Indiana University Southeast.
The demand for a better de¿nition of professionalism in medicine is a result of signi¿cant changes within our society and a growing need to guarantee improved quality in community-based health care services 100 mg aldactone amex prehypertension headaches. Thus discount 100 mg aldactone amex demi lovato heart attack mp3, the term professionalism is being identi¿ed as the essence of humani- sation buy 100mg aldactone hypertension mayo clinic, competence and specialisation  order aldactone 25 mg online blood pressure chart on age. Modi¿ed from  De¿nition That part of the system represented by healthcare professionals Role To pause; to allow for critical-thinking skills Goal To do the best for patients; patient safety; professional performance Bion and co-workers recently focused on the importance of human factors in managing critically ill patients . The analysis of human factors provides a useful framework in which to understand and rectify unreliability and causes of errors, in particular, in complex systems such as the critical care setting. Human factors inÀuence performance as concerns the task, the individual and the organisation or system. By de¿nition, professionalism indicates a crucial concept concern- ing the contract between medicine and society (Table 30. In this scenario we express our personal point of view on medical professionalism according to physicians’ specialty, practice set- ting and pay-for-performance trials . Professionalism, which is fundamental to medical practice, must be thought of explic- itly. It is the basis of the relationship between medicine and society, which most observers call a social contract. The social contract serves as the basis for society’s expectations of medicine and medicine’s expectations of society. It therefore directly inÀuences pro- fessionalism, considering that we live in the era of commercialism, consumerism, bu- reaucratisation and industrialisation . When we think of profes- sionalism, it should be related to different cultures and their social contracts, respecting local customs and values . A decreased public trust in all professions has brought increased attention to medical professionalism; it relates to those skills, attitudes and behaviours that people have come to expect from individuals during the practice of a profession and includes several concepts, such as maintenance of competence, ethical behaviour, integrity, honesty, relationships, responsibility, reliability, altruism, caring and compassion, service to others, adherence to professional codes, justice, respect for others, self-regulation, scienti¿c knowledge, excel- lence, scholarship and leadership. There are no codes in the physician charter of medical professionalism  concerning pay-for-performance service. Health care systems are regulated to support the health care needs to a target popula- tion. In some countries, health care system planning is delivered among market participants, whereas in others, planning is made more centrally among governments, trade unions, charities, religious or other coordinated bodies to delivery planned health care services targeted to the populations they serve. It seems a very dif¿cult task comparing different organisations of health care systems, resource allocation and the modality to assure a horizontal and extra salary to improve the quality of care and outcome while reducing costs at the same 30 Professionalism, Quality of Care and Pay-for-Performance Services 351 time. However, health care planning has often been evolutionary rather than revolution- ary. The goals set by health care systems, according to the World Health Organization , are good health responsiveness to the expectations of the population and fair ¿nancial contribution. Duckett proposed a two-dimensional approach to evaluation of health care systems: quality, effectiveness and acceptability on one dimension, and equity on the other . Health care providers are trained professionals, working as self-employed individuals or as employees within an organisation – either a for-pro¿t corporation, a nonpro¿t company, a government entity or a charitable organisation. Examples of health care providers are doctors and nurses, paramedics, dentists, medical laboratory personnel, specialist thera- pists, psychologists, pharmacists, chiropractors and optometrists. There are generally ¿ve primary methods of funding health care systems [10–12]: 1. Advances towards improving the standard of care represent a real challenge in health care system management. Escalating costs and the growing imbalance between primary and specialty care have increased the urgency of calls for a fundamental reform of the health care payment system. This is a very critical point of controversy, and strong dispari- ties persist in different area such as continental, national, regional and local environments . At the core of the problem is the fact that the dominant fee-for-service models reward volume and intensity rather than value. However, although faults in the way we pay for health care are