Bad Side Effects Research Articles

POTENSI TEMPE (RHYZOPUS.SP) SEBAGAI SUMBER PHYTOESTROGENS UNTUK MENGAKTIFKAN DAN MENCAPAI SEL STEM DALAM PERBAIKAN LENSA KATARAK DAN PERBAIKAN METANOLIK DARI EKSTRAK GARLIC (ALLIUM SATIVUM) SEBAGAI TERAPI TERAPI DALAM KATAK DIABETIK

Cataracts are turbidity lenses that are normally transparent and light is passed through to the retina, which is caused by various things resulting in impaired vision. One of the causes of cataract is diabetes mellitus which manifests clinically as hyperglycemia. Various therapies have been developed to deal with cataracts. However, the therapy is a definitive form of surgery which causes long-term complications in the form of blindness. One of the therapeutic modalities developed today is stem cell therapy. Stem cells are undifferentiated cells and have high potential to become other cells. Stem cells can differentiate to repair damaged lentic capsules and the formation of subepithelial lamellar fibers. Stem cells proliferate and migrate will be assisted by estrogen. However, the use of estrogen often causes bad side effects for the body. So, estrogen replacement is needed which has the same effect but does not produce side effects.Tempe is a typical Indonesian food that has isoflavonoid content. Isoflavonoids are able to function as phytoestrogens in the human body and have the same function as 17β-estradiol. In stem cells, phytoestrogens will play a role in activating paracrine actin (Akt) and stromal cell derived-1 (SDF-1) signals. Phytoestrogens will accelerate the rate of mesenchymal stem cell (MSC) / induced pluripotential stem cell (iPSC) and bind to the right receptors, so as to increase the work effectiveness of stem cells. Meanwhile, in diabetic cataract conditions the potential for garlic methanolic has recently been developed in relation to antioxidant effects, effective hypoglycemic and scavenging oxidative stress factors such as H2O2 and decreasing protein fraction in the lens due to protein insolubility. Keywords : Tempe, Stem Cell, Phytoestrogens, Garlic, and Metanolic.

Periodontal ligament injection v/s oral nerve block

As we all know local anesthesia is used for reversible blockade of nerves, which leads to a transient loss of sensation. Local anesthesia is use in a variety of dental procedures such as tooth extraction, root canal treatment, traumatic injuries and the list will go on. But, it has been found that inferior alveolar nerve block technique is associated with many bad side effects. So, periodontal ligament injection technique is a safer alternative to oral nerve block in various dental procedures. In this article, we have done the comparison between the PDL injection and oral nerve block. Keywords: Local anesthesia, Periodontal ligament injection, Local infiltration techniques, Oral nerve block techniques, Inferior alveolar nerve block, Effectiveness, Comparison, Side effects, Safe, Pulpal anesthesia.

Soluble Alpha Klotho Serum Level in Chronic Kidney Disease

AbstractBackground: Chronic Kidney Disease (CKD) is a world-wide public health problem which has bad side effects. Soluble alpha klotho is a phosphate and calcium regulatory hormone which can be used as a biomarker in diagnosis of chronic kidney disease.Aim of Study: Evaluation of the level of soluble alpha klotho and its role in diagnosis of chronic kidney disease.Patients and Method: The study was done on eighty cases that were divided into two categories according to their health status and estimated Glomerular Filtration Rate (eGFR), diseased group including sixty patients with chronic kidney disease (eGFR 120ml/min/1.73m2). Patients group were subdivided into five subgroups according to variation in their eGFR. All subjects were subjected to full history taking, thorough clinical examination and assessment of age, sex and risk factors for CKD as hypertension, diabetes mellitus and urinary tract infection. Routine laboratory tests included urea, creatinine, Ca, Po4 level and protein in urine. Serum soluble alpha klotho was estimated by Enzyme Linked Immunosorbent Assay (ELISA).Results: Our study found that there was significant de-crease in soluble alpha klotho serum level with progression of chronic kidney disease which started to be more obvious in stage IIIB.Conclusion: Soluble alpha klotho is a novel biomarker of chronic kidney disease that shows a significant decrease with disease progression and correlates with other mineral disorders of the disease, so it can be used in diagnosis of chronic kidney disease.

