Condoms, IUDs, counseling and natural family planning.
Explore the source record for details and available documents.
Female↗
Biomedical subjects
M I Rahman
Publications and source records attributed to M I Rahman.
Selections from current literature: magnesium, myocardial infarction and meta-analysis.
If the results of LIMIT-2, the two meta-analyses reviewed and the cumulative meta-analysis by Lau et al. are viewed in aggregate, there can be very little doubt regarding the beneficial effects of i.v. magnesium on mortality in suspected acute MI. The results of ISIS-4 should strengthen these odds ratios and help clarify the role of magnesium and arrhythmias in acute MI. Furthermore, the combined effect of i.v. magnesium and thrombolytics will again be focused upon. Though the cardioprotective effects of magnesium are unknown, this should only spur more studies to elucidate these mechanisms and should not be a reason to delay the inclusion of i.v. magnesium in the usual regimen for treating suspected acute MI. The regimen of i.v. magnesium needs to be standardized. Further studies are also needed to evaluate whether oral magnesium can be used as tertiary prevention for MI. Finally, meta-analyses are studies of studies that are valid and reliable if they follow certain rules. This is true of all types of research. Due to the exponential increase in the medical literature of these types of studies, and the fact that they may eventually supplant the traditional narrative review, it is incumbent upon physicians to understand the process by which a meta-analysis is conducted.
Humans↗
Selections from current literature: screening for colorectal cancer.
Of the five modalities currently used to screen for colorectal cancer, the DRE is the least useful as a solitary screening tool. Also, while FOBT is widely used, its high false positive rate and uncertain cost benefit ratio make it less than ideal as a screening tool. Flexible sigmoidoscopy in a well defined regimen, has been shown to result in a decrease in CRC mortality. Paramedical personnel with a moderate amount of training have been shown to be able to safely and efficiently perform screening sigmoidoscopy. This has the potential to make it widely available at an affordable cost to the general population; however, its limitations, namely its ability to detect only lesions found in the distal colon, need to be kept in mind. With all limitations in the above mentioned screening modalities, colonoscopy may be the best tool to detect colorectal cancers. It has a significant advantage over DCBE of being both a diagnostic and therapeutic tool; however, it is imperative that a randomized controlled trial be performed to fully document its potential efficacy, advantages and disadvantages. Finally while genetic testing looms on the horizon as a promising new tool for CRC screening, at this time there are still too many unanswered questions and dilemmas, ethical as well as others, to warrant its use in the general clinical setting. However, maybe in the future, CRC screening will involve a simple blood test performed at birth, or perhaps even prenatally.
Aged↗
Implementing the Put Prevention into Practice program.
Put Prevention into Practice (PPIP) is a national program designed to improve the delivery of preventive care to patients by all primary care clinicians. It covers the full range of clinical preventive services, including immunizations, screening tests, chemoprophylaxis, and counseling interventions. The materials that comprise this program involve patients, office/clinic systems and staff, and clinicians, including nurse practitioners. The need for preventive care, the barriers to be overcome, the PPIP program, and a strategy for its implementation are delineated. Principles for successful implementation include: high level administrative support, ownership by all the players in the implementation process, a person designated to manage implementation, and an ongoing evaluation/auditing process that provides feedback to clinicians and others participating in the program.
Adult↗
Selections from current literature: inhaled steroid use in asthma management.
Though our understanding of asthma has improved, its incidence, prevalence and associated death rate have been increasing in most industrialized countries. Inadequate treatment of airway inflammation may explain some of this trend. Steroids are the most effective anti-inflammatory agents and are effective and safe in inhaled form. Together with sodium cromolyn, they should be used more frequently in the management of all types of asthmatics, especially those who require chronic or acute administration of oral steroids.
Administration, Inhalation↗