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By X. Pyran. Tennessee Technological University. 2018.

The results of the survey questions on how people obtained antibiotics and whether they got advice on how to take them show that a sizeable majority of respondents across the countries surveyed state that they got their last course of antibiotics 60caps brahmi for sale, or a prescription for them trusted 60caps brahmi, from a doctor or nurse (81%), and that they received advice from a medical professional on how to take them (86%). These factors indicate that the antibiotics are more likely to be taken to treat an appropriate condition and in the appropriate fashion, both of which are important in the context of tackling antibiotic resistance. Respondents were asked to indicate whether they thought the statement It s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness was true or false. Although it is in fact a false statement, one quarter (25%) of respondents across the 12 countries included in the survey believe that this statement is true, though there is considerable variation in the findings between countries. While only 10% of respondents in Barbados think the statement is true, this rises to 37% in Nigeria. Across the 12 countries surveyed, respondents in rural areas, those with lower levels of education and those in lower income countries are more likely to think that this statement is true. Further investigations are needed in order to check if there is a link between broader issues around access to health care and medicine, and the affordability of antibiotics and other drugs for these groups. There is even more evidence of misunderstanding around the second statement shown to respondents: It s okay to buy the same antibiotics, or request these from a doctor, if you re sick and they helped you get better when you had the same symptoms before. Across the 12 countries included in the survey, 43% think this false statement is in fact true. However, close to one third (32%) of respondents surveyed across the 12 countries believe that they should stop taking the antibiotics when they feel better, and this rises to 62% in Sudan. Younger respondents and those in rural areas across the 12 countries, as well as those in lower income countries, are more likely to think they should stop taking antibiotics when they feel better. Understanding which conditions can be treated with antibiotics is also important, as the use of antibiotics for conditions which are not in fact treatable with these medicines is another contributor to misuse, and therefore to the development of resistance. Respondents were asked to indicate which of a list of medical conditions could be treated with antibiotics the list included both conditions that can and cannot be treated with antibiotics. Antibiotics are used to treat bacterial infections, whereas colds and flu are caused by viruses and therefore are not treatable with antibiotics. Further to this, we see that in Sudan, Egypt and India, three quarters or more of respondents think colds and flu can be treated with antibiotics. Younger respondents and those with lower levels of education are also more likely to think antibiotics should be taken for colds and flu. In combination, these survey findings related to the appropriate use of antibiotics suggest that action which effectively builds understanding of how and when to take antibiotics and what they should be used for particularly targeting groups among whom misunderstandings seem to be most prevalent is critical. The survey explored levels of awareness and understanding by asking respondents whether they had heard of a series of commonly used terms relating to the issue. The results show high levels of familiarity (more than two thirds of respondents) with three of the terms: antibiotic resistance, drug resistance and antibiotic-resistant bacteria. Levels of awareness of the terms is not uniform across the countries surveyed however for example, while 89% of respondents in Mexico are aware of the term antibiotic resistance, only 21% of those in Egypt are. Those who were aware of any or all of the terms were asked where they had heard the term. It is, of course, important that the public is not only aware of the issue, but also understands it. The survey sought to establish levels of understanding by asking respondents to indicate whether a series of statements around antibiotic use were true or false. Similarly to the survey findings related to appropriate antibiotic use, the results suggest that there are high levels of misunderstanding in this area. While large proportions of respondents correctly identify some statements, even larger numbers incorrectly identify others. For example, more than three quarters (76%) of respondents believe that antibiotic resistance occurs when their body becomes resistant to antibiotics. Encouragingly, the majority of respondents in all cases agreed that the actions could help, with numbers rising to 91% across the 12 countries in relation to People should wash their hands regularly. However, when respondents were then asked whether or not they agreed with a series of statements on the scale of the problem of antibiotic resistance, the results reveal some misconceptions and misunderstandings. Notable is the fact that 63% of respondents believe they are not at risk of an antibiotic-resistant infection, as long as they take their antibiotics correctly, which is not in fact the case. Antibiotic-resistant bacteria can spread from person to person, with the potential to affect anyone, of any age, in any country. The findings show considerable variation between countries 89% of those surveyed in Sudan and 81% in Nigeria believe that taking antibiotics correctly protects them from risk, compared to 27% in Barbados. Also notable is the fact that 57% agree with the statement: There is not much people like me can do to stop antibiotic resistance. This is concerning, as addressing the problem of antibiotic resistance in fact requires action from everyone, from members of the public and policy makers, to health and agricultural professionals. Doctorate degree S6 Which of following best describes your total household income, before tax?

