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The issue of adulteration and contamination buy verapamil 80 mg low price, particularly from Asian 7 perspective buy 120mg verapamil fast delivery, it should be noted that despite the widespread use of traditional medicine, 31 reports of serious adverse effects are rare. As a result, manufacturers may be only responsible for making a good faith effort to ensure products contain pure substances that are not contaminated, weakened or 32 mislabeled. These rules set requirements for domestically marketed herbs that include meeting specifications for identity, purity, strength and 37 composition. High-profile cases of adverse effects from herbal supplements have demonstrated the potential dangers of poorly regulated traditional medicine. National attention has recently been focused on this matter in the aftermath of incidents related to infant formula, pet food, and toothpaste contamination. When appropriately prepared and used, traditional Chinese herbs are generally safe and effective. The use of herbs, including their active ingredients, without appropriate diagnosis and outside of traditional guidelines should not be considered traditional 39 medicine. Ephedra Sinica is one of the oldest and most commonly used medicines in the Chinese herbal pharmacopeia. It was included as one of more than 360 herbs in the first herbal compendium written more than 2,000 years ago. In the 1980s and 1990s, some dietary supplement manufacturers began using Ephedra as a component of weight-loss and athletic enhancement supplements, without 41 regard for its traditional use, dosage or contraindications. Despite the fact that Ephedra was known to raise blood pressure and act as a stimulant to the cardiovascular and central 42 nervous systems, supplements containing Ephedra were marketed broadly without health warnings or restrictions. Furthermore, these supplements were of highly variable quality and concentration; an examination of Ephedra containing supplements revealed 18-fold 43 variations in the content of ephedrine and ephedrine-like substances. Ultimately, these supplements caused a large number of adverse effects, including heart attacks, strokes and 44 45 even death. For example, in 2012, 32 billion dollars was spent in the United States of America on dietary supplements, an amount projected to increase to 60 46 billion dollars in 2021. Benowitz, Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids, 343 New Eng. Traditional medicines also contribute to the development of pharmaceutical treatments. As much as one-third to one-half of pharmaceutical drugs was 48 originally derived from plants. The anti- cancer drug Taxol was derived from the bark of the Pacific yew tree, and Aspirin was 49 isolated from willow bark. Traditional medicine does more than provide raw materials for pharmaceuticals holders of traditional knowledge often have valuable knowledge for new drug development. Pharmaceutical companies invest billions of dollars annually in the hope of developing new chemical entities that are safe and effective, and that can be manufactured in a cost effective way. It is estimated that for every 10,000 pure compounds that are biologically evaluated, only one achieves 50 regulatory approval. A single approval can take upwards of a decade and cost 51 hundreds of millions of dollars. Traditional knowledge can provide valuable guidance in selecting and obtaining plant material of potential therapeutic interest. Bioactive compounds derived from currently used herbal medicines are more likely to have minimal toxicity, and a long history of clinical use suggests that a herbal medicine may be clinically effective. Plant-derived compounds used as drugs are generally used in ways that correlate directly with their traditional uses as plant 52 medicines. Malaria also causes significant economic damage in high-rate areas, and disproportionately 54 affects poor people who cannot afford treatment or have limited access to health care. Traditional medicines are the source of some modern antimalarial drugs (artemisinin and quinine derivatives). Artemisinin was isolated in 1972 as the active ingredient of the plant Artemisia annua, and this innovation relied upon the Chinese traditional medical text, rd 55 Handbook of Prescriptions for Emergencies, written in the 3 century A. Carter, The evolving role of natural products in drug discovery, 4 Nature Reviews Drug Discovery 206-220, 206 (March 2005). A study investigating plant-derived pure compounds used as drugs identified 122 compounds obtained from 94 species of plants. These compounds are used globally as drugs and 80% are used in ways that correlate directly with their traditional uses as plant medicines by native cultures. Farnsworth, The Value of Plants Used in Traditional Medicine for Drug Discovery, 109 Environmental Health Perspectives 69-75, 69 (2001). This process is sometimes referred to as "bioprospecting," the development of new therapeutics from products of nature. On the one hand, bioprospecting can be beneficial to indigenous communities and developing countries.