A Proposal of Interactive Contents for Prevention of Smartphone Overdependence

IoT technology application has been part of modern people’s everyday life. This technology makes people to depend on smart devices. ‘Smartphone’ is the most typical example. Despite the advantages given by this device, the bad side effects are also notable. This paper presents interactive content on the dependence of smartphone device. The research objective is to make individuals to reduce the use of smartphones by realizing their own problems of smartphone dependency. Research was progressed by analyzing aspects obtained from users participating in the self-developed interactive game contents. As a result of the analysis, approximately 68% of people were aware of the problem through this content. This indicates the potential of using convergence research in interactive contents with other fields furthermore.

Facilitators to Immediate Post Partum Intra Uterine Contraceptive Device Uptake among Mothers Delivering in Meru Hospital

Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that; the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.

ANALISIS BAHAN BAKU AIR MINUM DAN PRODUK OLAHANNYA SERTA ELIMINASI TERHADAP PENCEMARAN HORMON STEROID DAN LOGAM BERAT

Steroid hormone and alloy could contaminate the drinking water which danger to human, because make bad side effect on the health. Steroid hormon may cause diseases ie. malignancy particularly of gen mutation and and heavy alloy may cause discrepancies oforgan among others: lever, kidneys, brain and the others. The objective of this research was to identify quantitatively either steroid sexhormones or heavy metal contaminants in drinking water. The water examination of PDAM, household and mineral water was doneby ELISA method to steroid hormones in Laboratory of veterinary obstetric and endocrine UNAIR .The alloy were analyzed by Atomicabsorption method in Dept. Of Chemistry in ITS laboratory. The data were analyzed by descriptive statistic show that all kinds of drinkingwater samples were not contaminated neither heavy metal such as Cd and Pb nor male sex hormone. But unfortunately contaminationof heavy metal mainly cuprum (Cu) spread it out for all kind of drinking water and its product so then the highest contamination foundin dig-land-water was 87%. The other hand more frequent female sex hormone contaminated drinking water there was estrogen and secondly followed with progesterone hormone. Examination of contaminant steroid hormone in drinking water, water supply of PDAM, Vendors water and mineral water didn't contaminate with alloy (Cd and Pb) ,also they didn't contaminate with testoteron hormonehowever almost water reservoir and more over dig-land-water of Mamuju Regency contaminated with Cu more than 0.02 ppm

ISOLATION, SCREENING, AND CHARACTERIZATION OF PROBIOTICS (LACTIC ACID BACTERIA) ANTAGONISTIC AGAINST Candida albicans

Candidacies in female reproductive tract are mainly caused by Candida albicans. This infection often causes serious problems, particularly on their reproductive tract (genital part). Until recently, control of this infection has relied on the use of antibiotics. However due to numerous bad side effects of antibiotics, lactic acid bacteria have been proposed as an alternative method to control the growth of Candida albicans. Therefore, this research was aimed to isolate, screen, and characterize lactic acid bacterial isolates (LAB) antagonistic against Candida albicans (the causative agent of candidacies infection in reproductive tract of human). LABs were isolated from various fermented foods, such as tape ketan and kimchi. Isolation of LABs was conducted by applying dilution and spread plate method on MRS agar medium supplemented with BCP indicator to distinguish LABs from non acid-producing bacteria. Colonies with indication to produce acid were screened for antagonistic activity against C. albicans on MRS agar and followed by characterization of those isolates (Gram stain, catalase production test, oxydase production, gas production test, resistance test to low pH conditions and to high level of NaDC (sodium deoxicolic), and test for ability to convert colic acid (CA) into deoxicolic acid (DCA)). The results showed that 46 LAB isolates were successfully isolated from samples of tape ketan and kimchi. Among those, 7 isolates showed antagonistic activity against C. albicans in in vitro tests. All these 7 candidates were also found to be resistance to low pH conditions (up to pH 2) and to high level of NaDC (up to 0.6 mM). Four most potential isolates were further testes for ability to convert colic acid into deoxycolic acid and none showed positive result, indicating that they all showed initial potential and safe for future human probiotic development (especially to be used to treat patients infected by C. albicans).

