Se Asian J Trop Med
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Se Asian J Trop Med · Mar 2005
ReviewRisk of respiratory infections in health care workers: lessons on infection control emerge from the SARS outbreak.
Close proximity of persons together with handling of human secretions (eg respiratory secretions) make health care workers (HCW) particularly vulnerable to transmission of droplet-transmitted respiratory infections. This was tragically highlighted during the international outbreak of severe acute respiratory syndrome (SARS) in 2003 with attack rates of more than 50% in HCW. The purpose of this article is to review common airborne and droplet-transmitted bacterial and viral respiratory tract infections with regard to their impact on health care workers. ⋯ Integrated syndromic and virological surveillance systems set up during the SARS epidemic will also further our understanding of other respiratory infections in the hospital setting. Even if pursuing early diagnosis for unspecific respiratory illnesses is expensive, identification of the causative organism may reduce unnecessary isolation, contact tracing and anxiety, in particular during an outbreak situation. We have a duty to protect our health care workers.
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Se Asian J Trop Med · Mar 2005
Comparative StudyDecentralization and recentralization: effects on the health systems in Lao PDR.
In Lao PDR, lack of skilled manpower and financial resources in the central government, plus the policy urging local authorities to be self-sufficient and self-reliant caused the central government to decentralize all sectors to the provincial level in 1987. After 1987, the provinces took over all responsibilities such as planning, financing and provision of health services, only informing the Ministry of Health (MOH) about their activities. Because of economic differences between the 18 provinces, health services became unequal between the richer and poorer provinces. ⋯ A cost-recovery system was introduced to obtain additional funds, and conditions in the provinces gradually improved. The unique situation of decentralization followed by recentralization provides an excellent opportunity for study. We reviewed documents relating to these periods and interviewed officials at all levels who were concerned with the process.
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A retrospective review of dengue patients admitted to Queen Sirikit National Institute of Child Health (previously known as Children's Hospital) from 1995 to 1999 revealed 4,532 confirmed cases of dengue infection; 80.9% were dengue hemorrhagic fever (DHF) and 19.1% were dengue fever cases (DF). Among the DHF patients; 30.6% had shock. The majority of them, 66.6%, had a normal nutritional status, while 9.3% were malnourished and 24.2% had obesity as classified by weight for age. ⋯ Complications of fluid overload were found more in obese patients (6.5%) compared to normal (3.2%) and malnourished patients (2.1%) (p = 0.000). The case-fatality rates (CFR) in malnourished patients and obese patients were 0.5% and 0.4%, respectively, while in normal patients the CFR was 0.07%. Under and over nutrition DHF patients had either a greater risk of shock or unusual presentations and complications, which can lead to severe disease or complications and probably a higher CFR.
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Massive hemoptysis is a life-threatening condition and can lead to asphyxiation. This is a retrospective review of 101 patients hospitalized with massive hemoptysis at Srinagarind Hospital, Khon Kaen, Thailand, between January 1993 and December 2002. The male to female ratio was 2.1:1. ⋯ We conclude that, the most common cause of massive hemoptysis is benign rahter than malignant disease. Intensive care with conservative treatment should be applied vigorously. Bronchial artery embolization is an excellent, non-surgical alternative to control bleeding, and should be done before specific surgical intervention.
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Se Asian J Trop Med · Mar 2005
Prevalence and factors associated with current smoking among high school adolescents in Karachi, Pakistan.
Our objective was to estimate the prevalence and evaluate factors associated with smoking among high school adolescents in Karachi, Pakistan. A school-based, cross-sectional survey was conducted in three towns in Karachi, namely, Gadap Town, Bin-Qasim Town and Malir Town, from January through May 2003. ⋯ The prevalence of smoking (30 days) among adolescents was 13.7%. Final multiple logistic regression analysis showed that after adjusting for age, ethnicity, and place of residence, being a student at a government school (OR=1.6; 95% Cl: 1.0-2.7), parental smoking (OR = 1.7; 95% Cl: 1.1-2.8), uncle smoking (OR = 1.7; 95% Cl: 1.2-2.8), peer smoking (OR = 6.2; 95% Cl: 3.9-9.9), and spending leisure time outside home (OR = 3.9; 95% Cl 1.2-13.2) were significantly associated with adolescent smoking.