Current Issue : October - December Volume : 2014 Issue Number : 4 Articles : 9 Articles
When compared to the general population and other professionals, majority of the medicos and practicing physicians are more prone to psychological health problems. Especially in case of medical students, psychological stress is very common and is mainly associated with depression and anxiety. Heavy work load, lack of practical knowledge and also the unfamiliar environment of the hospital may provoke stress in medicos during their clinical practice. Majority of the studies were done and published from Western and European countries. But from Asian and Eastern countries very few studies were available in this regard. Our study has made an attempt to assess the prevalence and severities of depression, anxiety and stress among Indian medical students. This was a cross sectional study involving medical students, who were interested to participate in the study from the first year to final year were included. Individuals with past history of depression before joining in the course were excluded from the study. The data was collected and assessed by using the scale, depression anxiety stress Scale-42 (DASS-42). Graph pad prism software version 6.02 was used to perform Statistical analysis. Among these 180 individuals, 73 (40.5%) were found to be depressed (mean score: 16.6-moderate depression), 74 (41.1%) were observed with anxiety (mean score: 13.8- moderate anxiety) and 55 (30.5%) were observed with stress (mean score: 21-moderate stress). Majority of the students were diagnosed as stress associated with depression and anxiety than a single disorder alone. The prevalence of depression, anxiety and stress was found to be high in female medical students than the male medical students. According to this study, academic stressors are the major factors that influenced the students to feel to be stressful. To prevent the psychological morbidity among medicos, early detection of symptoms of depression, anxiety and stress is very much essential. Hence, it is mandatory to design relevant methods of stress management programs to reduce the levels of depression, anxiety and stress which enhance the quality of life of medicos....
The current study targets on the evaluation of the patient’s attitude and knowledge toward antibiotic self-medication. A questionnaire was prepared to assess the patient’s knowledge and use of herbal products and dietary supplements. The patient survey was conducted at primary health care centers in Coimbatore district (Tamil Nadu). A cross-sectional study was piloted on a sample of 500 personals in the year of 2013. Data was collected using self-administered questionnaires with open-ended items. Self-medication with antibiotics was reported by 45.23% during the last 6 months. Gastrointestinal problems such as diarrhoea, vomiting and abdominal pain was the main indication for self-medication with antibiotics (23.80%) as well as respiratory tract and skin associated infections. The choice of self-medication was based on medical knowledge and non-physician advice (60.38%) or on a previous account by a physician for self and others with similar indication (49.35%). Most of the subjects aspire on further more guidance regarding the usage of antibiotic. The continuing medical education programs and drug information sources about rational use of antibiotics use must be made available for the patient’s and the awareness about the antibiotics misuse should be given to the patients. In addition, clearly defined knowledge of antibiotics use can help to design safer pharmacological regimens to the individual patients for the better therapeutic outcome....
Aim of the Study: To compare effect of asthma care by pharmacist intervention versus routine care\non asthma control. Patients and Methods: A 2-month randomised, controlled trial was conducted\nin outpatient clinics of Ain Shams University Hospitals, Cairo, Egypt. Patients were randomly assigned\nto receive routine care or a pre-defined pharmacist intervention. This intervention was\nmainly focused on patient education, improving inhalation technique and medication assessment.\nPrimary outcome was the level of asthma control, as assessed by the Asthma Control Questionnaire\n(ACQ). Results: By the end of the study, intervention patients who received a written action\nplan significantly improved their ACQ results than routine care group who did not receive a plan\n(p < 0.0001). Inhalation technique and adherence to controller medication were significantly better\nin the intervention group. Conclusion: The present study results provide supportive evidence\nconcerning pharmacists� favourable effects on asthma patient care and support pharmacists as\nvaluable members of the health care team....
Background: The interaction between physicians and medical representatives (MRs) through gift\noffering is a common cause for conflicts of interest for physicians that negatively influence prescribing\nbehaviors of physicians throughout the world. This study aimed to evaluate the interaction\nbetween MRs and Iraqi specialist physicians through the acceptance of MRs gifts and the effect\nof such acceptance on physician�s prescribing patterns. Methods: A survey in a questionnaire\nformat for specialist physicians was done during March-October 2013 in Iraq, Baghdad. The questionnaire\ninvolves four major parts regarding the approximate number of patients and medical\nrepresentatives, gift acceptance, medical conferences, and prescribing pattern. Results: In Iraq\nspecialist physicians were visited by 1 - 3 MRs/day. 50% of the Iraqi physicians like to get the\neducational information by attending conferences outside Iraq. Regarding Gift acceptance, 41% of\nparticipated physicians showed a general acceptance to promotional gifts, and 91% of physicians\naccept low cost gifts but only 41% of them accept high cost recreational gifts. Free samples were\nused by 59% of Iraqi physicians to treat some people. 77% of physicians prefer prescribing new\nmedications, while more than 95% of participated physicians stated that they stop prescribing\nthese new drugs either due to their ineffectiveness or due to their side effects. On the other hand\nphysicians significantly change their prescribing behavior through shifting not only among generic\ndrugs, but also from brand to generic drugs in their prescriptions. Gift acceptance is directly\ncorrelated with such shift and change in prescribing behavior. Conclusion: Iraqi physicians accept\nvarious types of gifts from pharmaceutical companies; this can influence physician prescribing\npattern and result in early adoption to prescribe newly medications depending on promotional\ninformation even in absence of clinical evidence about the drug effectiveness or side effects, which\nmay result in undesirable outcomes to the patient....
