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1. INTRODUCTION The Standard Drug Treatment Schedule SDTS ; for Health Posts was published by MOH for the first time in Nepal in 1988 following publication of the first Essential Drug list EDL ; in 1986. The Essential Drug List was revised in 1992 and subsequently the Standard Drug Treatment Schedule for Health Posts was also revised in 1993. The Standard Drug Treatment Schedule for Health Posts has been revised, once again, and has been named Standard Treatment Schedule STS ; for Health Posts and Sub-health Posts, 1999. It has also been translated for the first time into Nepali language with the financial support of Rational Pharmaceutical Management RPM ; Project following second revision of Essential Drug List in 1997. Though the SDTS was revised, published, distributed as well as few training also imparted to implement the SDTS, the impact has never been evaluated. A study was designed in 1994 by International Network for Rational Use of Drugs INRUD ; , Nepal with financial support of United States Agency for International Development USAID ; Rational Pharmaceutical Management RPM ; John Snow Inc. JSI ; to see the impact of training using SDTS along with other strategies. The training had to be imparted by UNICEF and strategy evaluation was to be done by INRUD, Nepal. Unfortunately, the training on SDTS could not be imparted. The effect of another strategy i.e. supervision monitoring to change prescribing practices in accordance with STS was significantly improved. Experiences have also shown that the compliance with the guidelines increases with use of different types of strategies. Different strategies are appropriate in different contexts. The successful introduction of guidelines is dependent on many factors, including the clinical context and methods of developing, disseminating and implementing those guidelines 1 ; . These experiences are from the industrialized countries. There are few experiences of testing these strategies in developing countries. Obviously, urgent need was felt to develop an effective strategy to implement STS in health facilities to promote the quality use of medicines. The possible strategies are training, training with self-assessment and peer discussion. A consultancy report Dennis Ross-Degnan, RPM, April 1996 ; recommended training primary health care workers on how to use the STS as a reference guide as well as training that focuses on treatment of four key health problems ARI, Diarrhea, Skin infection and Fever. The report recommended developing simple and colorful wall posters to illustrate differential diagnosis and treatment protocols based on materials in the STS. It also recommended a selfassessment strategy for improving provider practices.
Carbohydrate-rich foods in those people who have low intakes, and to maintain optimal intakes among those currently eating high-carbohydrate diets. Other carbohydrate-containing foods are root crops, sugar crops, pulses legumes ; , vegetables, fruit and milk products. The recommendation to make starchy foods the basis of most meals should be accompanied by advice to choose unrefined or minimally processed cereals and grains where possible, and to concentrate on fortified cereals and grains when available. There are several ways in which high intakes of cereals and grains will beneficially influence total nutrient balance and health. Direct effects of an increased starch intake on the physiology of the intestinal tract and metabolism can be expected. Many associated substances in these foods such as cereal fibre, oligosaccharides, phytoestrogens, phytosterols, flavonoids, terpenes and isothiocynates are now known to influence health beneficially. Carbohydrate-containing foods are also excellent sources of several vitamins and minerals, and some, if eaten in sufficient quantities, can make substantial contributions to protein intake. Although some of the substances such as phytates in unrefined cereals and grains may inhibit absorption of these micronutrients, unrefined cereals and grains are accepted as good sources of micronutrients. Increased intakes of starchy foods can also replace some animal-derived and fatty foods in the diet, leading to a decreased fat and animal protein intake. This, together with increased intakes of fibre, resistant starch and associated plant substances will decrease the risk of many overnutrition-related chronic diseases such as coronary heart disease CHD ; , stroke, non-insulin-dependent diabetes mellitus NIDDM ; , and some forms of cancer. The contribution of micronutrients to the diet by unrefined and fortified cereals and grains will help to prevent micronutrient undernutrition. Starchy foods therefore have direct, indirect or `replacement' effects on nutritional status and health. The scientific evidence to support these statements on the beneficial effects of starchy foods and or high-carbohydrate diets, which form the background and motivation for this guideline, will be reviewed briefly, for example, . Pedialyte Sinus medications Sleeping aids Smoking cessation products e.g.

