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The secondary outcomes are the angina attack frequency and duration, the nitroglycerin dosage consumed, the Canadian Cardiovascular Society grading of effort angina, the Seattle Angina Questionnaire, the EuroQol-5-Dimensions-5-Level, the incidence of major adverse cardiac events, health cost evaluation, and overall assessment for study drugs. Ethics and Dissemination. The study has been approved by the ethics committee of Guangdong Provincial Hospital of Chinese Medicine (approval no. BF2019-175-01). Results will be submitted for publication in peer-reviewed journals and disseminated at scientific conferences. This trial is registered with ChiCTR1900026899, registered on 26 October 2019.The withdrawal reflex is a defensive reaction to nociceptive stimuli and can be used to regulate locomotor gait during rehabilitation. We investigated the effect of successive needle-pricking of the plantar and dorsal foot surfaces on poststroke lower limb function. Thirty-five hemiplegic patients, within one month after primary stroke, with an affected lower limb (Brunnstrom stage III) were randomly divided into intervention and control groups. Both groups received routine drug treatment, rehabilitation training, and upper limb acupuncture treatment on the hemiplegic side. The control group also received routine acupuncture on the hemiplegic side of the lower limb, while the intervention group received successive needle-pricking on the sole and instep of both the unaffected and affected side feet. Outcomes were assessed before inception (D0) and after three (D3) and six (D6) treatment days, using Brunnstrom stage (Ueda assessment), total Fugl-Meyer lower extremity assessment (FMA-LE) and its subscores (FMA-Lth ChiCTR1900020633.Access to safe water, sanitation, and hygiene (WASH) facilities is a basic necessity for human livelihood, survival, and well-being. #link# Adequate WASH facilities provision is a critical issue to most developing countries around the world including Nigeria. Knowledge, attitudes, and practices regarding WASH are integral to effective and sustainable WASH facilities provision. This study assessed the level of knowledge, behavior, and practices towards water, sanitation, and hygiene in Kaduna state, Nigeria, with a view to ensuring sustainable WASH facilities intervention in the region. Data collection tools included spot check observation and questionnaire involving 854 participants, selected from five local government areas (LGAs) Chikun, Kajuru, Soba, Kachia, and Zango Kataf. From the results, major drinking water sources were surface waters (52.5%) and unprotected hand dug wells (44.8%); only 46.2% treated their water supply and few (16.6%) used chlorination method. Pit latrine toilets were the major (76.5%) excreta disposal means, and open defecation practices were widespread (41.4%). Level of personal and environmental hygiene understanding was fairly good in all the local government areas, and 65.4% claimed to use water and soap for washing hands after defecation. Incidence of water related diseases is generally low in the area. Despite the commendable findings in the study areas, communities are still at risk due to lack of safe water supply and poor practices of home treatment and excreta disposal. Therefore provision of WASH facilities and WASH education is fundamental for ensuring public health in the study area.
Burden of epilepsy in sub-Saharan Africa is huge in the midst of shortage of human resource in its health sector. Using skilled staff to supervise and support lower level healthcare workers providing frontline primary healthcare is a pragmatic coping solution. But, lower level health providers face enormous challenges due to absent clinical algorithms or pragmatic rapid diagnostic tests.
This study aimed to determine if the use of an epilepsy questionnaire in a traditional clinical setting would improve semiological details obtained and diagnostic accuracy.
A prospective study was conducted involving patients diagnosed with epilepsy each with an eye witness who had regularly witnessed the seizures. Routine seizure history from clinical documentation and an interviewer-based questionnaire were compared. The data obtained were assessed for content, accuracy, intermethod and test-retest reliability.
Sixty-seven patients with a median age of 24 years were recruited. Routine seizure history had obtained ley, especially in nonspecialist settings.Some arbovirus infections, especially dengue, have increased rapidly over the last few decades in Sri Lanka. Prevalence and distribution of different mosquito species have been limitedly documented, which remains grossly inadequate in providing evidence for potential health risks. In this study, the diversity and species composition of mosquitoes in four selected districts in Sri Lanka (Kurunegala, Gampaha, Kegalle, and Kandy) were investigated. Entomological surveys were conducted from a total of 160 temporary and permanent mosquito breeding habitats identified in the study area from June 2017 to October 2018. Mosquito immature stages were sampled using standard dipping, siphoning, or pipetting methods and identified up to the species level. Galicaftor modulator and habitat characteristics such as species richness, dominance, and Shannon-Weiner diversity were calculated for each surveyed habitat type. Associations between co-occurring species were estimated by Hulbert's coefficient of interspecific knowledge to specified disease vectors, under which the control program is concerned.
Postpartum maternal infection is still a common problem worldwide, mainly due to obstetric risk factors. The use of prophylactic antibiotic at operative vaginal delivery (OVD), taking it as a standalone risk factor, has been controversial. The purpose of this review was to rigorously evaluate the association of OVD with postpartum infection and shed light on such highly controversial issue.
A computer-based literature search was done mainly in the databases of PUBMED, HINARI health research, and the Cochrane library. Systematic review and meta-analysis were done by including 14 articles published between 1990 and August 2019.
The average absolute risk of postpartum infection at OVD from seven large cohort studies was 1%. Few studies showed a weak association of OVD with postpartum infection without being adjusted to perineal wound, but the pooled meta-analysis showed statistically significant association with non-OVD. In the included randomized trial, 97% of the study participants had perineal wound for whom repairs were performed; the risks of maternal infection and perineal wound breakdown were comparable, and maternal infections other than perineal wound infection did not show significant difference between prophylactic antibiotic and placebo groups.