Variations in judgments of intentional action and moral evaluation across eight cultures

Individuals tend to judge bad side effects as more intentional than good side effects (the Knobe or side-effect effect). Here, we assessed how widespread these findings are by testing eleven adult cohorts of eight highly contrasted cultures on their attributions of intentional action as well as ratings of blame and praise. We found limited generalizability of the original side-effect effect, and even a reversal of the effect in two rural, traditional cultures (Samoa and Vanuatu) where participants were more likely to judge the good side effect as intentional. Three follow-up experiments indicate that this reversal of the side-effect effect is not due to semantics and may be linked to the perception of the status of the protagonist. These results highlight the importance of factoring cultural context in our understanding of moral cognition.

Production of Antitumor Agents from Novel Marine Actinomycetes Strains Isolated from Alexandria, Egypt

Production of antitumor agent(s) from alternative natural marine microbial resources may decrease or avoid the bad side effects of the used anti-tumour chemotherapeutic agents and may increase the specificity of the antitumor agents to be safer for human application. So, this study aimed to search for new alternative antitumor agent producers using two recommended bioassays (Red Potato Disc Bioassay and Sulforhodamine B Bioassay). The obtained results indicated the isolation of three new marine actinomycetes strains from the western harbor of Alexandria, they identified using the 16S rRNA gene sequence as Streptomyces sp. strain AMS11, Nocardiopsis halotolerans strain AMS10b and Nocardiopsis halotolerans strain AMS10a. The bio-toxicity test was carried out using the biomarker Artemia salina, they showed a moderate toxicity level (LC50< 1000 ppm). The antitumor activities of their supernatants against the colon cancer cell line (HCT116) and the liver cancer cell line (HEPG2) showed promising results in comparison to the recommended chemotherapeutic drug 5-flourouracil used for the treatment of both liver and colon cancer cells. The optimization for antitumor activity was performed using the Plackett –Burman experimental design.

P212 A Review of Treatment Outcomes of Colorectal Carcinoma in Adults at Hospice Center and Its Implication for Provision of Palliative Care

The aim was to help the guy patients when providing palliative care services not living any patient untouched when they need palliative care services. Colorectal cancer is one of the major malignancies associated with HIV/AIDS infection in Africa and the gays. However their limited data on treatment outcomes of patients affected with HIV/AIDS especially with its associated symptoms. A review of case notes for patient with colorectal cancer was carried out. The case notes of ten histology for patents confirmed adult were reviewed and this is because it was never considered. Of the male reviewed, 6{60%} were male and {40%} were female, the gender ratio therefore being 3.5.The age of male ranged from 28 to 80 years with the mean age being 30years. In reviewing the histology, the most common treatment was surgery, chemotherapy and later radiotherapy and sometimes combination of both palliative therapies to relieve symptoms and improve quality of life. Despite the clinical trails only 2 of them have responded to the radiotherapy and managed to live for 5 years. Of the 8 who received both chemotherapy and radiotherapy 6 died and 2 experienced bad side effects of radiotherapy and died as well. Although this review is small it to suggest that despite of combination therapies recurrence of symptoms of is common. Within the provision of palliative care this has implications both for youth and adults. Bigger studies are recommended in the young generation to study this in more depth and also to consider these people when giving palliative care services.

Evidence for the Context Dependence of the Side-Effect Effect

In four experiments involving 565 German speakers we tested several hypotheses about possible determinants of the side-effect effect (see), which consists of judging foreseen bad, but not good, side-effects of actions as intentionally produced. Experiment 1 failed to find intentionality ascriptions for bad side-effects for the majority of the participants in two different scenarios and obtained no consistent support for two hypothesized social-cognitive determinants of the see, the agent’s attitude and the mode of effect description. Experiment 2 replicated the see in the original ceo scenario, but again found no evidence that the effect was influenced by the agent’s attitude towards the side-effect. The see was also not influenced by a manipulation of the moral quality of the agent’s primary goal. Experiment 3 investigated six additional scenarios used in previous studies and again obtained clear evidence for the see only in the ceo scenario. In addition, Experiment 3 demonstrated that judgments of both intent and intentionality strongly increased if the original side-effect was described as a means to the agent’s primary goal, or as an independently pursued goal. Taken together, the findings suggest that for German speakers, the see depends on the specifics of the scenario content and is difficult to obtain outside the original ceo scenario. Consistent with these conclusions, Experiment 4 documented parallel difficulties replicating the “means effect”, an analogue of the see on the level of means, but replicated the see in a scenario closely modeled after the original ceo scenario.

