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Knowledge,access and utilization of bednets among stable and seasonal migrants in an artemisinin resistance containment area of Myanmar

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Infectious Diseases of Poverty 2017年第1期6卷 1227-1234页

作者： Wint Phyo Than Tin Oo Khin Thet Wai Aung Thi Philip Owiti binay kumar Hemant Deepak Shewade Rony Zachariah Regional Public Health Department Ministry of HealthBagoMyanmar Department of Medical Research Ministry of HealthYangonMyanmar National Malaria Control Program Ministry of HealthNaypyitawMyanmar Academic Model Providing Access to Healthcare(AMPATH) EldoretKenya GAVI the Vaccine Alliance GenevaSwitzerland International Union Against Tuberculosis and Lung Disease(The Union) South-East Asia Regional OfficeNew DelhiIndia Medecins Sans Frontieres Operational Research Unit(LuxOR)Luxembourg CityLuxembourg

Background:Myanmar lies in the Greater Mekong sub-region of South-East Asia faced with the challenge of emerging resistance to artemisinin combination therapies(ACT).Migrant populations are more likely than others to spread ACT resistance.A vital intervention to reduce malaria transmission,resistance spread and eliminate malaria is the use of bed *** seasonal and stable migrants in an artemisinin resistance containment region of Myanmar,we compared a)their household characteristics,b)contact with health workers and information material,and c)household knowledge,access and utilization of bed ***:Secondary data from community-based surveys on 2484 migrant workers(2013 and 2014,Bago Region)were analyzed of which 37%were seasonal *** net access and utilization were assessed using a)availability of at least one bed net per household,and b)one bed net per two persons,and c)proportion of household members who slept under abed net during the previous night(Indicator targets=100%).Results:Over 70%of all migrants were from unstable work settings with short transitory *** household size was five(range 1-25)and almost half of all households had children under-five *** 10%of migrants were night-time *** than 40%of households had contact with health workers and less than 30%had exposure to information education and communication(IEC)materials,the latter being significantly lower among seasonal *** 70%of households were aware of the importance of insecticide-treated bed-nets/long-lasting insecticidal nets(ITNs/LLINs),but knowledge on insecticide impregnation and retreatment of ITNs was poor(<10%).Although over 95%of households had access to at least one bed net,the number with one bed net per two persons was grossly inadequate(13%for stable migrants and 9%for seasonal migrants,P=0.001).About half of all household members slept under a bed net during the previous ***:This study reveals important short-fa

关键词： Operational research Malaria Transmission Artemisinin Greater Mekong sub-region Mosquito

Assessment of household ownership of bed nets in areas with and without artemisinin resistance containment measures in Myanmar

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Infectious Diseases of Poverty 2018年第1期7卷 199-205页

作者： Thae Maung Maung Tin Oo Khin Thet Wai Thaung Hlaing Philip Owiti binay kumar Hemant Deepak Shewade Rony Zachariah Aung Thi Department of Medical Research Ministry of Health and SportsYangonMyanmar Department of Public Health Ministry of Health and SportsNay Pyi TawMyanmar Academic Model Providing Access to Healthcare(AMPATH) EldoretKenya Gavi the Vaccine AllianceGenevaSwitzerland International Union Against Tuberculosis and Lung Disease(The Union) South-East Asia Regional OfficeNew DelhiIndia Medecins Sans Frontieres Brussels Operational CentreLuxembourg cityLuxembourg National Malaria Control Program Ministry of Health and SportsNay Pyi TawMyanmar

Background:Myanmar lies in the Greater Mekong Subregion where there is artemisinin-resistant Plasmodium falciparum *** the artemisinin compound is the pillar of effective antimalarial therapies,containing the spread of artemisinin resistance is a national and global *** use of insecticide-treated bed nets/long-lasting insecticidal nets(ITNs/LLINs)is the key intervention for ensuring the reduction of malaria transmission and the spread of resistant strains,and for eventually eliminating *** study aimed at assessing household ownership of,access to,and utilization of bed nets in areas of Myanmar with and without artemisinin resistance containment ***:Secondary data from a nationwide community-based malaria survey conducted by the National Malaria Control Program in 2014 were *** on evidence of artemisinin resistance,Myanmar was divided into tiers 1,2,and 3:townships in tiers 1 and 2 were aggregated as the Myanmar Artemisinin Resistance Containment(MARC)areas and were compared with tier 3 townships,which were defined as non-MARC *** chi-square test was used to compare groups,and the level of significance was set at P≤***:Of the 6328 households assessed,97.2%in both MARC and non-MARC areas had at least one bed net(any type),but only 63%of households had ITNs/*** 44%of households in MARC areas and 24%in non-MARC areas had adequate numbers of ITNs/LLINs(one ITN/LLIN per two persons,P<0.001).Nearly 44%of household members had access to ITNs/*** the utilization of ITNs/LLINs,45%of household members used them in MARC areas and 36%used them in non-MARC areas(P<0.001,desired target=100%).Utilization of ITNs/LLINs among children aged below five years and pregnant women(high malaria risk groups)was low,at 44%and 42%,***:This study highlights the nationwide shortfalls in the ownership of,access to,and utilization of ITNs/LLINs in Myanmar,which is of particular concern in terms

