were rotavirus (16% of cases, 2% of controls), Shigella spp. Rotavirus was commonest among 6-11-month-olds, accounting for 20% of all cases in this age group; 71% of all rotavirus episodes occurred during the first year of life. The proportion of cases that yielded no pathogen was inversely related to age, being highest (41%) among infants below 6 months of age and lowest (19%) among those aged 24-35 months. These results suggest that microbe-specific intervention strategies for the control of childhood diarrhoeal diseases in developing countries should focus on rotavirus, Shigella spp. Methods: The study was undertaken in Burma on 33 children aged 18 months to 12 years. Thirty three patients (55%) were found to be associated with enteropathogenic bacteria. Biopsy findings of gastric ulcers and, operative findings of all cases st th were recorded. There were 42 patients with radiologically diagnosed gastric ulcers, 26 cases had benign gastric ulcers and 16 cases had malignant gastric ulcers. Therefore a laboratory profile of acute and persistent 90 diarrhoea in children admitted to Paediatric Unit xecluding Special Care Baby Unit of Mandalay General Hospital had been done during June 1996 to October 1996 with the following objectives. Out of a total 184 stool culture, the commonest bacterial pathogen isolated was enteropathogenic E. In children with persistent diarrhoea, out of total 16 stool culture done, 50% revealed positive culture. Out of this total 200 cases with diarrhoeal diseases, 16 cases (8%) had persistent diarrhoea. Abdominal pain, tenemus and muscle cramp were more marked in persistent diarrhoea 31. In conclusion, the causal organism in children with acute and persistent diarrhoea had been isolated in about 50% of cases. The common protozoa and worm infestation were Entamoeba histylitica, Giadia lamblia, Ascaris lumbricoid and tricuris trichura. In children with persistent diarrhoea, more combination of infection or infestation was detected. So more antimicrobial therapy was found to be given in all persistent diarrhoeal patients. Also the usage of antibiotics in acute diarrhoeal cases should be minimized to actual indiacted cases. Bacteria isolated from the jejunal fluid in upper small intestines of these children were incubated with lactulose at neutral pH. Anaerobes were present in all but one child, and in 15 children they were present in numbers greater than 5 log 10 organisms per ml. This study suggests that in the diagnosis of small bowel bacterial overgrowth using lactulose breath hydrogen test, it is important to consider that patients with a flat breath hydrogen response to a carbohydrate challenge during the first 60min may be infected with enteric bacteria which are not capable of producing H2. Rotavirus was detected by enzyme linked immunosorbent assay in stools of 43 children. Cases were 67 children 1-59 months old hospitalized for diarrhoea lasting >14 days and complicated by severe malnutrition; for each case, a healthy control child was selected who was age- and sex-matched from the same neighbourhood. Homes of cases and controls 92 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar were visited for interviews and for direct observation of household child-care practices. Risk factors were catalogued and calculations made for relative risk and etiologic fractions.

It diffuses the death-image of the medicalized elite among the masses and reproduces it for future generations order ayurslim 60 caps amex. But when "death prevention" is applied outside of a cultural context in which consumers religiously prepare themselves for hospital deaths buy ayurslim 60 caps cheap, the growth of hospital-based medicine inevitably constitutes a form of imperialist intervention buy cheap ayurslim 60 caps. A sociopolitical image of death is imposed; people are deprived of their traditional vision of what constitutes health and death. The self-image that gives cohesion to their culture is dissolved, and atomized individuals can now be incorporated into an international mass of highly "socialized" health consumers. The expectation of medicalized death hooks the rich on unlimited insurance payments and lures the poor into a gilded deathtrap. The contradictions of bourgeois individualism are corroborated by the inability of people to die with any possibility of a realistic attitude towards death. I wanted to know from him how people along the Niger could understand each other, though almost every village spoke a different tongue. For him this had nothing to do with language: "As long as people cut the prepuce of their boys the way we do, and die our death, we can understand them well. For a generation people continue in their traditional beliefs; they know how to deal with death, dying, and grief. By their ministration they urge the peasants to an unending search for the good death of international description, a search that will keep them consumers forever. Like all other major rituals of industrial society, medicine in practice takes the form of a game. He is