Reclaiming Proportionality (Society for Applied Philosophy Annual Lecture 2016)

Reclaiming Proportionality (Society for Applied Philosophy Annual Lecture 2016)

Purification, characterization and anti-aging capacity of mycelia zinc polysaccharide by Lentinus edodes SD-08.

BackgroundIn the modern society, aging had been a major problem. People may rely on many medicines to delay it. However, lots of medicines were chemosynthetic, and they would do a bad side-effect on human body. Microbial sources could be used as a potential means of producing natural antioxidants. Lentinus edodes, commercial obtained in daily life, had recently become more attractive in physiological research. Zinc was now considered as a major element in assuring the correct functioning of an organism and essential for maintaining coordination of the major homeostatic networks. To investigate the bioconversion of zinc and the physiological effects of their complex (MZPS), the present studies were processed.MethodsMycelia polysaccharides (MPS) and mycelia zinc polysaccharides (MZPS) of Lentinus edodes SD-08 were extracted by hot water leaching and purified by DEAE-52 cellulose anion-exchange column chromatography separately. The zinc content was determined by flame atomic absorption spectrometry. The evaluation of monosaccharide compositions and proportions used gas chromatogram. The analysis of molecular weight used HPGPC chromatogram. The typical structure of polysaccharide was evaluated by IR spectrum. The antioxidant activities in vitro measured through reducing power, the scavenging effects on hydroxyl radical and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals. The anti-aging activities in vivo measured through the total antioxidant capacity (T-AOC), GSH peroxide (GSH-Px), superoxide dismutase (SOD) and the contents of malondialdehyde (MDA).ResultsMPS and MZPS of Lentinus edodes SD-08 were extracted and purified by DEAE-52 cellulose anion-exchange column chromatography separately, and four fractions (MPS-1, MPS-2, MZPS-1 and MZPS-2) were obtained. In addition, MPS composing of rhamnose, arabinose and mannose (molar proportion = 1.75:1.00:3.02) and MZPS containing rhamnose, arabinose, mannose and glucose (molar proportion = 7.19:2.26:1.00:8.39) were investigated by gas chromatography. Infrared spectrum analysis indicated that there were C-H, C=O and -CH2 bonds in MPS and MZPS. MPS also had the typical absorption of -NH3+, -NH2 and -COOH. Compared with MPS, MZPS showed in vitro positive rising of reducing power and certain scavenging effects on hydroxyl radical and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals. MZPS were found to upregulate in vivo the anti-aging activities of total antioxidant capacity (T-AOC), GSH peroxide (GSH-Px), superoxide dismutase (SOD), and decrease the contents of malondialdehyde (MDA).ConclusionsMZPS effectively showed potential anti-aging activities in vivo and antioxidant activities in vitro, and the molecular constituents, chemical bonds and functional groups of MZPS were superior to MPS, suggesting that the MZPS of L. edodes SD-08 could be used as a potential natural antioxidant.

Anti-inflammatory Effects of Quranic Plants’ Mixture: A New Pharmaceutical Product

Aims:&nbsp;This work was carried out to determine anti-inflammatory effects of this new pharmaceutical product (Quranic Plants’ Mixture) and also to study side effects of this product on many important organs of the body of investigated animals.Place and Duration of the Study:&nbsp;In vivo&nbsp;studies were carried out in the Animal House of the National Research Centre, Dokki, Giza, Egypt (during 21-22 July 2014). Histological studies of investigated animals were done in the Pathology Department Lab, Theodor Bilharz Research Institute, Giza, Egypt.Study Design:&nbsp;Three different doses of this new pharmaceutical product were tested in this study regarding their anti-inflammatory effects.Methodology:&nbsp;In vivo&nbsp;studies of anti-inflammatory effects of feeding adult female albino rats under investigation with three different doses (2, 4 and 8 g/kg ) of this new pharmaceutical product were carried out after 24 hours of inducing inflammation by injecting investigated animals with carrageen. Additionally, weights of many important organs (Brain, Kidney, Liver, Heart, Lung, Spleen, Stomach and Colon) of the body of investigated animals were measured, along with investigations of their histological structures, to examine any bad side effects of this new pharmaceutical product on investigated animals.Results:&nbsp;In vivo&nbsp;studies of anti-inflammatory effects of feeding adult female albino rats under investigation with three different doses (2, 4 and 8 g/kg ) of this new pharmaceutical product showed that, both edema sizes and weights were decreased in case of feeding these rats with all investigated doses of Quranic plants’ mixture. In this regard the highest anti-inflammatory effect was obtained by feeding animals with 8 g/kg of Quranic plants’ mixture based on edema weight estimation; however, 2 g/kg of Quranic plants’ mixture was found to be the best effective dose by estimating edema sizes of inflammated rats. Weights’ estimation and histological investigations of many important organs of the body of investigated animals revealed that, all investigated doses (2, 4 and 8 g/kg ) of Quranic plants’ mixture have not any bad side effects on many important organs of all examined rats.Conclusion:&nbsp;These promising results of anti-inflammatory effects of Quranic plants’ mixture will add a new safe anti-inflammatory agent in the world of pharmaceutical products; also these results will lead us to more biological and chemical investigations of this new, cheap and safe pharmaceutical natural product of plant origin.

