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Variation Analysis of Medical Service Utilization in Oriental Medicine Frequent Disease of Rural Area (농어촌지역 한방 외래 다빈도 상병의 의료이용 변이분석)

  • Jang, Yong-Myung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.2
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    • pp.713-720
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    • 2013
  • The objectives of this study are to identify whether the small area variation also exists in the oriental medicine and, if it exists, what causes, to expand our boundary of research interests on the small area variation observed at the western medicine toward the oriental medicine as one of the fundamental research foundations and to provide any fundamental findings from this study results to the healthcare politicians to promote consumer's rational behaviors for the use of healthcare. This study analyzed the health insurance claim data (2010, 2011) which were the patients of western medicine and the outpatients of the oriental medicine with the top 10 most frequent diseases and looked into the variation of healthcare utilization among the areas after grouping resident area into an 86-area category. The study result shows that the small area variation was also observed at the part of the oriental medicine in which the characteristics of patients critically affect the healthcare expenditure per visit day rather than those of providers and the characteristics of both patients and providers equally affect the healthcare expenditure per patient. Therefore, this study suggests that government set up healthcare policies on the standardization of oriental medicine to prevent its over-utilization and unmet need, enforcing the roles of oriental medicine in the markets, enhancing the appropriate health care utilization, and expanding provision and sharing the health care information to reduce unnecessary health care utilization.

Effect of different soybean meal type on ileal digestibility of amino acid in weaning pigs

  • Kim, Dong Hyuk;Heo, Pil Seung;Jang, Jae Cheol;Jin, Song Shan;Hong, Jin Su;Kim, Yoo Yong
    • Journal of Animal Science and Technology
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    • v.57 no.3
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    • pp.11.1-11.8
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    • 2015
  • An experiment was conducted to evaluate apparent (AID) and standardized (SID) ileal digestibilities of crude protein (CP) and amino acids (AA) with 6 soybean products in weaning pigs. A total of 14 weaning barrows with an initial body weight of $6.54{\pm}0.34kg$ were fitted with T-cannula at the distal ileum and allotted to 7 diets containing various soybean products. The soybean products used in the experiment were conventional soybean meal (CSBM), SBM fermented by Aspergillus oryzae GB-107 (FSBMA), SBM fermented by Bacillus subtilis PP6 (FSBMB), UV sterilized SBM fermented by Bacillus subtilis PP6 (UVFSBMB), SBM containing Bacillus subtilis PP6 (PSBM), and soy protein concentrate (SPC). Six corn-based diets were used and each of soybean products was added. All diets contained 5.0 g/kg of chromic oxide as an indigestible indicator and an N-free diet was used to measure basal endogenous losses of CP and AAs. Ileal CP digestibility did not differ by different soybean products. However, SIDs of Ile, Phe and Val were improved in pigs fed the FSBMB, UVFSBMB and SPC diets and the pigs fed the FSBMA diet showed higher SIDs of Phe and Val compared with those fed the CSBM diet (P < 0.05). The FSBMB diet had higher SIDs in most AAs compared with the FSBMA diet (P < 0.05), and higher SIDs of Lys, Ala, Pro, Ser, and Tyr compared with PSBM diet (P < 0.05). However, there was no response of UV-sterilization on the FSBMB in the SIDs of AAs. These results suggest that SIDs of AAs could be improved by the supplementation of fermented soybean products in the diet for weaning pigs but fermentation with Bacillus subtilis is more efficient in improving ileal AA digestibility than that with Aspergillus oryzae. Furthermore, probiotics supplementation in the CSBM and UV-sterilization of the FSBMB had no effects on chemical composition and ileal AA digestibility.