the agent or representative of the social body, with the duty to make sure that everyone plays the game according to the rules. Death no longer occurs except as the self-fulfilling prophecy of the medicine man. The struggle against death, which dominates the life-style of the rich, is translated by development agencies into a set of rules by which the poor of the earth shall be forced to conduct themselves. Only a culture that evolved in highly industrialized societies could possibly have called forth the commercialization of the death-image that I have just described. In its extreme form, "natural death" is now that point at which the human organism refuses any further input of treatment. People63 die when the electroencephalogram indicates that their brain waves have flattened out: they do not take a last breath, or die because their heart stops. Socially approved death happens when man has become useless not only as a producer but also as a consumer. It is the point at which a consumer, trained at great expense, must finally be written off as a total loss. Society felt threatened that the man on Death Row might use his tie to hang himself. Today, the man best protected against setting the stage for his own dying is the sick person in critical condition. Society, acting through the medical system, decides when and after what indignities and mutilations he shall die. Health, or the autonomous power to cope, has been expropriated down to the last breath. In order to focus on this specific counterproductivity of contemporary industry, frustrating overproduction must be clearly distinguished from two other categories of economic burdens with which it is generally confused, namely, declining marginal utility and negative externality. Direct costs reflect rental charges, payments made for labor, materials, and other considerations. The production cost of a passenger-mile includes the payments made to build and operate the vehicle and the road, as well as the profit that accrues to those who have obtained control over transportation: the interest charged by the capitalists who own the tools of production, and the perquisites claimed by the bureaucrats who monopolize the stock of knowledge that is applied in the process. The price is the sum of these various rentals, no matter whether it is paid by the consumer out of his own pocket or by a tax-supported social agency that purchases on his behalf. Negative externality is the name of the social costs that are not included in the monetary price; it is the common designation for the burdens, privations, nuisances, and injuries that I impose on others by each passenger-mile I travel. The dirt, the noise, and the ugliness my car adds to the city; the harm caused by collisions and pollution; the degradation of the total environment by the oxygen I burn and the poisons I scatter; the increasing costliness of the police department; and also the traffic-related discrimination against the poor: all are negative externalities associated with each passenger-mile. Some can easily be internalized in the purchase price, as for instance the damages done by collisions, which are paid for by insurance. Other externalities that do not now show up in the market price could be internalized in the same way: the cost of therapy for cancer caused by exhaust fumes could be added to each gallon of fuel, to be spent for cancer detection and surgery or for cancer prevention through antipollution devices and gas masks. But most externalities cannot be quantified and internalized: if gasoline prices are raised to reduce depletion of oil stocks and of atmospheric oxygen, each passenger- mile becomes more costly and more of a privilege; environmental damage is lessened but social injustice is increased. Beyond a certain level of intensity of industrial production, externalities cannot be reduced but only shifted around. Counterproductivity is something other than either an individual or a social cost; it is distinct from the declining utility obtained for a unit of currency and from all forms of external disservice. It exists whenever the use of an institution paradoxically takes away from society those things the institution was designed to provide. The price of a commodity or a service measures what the purchaser is willing to spend for whatever he gets; externalities indicate what society will tolerate to allow for this consumption; counterproductivity gauges the degree of prevalent cognitive dissonance resulting from the transaction: it is a social indicator for the built-in counterpurposive functioning of an economic sector. This specific counterproductivity constitutes an unwanted side-effect of industrial production which cannot be externalized from the particular economic sector that produces it. Fundamentally it is due neither to technical mistakes nor to class exploitation but to industrially generated destruction of those environmental, social, and psychological conditions needed for the development of nonindustrial or nonprofessional use- values.