A Better Way to Know What Patients Believe and Value about Health

In every medical school, residency training, and professional society, there is a push for doctors to practice “patient-centered” medicine. A central tenet of patient-centered medicine is that the patient’s values and beliefs guide the treatment. But what does that really mean? And how are doctors, who face increasing time pressure, supposed to know what a patient believes and values about health? As a primary care doctor, I have been trained from medical school, and onwards, to take a history from patients that mostly focuses on organs and symptoms. The traditional medical history is based on the false idea that health is largely “physical.” However, in a national survey, 30 % of Americans said that health is a mix of emotional, spiritual, mental, and social factors.1 This matters because what patients believe about health has been linked to their willingness to change health behaviors, take medications, and even whether or not the patient’s health improves.2 After many years of patient care and research on patients’ explanatory models of health and disease, I have learned that there is a more effective and efficient way for doctors to understand what a patient believes and values about their health. Here’s how. Start the visit with what I call, ‘The two questions that every medical student and doctor should be asking their patients.’ These two simple questions, developed by health communication experts and used mostly in research settings,1 are: “How is your health,” followed by, “How do you know (or, why do you think that)?” “Hmmmm,”—the patient often says in response, “No one has ever asked me that,” or, “I never really thought about it.” But if I give them just a few seconds, they become fountains of valuable information about what’s making them sick, what keeps them healthy, and what matters most to them about their health. That’s true even for men, who, we know, are less likely than women to see a doctor or to ask questions at the visit. Let me illustrate. When I asked these questions of Carl, one new patient, he said his health was “just okay.” Asked how he knew, Carl said, “Because right now I take high blood pressure medicine. I want to get off the medicine and lose weight. It’s hard because I don’t like running, though I enjoy walking. My weight has been a struggle ever since I was a kid.” For a 47-year-old man, that was a veritable flood of insight. With this information, I could quickly focus on Carl’s priorities. I offered information on the Dietary Approaches to Stop Hypertension (DASH) diet and encouraged him to walk for exercise. I acknowledged his lifelong weight struggles with empathy, becoming his ally. Studies show that when doctors and patients develop a treatment plan as allies, patients benefit far more. The results? Six months later, Carl had lost 11 lb, his blood pressure was lower, and we cut down his medication. Two questions had resulted in better care and a healthier patient. In a recent study, patients reported that patient-centered decision making occurred least often in routine primary care situations, such as being started on blood pressure or lipid-lowering medicines.3 But these routine situations are exactly when these two questions are most helpful, because the answers provide key information on the patient’s values and beliefs—which has to be the starting point for any patient-centered decision making. Here’s another example. Sondra, a 64-year-old woman, answered my first question by saying that her health was “better now, pretty good,” because she had, at last, finished cancer treatment. The treatment caused “bad side effects and depression,” she explained, “but I also had a lot of family support.” Sondra said she knew her health was pretty good because, “my energy is back, and I want to start traveling again.” Our visit focused on keeping her energetic and making sure her depression was controlled, so that she could do the things she felt she missed during cancer treatment. And I had learned that I could involve her family in her care, if I needed—another hallmark of quality health care. Primary care physicians face increasing time pressure and burn-out. These two questions are effective and efficient in helping me crack open the black box of my patients’ lives, beliefs, and values—and they bring me closer to patients, instead of keeping them at a distance. The next time you are with a patient, try asking these two questions. The answers will help you learn what you really need to know about your patients and can help fulfill the promise of patient-centered care.

