METHODS: A quasi-experimental economic evaluation comparing CPE impact on 6-month CKD mortality was conducted on the basis of payer perspective. The experimental group (n = 63) received care by health care providers who were given CPE on drug-related problems and dose adjustment. The control group (n = 80) was based on the historical cohort of patients who received care before the CPE. Measure of clinical outcome applied in this study was number of lives saved/100 patients treated. Cost-effectiveness ratios for CKD stages 4 and 5 patients without CPE and with CPE and incremental cost-effectiveness ratios (ICERs) for CKD stages 4 and 5 patients were analyzed.
RESULTS: Lives saved (%) in the treatment of CKD without CPE: CKD stage 4, 78.57; CKD stage 5, 57.58. Lives saved (%) in the treatment of CKD with CPE: CKD stage 4, 88.89; CKD stage 5, 65.45. Cost-effectiveness ratios for stage 4 with and without CPEs were Rp3,348,733.27 and Rp3,519,931.009, respectively. Cost-effectiveness ratios for stage 5 with and without CPEs were Rp7,137,874.93 and Rp7,871,822.27, respectively. ICERs were Rp2,045,341.22 for CKD stage 4 and Rp1,767,585.60 for CKD stage 5.
CONCLUSIONS: Treatment of CKD stages 4 and 5 with CPE was more effective and cost-effective compared with treatment of CKD stages 4 and 5 without CPE. The ICERs indicated that extra costs were required to increase life saved in both stages.
METHODS: The plant essential oil at varying concentrations ranging between 10,000 to 80,000 ppm were placed inside glass beakers, rolled horizontally to ensure the essential oil covers all sides of the beakers and exposed to adults and nymphs of P. americana. Resigen (R) 1ppm was used as positive control and distilled water as negative control. The LT50 and LT90 was obtained using Log Probit programme.
RESULTS: Exposure of essential oil to females P. americana at concentrations between 10,000 to 80,000 ppm indicated the LT50 and LT90 values between 5.31 h-189.19 h and 14.90 h-2105.31 h, respectively. Treatment with the same concentrations against males P. americana ,the LT50 and LT90 were 2.08 h-181.73 h and 5.4 h-8460.51 h, respectively. Treatment against the nymphal stage with the same range of concentrations indicated the LT50 and LT 90 of 4.68 h-381.02 h and 28.71 h-5313.36 h, respectively.The nymphs and males were more susceptible than the females cockroaches. Treatment with Resigen (R) at 1ppm indicated much lower LT 50 and LT 90 values of 2.54 h-9.47 h for the females, 1.47 h-4.22 h for the males and 4.69 h-8.92 h for the nymphs.The negative control indicated no mortality for all stages of the cockroach.
CONCLUSION: Piper aduncum essential oil can be used as an alternative natural product for controlling the cockroach Peripatetic americana.
METHODS: Aedes aegypti first-instar larvae were exposed to various doses of Pichia-TMOF, Bt and combination of Pichia-TMOF and Bt. The development of the larvae were observed and recorded daily during the bioassay larval test until the adult emergence.
RESULTS: The results showed that 400 ppm Pichia-TMOF and 300 ppm Pichia-TMOF were able to cause 100% and 67% cumulative mortality on Ae. aegypti larvae on 8(th) day respectively. At 200 ppm, 100 ppm and 50 ppm concentration Pichia-TMOF showed obvious stunted effect on Ae. aegypti larvae. Moreover, the combination of 400 ppm Pichia-TMOF with 0.1 ppm Bt showed synergistic effect on Ae. aegypti.
CONCLUSION: Pichia-TMOF inhibited trypsin biosynthesis is potential to act in larval gut causing stunted growth and larval development and causing mortality. The combination of Pichia-TMOF and Bt increased the effectiveness in causing larval mortality.
METHODS: Parous women with favorable cervixes after amniotomy for labor induction were randomized to immediate titrated oxytocin or placebo intravenous infusion in a double-blind noninferiority trial. After 4 hours, study infusions were stopped, the women were assessed, and open-label oxytocin was started if required. Maternal satisfaction with the birth process was assessed with a 10-point visual numerical rating scale (lower score, greater satisfaction).
RESULTS: Vaginal delivery rates at 12 hours were 91 of 96 (94.8%) compared with 91 of 94 (96.8%) (relative risk 0.98, 95% confidence interval [CI] 0.92-1.04, P=.72), and maternal satisfaction on a visual numerical rating scale (median [interquartile range]) was 3 [3-4] compared with 3 [3-5], P=.36 for immediate compared with delayed arm, respectively). Cesarean delivery, maternal fever, postpartum hemorrhage, uterine hyperactivity, and adverse neonatal outcome rates were similar between arms. The immediate oxytocin arm had a shorter amniotomy-to-delivery interval of 5.3±3.1 compared with 6.9±2.9 hours (P
METHODS: A randomized controlled trial was carried out in a university hospital in Malaysia. Women with lifestyle-controlled gestational diabetes scheduled to receive clinically indicated antenatal corticosteroids (dexamethasone) were randomized to 12-mg 12 hourly for one day (2 × 12-mg) or 6-mg 12-hourly for two days (4 × 6-mg). 6-point (pre and 2-h postprandial) daily self-monitoring of capillary blood sugar profile for up to 3 consecutive days was started after the first dexamethasone injection. Hyperglycemia is defined as blood glucose pre-meal ≥ 5.3 or 2 h postprandial ≥ 6.7 mmol/L. The primary outcome was a number of hyperglycemic episodes in Day-1 (first 6 BSP points). A sample size of 30 per group (N = 60) was planned.
RESULTS: Median [interquartile range] hyperglycemic episodes 4 [2.5-5] vs. 4 [3-5] p = 0.3 in the first day, 3 [2-4] vs. 1 [0-3] p = 0.01 on the second day, 0 [0-1] vs. 0 [0-1] p = 0.6 on the third day and over the entire 3 trial days 7 [6-9] vs. 6 [4-8] p = 0.17 for 6-mg vs. 12-mg arms, respectively. 2/30 (7%) in each arm received an anti-glycemic agent during the 3-day trial period (capillary glucose exceeded 11 mmol/L). Mean birth weight (2.89 vs. 2.49 kg p
METHODS: A randomized trial was conducted in a University hospital in Malaysia. Nulliparous women at term who were about to start pushing were randomized to massage during pushing and warm compress to the perineum in between pushes or to standard "hands-off" care. Primary outcome was suturing for perineal injury (episiotomy or tear).
RESULTS: A total of 156 participants were analyzed based on intention to treat. Perineal repair rates were 53/79 (67%) for MassComp versus 70/77 (91%) for control (relative risk [RR] 0.72, 95% confidence interval [CI] 0.61-0.98, number needed to treat for an additional beneficial outcome [NNTb ] 5, 95% CI 2.83-8.62, P