关键词： Malaria Insecticide-treated bed nets Long-lasting insecticidal nets Myanmar artemisinin resistance containment Bed nets ownership Bed nets access Bed nets utilization Myanmar

比较阿托伐他汀与联合应用普罗布考对冠状动脉粥样硬化患者血浆LDL-C达标水平的影响

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比较阿托伐他汀与联合应用普罗布考对冠状动脉粥样硬化患者血浆LD...

作者： binay kumar ADHIKARI 吉林大学

学位级别：硕士

目的：主要目的是评估冠状动脉粥样硬化病人，强化他汀和常规他汀治疗和在此基础上加用普罗布考，各组之间在LDL-C达标率的差异的比较。达标率依根据欧洲血脂指南标准： LDL-C目标值达到2.5mmol/L。排除标准是有急性冠状动脉综合征，糖... 详细信息

目的：主要目的是评估冠状动脉粥样硬化病人，强化他汀和常规他汀治疗和在此基础上加用普罗布考，各组之间在LDL-C达标率的差异的比较。达标率依根据欧洲血脂指南标准： LDL-C目标值达到2.5mmol/L。排除标准是有急性冠状动脉综合征，糖尿病，肝肾功能异常，心衰的患者。将病人随机分为四组，第一组为常规治疗AS组：阿司匹林A他汀S，第二组为常规治疗PAS组：普罗布考P阿司匹林A他汀S。常规剂量给予阿司匹林100mg/d、阿托伐他汀钙片20mg/d、普罗布考0.5g/d。第三组为强化他汀AS组:阿司匹林A他汀S，第四组为强化他汀PAS组：普罗布考P阿司匹林A他汀S。强化他汀组给予阿司匹林100mg/d、阿托伐他汀钙片40mg/d、普罗布考0.5g/d。四组口服一个月。一些病人同时口服二级预防药物，如β受体阻滞剂、硝酸脂类、ACEI类或CCB类药物。所有数据结果均使用SPSS21.0统计软件，P0.05无统计学意义。200名患者中有25人失访。常规治疗AS组中48人、常规治疗PAS组中39人，强化治疗AS组中36人，强化治疗PAS组中52人完成了此研究。结果：在常规治疗AS组48人之中14人（33%），常规治疗PAS组39人之中24（61.5%）达到LDL-C目标值<1.8mmol/。在强化他汀AS组36人之中23人（63.88%），强化他汀PAS组52人之中41人（78.8%）达到LDL-C目标值<1.8mmol/L。强化他汀AS组比常规治疗AS组在LDL-C达标方面相比有显著统计学意义（p=0.000）。但强化他汀PAS组比常规治疗PAS组，LDL-C达标方面相比无显著统计学意义（p=0.279）。强化他汀PAS组比强化他汀AS组， LDL-C达标方面相比无显著统计学意义(p=0.148).常规治疗P组与常规治疗AS组相比有显著差异（p=0.03）。对HDL-C水平的影响，强化他汀PAS组，与治疗前比较对HDL-C水平的下18.10%，有统计学意义（p=0.000）。常规治疗AS组、常规治疗PAS组和强化他汀AS组与治疗前比较无统计学意义.强化他汀治疗组较较常规他汀治疗组比较显著降低甘油三酯26.28%和总胆固醇45.27%。在200名患者中，仅在强化PAS组发现1名患者肝酶较参考范围升高3倍。其余患者无其它不良反应。强化治疗组：AS组11人血糖较治疗前增高，但平均有降低趋势（3.33%），治疗后血糖：5.51±0.72mmol/L，无统计学意义（p=0.133）, PAS组20人血糖较治疗前增高，增高6.79%，治疗后血糖：5.66±0.62mmol/L，但无统计学意义（p=6.79）. 结论：从他汀的剂量来评价，我们认为阿托伐他汀钙片40mg在LDL-C <1.8mmol/L的达标率高比常规治疗组高达30.88%.在强化他汀治疗PAS组比强化他汀治疗AS组，达标率显著的提高15%。说明加用抗氧化普罗布考有协同作用。普罗布考方案可以降低高密度脂蛋白水平，故对于HDL-C水平本身较低的患者应慎用。在降低胆固醇方面，强化他汀治疗较标准化他汀治疗更有效。在同时能降低甘油三酯和胆固醇方面，强化他汀治疗较标准化他汀治疗更有效。除了一名患者肝酶较正常限值高3倍外，其余未出现其它不良反应或心血管事件，故强化降脂治疗方案是安全的。强化治疗组有31人血糖升高，均在正常范围内。