Apparent and standardized ileal nutrient digestibility of broiler diets containing varying levels of raw full-fat soybean and microbial protease

  • Erdaw, Mammo M.;Perez-Maldonado, Rider A.;Iji, Paul A.
    • Journal of Animal Science and Technology
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    • v.59 no.10
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    • pp.23.1-23.11
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    • 2017
  • Background: Although soybean meal (SBM) is excellent source of protein in diets for poultry, it is sometimes inaccessible, costly and fluctuates in supply. The SBM can partially be replaced by full-fat SBM, but the meals prepared from raw full-fat soybean contain antinutritional factors. To avoid the risk of antinutritional factors, heat treatment is always advisable, but either excessive or under heating the soybean could negatively affect the quality. However, the potential for further improvement of SBM by supplementing with microbial enzymes has been suggested by many researchers. The objective of this study was to evaluate the performance and ileal nutrient digestibility of birds fed on diets containing raw soybeans and supplemented with microbial protease. Methods: A $3{\times}2$ factorial, involving 3 levels of raw full-fat soybean (RFFS; 0, 45 or 75 g/kg of diet) and 2 levels of protease (0 or 15,000 PROT/kg) was used. The birds were raised in a climate-controlled room. A nitrogen-free diet was also offered to a reference group from day 19 to 24 to determine protein and amino acid flow at the terminal ileum and calculate the standardized ileal digestibility of nutrients. On days 10, 24 and 35, body weight and feed leftover were recorded to calculate the body weight gain (BWG), feed intake (FI) and feed conversion ratio (FCR). On day 24, samples of ileal digesta were collected at least from two birds per replicate. Results: When RFFS was increased from 0 to 75 g/kg of diet, the content of trypsin inhibitors was increased from 1747 to 10,193 trypsin inhibitors unit (TIU)/g of diets, and feed consumption of birds was also reduced (P < 0.05). Increasing RFFS level reduced the BWG from hatch 0 to 10 d (P < 0.01) and hatch to 24 d (P < 0.05). The BWG of birds from hatch to 35 was not significantly (P = 0.07) affected. Feed intake was also reduced (P < 0.05) during 0 to 35 d. However, protease supplementation improved (P < 0.05) the BWG and FCR during 0 to 24 d. Rising levels of RFFS increased the weight of pancreas (P < 0.001) and small intestine (P < 0.001) at day 24. Except for methionine, apparent and the corresponding standardized ileal digestibility of CP and AA were reduced (P < 0.01) by increasing levels of RFFS in diets. Conclusion: This study showed that some commercial SBM could be replaced by RFFS in broiler diets, without markedly compromising productivity. The AID and SID of CP and lysine were slightly improved by dietary supplementation of microbial protease.

Effects of mealworm (Tenebrio molitor) larvae hydrolysate on nutrient ileal digestibility in growing pigs compared to those of defatted mealworm larvae meal, fermented poultry by-product, and hydrolyzed fish soluble

  • Cho, Kyung Hoon;Kang, Sun Woo;Yoo, Jong Sang;Song, Dae Kil;Chung, Yi Hyung;Kwon, Gyoo Taik;Kim, Yoo Yong
    • Asian-Australasian Journal of Animal Sciences
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    • v.33 no.3
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    • pp.490-500
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    • 2020
  • Objective: To investigate effect of mealworm (Tenebrio molitor) larvae hydrolysate on nutrient ileal digestibility compared to those of dried mealworm larvae meal, fermented poultry by-product, and hydrolyzed fish soluble in growing pigs. Methods: A total of 12 crossbred ([Landrace×Yorkshire]×Duroc) growing pigs with average body weight of 28.70±0.32 kg were surgically equipped with simple T-cannulas. A total of 12 pigs were assigned to individual metabolic crates and allotted to one of four treatments with 3 replicates in a fully randomized design. Results: Apparent ileal digestibility (AID) of dry matter (DM) was the highest in pigs fed HML diet. AIDs of crude protein (CP) were higher in pigs fed HML and DMLM diets than those in pigs fed the other two diets. AID of total amino acid was higher (p = 0.06) in pigs fed HML diet. AIDs of lysine (Lys), methionine (Met), and threonine (Thr) were similar in pigs fed DMLM and HML diets, but were higher (p = 0.05, p<0.05, and p = 0.05, respectively) than those in pigs fed FPBM or HFS diet. Pigs fed HML diet had higher standardized ileal digestibilities (SIDs) of DM and CP (p<0.05 and p<0.05, respectively) compared to pigs fed the other FPBM and HFS diets. SIDs of total amino acid were not different (p = 0.06) between treatments. For SIDs of Lys, Met, and Thr, pigs fed HML and DMLM diets showed higher SIDs (p = 0.05, p<0.05, and p<0.05, respectively) than pigs fed FPBM and HFS diets. SIDs of non-essential amino acids (aspartic acid, glycine, and alanine) were higher (p<0.05, p<0.05, and p<0.05, respectively) in pigs fed HML, FPBM, and DMLM diets than those in pigs fed the HFS diet. AID and SID of glutamic acid were higher in pigs fed HML and FPBM diets. Conclusion: In conclusion, dietary supplementation of mealworm larvae hydrolysate had higher digestibility in DM, CP, Lys, Met, and Thr compared to dietary supplementation with fermented poultry by-product and hydrolyzed fish soluble.