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Correlates with patient survival. In future, ultrasound may replace clinical assessment of the skin as a more objective measure of skin thickness w52x. Similarly, high resolution CT scanning and Doppler-echocardiography have been shown to be effective ways of evaluating fibrosing alveolitis and pulmonary hypertension respectively. Recently, as a result of another international collaboration, a disease severity score has been published w53x. Severity scales were developed for nine organ systems from 0 no involvement ; to 4 end stage disease ; . No attempt was made to combine the individual scores into a global score of disease severity. The scales employed in the instrument have been validated using a large patient database. Its sensitivity to change has not yet been assessed and its usefulness in the longitudinal study of individual patients and in therapeutic trials has not been established. To date, there is no consensus about what instruments should be used in patients with SSc to measure health status and assess the economic impact of the disease and its treatment. The Health Assessment Questionnaire, developed for rheumatoid arthritis, has been used and has been shown to correlate with loss of hand function in early diffuse SSc w54x. Recently, a scleroderma-specific questionnaire to be completed by the patient has been described which may have advantages over the HAQ w55x. Over the years, a number of laboratory markers Table 2 ; have been described to reflect important biological processes in SSc including immune reactivity, endothelial activation and vascular damage, and extracellular matrix deposition w56x. As yet their role in assessing the effects of treatment has not been established. Markers of vascular injury, of potential relevance to the QUINS study include plasma levels of von Willebrand factor antigen, which, in previous studies, correlates with the frequency, and severity of Raynaud's attacks w57x. Similarly, microalbuminuria and urine levels of renal tubular enzymes such as N-acetyl-Dglucosaminidase NAG ; have been shown in pilot studies Dr R. Moots, personal communication ; to be elevated in SSc patients compared with other forms of renal disease and normal controls. Which of these surrogate markers of SSc activity will be of value in therapeutic studies will be an important challenge for the future and pregabalin.

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Symptom Text: Patient developed a large local reaction of the right arm following anthrax vaccinations in April 2003. Redness, pain and swelling persisted x 6-7 weeks. On 7 June, she was re-evaluated for ongoing symptoms and was diagnosed with a DVT in the right subclavian vein. The medical record received on 2 24 confirms diagnosis of deep vein thrombosis. Also states cellulitis of right antecubital fossa. 60-day follow up on 02 04: "Pt has recovered from adverse events." Other Meds: Lab Data: History: Prex Illness: Prex Vax Illns: Ultrasound, venogram, PT, PTT None redness, swelling of vaccination site right arm.

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The following neuroleptic drugs, listed by their trade names, are registered for use in Sweden 1990 ; : Buronil, Cisordinol, Dridol, Esucos, Fluanxol, Haldol, Hibernal, Leponex, Luvatren, Mallorol, Navane, Neulactil, Nozinan, Orap, Pacinol, Siqualone, Stemetil, Terfluzin, Theralen, Tindal, Trilafon, Truxal. Common neuroleptic drugs in the U.S. in 2004 include: Clozaril, Geodon, Haldol, Loxitane, Mellaril, Moban, Navane, Permitil, Prolixin, Risperdal, Serentil, Seroquel, Stelazine, Thorazine, Trilafon, Zyprexa. ; The purpose of this article is, first, to explain how neuroleptic drugs act, secondly, to show how the psychiatric language misleads, and thirdly, to show why the use of neuroleptic drugs is contrary to medical ethics and to central values of our society. IN THE HANDBOOK OF DRUGS Lkemedelsboken ; for Swedish physicians, professor Goran Sedvall of the Karolinska institute, who is an international authority on the subject, describes the mental effects of neuroleptic drugs in three points and labetalol.

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Venue : Le Meridien Hotel and International Convention Centre, Maradu, NH Bypass, Kochi. Dates: 10th to 13th January 2008 For further details contact : - Dr. NN Asokan, Org. Secretary APICON 2008, Muvattupuzha Medical Centre M.C.Road, Muvattupuzha. Phone: 0485-2812215 Hosp 2835480 81 82 Res Mob: 9847031241, 9895844000 Email : drnnasokan hotmail Website for APICON 2008 is apicon2008.

