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The evolution of international health is showing increasing symptoms of decline. The paradigms of world health crystallized into a clear system of international health relations in the post-war period (1945-1960), based upon the tenet to preserve and promote peace, culminating in the establishment and effectiveness of the World Health Organization (WHO). The last decades have witnessed the emergence of Primary Health Care (PHC) and the subsequent objective of "Health for All" (HFA) as the guiding principles of the field. By the 1990s, however, the strategic weakness of these paradigms has become apparent, yet no realistic substitute is in sight. Unless a serious and urgent attempt is undertaken at reformulating its basic conceptual tenets, the field of international health, and with it WHO, is risking a major decline and could ultimately pass into obscurity and oblivion.
Asia Pac J Public Health 1991
PMID:Shifting paradigms of international health. 181 15

An equimolal single dose (1 mmole/kg) of leptophos or cyanofenphos was given orally to chickens to assay the clinical and biochemical neurotoxic effects of these two organophosphorus insecticides. Parathion and TOCP at 2 and 1000 mg/kg of chicken body weight were tested in the same manner as negative and positive neurotoxicants, respectively. Three birds of each of five groups tested were sacrificed 1,2,3,7,14,21 and 28 days after treatment and the brains were taken for the biochemical tests. Acetylcholinesterase (AChE) and neurotoxic esterase (NTE) activities were determined in the brain microsomal fractions. In addition, the AChE activity in the brain soluble fractions was measured. Clinical observations indicated that leptophos-, cyanofenphos- and parathion-treated chickens became acutely poisoned but recovered from the typical cholinergic signs in a day or two. However, about 10 to 15 days later leptophos- and cyanofenphos-treated chickens developed the characteristic leg weakness and unrecoverable ataxia seen in birds given TOCP. The biochemical results indicated that cyanofenphos followed by leptophos and parathion produced more in vivo AChE inhibition than that produced by TOCP in both chicken brain soluble and microsomal fractions. Results suggested that there are no correlations between the in vivo effect of TOCP, leptophos and cyanofenphos on AChE and phenyl valerate-total hydrolyzing activities and the ability of these chemicals to produce neuropathy in hens. The results obtained from this study of the in vivo effect of the tested compounds on chicken brain NTE activity present an acceptable correlation between the inhibition of this enzyme and the ability of these chemicals to induce neuropathy. The mechanism and explanation for this correlation are presented. The in vivo effect of the tested compounds on the chicken brain NTE activity was determined using the indirect and a new direct method. The data presented in this report suggested that the new direct technique of assaying NTE activity using 4-nitrophenyl valerate (4-NPV) as substrate, can be useful in the in vivo screening studies of organophosphates for their ability to induce neuropathy in hens.
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PMID:In vivo inhibition of chicken brain acetylcholinesterase and neurotoxic esterase in relation to the delayed neurotoxicity of leptophos and cyanofenphos. 243 15

The overall objective of India's Population Education Project, launched in 1980 with financial and technical support from United Nations' agencies, is to institutionalize such education in all the country's educational processes. As the Project begins its third phase (1991-95), an emphasis is being placed on reaching the 60% of children (most of them girls) who drop out of school between classes I-V through a variety of interventions in the nonformal education sector. Within the formal sector, integration of population education into school sylabi and textbooks at the secondary and plus-two levels will be pursued; such integration is now largely complete at the primary and upper primary levels. Another focus will be to reach the estimated 60-70% of teachers who have not yet received the in-service training in population education and to integrate this subject into some courses taught at the pre-service teacher training level. To strengthen the attitude formation and value orientation aspects of population education, a greater emphasis will be placed on linking co-curricular activities in the community with the school curriculum. Given the finding that students exposed to print, audio, and audiovisual media show higher levels of awareness of population themes, the use of the mass media in population education will be promoted. A weakness of the project to be addressed in the 1990s is inadequate coordination between the school and other sectors, especially at the grassroots level and in terms of development activities. Another goal is to emphasize the links between family planning and population education. In the past, the population education project tended to differentiate itself from family planning to increase program acceptability. At present, however, there is awareness that a major purpose of population education is to create demands for family planning services.
Popul Educ Asia Pac Newsl Forum 1991
PMID:Population Education Programme in the 90s in India. 1228 93

