Hypertensive disorders of pregnancy is a major cause of fetal and maternal morbidity. Epidemiologic observations have shown an inverse association between calcium intake and incidence of eclampsia. Calcium supplementation has been reported to decrease blood pressure in pregnant women, although this remains controversial. The mechanism responsible for the effect of calcium on hypertinsion in pregnant women is unknown. This paper is a review of some of the recent calcium supplementation trials that have been carried out and their effectiveness in reducing systolic and diastolic blood pressure and decreasing the incidence of hypertensive disorders of pregnancy.
118 cases of cervical dysplasia were followed up by cytological smears for over 9 years to determine their biologic outcome. All grades of dysplasia showed evidence of regression and progression to more severe lesions, including carcinoma. Severe dysplasia however did not regress to normalcy and had the maximum conversion rates to malignancy. The period taken for transition to malignancy was found to be shorter than that generally described. Since even mild dysplasia carries with it a malignant potential, all patients with cervical dysplasia, irrespective of the grade, have to be followed up by repeated clinical and cytological examinations.
Significant changes have occurred in relation to how chronic asthma is being treated. Emphasis has now shifted from viewing asthma as a condition of smooth muscle dysfunction to one of chronic inflammation. As such, anti-inflammatory therapy forming the cornerstone of treatment represents the first important milestone in the evolution of asthma treatment. For this purpose, inhaled corticosteroid (ICS) is by far the most effective anti-inflammatory therapy. Another important milestone is the recognition of the superiority of adding long-acting β2-agonist (LABA) to ICS over escalating ICS dose alone or other forms of add-on therapies in treating asthmatic patients not responding to regular ICS alone. The effectiveness of adding LABA to ICS in treating asthma logically led to combining the two drugs into one single inhaler (salmeterol/fluticasone and budesonide/formoterol) that has the attractiveness of being user-friendly and ensuring that ICS is not missed out. The unique property of formoterol that allows for repetitive flexible dosing paved way to the concept of using Symbicort for both regular maintenance dosing and as required rescue medication. This revolutionary approach has been recently shown to provide improved asthma outcome, achieved at an overall lower or at least comparable corticosteroid intake, and may represent another evolutionary step in the treatment strategy of chronic asthma.
Significant changes have occurred in relation to how chronic asthma is being treated. Emphasis has now shifted from viewing asthma as a condition of smooth muscle dysfunction to one of chronic inflammation. As such, anti-inflammatory therapy forming the cornerstone of treatment represents the first important milestone in the evolution of asthma treatment. For this purpose, inhaled corticosteroid (ICS) is by far the most effective anti-inflammatory therapy. Another important milestone is the recognition of the superiority of adding long-acting beta2-agonist (LABA) to ICS over escalating ICS dose alone or other forms of add-on therapies in treating asthmatic patients not responding to regular ICS alone. The effectiveness of adding LABA to ICS in treating asthma logically led to combining the two drugs into one single inhaler (salmeterol/fluticasone and budesonide/formoterol) that has the attractiveness of being user-friendly and ensuring that ICS is not missed out. The unique property of formoterol that allows for repetitive flexible dosing paved way to the concept of using Symbicort for both regular maintenance dosing and as required rescue medication. This revolutionary approach has been recently shown to provide improved asthma outcome, achieved at an overall lower or at least comparable corticosteroid intake, and may represent another evolutionary step in the treatment strategy of chronic asthma. Keywords: Asthma treatment, airway inflammation, corticosteroid, long-acting beta2-agonist
This article chronicles the popular health beliefs of the Malays and Chinese regarding chickenpox, as seen through the eyes of a doctor. The interplay of several factors, namely, a marriage of two major cultures, chickenpox in pregnancy, concurrence of two major festivals make this a unique study in medical socio-anthropology.
This article highlighted the recent development in the prevention and management of child abuse in Malaysia. There is now a willingness to recognise the conlplex social, moral, medical, educational, legal and economic problems related to child abuse. Multidisciplinary research, comprehensive and longitudinal targeted services to prevent child abuse and neglect are needed.
Six cases of children of divorced parents are discussed. Their presentations are described and other relevant findings are mentioned. It is interesting to note that in the majority of the cases, the caretakers had difficulties in looking after the children and hence brought them to seek treatment.
Study site: Psychiatric clinic, Universiti Kebangsaan Malaysia