obvious, it is much less clear what feasible approach would yield better results. Avoiding disparity of care delivery and the capacity of high-quality care while low- ering costs  and protecting patient safety are the cardinal points in a period of recession caused by a broken economy. Poor quality of care is not only costly but also produces errors and increased human suffering; in other words, poor quality of care results in an increase in morbidity and mortality. Patient safety is a new health care discipline that emphasises the reporting, analysis and prevention of medical errors that often lead to adverse health care events. The frequency and magnitude of avoidable ad- verse patient events was not well known until the 1990s, when several countries reported staggering numbers of patients harmed and killed by medical errors. Presenting accounts of anaesthesia-related accidents, the producer stated that every year, 6,000 Americans die or suffer brain damage related 352 A. Media attention, however, mainly focused on staggering statis- tics: from 44,000 to 98,000 preventable in-hospital deaths annually, and 7,000 preventable deaths related to medication errors. According to Hendrickson , the concept of using ¿nancial incentives to support and improve quality of care within the context of a professional endeavour such as medicine is not without moral and practical risks: damag- ing professionalism, increasing patient dissatisfaction with the low quality of care deliv- ered, threatening the ongoing physician–patient relationship and, last but not least, the negative trend for access to care for all patients are the main negative elements empow- ering medicine as a mission. Anaesthesiologists, intensivists, critical care physicians and nurses have a broad exper- tise in hospital organisation and the expanding area of quality and safety management by increased adherence to evidence-based guidelines, monitoring processes and improving quality of care . The doctor’s expertise includes both diagnostic skills and consid- eration of each patient’s rights and preferences in making decisions about patient care. Clinicians use relevant clinical research based on the accuracy of diagnostic tests and the ef¿cacy and safety of therapy, rehabilitation and prevention to develop an individual treatment plan . The development of evidence-based recommendations for speci¿c medical conditions, termed clinical practice guidelines, or “best practices”, has improved in the last decade. The process of measuring performance often requires the use of statistical evi- dence to determine progress towards speci¿c organisational objectives. Performance may 30 Professionalism, Quality of Care and Pay-for-Performance Services 353 Table 30. Psychosocial and ethical outcome - Long-term functioning and quality of life - Patient satisfaction - Family satisfaction - Concordance on desired end-of-life decisions - Appropriateness of medical interventions provided 4. There are three ways of evaluat- ing performance: structure, process and outcome (Table 30. Structural measures are used to track and pay for resources that help improve care delivery (e. Process measuring evaluates clinical services demonstrated to be necessary to facilitate positive health outcome, such as testing haemoglobin A1c levels in patients with diabetes or prescribing aspirin to heart attack patients upon hospitalisa- tion. Measures that are not directly connected to improving performance (such as those directed to improving communication with the public to build trust) are measures that are means to achieving the ultimate purpose. As de¿ned by Radwin, what is needed to reduce the clash between “medicine, money and morals” are policies that hold doctors accountable to patients for ful¿lling the profession’s ideals . To evaluate how well a public agency is performing: formulate a clear, coherent mission, strategy and objectives; then based on this information, choose how those activities will be measured; 2. To control how managers can ensure their subordinates are doing the right thing; 3. To motivate: give staff signi¿cant goals to achieve and then use performance measures, including interim targets, to focus their thinking and work and to provide a periodic sense of accomplishment; performance targets may also encourage creativity in developing better ways to achieve the goal; measures to motivate improvements may also motivate learning; 5. To celebrate: commemorate accomplishments – such rituals bond staff, give them a sense of individual and collective relevance; moreover, by achieving speci¿c goals, people gain sense of personal accomplishment; celebration helps improve performance because it must work through one of the likes – motivation, learning, etc. To produce: how public manager convinces political superiors, legislators, stakeholders, journalists and citizens that the agency is doing a good job; 7. To learn: learning is involved with a process – of analysis information provided by evaluat- ing corporate performance (identifying what works and what does not); 8. To improve: what exactly should who do differently to improve performance; for a corpora- tion to measure what needs to improve, it ¿rst needs to identify what it will improve and develop processes to accomplish that United States and United Kingdom policy makers and payers (those who pay for health care services) as a means of improving the quality of health care. In fact, the Institute of Medicine’s 2001 report, “Crossing the Quality Chasm”, suggested realigning incentives to improve care . Compensation is a core function of human resource management, one that has impor- tant direct and indirect implication, appraisal, training, retention and labour relations.