Complications and Carcinogenic Effects of Mustard Gas - a Systematic Review and Meta-Analysis in Iran

  • Panahi, Yunes;Gholami, Nasrin;Ghojazadeh, Morteza;Moslemi, Farnaz;Naghavi-Behzad, Mohammad;Azami-Aghdash, Saber;Ghaffari, Alireza;Piri, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7567-7573
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    • 2015
  • Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Meta-analysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6%, pulmonary complications 94.5% and ocular complications 89.9%. The incidence of various cancers in victims exposed to mustard gas was 1.7% worldwide where the rate was 2.2% in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90% and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures for populations exposed to this agent.

Interaction Contents for Reconsidering Visually Disabled Parents

  • Hong, Joo-Bong;Lee, Chan-Kyu;Lim, Chan
    • International journal of advanced smart convergence
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    • v.9 no.1
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    • pp.54-62
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    • 2020
  • According to the Ministry of Health and Welfare, "Status of Registered Persons with Disabilities", the number of people with disabilities is 2,494,460 as of 2015. The lowest rates of children with disabilities were intellectual disabilities (23%) and mental disorders (33.3%). The highest rates of screening were blindness (97%), heart failure (94.4%), and hearing impairment (92.7%). 65.2% of visually impaired people who have already had a disability at the time of marriage, and the remaining 34.8% can be thought to be the cause of high incidence of disability after marriage. 'SID (Seed in the Dark)' project was designed to recapture the visually impaired parent's desire for attachment and the space difficulties of the blind who want to be a normal parent to their children through a visual impairment of a father with 7-year-old daughter. Using Gear VR(Virtual Reality), the general public was able to feel the surroundings as if they had no vision and focused on the hearing. Especially, We expressed the sound wave visually and added the hilarious game element which grasps the terrain of the maze by sound wave like a 'blind person who perceives the surroundings by sound' and catches up with daughter. People with disabilities who are far from mental illness often have a form of family with children. The fact that the rate of childbirth is high means that there is relatively little problem in daily life. It is wondered that the rate of blindness among the visually impaired, which accounts for 10% of the total disabled, is the highest at 97%. This is because, in the case of the visually impaired, the obstacle is often caused by aging, accidents, or diseases due to inherited causes rather than the visual disorder. In particular, However, the fact that there is an obstacle in vision that accounts for 83% of the body's sensory organs causes other difficulties in the nursing process of children who are non-disabled. Parents do not know the face of child when their visual impairment is severe. Parents are extremely anxious about worry that they will be lost or abducted if their children are not by their side. And that the child recognizes the disability of his or her parents other than the other parents easily and takes it as a deficiency. Since visually impaired parents are mentally mature parents with non-disabled people, they may want their children not to feel deprived of their disability. The number of people with visual impairments has been increasing since 2001, and people with impairments often become disabled. In addition, there is much research on the problem of nondisabled parents who have children with disabilities, while there is relatively little interest and research on the problem of nondisabled child rearing of parents with disabilities.

Performance of Broiler Chickens Fed Low Protein, Limiting Amino Acid Supplemented Diets Formulated Either on Total or Standardized Ileal Digestible Amino Acid Basis

