The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of developing best management practices, coordinating research and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis (UC) with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis and management of Crohn's disease (CD). The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses and treatment availability. It does not intend to be all-comprehensive and future revisions are likely to be required in this ever-changing field.
Generally there is a significant delay before optimized performance of mammography is fully realized in the developing countries. To evaluate the status of mammographic performance, a survey of mammographic image quality and exposure was performed in nine hospitals from four selected South East Asian countries. The entrance exposure on the surface of the American College of Radiology (ACR) mammographic phantom (ACR-RMI model 156) was made using both thermoluminescent dosimeters (TLDs) and an ionization chamber. The TLDs were mailed from the University of Wisconsin Radiation Calibration Laboratory (UWRCL) to the cooperating hospitals. The surveyed hospitals processed the images and returned them to the UWRCL for subsequent evaluation of the image quality of the mammographic phantom. Machine-specific data, technique factors and sensitometric data were also obtained. At 28 kVp, the mean entrance exposure is 0.91 R (0.46 to 2.6 R), mean glandular dose is 1.61 mGy (0.90 to 4.15 mGy), mean optical density is 1.37 (0.66 to 2.30), mean total phantom image score is 9.1(4-12). Only three of the nine hospitals tested achieved an acceptable score above the minimum 10. Results for 25 and 30 kVp showed similar trend. The variation between the ion chamber measurements and TLD measurements ranged from 4 to 24%. There is a wide variation in the image quality and entrance exposure among hospitals in South East Asia. There is a need for a quality assurance program. The factors that cause low score in the phantom images must be corrected. Calibration and the use of appropriate ionization chambers for mammography is important.
Investigations of land management impacts on hydrology are well developed in South-East Asia, having been greatly extended by national organizations in the last two decades. Regional collaborative efforts, such as the ASEAN-US watershed programme, have helped develop skills and long-running monitoring programmes. Work in different countries is significant for particular aspects: the powerful effects of both cyclones and landsliding in Taiwan, the significance of lahars in Java, of small-scale agriculture in Thailand and plantation establishment in Malaysia. Different aid programmes have contributed specialist knowledge such as British work on reservoir sedimentation, Dutch, Swedish and British work on softwood plantations and US work in hill-tribe agriculture. Much has been achieved through individual university research projects, including PhD and MSc theses. The net result is that for most countries there is now good information on changes in the rainfall-run-off relationship due to forest disturbance or conversion, some information on the impacts on sediment delivery and erosion of hillslopes, but relatively little about the dynamics and magnitude of nutrient losses. Improvements have been made in the ability to model the consequences of forest conversion and of selective logging and exciting prospects exist for the development of better predictions of transfer of water from the hillslopes to the stream channels using techniques such as multilevel modelling. Understanding of the processes involved has advanced through the detailed monitoring made possible at permanent field stations such as that at Danum Valley, Sabah.
Vibrio cholerae O139 isolated from different countries, as well as from different locations within a country, were examined using macrorestriction DNA analysis to determine the clonality of the O139 strains. NotI digests of genomic DNA of representative strains from Nepal, India, Bangladesh, China, Thailand, and Malaysia revealed very similar but not identical patterns. Examinations of the banding patterns generated by pulsed-field gel electrophoresis of strains isolated within countries revealed complete homogeneity. These results further reiterate the spread of an identical clone of V. cholerae O139 although it appears that genetic polymorphism among the O139 strains is becoming apparent.
This report describes the ethical and legal aspects of assisted reproduction technology (ART) that have been instituted in Asian countries. The data were collected by a questionnaire circulated to ART units in Asia. These are Taiwan, Singapore, Korea, Indonesia, Thailand, Japan, Iran, India, Jordan, Malaysia, China, Israel, Hong Kong, Pakistan, Lebanon, Saudi Arabia, and Persian Gulf countries. According to the survey, there are approximately 260 ART centers in Asia (half of which are in Japan). On a global basis each ART centre in Asia serves an average population of 13 million people. On the other hand, in those Asian countries where the standards of living are relatively high, the availability of ART services, including the more sophisticated and costly ART procedures like micromanipulation, is similar to that in the Western world. In most of the Asian countries practising ART, however, no state registry exists. Taiwan is the only country that has specific legislation, and in six other countries some kind of ministerial regulations are practised. We conclude that ART is now practised in 20 countries in Asia. The prevailing rules and cultural heritage in many of these Asian countries has a major influence on the implementation of ART in Asia. However, in view of the complicated and sensitive issues involved, and as no supervision on ART clinics exists in most of the Asian countries, we advocate that some kind of quality control should be urgently instituted in all centres practising ART. In this way, it is hoped that the highest standards be attained for all parties concerned.