The bird was placed on are valuable in avian patients for broad-spectrum antibiotics and steroids buy discount aldactone 25 mg blood pressure 1. A deep pain response was noted five days after distinguishing between a neuropa- the initial injury discount 25 mg aldactone free shipping hypertension 4th report, and the bird slowly improved with a complete return to normal function over a three-month period cheap aldactone 25mg with amex blood pressure level chart. A nerve stimulator is used to generate an M consists of insertion potentials buy 100mg aldactone with visa arrhythmia event monitor, motor unit potentials response at two different locations along the course and spontaneous waves, which occur infrequently. The distance between the sites When the electrode is inserted into the muscle, the is divided by the latency difference in the two M intrafascicular nerve branches and muscle fibers are responses to determine the velocity with which the stimulated, creating a brief burst of electrical activ- impulse travels along the nerve (m/s). Where there is ity, which ceases immediately after the electrode a peripheral neuropathy such as demyelination, the stops moving. If the electrode is moved, insertional velocity is slow and the M responses are polyphasic activity will again be recorded. If the electrode is inserted stimulation distal to the site will produce an M re- coincidentally near a motor endplate, a low continu- sponse, while stimulation of the site proximal to the ous level of electrical activity will be recorded with an lesion will not. The H-wave reflex muscle contraction or when a motor nerve is stimu- evaluates both the afferent and efferent pathways. The M response has two peripheral site is stimulated and sensory impulses phases and represents the sum of the electrical activ- are carried to the spinal cord, where the alpha motor ity of all of the muscle fibers in that motor unit. Prolonged insertional activ- with a lower intensity than that required to cause an ity due to muscle hyperexcitability occurs six to ten H-wave production, activating the motor neuron to days following peripheral nerve injury, then gradu- generate an efferent impulse. Fibrillation potentials are mono- or wave reflexes are used in combination to evaluate biphasic and occur five to seven days following den- nerve root avulsion. These spontaneous, repetitive action poten- Signal-averaging capabilities are required for soma- tials from muscle fibers, not produced by nerve im- tosensory-evoked potentials, spinal-evoked poten- pulses, occur because of the instability of the cell tials and motor-evoked potentials. Fibrillation potentials evoked potentials correspond clinically to the increase for several weeks after denervation, then presence or absence of pain perception. They utilized to determine if failure to react to a painful stop if reinnervation occurs. This procedure is performed denervation, but may be observed with primary by stimulating a peripheral nerve and recording the myopathies. They are characterized by an initial response in the cervical spinal cord or cerebral cor- positive deflection followed by a slower negative po- tex. It is important to recognize that these evoked tential with a “dive bomber engine” auditory compo- potentials evaluate sensory, not motor nerve func- nent. A response may persist after permanent loss of potentials are generally indicative of a primary motor function. Physical examination revealed a discharge of necrotic debris from the right ear canal that contained gram-negative rods. They can discretely evaluate the sensory path- way of a focal segment of spinal cord such that loss of response cranial to a specific vertebra identifies the location of the lesion. Motor-evoked poten- tials are capable of evaluating motor function, but techniques are not well established for animal use. They are currently being evaluated for safety, effects of anesthetics and correlation with injury. They vary with head size, environment, re- straint techniques and state of consciousness of the Nutritional patient. They may be beneficial in monitoring pro- Hypovitaminosis E and Selenium Deficiency gress in response to brain lesions or injury. Auditory- evoked potentials evaluate the brainstem response Deficiencies of vitamin E and selenium have been to auditory stimuli. They may be used to assess reported to cause a wide variety of clinical signs and hearing ability