Promover la seguridad de la tenencia de tierras para los desplazados internos

El caso de Maslakh, en la zona oeste de Afganistán, es un ejemplo de una nueva política de desplazados internos. Si triunfa, el proyecto garantizará la seguridad de la tenencia de tierras para los desplazados internos que se encuentren en entornos urbanos y sentará un precedente para su integración local a lo largo y ancho de Afganistán, una cuestión muy controvertida y politizada hasta la fecha

Inappropriate drug use

This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of inappropriate drug use in the elderly

ANTIMICROBIAL ACTIVITY OF AQUEOUS AND ETHANOLIC LEAF EXTRACTS OF ANACARDIUM OCCIDENTALE

Objective: The objective of this study was to evaluate the antimicrobial activity of leaves of Anacardium occidentale (A. occidentale) against microorganisms including multidrug-resistant (MDR) bacteria. Methods: Agar well diffusion method was employed to demonstrate the antimicrobial activity of leaves A. occidentale. Ethanol and aqueous extracts of the leaves were used against microorganisms, which included American type culture collection strains of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Pseudomonas aeruginosa and the clinical isolates of Streptococcus pneumoniae, Candida albicans, MDR Escherichia coli, and MDR Klebsiella pneumoniae. Results: The ethanolic extract of leaves of A. occidentale showed significant antimicrobial activity. Aqueous extract had mild antifungal activity. Conclusion: Ethanolic extract of leaves of A. occidentale could be a good source for the antibacterials to combat MDR bacterial infections. Further studies are necessary for these potent plant extracts to evaluate the in vivo efficacy and toxicity

Minimal excision technique for epidermoid (sebaceous) cysts

This issue of eMedRef provides information to clinicians on the indications, procedures and follow up for the minimal excision technique for epidermoid (sebaceous) cysts

Should you treat carriers of pharyngeal group A strep?

The jury is out as to whether you should treat asymptomatic carriers of group A streptococci (GAS), because no studies specifically address the issue. In addition, many patients are unlikely to care about their carrier status, although they probably care about symptoms and treatment side effects. Nonetheless, you may want to consider treating GAS carriers under the certain circumstances (strength of recommendation [SOR]: C, expert opinion)

Assessment of Metabolic Parameters For Autism Spectrum Disorders

Autism is a brain development disorder that first appears during infancy or childhood, and generally follows a steady course without remission. Impairments result from maturation-related changes in various systems of the brain. Autism is one of the five pervasive developmental disorders (PDD), which are characterized by widespread abnormalities of social interactions and communication, and severely restricted interests and highly repetitive behavior. The reported incidence of autism spectrum disorders (ASDs) has increased markedly over the past decade. The Centre for Disease Control and Prevention has recently estimated the prevalence of ASDs in the United States at approximately 5.6 per 1000 (1 of 155 to 1 of 160) children. Several metabolic defects, such as phenylketonuria, are associated with autistic symptoms. In deciding upon the appropriate evaluation scheme a clinician must consider a host of different factors. The guidelines in this article have been developed to assist the clinician in the consideration of these factors

What is the best strategy for impaired glucose tolerance in nonpregnant adults?

The best treatment strategy for impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) is lifestyle intervention with a structured weight loss program of diet and exercise (strength of recommendation [SOR]: B, based on high-quality randomized controlled trials [RCTs] for disease-oriented outcomes). Patients with IGT and IFG should be counseled to lose 5% to 7% of their body weight and instructed on moderate intensity physical activity for ~150 minutes per week

IN VITRO ANTIBACTERIAL AND ANTIFUNGAL ACTIVITIES OF AQUEOUS AND ETHANOLIC LEAF EXTRACTS OF ACACIA AURICULIFORMIS

Objective: The present study focuses on in vitro antimicrobial properties of aqueous and ethanol leaf extract of Acacia auriculiformis tested on Gram-positive cocci, Gram-negative bacilli, multidrug-resistant (MDR) Gram-negative bacilli, and fungus.Methods: Ethanol and aqueous extracts of the leaves of A. auriculiformis were prepared. Agar well diffusion was the method for antimicrobial susceptibility. Freshly grown standard strains of Staphylococcus aureus, Enterococcus faecalis, Klebsiella pneumoniae (K. pneumoniae) , Escherchia coli (E.coli) and Pseudomonas aeruginosa, clinical strains of Streptococcus pneumoniae, Candida albicans (C. ailbicans), and MDR E. coli, and MDR Klebsiella pnuemoniae were used. Ampicillin disc (10 μg) was used as control.Results: The zone of inhibition was measured to determine the antimicrobial activity. Ethanolic extract of A. auriculiformis exhibited antibacterial activity against all the strains including MDR strains of K. pneumoniae and E. coli. Antifungal activity was exhibited by both aqueous and ethanol leaf extracts of A. auriculiformis.Conclusion: Ethanol extract could be used against MDR K. pneumoniae and MDR E. coli. Similarly, aqueous and ethanol extract can be the drug of choice for C. albicans infection. Further study is necessary to evaluate the accurate compound responsible for antibacterial and antifungal activity for pharmaceutical applications

A QUESTION MODULE FOR ASSESSING COMMUNITY STIGMA TOWARDS HIV IN RURAL INDIA

This paper describes a simple question module to assess community stigma in rural India. Fear of stigma is known to prevent people from seeking HIV testing and to contribute to further disease transmission, yet relatively little attention has been paid to community stigma and ways of measuring it. The module, based on a vignette of a fictional HIV-positive woman, was administered to 494 married women and 186 unmarried male and female adolescents in a village in rural Maharashtra, India. To consider the usefulness of the question module, a series of hypotheses were developed based on the correlations found in other studies between HIV-related stigma and socio-demographic characteristics (age, education, discussion of HIV with others, knowing someone living with HIV, knowledge about its transmission and whether respondents acknowledged stigmatizing attitudes as their own or attributed them to others). Many of the study's hypotheses were confirmed. Among married women, correlates of stigma included older age, lack of discussion of HIV and lack of knowledge about transmission; among adolescents, lower education and lack of discussion of HIV were the most significant correlates. The paper concludes that the question module is a useful tool for investigating the impact of interventions to reduce stigma and augment social support for people living with HIV in rural Indi

What is the best way to treat patients with white-coat hypertension?

Evidence is conflicting regarding the risk of cardiovascular complications from white- coat hypertension. Some but not all studies show lower cardiovascular event rates for patients with white-coat hypertension compared with those with sustained hypertension (strength of recommendation [SOR]: B, cohort studies with conflicting results and methodological problems). Little information is available about the use of antihypertensive medication for white-coat hypertension. In 1 small randomized trial, the difference in stroke incidence and cardiovascular complications between active treatment and placebo did not reach statistical significance (SOR: B, based on an underpowered randomized controlled trial). Some experts recommend that patients with white-coat hypertension should be evaluated for evidence of target organ injury and monitored for the development of sustained hypertension (SOR: C, expert opinion)