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Guo P, Xu J, Xu S, Wang K. Inhibition of hydrogen peroxide production in chondrocytes induced by fulvic acid by ginger volatile oil. China J Chinese Materia Medica 1997; 22: 559-61. BONJOUR J.-P. Division de Physiopathologie Clinique Hpital Cantonal Universitaire 24 rue Micheli du Crest 1211 GENEVE 14 - SUISSE CHUMLEA Wm.C. Division of Human Biology - Department of Community Health Wright State University - School of Medicine 1005 Xenia Avenue YELLOW SPRINGS OH 45387 - USA CORMAN B. CEA - Dpartement de Biologie Cellulaire C.E. Saclay - Btiment 520 532 91191 GIF SUR YVETTE - FRANCE DEBRY G. Centre de Nutrition Humaine - Universit de Nancy 40 rue Lionnois 54000 NANCY - FRANCE DRISS F. Hpital Sainte Prine 49 rue Mirabeau 75016 PARIS - FRANCE FITTEN L.J. Department of Psychiatry - Veterans Administration Hospital 16111 Plummer Street SEPULVEDA CA 91343 - USA GARRY P. University of New Mexico - School of Medicine Clinical Nutrition Program 2701 Frontier Place NE - Surge Building Room 215 ALBUQUERQUE, NM 87131-5666 - USA HEANEY R. Creighton University 2500 California Plaza OMAHA, NE 68178 - USA JEANDEL C. CHU de Nancy - Hpitaux de Brabois Rue du Morvan 54511 VANDOEUVRE Cedex - FRANCE KRONMAL R. Department of Biostatistics - University of Washington School of Public Health and Community Medicine F600 Health Sciences - Box 357232 SEATTLE, WA 98195 - USA LIPS P. Department of Endocrinology - Free University's Hospital De Bolelaan 1117 081 HV AMSTERDAM - PAYS BAS McNAMARA D.J. E.N.C. 1819 H Street, NW, Suite 520, WASHINGTON, DC 20006 - USA MICHEL J.-P. Hpitaux Universitaires de Genve Route de Mon Ide, CH-1226 THNEX-GENEVE - SUISSE NELSON M. Jean Mayer - United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University 711 Washington Street BOSTON, MA 02111 - USA PATUREAU MIRAND P. INRA - Laboratoire d'Etude du Mtabolisme Azot 63122 CEYRAT - FRANCE ROUSSEL A.-M. CHU Albert Michalon - Laboratoire de Biochimie B.P. 217 38043 GRENOBLE Cedex - FRANCE RUSSELL R. Jean Mayer - United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University 711 Washington Street BOSTON, MA 02111 - USA SCHLIENGER J.-L. Hpital de Hautepierre Avenue Molire 67098 STRASBOURG Cedex - FRANCE VELLAS B. CHU de Toulouse - Hpital de Casselardit Pavillon J.-P. Junod 31059 TOULOUSE Cedex - FRANCE YU B.P. University of Texas - Health Science Center at San Antonio Department of Physiology 7703 Floyd Curl Drive SAN ANTONIO, TX 78284-7756 - USA and mevacor.
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FDA Guideline for the Clinical Evaluation of Analgesic Drugs. DHHS Pub. No. 93-3093. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Food and Drug Administration, 1992. Noyes, R., Jr.; Brunk, S.F.; Baram, D.A.; and Canter, A. Analgesic effect of delta-9tetrahydrocannabinol. J Clin Pharmacol 15 2-3 ; : 139-143, February-March, 1975a. Noyes, R., Jr.; Brunk, S.F.; Avery, D.A.H.; and Canter, A.C. The analgesic properties of delta-9tetrahydrocannabinol. Clin Pharmacol Ther 18 1 ; : 84-89, July, 1975b. Raft, D.; Gregg, J.; Ghia, J.; and Harris, L. Effects of intravenous tetrahydrocannabinol on experimental and surgical pain. Clin Pharmacol Ther 21 1 ; : 26-33, 1977 and maxalt and loxitane, because coumadin!

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