ABSTRACT
Severe falciparum malaria is a major cause of death in tropical countries, particularly in African children. Rapid and accurate diagnosis and prognostic assessment are critical to clinical management. In 6027 prospectively studied patients diagnosed with severe malaria we assess the prognostic value of peripheral blood film counts of malaria pigment containing polymorphonuclear leukocytes (PMNs) and monocytes. We combine these results with previously published data and show, in an individual patient data meta-analysis (n = 32,035), that the proportion of pigment containing PMNs is predictive of in-hospital mortality. In African children the proportion of pigment containing PMNs helps distinguish severe malaria from other life-threatening febrile illnesses, and it adds to the prognostic assessment from simple bedside examination, and to the conventional malaria parasite count. Microscopy assessment of pigment containing PMNs is simple and rapid, and should be performed in all patients hospitalised with suspected severe malaria.
Subject(s)
Hemeproteins , Malaria, Falciparum , Malaria , Child , Humans , Malaria, Falciparum/parasitology , Prognosis , Malaria/parasitologyABSTRACT
Relationships between social support characteristics with blood pressure control and recommended behaviors in Vietnamese hypertensive patients have not been investigated. This study is aimed at examining the role of social support characteristics in hypertension control and behaviors. Patients with hypertension (n = 220) in Hanoi, Vietnam, were recruited into a cross-sectional study. Both functional and structural characteristics of social support and network were examined. Results showed that increasing total network size was related to 52% higher odds of uncontrolled hypertension (adjusted OR = 1.52, 95%CI = 1.22 - 1.89). Higher network sizes on the provision of information support related to advice, emotional support related to decisions, and practical support related to sickness were associated with lower odds of uncontrolled hypertension. Every additional 1% of the percentage of network members having hypertension decreased 2% the odds of uncontrolled hypertension (adjusted OR = 0.98, 95%CI = 0.96 - 1.00). A 1% additional network members who were living in the same household was associated with a decrease of 0.08 point of behavioral adherence score (coef. = -0.08; 95%CI = -0.12 - 0.03). Meanwhile, a 1% increase of network members who were friends on the provision of practical support related to sickness and jobs was related to an increase of 0.10 point and 0.19 point of behavioral adherence score (coef. = 0.10; 95%CI = 0.04 - 0.17 and coef. = 0.19; 95%CI = 0.06 - 0.32, respectively). The current study suggested that further interventions to improve hypertension management should address the potential effects of social network characteristics.
Subject(s)
Blood Pressure/physiology , Developing Countries , Hypertension/physiopathology , Outpatients , Social Support , Behavior , Humans , Middle Aged , Social NetworkingABSTRACT
The essential oil obtained from the branches and leaves of Clausena indica (Dalz) Oliv. (Rutaceae) has been analyzed by GC/MS. Fifty-three components of the essential oil, representing 96.9% of the total amount, were identified. The main constituents were myristicin (35.3%), terpinolene (16.7%), and delta-3-carene (11.3%). The essential oil was screened for antimicrobial activity, showing positive results against some bacterial strains. Moreover, a comparison between constituents of C. indica essential oil with the ones reported in the literature for other Clausena ssp. is pointed out and some chemotaxonomic considerations have been identified.