For this reason protection from environmental and occupational irritants can be helpful in both allergic and non-allergic individuals brahmi 60caps amex. The relationship between asthma and chronic rhinosinusitis has been well described buy brahmi 60caps low price, and can best be understood by the fact that the entire upper respiratory tract is lined by the same type of mucous membrane, and therefore may react to similar irritants or allergens. The evaluation and management of chronic rhinosinusitis can be quite variable and complex. As the underlying cause is often exposure to some type of irritant whether it is a classical allergy or not, the detection of and protection from these irritants is quite helpful if possible. This evaluation may include formal allergy testing either by means of a blood test or evaluation by an allergist, and taking a careful history to determine if there is some preceding exposure or seasonal variation to the symptoms that may give some clue as to the irritant. If this cannot be practically achieved other options are considered and can be described as those that either decrease the body s exposure to the irritants, or those that attenuate the bodies response to the irritants. Practical ways of decreasing the body s exposure to airway irritants would include a mask or respirator designed to filter out the offending particles, or a nasal and sinus saline rinse applied immediately after a large exposure or on a regular basis in situations where the exposures are more persistent. This would include topical and systemic (usually taken by mouth) medications designed to minimize the inflammatory response. Some medications and nose sprays are intended for symptomatic relief, and some are intended to minimize the development of symptoms. This distinction is very important, and should be clarified with your physician in order to ensure proper use. In situations where symptoms persist even with carefully considered medical therapy, one must be evaluated for other factors. Certain defects of the immune system, either innate or acquired, may be considered. There are also anatomic factors that may warrant evaluation and possible treatment such as obstructing polyps, major deformities of the nasal septum, or narrowing or obstruction of the natural sinus openings. Benign and malignant tumors of the nasal cavities, though rare, have many of the same signs and symptoms as chronic rhinosinusitis, so evaluation is important if symptoms persist despite what would otherwise be considered adequate treatment. Sometimes a surgical procedure is helpful in addressing nasal obstructions or clearing the sinuses in order for them to clear more effectively. It should be noted that surgery is rarely if ever to be considered a cure for chronic sinusitis. It is simply one more tool that specialists have available in their armament in order to relieve most symptoms, and improve the body s ability to be more resilient when exposed to environmental allergens or irritants. As there are many occupational exposures that have been associated with higher incidences of certain types of sinus cancers, and the latency, or time between the actual exposure and the development of the resulting disease can be more than a decade, careful acquisition of all known exposures is important. Pharyngitis, Laryngitis, and Laryngopharyngitis Irritation of the throat has many names depending on where the irritation occurs. As the irritation is often not isolated to one specific area the term laryngopharyngitis, irritation of the throat and voice box, has become more favored. If the symptoms are severe, persistent, or progressive, prompt evaluation is neces- sary. Some forms of acute inflammation of the throat can progress to airway obstruction, and should be taken seriously. Persistent hoarseness can be a sign of something more serious, and should be evaluated if present for more than four to six weeks. Signs and Symptoms of Chronic Laryngopharyngitis Hoarseness or loss of voice Raw or sore throat Cough (typically dry) Difficulty breathing Sensation of a lump in the throat Trouble swallowing Table 2-1. While most cases of acute laryngitis are managed with self-care, chronic laryngitis, cases lasting for more than two weeks, should usually be managed only after discussing one s symptoms with a physician. Voice rest, adequate fluid intake, lubricants such as throat lozenges, and ensuring that the ambient air is humid without being contaminated with mold or fungus are excellent first steps to ensuring prompt recovery in cases of acute laryngopharyngitis. Cigarette smoking, allergies, repeated exposure to environmental irritants, and voice overuse are often substantial risk factors. In some situations, evaluation of the voice and the throat and vocal cords by a specialist is necessary. This exam is often aided by performing a laryngoscopy procedure in which a very small fiberoptic scope is placed in the throat in order to view the mucous membrane surfaces and architecture with excellent resolution. The coordination of the muscles of the larynx can be examined as well as the vibrations of the vocal cords when using specialized instruments. As the treatment of chronic laryngopharyngitis largely depends on what is the underlying cause, a specialist evaluation is sometimes necessary in order to determine what that cause is. One common cause that warrants further discussion is chronic laryngopharyngitis due to reflux disease. This disorder refers to the backflow of stomach contents through the esophagus and potentially into the larynx and pharynx. When the reflux is limited to the esophagus, it may cause erosions that are experienced as heartburn (a burning sensation in the middle of the chest. This is due not only to the fact that the esophagus has more protective properties, but that the reflux is not spending enough time in the esophagus. As the esophagus is better suited to withstand the irritation of stomach contents such as acid, often a patient will have throat symptoms suggestive of laryngopharyngitis prior to experiencing traditional heartburn. Reflux can occur day and night, and often takes place even hours after a meal (Table 2-1.