关键词：动脉粥样硬化阿托伐他汀钙普罗布考血脂异常 LDL-C目标强化他汀治疗

A Case Report of Cardiac Amyloidosis Presenting with Chest Discomfort

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World Journal of Cardiovascular Diseases 2018年第2期8卷 162-168页

作者： binay kumar Adhikari Yonggang Wang Bo Li Quan Liu Weihua Zhang Center of Cardiovascular Medicine The First Hospital of Jilin University Changchun China

Introduction: Cardiac amyloidosis is one of the several systemic manifestations of amyloidosis. It is a relatively uncommon disease. Patients with cardiac amyloidosis clinically present with rapidly progressive heart failure. Case Presentation: We present a case of 64-year-old man with multiple episodes of chest discomfort accompanied sometimes with dyspnoea for the past several months. A non-specific ST-T changes with low voltage limb leads on ECG, a diastolic dysfunction with preserved ejection fraction on echocardiography, increased troponin and BNP, increased serum λ/κ light chain ratio led us to highly suspect amyloidosis with cardiac involvement. Abdominal fat pad biopsy confirmed the amyloid type change of subcutaneous fat, with immunohistochemistry revealing Lambda positive. After confirmed diagnosis of primary systemic amyloidosis with cardiac involvement, patient completed six cycles of chemotherapy with bortezomib and dexamethasone. The patient showed significant improvements after chemotherapy and supportive therapy. Conclusion: Amyloidosis is relatively fatal disease. Patients often have a short life expectancy after symptom onset. Early diagnosis is crucial to proper management and better prognosis.

关键词： Cardiac Amyloidosis Cardiomyopathy Heart Failure

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胸壁肿瘤切除后的一期修复重建

中国修复重建外科杂志 2005年第5期19卷 338-340页

作者：檀振波 Nirmal Lamichhane 刘登湘肖奇海 binay kumar Thakur 邢台市人民医院胸外科河北邢台054031 尼泊尔B.P.Koirala纪念肿瘤医院外科

目的　观察胸壁肿瘤切除术后胸壁缺损一期修复重建的临床效果。　方法　1998年1月～2 0 0 3年3月外科治疗胸壁肿瘤31例。男2 0例,女11例。年龄8～72岁。原发性胸壁肿瘤2 1例,肺癌侵犯胸壁6例,乳腺癌术后复发2例,放射性坏死和皮肤癌各1... 详细信息

目的　观察胸壁肿瘤切除术后胸壁缺损一期修复重建的临床效果。　方法　1998年1月～2 0 0 3年3月外科治疗胸壁肿瘤31例。男2 0例,女11例。年龄8～72岁。原发性胸壁肿瘤2 1例,肺癌侵犯胸壁6例,乳腺癌术后复发2例,放射性坏死和皮肤癌各1例。切除肋骨2～7根,平均3.6根。缺损面积2 0～2 2 0 cm2 ,平均97.1cm2 。合并肺切除10例,部分膈肌切除2例,胸骨下段切除1例。单纯软组织修复7例(背阔肌+大网膜,背阔肌肌皮瓣,背阔肌肌瓣) ,单纯骨性重建5例(涤纶布或Prolene网) ,骨性合并软组织修复19例(背阔肌、胸大肌、背阔肌+阔筋膜或大网膜,与涤纶布或Prolene网修复)。　结果　术后发生并发症3例( 9.7% ) ,其中切口感染1例,软组织与修复物之间积液2例。无手术死亡。2 6例获5～5 7个月随访,术后生存时间6～5 7个月,中位生存时间2 2个月。　结论　胸壁肿瘤切除术后造成的巨大缺损。

关键词：一期修复重建 Prolene网切除后 2003年3月原发性胸壁肿瘤软组织修复背阔肌肌皮瓣临床效果切除术后生存时间 1998年放射性坏死背阔肌肌瓣修复重建术胸壁缺损外科治疗侵犯胸壁术后复发胸骨下段骨性重建切口感染

Percutaneous Intervention of CTO Lesion and Non-CTO Lesion in Patients with Coronary Chronic Total Occlusion

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World Journal of Cardiovascular Diseases 2019年第8期9卷 600-611页

作者： binay kumar Adhikari Shudong Wang Cheng Li Yonggang Wang Quan Liu Department of Cardiovascular Medicine The First Hospital of Jilin University Changchun China