So more antimicrobial therapy was found to be given in all persistent diarrhoeal patients buy verapamil 80 mg online. Also the usage of antibiotics in acute diarrhoeal cases should be minimized to actual indiacted cases buy 80 mg verapamil. 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. These results indicated that persistent diarrhoea and malnutrition in Burma is caused by a complex of several interrelated socioeconomic factors, unsanitary behaviour pertaining to personal hygiene, the practice of demand breastfeeding and lack of certain weaning foods, and low education of mothers who showed less knowledge about causes of diarrhoea and prevention of malnutrition. Glycine 4g and glycyl-glycine 4g patients with clinical cholera were given tetracycline 500mg q. Rectal swabs were also taken and investigated for culture and sensitivity at the Bacteriology Research Division of the Department of Medical Research. A total of 200 children under five years of age with acute diarrhoea were included in the study. Sixteen serogroups were identified 94 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar O125 and O126 were common serotypes. The serogroups of Escherichia coli classified were O1 K51; O8K25; K+; O25K+; O27K+; 028K+; O78K+; O86 K61, K62; O114 K90; O119 K69; O125 K70; O126 K71; O127 K63; O128 K67; O136 K78; O148 K+; O157 K+ and O159 K+. It was also noted that personal hygiene still plays an important role in causing acute diarrhoea. As peptic ulcer disease is very common in Myanmar, it is of great importance to elucidate whether H. A total of fifty biopsy specimens which were obtained from forty-three male and seven female patients were included in this study. Patients of age range forty-five and above forty-five years were observed to be of highest prevalence consisting of 44 percent. These patients had undergone endoscopic examination and the respective biopsies were taken. The invasive tests used in this study were rapid urease tests, histology and culture. Among the fifty patients studied, 95 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar thirty five patients (70%) were urease positive, twenty patients (40%) were positive on histological examination and ten patients (20%) were positive on bacteriological examination. The sensitivity and specificity of urease test, histology and culture were 90% and 35% for urease test, 50% and 62. The study included fifty biopsy specimens obtained from forty three male and seven female patients. These patients were submitted to endoscopic examination and the respective biopsies were taken. The sensitivity and specificity of urease test, histology and culture in the diagnosis of H. The endoscopic study from 50 patients revealed, 18 patients with only gastritis (36%); 19 with gastritis and duodenal ulcer (38%); 6 with gastritis and gastric ulcer (12% and with gastritis, duodenal and gastric ulcer (14%). Factors associated with duration of diarrhoea were ascertained by multiple regression analysis, where as prognostic indicators were confirmed by simple logistic regression procedure. Positive association with duration of diarrhoea of diarrhoea 96 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar noted with presence of mucus/blood/both in stool, decreased weight for age, lower income group and non-use of soap in hand washing after defecation. In addition to these factors lack of exclusive breast feeding in under 2 years children had positive association with duration of diarrhoea. In a logistic regression analysis, malnutrition, lack of hand washing with soap after defecation and lack of exclusive breast feeding were found to be prognostic indicators for the development of persistent diarrhoea. Endoscopic antral biopsy tissues for urease testing and 14C urea breath test confirmed the diagnosis of H. A total of 487 children, 327 with acute and 160 with persistent diarrhoea participated in the study, intestinal pathogen was detected in 71% (114) of persistent diarrhoea cases including bacteria agent 31%, viral agent 6. Male had more diarrhoea than female and peak incidence of acute and persistent diarrhoea occurred in the 2-11 months age group. Fever and vomiting were found frequent in persistent than acute diarrhoea during second week of illness (p<0.