and brainstem function (Figure 28. In a survey of central nervous system lesions from animals in a zoological collection, birds had a higher incidence of disease than mammals, and encephalomalacia his- tologically compatible with hypovitaminosis E was the most common lesion observed. In young birds, hypovitaminosis E may cause encephalomalacia, exudative diathe- sis or muscular dystrophy. Encepha- lomalacia results in ataxia, head tilt, circling and occasionally convulsions and is particularly common in hatch- ling budgerigars. The myositis associated with hypovitami- nosis E may cause clinical changes dif ficult to distinguish from neurologic signs. Clinical signs associated with vitamin E and sele- nium deficiencies include tremors, ataxia, incoordi- nation, abnormal head movements, reluctance to walk and recumbency. At presentation, the bird was recumbent and had stiff, nonmotile thoracic and pelvic limbs, but was bright, alert and cal signs or in birds that are found dead in their responsive. The muscle masses associated with all limbs were enclosures with no premonitory signs. His- Muscular dystrophy is characterized by light-colored topathology indicated severe, progressive, generalized muscle fi- brosis of undetermined etiology. Early histologic changes include hyaline degeneration, mi- tochondrial swelling, loss of striations and central been reported in a variety of other species including migration of the nucleus. Clinical signs include slow or incomplete eye blink due to paresis of the lower eyelid, weak jaw muscles, This deficiency has also been incriminated as the paresis of the tongue, poor digestion with passage of etiology of cockatiel paralysis syndrome. This condi- partially digested food, diminished playful activity, tion appears to occur most frequently in lutino cocka- hyperactivity, clumsiness and weak grip, low-pitched tiels infected with Giardia sp. Cockatiels and other nestling budgerigars with riboflavin deficiency (see psittacine birds showing these clinical signs have Color 48). Other signs include weakness, emaciation responded to vitamin E and selenium supplementa- in the presence of a good appetite, diarrhea, walking tion and antiprotozoal therapy. In one study, treat- on the hocks with toes curled inward and atrophy of ment of giardiasis resulted in an increase in serum leg muscles. Chicks fed a deficient diet may develop vitamin E levels from a deficiency state into the clinical signs as early as 12 days of age. There is Schwann cell proliferation sis in fledgling mocking birds fed a commercial cat and swelling, perivascular leukocytic infiltration and food has been reported. All affected birds cord and degeneration at the neuromuscular end- responded to parenteral administration of selenium plate may also be observed. Other ministration of oral or parenteral riboflavin and diet species of birds being raised at this facility were not correction; however, many of the changes are irre- affected. Vitamin E deficiency also occurs in piscivorous birds Hypovitaminosis B6 (Pyridoxine) fed an unsupplemented diet of frozen fish (especially Neurologic signs associated hypovitaminosis B are6 smelt). In birds of the family Ardeidae (herons and characteristic, with the bird exhibiting a jerky, nerv- bitterns), the deficiency manifests initially as fat ous walk progressing to running and flapping the necrosis accompanied by steatitis. Muscular dystrophy may resolve with sup- Deficiency in a Nanday Conure was reported to cause subacute, multifocal white matter necrosis. Head the anterior muscles of the neck resulting in pseudo- trauma may occur at night when a panicked bird flies hypertonus of the muscles of the dorsal aspect of the into an enclosure wall or if birds fly into windows or neck (see Color 48). Injured birds may remain on the bottom of ciency causes a polyneuritis with myelin degenera- the enclosure and exhibit depression, head tilt, cir- tion of peripheral nerves. Blood may be present edema of the skin are also characteristic of thiamine in the mouth, ears or anterior or posterior chamber deficiency. Anisocoria and delayed pupillary light hours of oral or parenteral administration of vitamin response may be present and convulsions may occur B1. Administration of thiamine is a useful adjunct to therapy in many nonspecific neurologic Fractures of the skull or scleral ossicles may be de- disorders. In some cases, a bruise might be visualized on the head that is the result of meningeal hemorrhage seen through the cranium. A fibrocartilaginous, wedge-shaped hemorrhage to occur within the brain parenchyma.