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A common feature of these diseases is the lack of clean water for washing generic brahmi 60caps free shipping, and lack of education about their causes and how to prevent them cheap brahmi 60caps line. As you will see, washing the body and clothes regularly and disposing of rubbish safely is the key to prevention and control. A better understanding of these diseases will help you to diagnose, treat or refer patients, and educate your community on prevention measures. Learning Outcomes for Study Session 39 When you have studied this session, you should be able to: 39. Infection of the eyes with the bacteria Chlamydia trachomatis usually occurs in childhood, but infected people generally do not develop severe sight problems until adulthood. First, we will describe the infectious agents that cause trachoma, their modes of transmission and the clinical manifestations of the disease. This knowledge will enable you to identify people with symptoms, grade the signs according to a classication of severity, and decide whether you should treat patients yourself or refer them to a health centre or hospital. Then you will learn how to give health education about trachoma and its prevention in your community. In the initial stages of trachoma, the bacteria Chlamydia trachomatis primarily infect the conjunctiva (pronounced kon-junk-tie-vah ). This is a thin clear membrane that covers the inner surface of the eyelid and the white part of the eyeball. First it becomes itchy and inamed (red, swollen and painful); later it becomes scarred and the eyelashes turn inwards. The cornea is the thick transparent tissue over the front part of the eye, covering the white, black and coloured areas. The damage to the cornea is not due to the bacteria, but by persistent scratching from the eyelashes, which have turned inwards due to scarring in the conjunctiva. The conjunctiva lining the inside of the eyelids is the area most visibly affected by trachoma in the early stages. These bacteria can live in the genitals of males and females, causing a sexually transmitted infection, which can get into the eyes of the baby as it is born. This is why tetracycline eye ointment (1%) is applied to the eyes of all babies as part of routine newborn care. However, the most common routes by which Chlamydia bacteria get into the eyes and cause trachoma are through:. Trachoma is a very common disease in developing countries, including Ethiopia particularly in dry rural areas. About 80 million people in the world suffer from trachoma, of whom about eight million have become visually impaired. There are currently more than 238,000 people with blindness due to trachoma in Ethiopia. Trachoma is very common among children in certain parts of the country; for example, more than 50% of Ethiopian schoolchildren have had trachoma infections at some time. Without proper treatment, many of them will suffer severe eye problems in later life. The rst grade is the earliest manifestation of the infection, and the fth grade is permanent eye damage causing sight loss and leading eventually to blindness. It is important for you to know the signs that indicate these grades, because the actions you take when you see a person with suspected trachoma depends on correct grading. Other signs that you may notice are redness and swelling of the conjunctiva as a result of inammation caused by the bacterial infection. In severe cases, the blood vessels of the inammation with trachomatous eyelids may not be visible due to the swelling of the conjunctiva. This sign is called trichiasis (pronounced trik-eye-assis ) and is the fourth grade of trachoma severity. This is painful and distressing for the person and it gradually damages the cornea. Surgical treatment A simple surgical procedure can save a patient from becoming blind. Surgery can be carried out at the health centre by trained nurses and may simply involve turning out the eyelashes that are scarring the cornea. Explain that the operation is very simple, quick and safe, and it will greatly reduce the discomfort in their eyes and prevent further damage from occurring. Antibiotic treatment You are expected to treat grade 1 and grade 2 active trachoma (i. If this is the case, treat all children with tetracycline eye ointment for ve consecutive days in a month, and repeat the same procedure for six consecutive months. Alternatively, a doctor may prescribe the oral antibiotic azithromycine (20 mg/kg bodyweight) as a single dose in place of tetracycline to treat the whole community. Go to schools to teach children there in a large group that washing regularly prevents the transmission of trachoma from person to person. Everyone should learn the habit of washing their hands with soap and water in the early morning before they touch their eyes, before and after eating or preparing food, and after using the latrine.

