SummaryA rapid single-step screening method for detection of glucose-6-phosphate dehydrogenase (G6 PD) deficiency was evaluated on Halmahera Island, Maluku Province, Indonesia, and in Shan and Mon States, Myanmar, in combination with a rapid diagnosis of malaria by an acridine orange staining method. Severe deficiency was detected by the rapid test in 45 of 1126 volunteers in Indonesia and 54 of 1079 in Myanmar, but it was difficult to distinguish blood samples with mild deficiency from those with normal activity. 89 of 99 severely deficient cases were later confirmed by formazan ring method in the laboratory, but 5 with mild and 5 with no deficiency were misdiagnosed as severe. Of the samples diagnosed as mild and no deficiency on-site, none was found to be severely deficient by the formazan method. Malaria patients were simultaenously detected on-site in 273 samples on Halmahera island and in 277 samples from Shan and Mon States. In Mon State, primaquine was prescribed safely to G6 PD-normal malaria patients infected with Plasmodium vivax and/or gametocytes of P. falciparum. The new rapid test for G6 PD deficiency may be useful for detecting severe cases under field conditions, and both rapid tests combined are can be useful in malaria-endemic areas, facilitating early diagnosis, prompt and radical treatment of malaria and suppression of malaria transmission.keyword rapid test, glucose-6-phosphate dehydrogenase, G6 PD deficiency, malaria diagnosis, acridine orange staining, field survey, Indonesia, Myanmar correspondence F. Kawamoto,
Attention Reaction response Relaxation A B S T R A C TPrevious human studies revealed that L-theanine influences brain function. The current study was designed to evaluate the affect of L-theanine (Suntheanine â ) on attention and reaction time response in 18 normal healthy University student volunteers. In accordance with preliminary analysis of the manifest anxiety scale (MAS), the subjects were divided into two groups referred to as high anxiety propensity group and the minimal anxiety propensity group. Both groups received L-theanine (200 mg/100 ml water) and placebo (100 ml water) in a double blind repeated measurement design protocol. Assessments were performed for 15-60 min after consumption under a relaxed condition upon exerting an experimentally induced visual attentional task as well as audio response tests. Self-reports of anxiety as State-Trait Anxiety Inventory (STAI) was characterized at post experiments. Alpha bands electroencephalographic activity and heart rate were recorded throughout the trial. The results demonstrate the significant enhanced activity of alpha bands, descending heart rate, elevated visual attentional performance, and improved reaction time response among high anxiety propensity subjects compared to a placebo. However, no significant differences were noticed among subjects with a minimal anxiety propensity. Results evidently demonstrated that L-theanine clearly has a pronounced effect on attention performance and reaction time response in normal healthy subjects prone to have high anxiety.
Background With the advent of low‐cost generic direct‐acting antivirals (DAA), hepatitis C (HCV) elimination is now achievable even in low‐/middle‐income settings. We assessed the feasibility and effectiveness of a simplified clinical pathway using point‐of‐care diagnostic testing and non‐specialist‐led care in a decentralized, community‐based setting. Methods This feasibility study was conducted at two sites in Yangon, Myanmar: one for people who inject drugs (PWID), and the other for people with liver disease. Participants underwent on‐site rapid anti‐HCV testing and HCV RNA testing using GeneXpert(R). General practitioners determined whether participants started DAA therapy immediately or required specialist evaluation. Primary outcome measures were progression through the HCV care cascade, including uptake of RNA testing and treatment, and treatment outcomes. Findings All 633 participants underwent anti‐HCV testing; 606 (96%) were anti‐HCV positive and had HCV RNA testing. Of 606 tested, 535 (88%) were RNA positive and had pre‐treatment assessments; 30 (6%) completed specialist evaluation. Of 535 RNA positive participants, 489 (91%) were eligible to initiate DAAs, 477 (98%) completed DAA therapy and 421 achieved SVR12 (92%; 421/456). Outcomes were similar by site: PWID site: 91% [146/161], and liver disease site: 93% [275/295]). Compensated cirrhotic patients were treated in the community; they achieved an SVR12 of 83% (19/23). Median time from RNA test to DAA initiation was 3 days (IQR 2‐5). Conclusions Delivering a simplified, non‐specialist‐led HCV treatment pathway in a decentralized community setting was feasible in Yangon, Myanmar; retention in care and treatment success rates were very high. This care model could be integral in scaling up HCV services in Myanmar and other low‐ and middle‐income settings.
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