However generic aldactone 100 mg online blood pressure chart with age and height, other factors appear to be more important in stimulating the release of histamine in hives discount aldactone 100mg with visa blood pressure headache. Causes Physical Conditions Hives can be produced as a result of reactions to various physical conditions buy aldactone 25mg online pomegranate juice blood pressure medication. The most common forms of physical urticaria are dermographic 100 mg aldactone overnight delivery blood pressure quiz, cholinergic, and cold urticaria. Less common types of physical urticaria or angioedema include contact, solar, pressure, heat contact, aquagenic, vibratory, and exercise-induced. Dermographism Dermographism, or dermographic urticaria, is a readily elicited hive formation that evolves rapidly when moderate amounts of pressure are applied. This pressure may occur as a result of simple contact with another human being, furniture, bracelets, watchbands, towels, or bedding. It is the most common type of physical urticaria and is found twice as frequently in women as in men, with the average age of onset in the third decade. The incidence is much greater among the obese, especially those who wear tight clothing. Dermographic lesions usually start within one to two minutes of contact as a generalized redness in the area; this effect is replaced within three to ﬁve minutes by a welt and surrounding reﬂex urticaria. While the redness (erythema) generally regresses within an hour, the edema can persist for up to three hours. Dermographism may be associated with other diseases, including parasite infection, insect bites, hormonal changes, thyroid disorders, pregnancy, menopause, diabetes, immunological alterations, other urticarias, drug therapy (during or following), chronic candidiasis, angioedema, and elevated blood levels of eosinophils (another type of white blood cell linked to allergies). Cholinergic Urticaria Cholinergic, or heat-reﬂex, urticaria (commonly referred to as “prickly heat rash”) is the second most frequent type of physical urticaria. These lesions, which depend upon stimulation of the sweat gland, consist of pinpoint wheals surrounded by reﬂex erythema. The wheals arise at or between hair follicles and develop most often on the upper trunk and arms. The three basic types of stimuli that may produce cholinergic urticaria are passive overheating, physical exercise, and emotional stress. Typical eliciting activities, besides physical exercise, may include taking a warm bath or sauna, eating hot spices, or drinking alcoholic beverages. The lesions usually arise within 2 to 10 minutes after provocation and last for 30 to 50 minutes. A variety of systemic symptoms may also occur, suggesting a more generalized mast cell release of the mediators than just in the skin. Headache, swelling around the eyes, tearing, and burning of the eyes are common symptoms. Less frequent symptoms include nausea, vomiting, abdominal cramps, diarrhea, dizziness, low blood pressure, and asthma attacks. Cold Urticaria Cold urticaria is a hives reaction of the skin when it comes into contact with cold objects, water, or air. Lesions are usually restricted to the area of exposure and develop within a few seconds to minutes after the removal of the cold object and rewarming of the skin. Widespread local exposure and generalized hives can be accompanied by ﬂushing, headaches, chills, dizziness, rapid heartbeat, abdominal pain, nausea, vomiting, muscle pain, shortness of breath, wheezing, or unconsciousness. Cold urticaria has been observed to accompany a variety of clinical conditions, including viral infections, parasitic infestations, syphilis, multiple insect bites, penicillin injections, dietary changes, and stress. Most drugs are composed of small molecules incapable of inducing antigenic/allergenic activity on their own. Typically, they produce allergic effects by binding to larger molecules and inducing the immune system to develop allergic antibodies to the new molecule complex. Alternatively, drugs can interact directly with mast cells to induce the release of histamine. Antibiotics Antibiotics, including penicillin and related compounds, are the most common cause of drug- induced hives. At least 10% of the general population is thought to be allergic to penicillin; of these people, nearly 25% react with hives, angioedema, or anaphylaxis. It is not known to what degree penicillin in the food supply contributes to hives. However, hives and anaphylactic symptoms have been traced to penicillin in milk,3 soft drinks,4 and frozen dinners. This study would seem to provide indirect evidence that penicillin in the food supply contributes to hives. In an attempt to provide direct evidence, penicillin-contaminated pork was given to penicillin- allergic volunteers. No signiﬁcant reactions were noted other than transient itching in two volunteers. Presumably this is because penicillin breaks down into more allergenic compounds in the milk. Aspirin The frequency of aspirin sensitivity in patients with chronic hives is at least 20 times greater than it is in people without hives. Daily administration of 650 mg aspirin for three weeks has been shown to desensitize patients with hives who have aspirin sensitivity. While taking the aspirin, patients also became nonresponsive to foods to which they usually reacted (pineapple, milk, egg, cheese, ﬁsh, chocolate, pork, strawberries, and plums). Individuals with eczema or asthma are most likely to experience hives as a result of classic allergic (IgE-mediated) mechanisms. A