SCABIES : PENYEBAB, PENANGANAN DAN PENCEGAHANNYA

&lt;em&gt;&lt;span style="text-decoration: underline;"&gt;Gudik &lt;/span&gt;or kudis is a kind of skin disease that could be found in people who living in crowded neighborhood, for examples slums area, Islamic boarding school, prison, military camp and hospital. &lt;span style="text-decoration: underline;"&gt;Gudik&lt;/span&gt; could be infect all age, race, and social economic level. Many people do not know that the cause of &lt;span style="text-decoration: underline;"&gt;gudik &lt;/span&gt;is mite which named &lt;span style="text-decoration: underline;"&gt;Sarcoptes scabiei.&lt;/span&gt; According to Departemen Kesehatan Republik Indonesia, &lt;span style="text-decoration: underline;"&gt;scabies&lt;/span&gt; ranked third of the twelve of skin disease that most often arises. Until now, &lt;span style="text-decoration: underline;"&gt;scabies &lt;/span&gt;is still neglected, and it becomes to be public health problems worldwide. As the transmission process is fast, misunderstanding of society about this disease makes difficult to eradicate &lt;span style="text-decoration: underline;"&gt;scabies. Sarcoptes scabiei&lt;/span&gt; lives in stratum corneum of skin and eat cell fluids. Female mite digs tunnels under skin surfaces and lays its eggs. This mite activities cause rash on the skin and itch at night. Transmission of &lt;span style="text-decoration: underline;"&gt;scabies&lt;/span&gt; can through direct or indirect contact with the patient. Drug of choice for scabies is still debatable. Although the results of therapy are effective, sulfur 5%-10%, &lt;span style="text-decoration: underline;"&gt;benzyl benzoate&lt;/span&gt;, crotamiton 10%, permethrin 5% and ivermectin give bad side effect for patient. &lt;span style="text-decoration: underline;"&gt;In vitro&lt;/span&gt; study showed the effectivity of tea tree 5% (&lt;span style="text-decoration: underline;"&gt;Melaleuca alternifolia&lt;/span&gt;), paste of neem leaves (&lt;span style="text-decoration: underline;"&gt;Azadirachta indica&lt;/span&gt;) and turmeric (&lt;span style="text-decoration: underline;"&gt;Curcuma longa&lt;/span&gt;), and anise (&lt;span style="text-decoration: underline;"&gt;Pimpinella anisum&lt;/span&gt;) as scabicide. Prevention of &lt;span style="text-decoration: underline;"&gt;scabies&lt;/span&gt; transmisstion is carried out by hygiene and treatment for all people who have direct contact with the patient.&lt;/em&gt;

The Perfect Hypnotic?

A compound that blocks a neurotransmitter receptor is the newest hope for getting a good night's sleep without the bad side effects.

Opportunity lost and found: Any easy way to improve outcomes for prostate cancer patients in the postoperative setting?

