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“Background Health workers’ malaria case-management practices often differ from national
guidelines. We assessed whether text-message reminders sent to health workers’ mobile phones could improve and maintain their adherence to treatment guidelines for outpatient paediatric malaria in Kenya.
Methods From March 6, 2009, to May 31, 2010, we did a cluster-randomised controlled trial at 107 rural health facilities selleck in 11 districts in coastal and western Kenya. With a computer-generated sequence, health facilities were randomly allocated to either the intervention group, in which all health workers received text messages on their personal mobile phones on malaria case-management for 6 months, or the control group, in which health workers did not receive any text messages. Health workers were not masked to the intervention, although patients were unaware of whether
they were in an intervention or control facility. The primary outcome was correct management with artemether-lumefantrine, defined as a dichotomous composite indicator of treatment, dispensing, and counselling tasks concordant with JSH-23 chemical structure Kenyan national guidelines. The primary analysis was by intention to treat. The trial is registered with Current Controlled Trials, ISRCTN72328636.
Findings 119 health workers received the intervention. Case-management practices were assessed for 2269 children who needed treatment (1157 in the intervention group and 1112 in the control group). Intention-to-treat analysis showed that correct artemether-lumefantrine management improved by 23.7 percentage-points (95%
CI 7.6-40.0; p=0.004) immediately after intervention and by 24.5 percentage-points whatever (8.1-41.0; p=0.003) 6 months later.
Interpretation In resource-limited settings, malaria control programmes should consider use of text messaging to improve health workers’ case-management practices.”
“BACKGROUND: Up-to-date, quantitative angiographic measurement of revascularization extent after bypass surgery has not been reported.
OBJECTIVE: To measure the extent of angiographic revascularization quantitatively 6 months postoperatively with the OSIRIS program (University Hospital of Geneva, version 3.1).
METHODS: A total of 75 bypass procedures were performed in 65 consecutive adult moyamoya disease patients, and 71 bypass surgeries in 61 adult moyamoya disease patients were studied 6 months postoperatively with angiography. We performed 5 different types of bypass surgeries: encephaloduroarteriosynangiosis (EDAS), superficial temporal artery-middle cerebral artery anastomosis (SMA), SMA with encephalomyosynangiosis (EMS), SMA with EDAS, and SMA with encephaloduroarteriomyosynangiosis (EDAMS).