  • Kumar, C. Basavanta;Gloridoss, R.G.;Singh, K.C.;Prabhu, T.M.;Suresh, B.N.
    • Asian-Australasian Journal of Animal Sciences
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    • v.29 no.11
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    • pp.1616-1624
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    • 2016
  • The aim of present experiment was to investigate the effect of protein reduction in commercial broiler chicken rations with incorporation of de-oiled rice bran (DORB) and supplementation of limiting amino acids (valine, isoleucine, and/or tryptophan) with ration formulation either on total amino acid (TAA) or standardized ileal digestible amino acids (SIDAA). The experimental design consisted of $T_1$, TAA control; $T_2$ and $T_3$, 0.75% and 1.5% protein reduction by 3% and 6% DORB incorporation, respectively by replacing soybean meal with supplemental limiting amino acids to meet TAA requirement; $T_4$, SIDAA control, $T_5$ and $T_6$, 0.75% and 1.5% protein reduction by DORB incorporation (3% and 6%) with supplemental limiting amino acids on SIDAA basis. A total of 360 dold fast growing broiler chicks (Vencobb-400) were divided into 36 homogenous groups of ten chicks each, and six dietary treatments described were allocated randomly with six replications. During 42 days trial, the feed intake was significantly (p<0.05) reduced by TAA factor compared to SIDAA factor and protein factor significantly (p<0.05) reduced the feed intake at 1.5% reduction compared to normal protein group. This was observed only during pre-starter phase but not thereafter. The cumulative body weight gain (BWG) was significantly (p<0.05) reduced in TAA formulations with protein step-down of 1.5% ($T_3$, 1,993 g) compared to control ($T_1$, 2,067 g), while under SIDAA formulations, BWG was not affected with protein reduction of 1.5% ($T_6$, 2,076 g) compared to $T_4$ (2,129 g). The feed conversion ratio (FCR) was significantly (p<0.05) reduced in both TAA and SIDAA formulations with 1.5% protein step-down ($T_3$, 1.741; $T_6$, 1.704) compared to respective controls ($T_1$, 1.696; $T_4$, 1.663). The SIDAA formulation revealed significantly (p<0.05) higher BWG (2,095 g) and better FCR (1.684) compared to TAA formulation (2,028 g; 1.721). Intake of crude protein and all limiting amino acids (SID basis) was higher in SIDAA group than TAA group with resultant higher nitrogen retention (4.438 vs 4.027 g/bird/d). The nitrogen excretion was minimized with 1.5% protein reduction (1.608 g/bird) compared to normal protein group (1.794 g/bird). The serum uric acid concentration was significantly reduced in $T_3$ (9.45 mg/dL) as compared to $T_4$ (10.75 mg/dL). All carcass parameters were significantly (p<0.05) higher in SIDAA formulation over TAA formulation and 1.5% protein reduction significantly reduced carcass, breast and thigh yields. In conclusion, the dietary protein can be reduced by 0.75% with TAA formulation and 1.5% with SIDAA formulation through DORB incorporation and supplementation of limiting amino acids and among formulations, SIDAA formulation was better than TAA formulation.

Evaluation of energy and amino acids of brown rice and its effects on laying performance and egg quality of layers

  • An, Byoung-Ki;An, Su Hyun;Jeong, Han-Seul;Kim, Kwan-Eung;Kim, Eun Jip;Lee, Sang-Rak;Kong, Changsu
    • Journal of Animal Science and Technology
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    • v.62 no.3
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    • pp.374-384
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    • 2020
  • Two experiments were conducted to determine apparent metabolizable energy (AME), nitrogen-corrected AME (AMEn), and ileal digestible amino acid (AA) content of brown rice (BR) and to investigate the effect of dietary supplementation of BR on laying performance and egg quality of laying hens. In Exp. 1, 72 Hy-line Brown layers (49-week-old) were allocated to two treatments using a completely randomized block design, and each treatment included six cages per treatment and six hens per cage. A semi-purified diet was formulated to include BR as the sole source of AA and energy and an N-free diet was used to determine basal endogenous loss of AA. The hens were fed a commercial layer diet for adaptation to the experimental environment and diet for 7 days from d 0, and then fed experimental diets for 5 days from d 7. Excreta were collected from d 10 to 11 and ileal digesta were collected on d 12. On a dry matter (DM) basis, the AME and AMEn of BR was determined at 3,773 and 3,729 kcal/kg, respectively. The apparent ileal digestibility (AID) of BR ranged from 32.7% for Thr to 73.7% for Arg. The range of the standardized ileal digestibility (SID) value was between 79.4% for Met and 96.6% for Lys. In Exp. 2, 252 Hy-line Brown layers (44-week-old) were divided into four groups, comprising seven replicates of nine birds each and assigned to four experimental diets containing 0 (Control), 5%, 10%, or 15% BR for 5 weeks. The BR-containing diets were formulated to be equal in the content of AMEn and digestible AA to those of the diet without BR. No significant differences were observed in laying performances. Egg quality and blood profiles were not linearly or quadratically affected by dietary treatments. These results suggest that up to 15% BR can be included into layer feed without any adverse effects on laying performance and egg quality, if its energy and digestible AA values are well evaluated.