The strengths and weaknesses of population education programs in Sri Lanka, Nepal, and the Maldives, based on descriptive research studies, are identified. The research topics were devised at a Subregional Meeting on Joint Research studies in Population Education for South Asia Subregion in 1990, as well as motivational strategies for promoting the small family norm in Bangladesh and Pakistan. Results were presented at a 1991 meeting held in UNESCO PROAP. The results were that 3 very different collaborative modalities operate in these countries. Sri Lanka had a formal national population committee for coordinating functions. The Maldives had no national formal structures, but there were linkages between population programs. Nepal had a formal structure but had failures in coordination. The Sri Lanka Population Committee, which began in 1972, established population education when the entire educational system was being reformed. The curriculum development committee consisted of representatives from a variety of disciplines and worked as a cohesive unit. As a consequence, junior secondary schools taught population education in such courses as social studies and science. Regional departments of education provided inservice training to the junior secondary school teachers. At the policy level, the education plan of 1972/73-77 was implemented within the National 5 Year Plan and the Population Committee functioned under a senior government Minister, which provided greater credibility and implementation. It also ensured linkage with other departments, agencies, and development programs. In the Maldives, the linkage was between the Population Education Program of the Educational Development Center (EDC) and the Allied Health Service Training Center's (AHSTC) child-spacing program. The small scale size may be a factor in the coordination and resource sharing and effective linkages without a formal national committee umbrella. The weakness was in multiplicity of effort, particularly i orientation. The recommendation was to do joint planning. Nepal's program needs coordination and linkages at the implementation level. There was breakdown in coordination and collaboration. Recommendations were to eliminate training and implementation from the Coordinator's Office and institute coordinating roles only, and to coordinate field programs by using CTSDC trained teachers in AES training. Content changes were also needed in linking community development and resource issues with nonformal population education, and consistency in materials used at the Certificate and Bachelor's level. Book revision needs to include population education content. Guidelines and manuals based on these research studies are planned for the future.
Popul Educ Asia Pac Newsl Forum 1991
PMID:Research reveals co-ordination and collaboration strengths and weaknesses in population education. 1228 79

This report summarizes the findings of a study designed to identify the reasons for non-use of family planning among Nepalese women who want to space or limit childbirth. The study's initial phase involved focus group sessions of women with unmet need for family planning who were asked their reasons for non-use. Researchers used this information to develop an in-depth questionnaire. Researchers then randomly selected a total sample of 5,152 women. After interviewing the women, researchers concluded that 31.6% the sample had unmet need for family planning. Consequently, researchers administered the questionnaire to the unmet demand population, which was almost equally divided among women who want to either spacing or limit childbirth. The study analyzes both reasons for the general non-use of contraception and reasons for the non-use of specific contraceptive methods (oral contraceptives, laparoscopy, and vasectomy). Although varying among the different contraceptive methods, the most commonly cited reasons were: 1) causes headache, weakness, nausea; 2) causes weight loss; 3) causes heavy bleeding; 4) insufficient money for nutritious foods; 5) causes weakness and cannot work; 6) currently in poor health; 7) husband disapproves; and 8) affects breastfeeding and dries breast-milk. Explaining the benefits of the study, the report indicates that the information can be incorporated into the training curriculum of health workers, and can be used to target information, education, and communication campaigns. Furthermore, evident in the responses that cite lack of nutritious foods and weakness, the study reveals that nutrition and food supplement programs could help increase contraceptive use.
Asia Pac Popul J 1991 Mar
PMID:The KAP-gap in Nepal: reasons for non-use of contraception among couples with an unmet need for family planning. 1234 62

A 44-year-old man was admitted to our hospital because of brain metastasis and intrapulmonary exacerbation of lung adenocarcinoma. Systemic chemotherapy (PAC + CBDCA) was administered, but neurological symptoms (muscle weakness of limbs and disorientation) appeared. Lumbar puncture and enhanced MRI of lumber vertebrae revealed meningeal carcinomatosis. MTX 20 mg/week (+ Ara-C 40 mg/week) was injected into the meningeal space. There was a clear improvement in the neurological symptoms, but it did not last long. Meningeal injection was performed 7 times. Whole-brain and whole-marrow radiation along with systemic chemotherapy gave a marked improvement in the symptoms and in the metastatic shadow on the chest CT scan.
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PMID:[A case of meningeal carcinomatosis from lung cancer successfully treated with aggressive multimodal therapy]. 1741 41