basic requirement for the development of a food allergy is the absorption of the allergen through the intestinal barrier. In addition, several investigators have reported alterations in gastric acidity, intestinal motility (contractions of the intestine that propel the food through), and other functions of the digestive tract in up to 85% of patients with chronic hives. In one study of 77 patients with chronic hives, 24 (31%) were diagnosed as having no gastric acid output, and 41 (53%) were shown to have low gastric acid output. Colorants (azo dyes), ﬂavorings (salicylates, aspartame), preservatives (benzoates, nitrites, sorbic acid), preservatives (hydroxytoluene, sulﬁte, gallate), and emulsiﬁers/stabilizers (polysorbates, vegetable gums) have all been shown to produce hives in sensitive individuals. The importance of controlling food additives is demonstrated by a study of 64 patients with hives. After two weeks on an additive-free diet, 73% of the patients had a signiﬁcant reduction in their symptoms. Reactions to this food additive are so common that its use has been banned in some countries (e. Tartrazine sensitivity is extremely common (20 to 50%) in individuals who are sensitive to aspirin. Both compounds inhibit the enzyme cyclooxygenase; this inhibition results in a higher production of allergic compounds known as leukotrienes in some individuals. These compounds are roughly 100 times more potent than histamine in producing an allergic reaction. In addition, tartrazine (as well as benzoate and aspirin) increases the production of lymphokine leukocyte inhibitory factor; this effect results in an increase in the number of mast cells throughout the body. Biopsies of patients with hives show that over 95% have more mast cells than individuals without hives. A broad range of salicylic acid esters are used to ﬂavor such foods as cake mixes, puddings, ice cream, chewing gum, and soft drinks. The mechanism of action of these agents is thought to be similar to that of aspirin. Most fruits, especially berries and dried fruits, contains salicylates; raisins and prunes have the highest amounts. Salicylates are also found in appreciable amounts in licorice and peppermint candies. Vegetables, legumes, grains, meat, poultry, ﬁsh, eggs, and dairy products typically contain insigniﬁcant levels of salicylates. Salicylate levels are especially high in some herbs and condiments, including curry powder, paprika, thyme, dill, oregano, and turmeric.
There was no significant difference between two groups on all score except staining score purchase aldactone 25 mg visa hypertension guideline update jnc 8. It was concluded that Ponna-yeik mouthwashes revealed anti-inflammation and anti-plague activity without staining buy aldactone 100mg with amex hypertension nutrition. The plant extracts were prepared using different concentrations of ethanol 100 mg aldactone amex blood pressure chart doc, aqueous solution and ethyl acetate in various rations purchase aldactone 100 mg without a prescription pulmonary hypertension 50 mmhg. Kywe-kyaung-hmin-sae was extracted with 50% ethanol, 95% ethanol, ethyl acetate and aqueous solution and the extracts were used to screen enteric infections, testing of antiamoebic effect and antibacterial activity in vitro. In vivo screening was done for inhibitory effect of the pe-natha seeds extracts on adrenaline induced hyperglycaemia in animal models. The morphology and anatomy of these plants were investigated so as to ascertain their correct identification. In addition, quercetin was identified and isolated from Euphorbia hypericifolia L. The purpose of the present study was to evaluate scientifically smooth muscle relaxant effect of Aegle marmelos Linn. In this study, ethanolic and aqueous extraction of Okshit dried leaves, acute toxicity and pharmacological screening tests, phytochemical analysis of both ethanolic and aqueous extracts of Okshit and experiments for smooth muscle were carried out. In acute toxicity study in mice, it was observed that both extracts of Okshit were not toxic up to the maximal feasible dose of (16g/kg) body weight. General pharmacology screening test of both extracts of Okshit had shown no abnormal changes. In isolated rabbit jejunum, both extracts caused relaxation of intestinal smooth muscles and had dose-dependent antagonism with histamine or acetylcholine. Their relaxation effects on intestinal smooth muscle could not be blocked by either tolazoline or propranolol. In isolated rabbit aortic strip, both extracts did not show any contractile effect and they did not relax the contraction caused by adrenaline. In isolated rat uterus, ethanolic extract showed no relaxation effect on normal rat uterus preparation but had antagonism against contraction caused by acetylcholine and oxytoxin. It may be an antagonist of histamine or an anticholinergic activity, but it is more likely to be due to its direct action on tissues. A total of 24 apparently healthy young male Myanmar adults were selected as subjects. For the two groups the changes in serum lipid profile after