A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are They Curable?

  • Niazi, Azin;Rahimi, Vafa Baradaran;Soheili-Far, Sina;Askari, Nafiseh;Rahmanian-Devin, Pouria;Sanei-Far, Zahra;Sahebkar, Amirhossein;Rakhshandeh, Hassan;Askari, Vahid Reza
    • Journal of Pharmacopuncture
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    • v.21 no.3
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    • pp.139-150
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    • 2018
  • Averagely 80% to 90% of breastfeeding women experience the nipple pain and fissures. The important factor for successful breastfeeding is to treat this problem. This study has done as a review with the aim of analysis of the clinical trials in the field of the prevention and treatment of the nipple fissures and pain due to the importance of breastfeeding. For this purpose, the key words of sore, nipples, fissure, trauma, wound, prevention, treatment, therapeutics, therapy, clinical trial, breastfeeding and their Persian synonyms and all of their possible combinations were searched in the national databases: SID and Iran Medex and Magiran, and in the international databases: PubMed, Scopus, Medline, Science direct by May 2017. The Jadad criterion was used to assess the quality of the articles and the articles with a score of 3 or more were included in this study. Finally, 48 clinical trials were reviewed that 17 of them (sample size 1801) scored 3 or more based on the Jadad criterion. Seven articles were also in the non- drug treatment group (sample size 491) and 2 articles in the drug treatment group (sample size 337) and 8 articles in the herbal treatment group (sample size 973).The results show that menthol and warm water compress as well as teaching the correct breastfeeding methods are effective treatments to prevent and treat the nipple pain and fissures. Moreover, applying the herbal medicine for prevention and treatment of the issues raised from breastfeeding may have beneficial such as Aloe vera, Portulaca olearacea. However, more studies with a great methodology are necessary to obtain more accurate evidence.

DNMT3B -149 C>T and -579 G>T Polymorphisms and Risk of Gastric and Colorectal Cancer: a Meta-analysis

  • Khoram-Abadi, Khadijeh Mirzaee;Forat-Yazdi, Mohammad;Kheirandish, Shahnaz;Saeidi, Nasim;Zarezade, Zeinab;Mehrabi, Nahid;Neamatzadeh, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.3015-3020
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    • 2016
  • Background: Numerous studies have investigated associations of DNA methyltransferase (DNMT) -149 C>T and -579 G>T polymorphisms with gastric cancer (GC) and colorectal cancer (CRC) susceptibility; however, the findings are inconsistent prompting the present meta-analysis. Materials and Methods: Related studies were identified from PubMed, Google scholar, and SID until 10 October 2015. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the associations. Results: Eleven studies were included based on the search criteria for CRC and GC related to the DNMT3B 149 C>T (3,353 cases and 4,936 controls) and DNMT3B 579 G>T (1,387 cases and 2,064 controls) polymorphisms. There was no significant association overall between DNMT3B -149 and 579 polymorphisms and the risk of cancer. In the stratified analysis by cancer type, DNMT3B 579G>T polymorphism was associated with the risk of CRC and GC. While the DNMT3B -149C/T polymorphism was related with a significantly increased risk of CRC in two tested models, dominant (GG+GT vs. TT: OR 0.51, 95 % CI 0.38-0.69; P = 0.00, Pheterogeneity=0.69, $I^2=0%$) and heterozygote (GT vs. TT: OR 0.50, 95 % CI 0.37-0.69; P=0.00, Pheterogeneity=0.41, $I^2=0%$), no evidence of any association with GC risk was observed as in the pooled analyses. Conclusions: More studies are needed to assess associations of DNMT3B -149C/T and DNMT3B 579G>T polymorphisms with cancer in different ethnicities with large population sizes to generate comprehensive conclusions.