Evidence-based medicine is a paradigm shift and is a key component in the provision of high-quality care. The highest quality evidence is clinical practice guidelines based on systematic reviews of the randomized controlled trial (RCT) literature. There are many challenges to successfully complete RCTs and it is problematic to synthesize recommendations when the RCTs have conflicting results. However, in the case of the utility of adjuvant postoperative radiotherapy (ART), this is not the case. There are three RCTs showing improvements in local and biochemical control;1–3 the study with the longest follow-up (SWOG 8794) also demonstrates improvements in distant metastatic disease-free survival and overall survival.2 Cancer Care Ontario (CCO) published a systematic review of the literature and clinical practice guideline on the topic showing that all subgroups benefitted in biochemical control and overall survival from ART (and those with seminal vesicle involvement seemed to benefit more not less).4 It is very interesting to see how this evidence is applied in the pragmatic setting. In this issue of CUAJ, Tyldesley and colleagues have published a population-based analysis of postoperative radiotherapy in British Columbia from 2007 to 2009.5 Many interesting facts are reported. Over the 3-year observation period, 9223 patients were identified from the tumour registry and linked to centralized radiotherapy records. Of these patients, initial therapy was radical prostatectomy in 24%. Postoperatively, 47% had one or more high-risk features (positive surgical margin: 36%; extracapsular spread: 22%; seminal vesicle involvement: 4%).5 Of the 47% with one or more high-risk features, 23% with any adverse features were seen by a radiation oncologist within 6 months of surgery. Only 10% of these patients received adjuvant ART (i.e., 2% of patients with any high-risk features). Of equal interest, 40% of those with adverse features who were seen were advised against ART. Why are the rates of referral (23%) and recommendation (60%) and use of ART (2%) so low for these patients? The first argument is a lack of knowledge. The EORTC and SWOG studies were published in 2005 and 2006, respectively (and all were presented in abstract before the observation period). Despite this, we know that evidence takes a while to diffuse into practice, particularly community practice. How long is too long when we have a treatment with a solid evidence base that improves not just biochemical, but distant metastatic disease and overall survival rates? Is there anything we could have done differently to accelerate this knowledge dissemination? The second argument is that the treatment is too toxic. It is easy to attribute really bad side effects (such as severe hemorrhagic cystitis) to all patients who might get radiation. However, when prospectively collected, the data demonstrate that the risk of serious RT toxicity was low. In the Wiegel trial, 1% and 0% of patients had grade 3 bladder and bowel problems.3 This is despite patients receiving 2-dimensional RT; RT has improved greatly in target localization with image-guided techniques and my experience is that modern RT has even fewer side effects. It is true that patients would require at least 30 visits to a cancer centre for consult, planning and treatment and for some patients this is costly and inconvenient. Much progress has been made in shortening the course of primary external radiation from 34 to 49 treatments to a few as 5 treatments;6–8 work from our group and Kruser and colleagues’ has applied these same techniques in the postoperative setting to improve the convenience without increasing the toxicity.9 The final argument is that early salvage postoperative RT is as good as immediate ART. Non-randomized data argue against this.10–12 However, this question (and the question of the optimal duration of adjuvant androgen deprivation therapy) is currently being tested in the intergroup RCT RADICALS which is open in more than 20 centres across Canada. Patients with any high-risk features should be considered for this trial. In short, ART is being underutilized. This is a lost opportunity not only for our patients, but also the health care system. There are now 6 systemic therapies which improve overall survival in the castrate-resistant prostate cancer setting, but none have improved median survival more than 5 months. A course of each treatment costs between $20 000 and $118 000 on top of the $11 000 to $32 000 of hormone therapy. In comparison, a course of ART costs about $4000 and improves median survival by 23 months. At 10 years, it offers more survival benefit than SPCG4 documented for radical prostatectomy over watchful waiting (8% vs. 5%).2,13 We have a tremendous opportunity to make a meaningful difference in the lives of our patients and the healthcare system – we just need to listen to the evidence and act accordingly.

Side-Effect effect without side effects: The pervasive impact of moral considerations on judgments of intentionality

Studying the folk concept of intentional action, Knobe (2003a) discovered a puzzling asymmetry: most people consider some bad side effects as intentional while they consider some good side effects as unintentional. In this study, we extend these findings with new experiments. The first experiment shows that the very same effect can be found in ascriptions of intentionality in the case of means for action. The second and third experiments show that means are nevertheless generally judged more intentional than side effects, and that people do take into account the structure of the action when ascribing intentionality. We then discuss a number of hypotheses that can account for these data, using reactions times from our first experiment.

Surprising connections between knowledge and action: The robustness of the epistemic side-effect effect

A number of researchers have begun to demonstrate that the widely discussed “Knobe effect” (wherein participants are more likely to think that actions with bad side-effects are brought about intentionally than actions with good or neutral side-effects) can be found in theory of mind judgments that do not involve the concept of intentional action. In this article we report experimental results that show that attributions of knowledge can be influenced by the kinds of (non-epistemic) concerns that drive the Knobe effect. Our findings suggest there is good reason to think that the epistemic version of the Knobe effect is a theoretically significant and robust effect, and that the goodness or badness of side-effects can often have greater influence on participant knowledge attributions than explicit information about objective probabilities. Thus, our work sheds light on important ways in which participant assessments of actions can affect the epistemic assessments participants make of agents’ beliefs.