Background: With the improved lifestyle of people, the incidence of coronary artery disease is gradually increasing. Approximately 15% - 20% of patients undergoing diagnostic catheterization had one or more chronically occluded coronary arteries. Method: The patients who were diagnosed with chronic total occlusion (CTO) in our hospital within one year period have been included. They were initially divided into two groups based on angiographic reports: single vessel disease (SVD) and non-single vessel disease (non-SVD) group, then into optimal medical therapy (OMT) group, percutaneous coronary intervention (PCI) group and coronary artery bypass graft (CABG) group.?Finally, PCI group is further divided into PCI of CTO lesion (CTO PCI group) and PCI?of non-CTO lesion (non-CTO PCI group). Results: A total of 261 patients were enrolled as CTO patients, mean age was 62.83 years, 70.1% were male patients.?The incidence rate of common risk factors was hypertension (64.4%), followed by smoking (48.3%), diabetes (34.5%) and hyperlipidaemia (27.2%).?SVD, DVD and TVD were present in 39 patients (14.94%), 81 patients (31.03%)?and 141 patients (54.02%) respectively. Comparing the long term efficacy, the rates of MACE and non-target vessel revascularization were higher in CTO PCI than non-CTO PCI group, and were statistically significant (p s of target vessel revascularization, CABG and all cause death were also lower in CTO PCI group, but were not statistically significant (p > 0.05). Conclusion: The rates of MACE, non-target vessel revascularization, CABG and all cause death are lower if PCI is successfully performed in CTO patients. CTO PCI success also improves quality of life, decreases myocardial ischemia induced angina, and overall improves long term efficacy.

关键词： Chronic Total Occlusion Percutaneous Coronary Intervention Clinical Efficacy

Various Scoring Systems for Predicting Revascularization of Chronic Coronary Total Occlusion by Percutaneous Coronary Intervention

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World Journal of Cardiovascular Diseases 2019年第6期9卷 385-393页

作者： binay kumar Adhikari Shudong Wang Cheng Li Yonggang Wang Weihua Zhang Quan Liu Department of Cardiovascular Medicine The First Hospital of Jilin University Changchun China

Successful revascularization of chronic total occlusion (CTO) by percutaneous?coronary intervention (PCI) is associated with reduced major adverse cardiovascular events (MACEs) compared with CTO PCI failure. The developments of new strategies and new devices have improved the success rate of CTO PCI. However, the complexity of CTO lesions, clinical characteristics of patients and operator experience highly determine the successful revascularization. Using search items,?“chronic total occluion”,?“percutaneous coronary intervention”,?“scoring systems”,?“predictablity”.?We searched Pubmed, ScienceDirect, Web of Science, Cochrane Library, and CNKI. We found six clinically used scoring systems from 2011 to 2018. They included J-CTO score, CT-RECTOR score, CL score, PROGRESS CTO score, ORA score, and Ellis score. All parameters of each scoring systems have been systematically reviewed. The patients with higher score have found to have?adecreased?probability of CTO recanalization. Ellis score that mainly focused on ambiguous proximal cap and hybrid approach seems to provide better predictability in deciding procedure strategy.

关键词： Chronic Total Occlusion Percutaneous Coronary Intervention Predictability

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精浆抗精子抗体对精子形态及运动特征的影响

中国妇幼保健 2008年第17期23卷 2451-2453页

作者：任明田芹许宗革张明 binay kumar Adhikari 刘睿智吉林大学第二医院泌尿外科 130041 东北师范大学生命科学学院吉林大学白求恩医学院细胞生物学教研室.吉林省生殖医学研究所

目的:探讨精浆抗精子抗体(AsAb)对精子形态和运动特征的影响。方法:检测251例男性不育患者精液样本,采用酶联免疫法进行AsAb检测,计算机自动分析精子运动特征,采用精子形态检测系统下人工修正方法进行精子形态分析。结果:251例男性不育... 详细信息

目的:探讨精浆抗精子抗体(AsAb)对精子形态和运动特征的影响。方法:检测251例男性不育患者精液样本,采用酶联免疫法进行AsAb检测,计算机自动分析精子运动特征,采用精子形态检测系统下人工修正方法进行精子形态分析。结果:251例男性不育患者中,AsAb阳性率为17·13%。AsAb阳性组正常形态精子百分率与阴性组无显著性差异(P>0·05),大头精子和锥形头精子百分率显著高于AsAb阴性组(P<0·05,P<0·005)。精浆AsAb阳性组a+b级精子百分率,精子运动参数MAD、LIN、WOB均明显低于阴性组,两组比较差异有显著性(P<0·05,P<0·01)。结论:精浆AsAb不影响正常形态精子百分率,但能使锥形头精子百分率显著升高;使a+b级精子百分率、精子运动参数MAD、LIN、WOB明显降低。

关键词：男性不育抗精子抗体精子形态精子运动特征

DEGRADATION OF HIGH-Tc YBCO CERAMIC IN ATMOSPHERE

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DEGRADATION OF HIGH-Tc YBCO CERAMIC IN ATMOSPHERE