Some patients with more diffuse underlying structural lesions that are limited to one hemisphere can also be treated surgically with hemispherectomy or hemispherotomy buy 120 mg verapamil with visa. Whereas 80 90% of patients with idiopathic epilepsies can expect to become seizure free order 120mg verapamil fast delivery, and many will undergo spontaneous remission, the gure is much lower for patients with symptomatic epilepsy, and perhaps only 5 10% of patients with temporal lobe epilepsy and hippocampal scle- rosis will have seizures that can be controlled by pharmacotherapy. Of these patients, however, 60 80% can become free of disabling seizures with surgery. Advances in neurodiagnostics, particularly neuroimaging, are greatly facilitating our ability to determine the underlying causes of seizures in patients with symptomatic epilepsies and to design more effective treatments, including surgical interventions. The overall incidence of epilepsy in Europe and North America ranges from 24 and 53 per 100 000 per year, respectively (4 6). The incidence in children is eventually higher and even more variable, ranging from 25 to 840 per 100 000 per year, most of the differ- ences being explained by the differing populations at risk and by the study design (3). In developing countries, the incidence of the disease is higher than that in industrialized countries and is up to 190 per 100 000 (3, 7). Although one might expect a higher exposure to perinatal risk factors, infections and traumas in developing countries, the higher incidence of epilepsy may be also explained by the different structure of the populations at risk, which is characterized by a predominant distribution of young individuals and a short life expectancy. Incidence by age, sex and socioeconomic status In industrialized countries, epilepsy tends to affect mostly the individuals at the two extremes of the age spectrum. The peak in the elderly is not detected in developing countries, where the disease peaks in the 10 20-year age group (8). This may depend on the age structure of the population and on a relative under-ascertainment of the disease in older individuals. The incidence of epilepsy and unprovoked seizures has been mostly reported to be higher in men than in women in both industrialized and developing countries, though this nding has rarely attained statistical signicance. The different distribution of epilepsy in men and women can be mostly ex- plained by the differing genetic background, the different prevalence of the commonest risk factors in the two sexes, and the concealment of the disease in women for sociocultural reasons. This assumption is sup- ported by the comparison between industrialized and developing countries and by the comparison, within the same population, of people of different ethnic origin (9). The prevalence of active epilepsy is generally lower in industrialized countries than in developing countries, which may reect a lower prevalence of selected risk factors (mostly infections and traumas), a more stringent case verication, and the exclusion of provoked and unprovoked isolated seizures. Prevalence by age, sex and socioeconomic status In industrialized countries, the prevalence of epilepsy is lower in infancy and tends to increase thereafter, with the highest rate occurring in elderly people (10). Where available, age-specic prevalence rates of lifetime and active epilepsy from developing countries tend to be higher in the second (254 vs 148 per 1000) and third decades of life (94 vs 145 per 1000) (8). The differences between industrialized and developing countries may be mostly explained by the differing distribu- tion of the risk factors and by the shorter life expectancy in the latter. However, this nding is not consistent across studies and, with few exceptions, is not statistically signicant. Socioeconomic background has been found to affect the frequency of epilepsy reports in both industrialized and developing countries. In developing countries, prevalence rates have been shown to be greater in the rural compared with the urban context (11, 12 ) or in the lower compared with the higher socioeconomic classes. However, opposite gures were reported in a meta-analy- sis of epidemiological studies from India (13), which suggests that rural and urban environments should not be invariably used as proxies of lower vs higher socioeconomic conditions. Mortality The mortality rate of epilepsy ranges from 1 to 8 per 100 000 population per year, but international vital statistics give annual mortality rates of 1 2 per 100 000 (14). The highest mortality risk in the youngest age groups can be interpreted in part in the light of the underlying epileptogenic conditions and the lower number of competing causes of death. It is extremely difcult to analyse the epilepsy death rate in the general population of a devel- oping country because incidence studies of epilepsy are difcult to perform, death certicates are unreliable and often unavailable, and the cause of death is difcult to determine. Based on available data, it seems that the mortality rate of epilepsy in developing countries is generally higher than that reported in developed countries. These data cannot be generalized, however, as they have been obtained from selected populations (17 ). Many more people, however an estimated 200 000 000 are also affected by this disorder, as they are the family members and friends of those who are living with epilepsy. Up to 70% of people with epilepsy could lead normal lives if properly treated, but for an overwhelming majority of patients this is not the case (18). People with hidden disabilities such as epilepsy are among the most vulnerable in any society. While their vulnerability may be partly attributed to the disorder itself, the particular stigma associated with epilepsy brings a susceptibility of its own. Stigmatization leads to discrimination, and people with epilepsy experience prejudicial and discriminatory behaviour in many spheres of life and across many cultures (20). People with epilepsy experience violations and restrictions of both their civil and human rights. Discrimination against people with epilepsy in the workplace and in respect of access to education is not uncom- mon for many people affected by the condition. Violations of human rights are often more subtle and include social ostracism, being overlooked for promotion at work, and denial of the right to participate in many of the social activities taken for granted by others in the community. For example, ineligibility for a driving licence frequently imposes restrictions on social participation and choice of employment.