Se Asian J Trop Med
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A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. ⋯ The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.
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Se Asian J Trop Med · Jun 1995
PCR to detect Mycobacterium tuberculosis DNA in sputum samples from treated leprosy patients with putative tuberculosis.
In this study of leprosy patients with putative tuberculosis, the polymerase chain reaction (PCR), one of the most reliable and sensitive molecular diagnostic methods, was carried out for the specific detection of Mycobacterium tuberculosis DNA. Sputum samples from 43 patients at Baba Baghi Leprosarium in Iran were tested. The DNA extraction method was based on the lysing and nuclease-inactivating properties of guanidinium thiocyanate (GuSCN) together with the nucleic acid binding properties of diatoms or silica particles. ⋯ In total, 14% of the patients in this study were found to be PCR positive for M. tuberculosis. No positive results were found by direct microscopy for acid fast bacilli (AFB) and culture. It was thought probable that the positive PCR results indicated the tuberculosis (TB) in such treated leprosy patients.
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Se Asian J Trop Med · Mar 1995
Comparative StudyScoring systems for predicting outcomes of critically ill patients in northeastern Thailand.
The Acute Physiology and Chronic Health Evaluation System (APACHE) III, the APACHE II, the Simplified Acute Physiology Score (SAPS), and the Therapeutic Intervention Scoring System (TISS), calculated within the first 24 hours of admission, were compared in 209 critically ill patients admitted to the regional hospital in northeastern Thailand. Eighty-five (40.7%) patients subsequently died. The nonsurvivors had significantly higher APACHE III, APACHE II, SAPS and TISS scores than the survivors. ⋯ All four scoring system correlated well with the short-term prognosis, ie the mortality outcome, of critically ill patients. APACHE III, APACHE II, SAPS, and TISS appeared to be comparable to predictors of severity of critical illness. Selection of a severity indicator will depend on the resources available.
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Se Asian J Trop Med · Mar 1995
Review Historical ArticleLocalized permanent epidemics: the genesis of chloroquine resistance in Plasmodium falciparum.
Localized permanent epidemics occur when, for an indefinite period of time, there is a temporary but continuous introduction of unprotected non-immunes into the same locality of a hyperendemic area. The main epidemiological factors involved in the genesis of localized permanent epidemics were encountered in Pailin (Cambodia) the epicenter of drug resistance in Southeast Asia: a very efficient vector, Anopheles dirus, exophilic and of limited distribution with, therefore, adjacent hyperendemic and non-endemic areas; a permanent pole of attraction in the hyperendemic area: Pailin's sapphires and rubies; a temporary but continuous influx of non-immunes into the pole of attraction: continuous influx of non-immunes into the Pailin gem mining area. In the gem-mining Pailin village drug pressure was considerable: mass drug administration, a medicated salt project and permanent self-medication with very high doses, much higher doses being required to cure non-immunes with heavy infections and severe clinical attacks in epidemic situations. ⋯ High level resistance was the result of continuous and intensive serial passages of P. falciparum in the non-immune subjects, large numbers of parasites being exposed to a high level of drug pressure at each passage. Similar epidemiological conditions are encountered in some parts of South America where the exophilic vector is An. nuneztovari. In Colombia, whose eastern mountains bordering Venezuela yield the most highly prized emeralds in the world, chloroquine resistance was detected at about the same time as in Southeast Asia.(ABSTRACT TRUNCATED AT 250 WORDS)