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Pharmacological experiments with sympathomimetic agents buy 60 caps brahmi with mastercard, sympatholytic agents brahmi 60 caps low price, parasympathomimetic agents, and parasym- patholytic agents were done in the stomachs of two albino-rats to prove the sympathetic and parasympathetic activities. The review also outlines the rational approach to promotion of growth of Myanmar children. Studies conducted in Myanmar have shown that rice malabsorption is common in children, and may occur in up to two thirds of the population. It is possible that Helicobacter pylori infection frequently acquired during childhhod in developing countries has an impact on small bowel function. The precise mechanism is unknown but it has been proposed that it relates to the impact of infection on acid secretion, resulting in hypochlorhydria which may open the gate to enteric infections, small bowel bacterial overgrowth, and associated carbohydrate malabsorption. Elucidation of these mechanisms would allow a rational approach to promotion of growth of Myanmar children. An increase in the number of siblings was also found to be a high risk factor for H. Density of living, drinking water source, and type of latrine were not significantly associated with H. The findings indicated that intrafamilial transmission could play an important role in the high prevalence of H. Before implementation of clinical use of such a serological test requires validations for local use. Again growing popularity of "test- and-treat" policy requires evaluation of usefulness of such serological test-performance among under and over forty-five years age groups. The objectives were: a) to compare the gastric acid secretion together with urine acid output between malnourished and well-nourished children, b) to determine the relationship between the gastric acid secretion and urine acid out put. The study was carried out during June to December 2000 at the Yangon Children Hospital. Gastric acid secretion and urine acid output level before and after coffee stimulation in 40 malnourished and 20 well-nourished children. It was found that there was significantly decreased volume of stimulated gastric acid secretion within first hour (17. However, there was no significant quantitative relationship between gastric acid secretion and urine acid output in both malnourished and well-nourished children. Malnourished children were unable to respond appropriate to a stimulus for gastric acid production, poor response was markedly observed in children with kwashiorkor and lesser extent in marasmic-kwashiorkor children. All these patients underwent semi-urgent haemorrhoidectomy (Standard Ligation and Excision). During hospital stay, early post-operative complication were elected and compared with other series. On each visit of the follow-up, late post- operative complications was explored and the results were also compared and discussed with the other series. Study was done regarding the incidence, clinical presentation, pathological staging and type of operation and postoperative complication. The youngest one was 23 years old man (medical student) the oldest one was 75 years old man. However, the peak age incidence as well as average age incidence was one decade earlier than the counterparts in the Western countries, but similar to that of Egyptians and South African Bantu. But the commonest symptoms of colorectal cancer are extremely varied and nonspecific. But the commonest symptoms after final result include bleeding per rectum (50%) and changing bowel habit (46%). Regarding distribution of colorectal cancinoma in this study, in most of the patients, tumour were siturated in the rectum (50%). Microscopic manifestation revealed that, most of the cases were adenocarcinoma (69. According to histological grading, most of the cases were placed in moderately differentiated (54. In clinical staging, most of the cases by the time of admission were more or less in advance stage and so there was staging of Dukes C2 (44. Duke B is only seen in 5 cases 193 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar (10. Because of most of the cases in this study was rectal tumour, abdomino-peritoneal resection 34. Immediate postoperative complication in this study shows mainly of local complication likes wound sepsis including both abdominal (10. The goal of surgery for colorectal carcinoma is to remove all cancerous tissue, while minimizing treatment related morbidity and mortality. There is no major and gross postoperative complication and mortality rate is also within standard limit. Many colorectal carcinoma only produce vague, nonspecific symptoms and asymptomic. Ideally this surgical emergency can be avoided by early recognition of changes in bowel habit is important and per rectal examination may help early diagnosis. Awareness and health education about colorectal carcinoma in public is also important.

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