Taking a form of Official Development Aid (ODA), the Japan International Cooperation of Welfare Services (JICWELS) and Imperial Gift Foundation, Boshi-Aiiku-Kai (Aiiku Association for Maternal and Child Health and Welfare) have extended a study program on maternal and child health (MCH) since 1989 on the commission of the Ministry of Health and Welfare. 'Community participation' is the key to the first international study program focused solely on MCH. The purpose of the program is to help to improve the planning and administration in the field of MCH. Through this, the information and experience attained in Japanese MCH activities are introduced especially by participation in community-level activities of 'Aiiku-Han' in which local citizens play a major role. The operation system of the Asian MCH Workshop, contents of the workshop, evaluation and future prospects are discussed.
There is a need to define Quality of Life and to develop a practical method to measure objectively this aspect in gastrointestinal diseases. This has not been performed in any Asian population. It is proposed that this evaluation be part of future trials in Asia on the basis that Asian patients are culturally, socially and politically different from Westerners.
While most Third World countries, particularly in Africa and Latin America, have experienced a deterioration in child welfare as a result of the severe economic downturn in the 1980s, Southeast Asia in general managed to sustain improvements in the situation of its children because it has maintained satisfactory rates of economic growth. However, there were exceptions within Southeast Asia. The Philippines, Vietnam, Dem. Kampuchea and Laos had unsatisfactory growth rates and, consequently, unsustained nutritional gains from the 1970s through the 1980s. Economic factors exerted a big impact on the Philippine nutrition situation, particularly on the dietary status of the households and the nutritional status of children. As a result of the economic dislocation occurring in the country, the nutritional gains of 1978-82 were not maintained in succeeding years. Unlike the case of Thailand, it has been estimated that the solution to nutritional problems in the Philippines is far from being achieved in the immediate future (Villavieja et al. 1989). On the other hand, the nutrition improvements in Thailand have been as remarkable as the economic growth over the last decade. Long-term investments in health, nutrition and other social services in Thailand (as well as in Indonesia) have paid off according to the assessment by the United Nations (1990). It appears, therefore, that the nutrition situation in developing countries is highly dependent on the economic situation, globally and nationally (Cornia et al. 1987), as well as on investment in social services. Adjustment policies should, therefore, consider their implications on distribution and poverty in order that they could positively contribute to the improvement of the nutrition of the people.
The problems of pediatric cardiology in Asia can be summarized as follows. In the countries like India, Indonesia, Malaysia, Pakistan and some other countries especially with government support like Thailand, the priority is primary health care. Except in Japan, cardiac care for children is not well supported financially. Training in pediatric cardiology is not readily available. Consequently small numbers of pediatric cardiologists, pediatric cardiac surgeons and active centres are available even in Japan. It is importannt to reduce the incidence of rheumatic fever and rheumatic heart disease by prevention of streptococcal infections and to increase the standard of living and environment. Transportation and referral system diagnosis, and treatment and follow-up is a special problem in neonatal care in relation to heart disease. Concentration of physicians, medical schools and cardiac centers in urban areas, old customs and poor understanding of people about the treatability and preventability of heart diseases in children complicate the improvement in the management of children with heart diseases.
Southeast Asia experiences frequent fires in fuel-rich tropical peatlands, leading to extreme episodes of regional haze with high concentrations of fine particulate matter (PM2.5) impacting human health. In a study published recently, the first field measurements of PM2.5 emission factors for tropical peat fires showed larger emissions than from other fuel types. Here we report even higher PM2.5 emission factors, measured at newly ignited peat fires in Malaysia, suggesting that current estimates of fine particulate emissions from peat fires may be underestimated by a factor of 3 or more. In addition, we use both field and laboratory measurements of burning peat to provide the first mechanistic explanation for the high variability in PM2.5 emission factors, demonstrating that buildup of a surface ash layer causes the emissions of PM2.5 to decrease as the peat fire progresses. This finding implies that peat fires are more hazardous (in terms of aerosol emissions) when first ignited than when still burning many days later. Varying emission factors for PM2.5 also have implications for our ability to correctly model the climate and air quality impacts downwind of the peat fires. For modelers able to implement a time-varying emission factor, we recommend an emission factor for PM2.5 from newly ignited tropical peat fires of 58 g of PM2.5 per kilogram of dry fuel consumed (g/kg), reducing exponentially at a rate of 9%/day. If the age of the fire is unknown or only a single value may be used, we recommend an average value of 24 g/kg.