In addition to modern medicinal therapy, many cancer patients in Taiwan are treated regularly with herbal medicines or prescribed a traditional herbal diet. In this paper, the effect of a Taiwanese traditional herbal diet (TTHD) on pain in terminal cancer patients was investigated. A total of 2,466 patients diagnosed with a variety of cancers were included. The most common patient-reported symptoms included troublesome pain (79.2%), weakness (69.0%), anorexia (46.4%), fever (36.5%), dyspnea (31.1%), and leg edema (30.9%). The 2,466 terminal cancer patients included in the study were randomly divided into three groups. The TTHD group (n=1044; 42.3%) were given the TTHD consisting of analgesic herbs (paeony root: licorice root=1:1) and a Taiwanese tonic vegetable soup (Lilii bulbus, Nelumbo seed, and Jujube fruit). The remaining patients were divided into a reference group, given the regular hospital diet, (n=909, 36.9%) and a control group, given the Taiwanese tonic vegetable soup without analgesic herbs, (n=513, 20.8%). All patients maintained their assigned diets for one week. A verbal numerical scale was used to assess pain. Results revealed that the patients given TTHD reported enhanced pain relief (p<0.05) compared to the reference and control groups. We found that TTHD could alleviate the pain among terminal cancer patients thereby supporting the supposition that Eastern and Western medicines can be effectively co-administered to enhance terminal patient's quality of life. Further research is warranted.
Asia Pac J Clin Nutr 2008
PMID:Effectiveness of Taiwanese traditional herbal diet for pain management in terminal cancer patients. 1836 21

Myasthenia gravis (MG) is an autoimmune disease. Approximately 15% of patients with MG have thymoma. Approximately 30% to 40% of them are invasive. A 26-year-old man was admitted with cough and difficulty breathing. He had transsternal thymectomy resulting from MG accompanied by thymoma 6 years previously. Thorax computerized tomography (CT) scans showed metastases to the extra-mediastinum. Diagnosis of invasive thymoma was made by CT-guided biopsy. A PAC regimen (cisplatin, doxorubicin, cyclophosphamide) and radiotherapy were added to MG treatment. Ten months later, he presented again with headache, weakness, and difficulty swallowing. We determined that he had intracranial multiple metastases. He was hospitalized. Cerebral multiple metastases were evaluated as inoperable. However, he died of transtentorial herniation after 1 month. This MG case accompanied by invasive thymoma with multiple intracranial metastases is discussed.
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PMID:Myasthenia gravis and invasive thymoma with multiple intracranial metastases. 1907 11

We report a case of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) that developed in a patient with cholangiocarcinoma after receiving oxaliplatin-based chemotherapy. A 62-year-old man had multiple hypodense lesions with delayed enhancement in the both lobes of the liver on abdominal computed tomography. He was treated with 5-fluorouracil, leucovorin and oxaliplatin (100 mg/m(2)). After eight cycles of treatment and a cumulative oxaliplatin dose of 780 mg/m(2), he developed an unsteady gait, dysphagia, weakness of both the upper and lower limbs and impairment of all sensory modalities. Nerve conduction studies confirmed the diagnosis of AIDP. Immunoglobulin G i.v. was administered for 5 days but the neurological deficits of both his upper and lower limbs did not improve. This case highlights unusual peripheral nervous system manifestations in a patient who received chemotherapy with oxaliplatin.
Asia Pac J Clin Oncol 2012 Jun
PMID:Acute inflammatory demyelinating polyradiculoneuropathy in a patient receiving oxaliplatin-based chemotherapy. 2252 80

Two adult female bontebok (Damaliscus pygarus dorcas) were euthanized because of signs of pneumonia and weakness (case 1), and a nonresponsive lameness with draining fistula (case 2). Necropsy findings were similar in both cases and consisted of disseminated granulomatous lesions in the liver, kidneys, spleen, lungs, pleural surfaces, and multiple lymph nodes. Mycobacterium kansasii was isolated from both cases after multiple attempts on a variety of samples by two laboratories. The remaining four animals in the herd were tested for antibody responses using the Chembio ElephantTB STAT-PAK, DPP VetTB kits, and multi-antigen print immunoassay (MAPIA), for immune reaction using the intradermal tuberculin test, and by tracheal wash cultures, and thoracic radiographs. Banked serum samples collected in 2005 and obtained from the original institution, revealed 1/9 (11.11%) seropositive animals using the three immunoassays. Retesting the current herd in 2008 showed 2/6 (33.33%) seropositive animals by the three tests, with MAPIA demonstrating antibody reactivity to MPB83 and MPB70 proteins. Inconsistent intradermal tuberculin test results, cross-reactivity in serologic assays designed for tuberculosis detection, difficulty in obtaining definitive identification by culture, and inability to identify a source of infection created challenges in distinguishing the atypical mycobacteriosis due to M. kansasii from the initially suspected tuberculous infection in this herd. Owing to regulatory considerations, differences in host-to-host transmission, and source of infection between Mycobacterium tuberculosis complex and nontuberculous mycobacteria, correct diagnosis is crucial for management of these diseases in wildlife species.
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PMID:Mycobacterium kansasii infection in a bontebok (Damaliscus pygaragus dorcas) herd: diagnostic challenges in differentiating from the Mycobacterium tuberculosis complex. 2295 Mar 20


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