consumption of 100g avocado with salt and 100g avocado with sugar per day for 6 weeks period was studied. The serum total cholesterol and triglyeride levels were decreased significantly with p<0. The consumption of avocado with salt and avocado with sugar has similar beneficial effect on serum lipid levels. Effect of Azadirachta indica Neem seed kernel extracts on Anopheles dirus mosquitoes. At a concentration of 2% no anopheles biting and the protection provided was 100% during 10-12 hrs periods. Moreover, under laboratory condition with 2 and 4%, the ovicidal effect was found to be 100% control. Theingi Thwin; Thet Thet Mar; Hnin Lwin Tun; Khin Than Yee; Mie Mie Nwe; Lwin Zar Maw; Tin Ko Ko Oo; Aye Myint Oo. The effect of administering dried Chinese quince fruits on high-cholesterol-fed rats was studied for a period of 90 days. A total of twenty male Wistar rat with 150-200gm body weight were included in the study. Thoroughly dried Chinese quince fruits were ordered from Lashio (Northern Shan State) and made into a fine powder. All rats were supplemented with a high cholesterol diet which was enriched with coconut oil (25% by weight) and egg yolk (66. Dried Chinese quince fruit powder was put into water in a ratio of 1:100 (w/v) and boiled for 10 hours to make a watery extract. One ml of watery extract (144mg dried Chinese quince/kg body weight) and an equal volume of distilled water were administered orally by intragastric intubation daily for ninety days to the test and control group (10 in each), respectively. When serum total cholesterol levels were compared between the test and control group on Day 30 (180. Effect of dried quince fruits (Cydonia cathayensis) supplementation on plasma lipid profile and peroxidation in hypercholesterolemic subjects. Theingi Thwin; Thet Thet Mar; Hnin Lwin Tun; Lwin Zar Maw; Tin Ko Ko Oo; Aye Myint Oo. The effect of dried quince fruit (Cydonia cathayensis) supplementation on plasma lipid profile and peroxidation was investigated for a period of ninety days in 12 hypercholesterolemic subjects (≥200mg% plasma total cholesterol levels). Throughly dried quince fruits were made into a fine powder and formed 250mg tablets. In comparison with the Simvastatin group, the mean plasma total cholesterol levels of the quince group were significantly higher than those of Simvastatin group on Day 45 and Day 90 (186. Plasma total cholesterol lowering effect of dried quince fruit supplementation was not as much as that of Simvastatin administration. The acute carbon tetrachloride induced liver damage was shown to be protected by Eclipta alba, an indigenous medicinal herb found in Burma. The parameters used for the assesment were (1) histology, (2) behavioural changes, (3) body weight changes, (4) mortality rate and (5) biochemical changes. Using rats as experimental animals reliable models of acute alcohol related liver disease was produced initially. After establishment of the model four experimental groups of rats were used in the present study. The test group of animals received daily oral intubation of 50% ethyl alcohol for 45 days: the protected group received E. All the rats were sacrificed at the end of the experimental period which lasted for 45 days. The protective effect of Eclipta alba on carbon tetrachloride induced acute liver damage was studied by using 63 female guniea pigs as experimental animals. Sixteen healthy volunteers were administered six gram daily dose of commonly used Burmese indigenous antipyretics Halleidda Sonna for 2 weeks. Antipyrine was selected for a locus for oxidative metabolism as it reflects the functional activity of cytochrome p-450 dependent mixed-function oxidase systems. There was little or no effect on apparent volume of distribution, but the mean metabolic clearance rate increased by 30±1%. Post-trial control data which were taken after one week indicated that the stimulation still persisted for at least one week. Thus, especially to the people with habit of taking this indigenous drug together with modern therapeutic agents, there will be considerably less durable or insufficient therapeutic effect of the latter. Sein Min; Pe Than Htun; Aye Mi Mi Htwe; Sein Thaung; Yan Naung Maung Maung; Khin Myo Aye; Moe Thuzar Min. Laboratory studies were carried out to determine the efficacy of ethanolic crude extracts and dry powder of Derris elliptica Benth. The tests were conducted using various breeding water samples comprising concrete drain water, septic tank water, earthen drain water and tap water as appropriate for Culex quinquefasciatus and Aedes aegypti laboratory reared fourth instars larvae. The most effective control was achieved in tap water followed by earthen drain water, septic tank water and concrete drain water respectively. Culex quinquefasciatus mosquitoes were more susceptible to both formulations of Derris elliptica Benth. The extract formulations were more effective than powder formulation for both species of mosquitoes. The aim of the present study was to investigate the antihyperglycemic effect of squeous extracts of Annona squamosa Linn.