The purposes of this research were to study the characteristics chemistry of pH, anions and cations in rainwater, and to identify the possible sources that contributing to the acid precipitation during southwest monsoon season with occurrence of extreme drought event. During the southwest monsoon season, it normally occurs along with haze phenomenon that every year will hit Southeast Asia. This condition will aggravate with high acidic particles in the atmosphere due to the prolonged drought. The analysed parameters which involved pH, anions (NO3-, SO42- and Cl-) and cations (Ca2+, Mg2+, Na+ and K+) were analysed using pH meter, Hach DR 2800, argentometric method and ICP-OES. From the findings, it showed that acid rain occurred during the southwest monsoon season with the range of pH values from 4.95 ± 0.13 to 6.40 ± 0.03 and the total average of pH 5.71 ± 0.32. Anions NO3-, SO42- and Cl- were found to be the dominant compositions of the acid rain occurrences with higher concentrations detected. In overall, rural area recorded with higher acidity of precipitation at total average of pH 5.54 ± 0.39 compared to urban area at pH 5.77 ± 0.26. Rural area surprisingly recorded higher frequency occurrences of acid rain with pH lesser than 5.6 and below compared to urban area. As for public health and safety, all rainwater samples during the acid rain event were found exceeded the allowable limits of NWQS and WHO standards, that shown not suitable for skin contact, recreational purposes even for drinking purposes.
Previously, the genus Merizocera Fage, 1912 comprised only seven species from Indonesia, Malaysia, Sri Lanka, and Thailand. In this study, 28 new species are described from South and Southeast Asia: M. baoshan Li, sp. nov. (♂♀), M. betong Li, sp. nov. (♂♀), M. colombo Li, sp. nov. (♂♀), M. galle Li, sp. nov. (♂♀), M. hponkanrazi Li, sp. nov. (♂), M. kachin Li, sp. nov. (♂♀), M. kandy Li, sp. nov. (♂♀), M. mandai Li, sp. nov. (♂♀), M. krabi Li, sp. nov. (♂♀), M. kurunegala Li, sp. nov. (♂♀), M. lincang Li, sp. nov. (♀), M. mainling Li, sp. nov. (♂♀), M. nyingchi Li, sp. nov. (♀), M. peraderiya Li, sp. nov. (♂♀), M. phuket Li, sp. nov. (♂♀), M. putao Li, sp. nov. (♂♀), M. ranong Li, sp. nov. (♂♀), M. ratnapura Li, sp. nov. (♂♀), M. salawa Li, sp. nov. (♂), M. tak Li, sp. nov. (♀), M. tanintharyi Li, sp. nov. (♂♀), M. tengchong Li, sp. nov. (♂), M. thenna Li, sp. nov. (♂♀), M. uva Li, sp. nov. (♀), M. wenshan Li, sp. nov. (♂♀), M. wui Li, sp. nov. (♂♀), M. yala Li, sp. nov. (♀), and M. yuxi Li, sp. nov. (♂♀). Among them the genus Merizocera is reported for the first time from China, Myanmar, and Singapore.
Brown planthopper (BPH; Nilaparvata lugens Stal) is considered the main rice insect pest in Asia. Several BPH-resistant varieties of rice have been bred previously and released for large-scale production in various rice-growing regions. However, the frequent surfacing of new BPH biotypes necessitates the evolution of new rice varieties that have a wide genetic base to overcome BPH attacks. Nowadays, with the introduction of molecular approaches in varietal development, it is possible to combine multiple genes from diverse sources into a single genetic background for durable resistance. At present, above 37 BPH-resistant genes/polygenes have been detected from wild species and indica varieties, which are situated on chromosomes 1, 3, 4, 6, 7, 8, 9, 10, 11 and 12. Five BPH gene clusters have been identified from chromosomes 3, 4, 6, and 12. In addition, eight BPH-resistant genes have been successfully cloned. It is hoped that many more resistance genes will be explored through screening of additional domesticated and undomesticated species in due course.
Reviewing selected policy responses in Asia and South America, this paper draws pragmatic lessons for developing countries to better address the COVID-19 pandemic. It argues that not acting quickly and adequately incurs much higher costs. So-called 'best practices', while useful, may be inappropriate, especially if not complemented by effective and suitable socio-economic measures. Public understanding, support and cooperation, not harsh and selective enforcement of draconian measures, are critical for successful implementation of containment strategies. This requires inclusive and transparent policy-making, and well-coordinated and accountable government actions that build and maintain trust between citizens and government. In short, addressing the pandemic crisis needs 'all of government' and 'whole of society' approaches under credible leadership.