A total 22 participants were excluded due to premature discontinuation of the treatment (N = 19) failure to meet the inclusion criteria (N = 2) or unauthorized concurrent treatment (N = 1) order 60caps ayurslim with mastercard. Matched placebo plaster Outcomes Primary outcome measure: Arhus Low Back Rating Scale buy discount ayurslim 60caps online. Secondary outcome measures: global assessment of efcacy and tolerance by physician and patient Notes Total quality score: 6/12 Adverse events: a total of 24 adverse events were reported (C = 15; P = 9) cheap ayurslim 60caps on line. The C group had ve cases of severe adverse events (inammatory contact eczema, urticaria, minute haemorrhagic spots, and vesiculation or dermatitis) and the P group had two such cases (vesiculation or allergic dermatosis). Blinding (performance bias and detection Low risk Study medication and placebo were identi- bias) cal in appearance. Incomplete outcome data (attrition bias) Low risk Out of 154 participants, 22 were excluded All outcomes - drop-outs? Krivoy 2001 Methods Thirty-ve participants randomized to two groups and a further 16 participants acted as controls. Period: four weeks Participants Fifty-one participants with 19 in the Salix alba group, 16 in a placebo group, and 16 in an acetylsalicylate group. Blinding (performance bias and detection Low risk Participants were blinded from treatment bias) groupallocation,andstudymedicationand All outcomes - patients? Krivoy 2001 (Continued) Blinding (performance bias and detection Low risk Outcome assessors were unblinded. How- bias) ever knowing the outcome of interest, All outcomes - outcome assessors? Low risk The groups were similar in baseline mea- suresexcept gender; there were more female participants in the placebo group (P = 0. Low risk Participantswere disallowed the use of anti- inammatory drugs within the trial pe- riod. Period: seven days Participants One hundred and sixty-one participants were randomly allocated to either group. The trial medications were not available to the providersinthe trial country at the time and all stakeholders assumed both medica- tions held active ingredients Blinding (performance bias and detection Low risk This was a double-blinded trial. While bias) there were reservations with the blinding All outcomes - outcome assessors? Low risk Group comparison was similar with no sig- nicant differences noted between groups at baseline Co-interventions avoided or similar? Low risk Anti-inammatory drugs were disallowed during the trial phase with paracetamol used as an emergency medication Compliance acceptable? Rapid improvement and three appli- cations per day may have inuenced non- compliance. Period: three weeks Participants Sixty-one patients were allocated to acupressure with lavender oil (N = 32) or conven- tional treatment (N = 29). Risk of bias Bias Authors judgement Support for judgement Random sequence generation (selection Low risk Participants were allocated by the research bias) team consulting a random numbers table Allocation concealment (selection bias) High risk Patients and clinicians were aware of group allocation. Blinding (performance bias and detection High risk Intervention treatment and control treat- bias) ment were dissimilar with no blinding All outcomes - patients? Blinding (performance bias and detection High risk Providers were aware and involved in the bias) treatment allocation process All outcomes - providers? Blinding (performance bias and detection Unclear risk Unclear from text bias) All outcomes - outcome assessors? Incomplete outcome data (attrition bias) Low risk Of the 61 original participants, 10 partici- All outcomes - drop-outs? High risk No discussion or controlling for medi- cation or additional treatment modalities noted Compliance acceptable? High risk There was no description of the control group s therapy beyond being a conven- tional therapy Selective Reporting Low risk All pre-specied outcomes were reported. Lee 2012 Conference abstract only, unknown participants type, unknown if a herbal medicine Liu 2013 Abstract or full text not available. Pabst 2013 Mixed low back and upper back pain with no subgroup analyses Pach 2011 Herbal medicine given by injection Reme 2011 Not a herbal medicine. Previous search strategies August 2013 Embase The animal study lter was updated from 2010 1. January 2011 Medline Back terms and herbal medicine terms were updated from 2009 1. Unclear reected the fact that there was insufcient information to determine whether this criterion was fullled or not. There is a high risk of bias if participants or investigators enrolling participants could possibly foresee assignments and thus introduce selection bias, such as allocation based on: using an open random allocation schedule (e. Blinding of participants Performance bias due to knowledge of the allocated interventions by participants during the study There is a low risk of performance bias if blinding of participants was ensured and it was unlikely that the blinding could have been broken; or if there was no blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be inuenced by lack of blinding. Blinding of personnel or care providers (performance bias) Performance bias due to knowledge of the allocated interventions by personnel or care providers during the study There is a low risk of performance bias if blinding of personnel was ensured and it was unlikely that the blinding could have been broken; or if there was no blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be inuenced by lack of blinding. Blinding of outcome assessors (detection bias) Detection bias due to knowledge of the allocated interventions by outcome assessors There is low risk of detection bias if the blinding of the outcome assessment was ensured and it was unlikely that the blinding could have been broken; or if there was no blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be inuenced by lack of blinding, or: for patient-reported outcomes in which the patient was the outcome assessor (e. The percentage of withdrawals and drop-outs should not exceed 20% for short-term follow-up and 30% for long-term follow-up and should not lead to substantial bias (these percentages are commonly used but arbitrary, not supported by literature) (van Tulder 2003). Selective reporting (reporting bias) Reporting bias due to selective outcome reporting There is low risk of reporting bias if the study protocol is available and all of the study s pre-specied (primary and secondary) outcomes that are of interest in the review have been reported in the pre-specied way, or if the study protocol is not available but it is clear that the published reports include all expected outcomes, including those that were pre-specied (convincing text of this nature may be uncommon).

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