The reimbursement model for pharmaceutical care remains a barrier to successful widespread\nimplementation of pharmacist-provided services. In some instances, community pharmacists have\nbeen successful in obtaining direct compensation for services from patients; however, evidence\nsuggests that lack of patient demand for pharmacist-services may ultimately undermine the campaign\nfor widespread third-party payment. The purpose of this study is to conduct a secondary\nanalysis of data indicating consumer/patients� rationale for not purchasing pharmacist-provided\ndisease management services when offered the opportunity to do so in community pharmacies.\nOur review of the data indicates that while financial concerns are clearly important in consumer\ndemand for pharmacist-provided services, other considerations exist. The consumer/patient belief\nthat pharmacist-provided services are duplicative or that these services are not needed are\nsignificant barriers to overcome. Intensive education and marketing campaigns are needed to\nsway consumer opinion on the value of pharmacist-provided services....
Objectives: To explore patientâ��s perspectives of the role of the community pharmacist in view of\nother health care professionals (specialist physician, general practitioner, nurse and others (e.g.\nherbalist)) in Jordan, UAE and Iraq. The study also investigated patientâ��s willingness to pay for\nspecialized pharmaceutical care services. Methods: This study followed a single phase cross sectional\nsurvey methodology, conducted in three Middle Eastern countries. Data were collected over\na period of 6 months on two consecutive years (March to May 2009 and 2010). A questionnaire\nwas designed and validated, then completed by patients walking into community pharmacies. The\nsource of advice (specialist physician, general practitioner, pharmacist, nurse, or herbalist) regarding\npatientâ��s medication use and medical management were investigated. Key findings: Patients\nvisiting community pharmacies in Jordan (n = 1000), UAE (n = 1000) and Iraq (n = 968)\nwere recruited into the study (mean age 35.9 �± 13.1, 50.6% males). Significant difference between\nthe three countries was shown, as more patients chose the pharmacist as their primary source of\nadvice on medication use vs. the specialist physician in Jordan (50.8% vs. 37.3%) and Iraq (41.9%vs. 36.7%) compared to UAE (38.0% vs. 40.1%), P < 0.001, Chi-square test. Few agreed to receive\npaid pharmaceutical care services (Jordan 19.5%; UAE 24.7%; Iraq 2.3%). Conclusion: Current\nsituation resulting in the lower socioeconomic status in Jordan and Iraq seems to lead to patientsâ��\nhigher reliance on the pharmacist, as compared to the UAE. Majority of patients, regardless of the\ncountry of origin, are not willing to pay for specialized pharmaceutical care services. These findings\nare important for future social pharmacy research in the area....
Drug utilization studies conducted at regular intervals help to guide the physician in rational drug prescription. This was a prospective observational study conducted in cardiology out-patient department for a period of six months. A total of 310 prescriptions were collected and analyzed during the study period. 28% of the patients were in the age group of 50-59 years and this was found to be higher in men. Male patients were more (60.96%) than female patients (39.03%). Average no. of drugs per prescription was 3.62. The average no. of antihypertensive drugs per prescription was 1.3. Study shows urban people were more (63.22%) than rural (36.77%). One antihypertensive drug containing prescriptions were more (40.85%) compared to two or three drug combination. The most frequently prescribed antihypertensives were β blockers (28.48%) followed by diuretics (24.70%). The most common two drug combination therapy involved in the study was aldosterone antagonists + diuretics (57.62%) followed by beta blockers + calcium channel blocker (20.33%). Moderate potential drug interactions were observed more in the study. In our study we conclude that the present study represents the current prescribing trends for antihypertensives. The most commonly prescribed drug classes involved were beta blockers followed by diuretics. The prescribing practices of antihypertensives by cardiologists showed adherence to the existing guidelines....
Objectives: To determine the influence of pharmacists on customers who have to decide between\nOver the Counter products in independently owned Maltese pharmacies. Methods: 20 managing\npharmacists in independently owned Maltese pharmacies were interviewed. The interviews were\nrecorded, transcribed verbatim and the data were coded. The main categories and subcategories\nwere extracted and interrelated by using the grounded theory of action approach. Key findings\nPharmacists dedicate time to ensure the right OTC is received by their patients. Before recommending\nan OTC medication the pharmacists ask key questions, which help them determine if an\nOTC is appropriate for the patient. The Maltese pharmacists engage their patients in a discussion\nbefore recommending an OTC product. In order to ensure that the patients are following their advice,\npharmacists use different techniques. Whenever the patient might want to purchase an OTC, which\ncould interfere with their medication regimen or might not be appropriate from the age point of\nview, then pharmacist intervenes accordingly. Each pharmacist offered specific examples how they\nconvince their patients to purchase the correct medication. The pharmacists provided specific examples\nhow they decide to select a specific OTC medicine and what type of questions were asked\nbefore taking a decision. In order to ensure their patients have the best access to the health care,\nmany pharmacists embraced other roles and services, such as measuring and monitoring the blood\npressure and glucose levels, determining the correct weight management product. Conclusions: The\nanalyzed data highlight that Maltese community pharmacists play an important role in counseling\npatients on their choice of OTC products. The analysis has also identified some useful counseling\ntechniques, which has been used by pharmacists for prescription medications. However, the Maltese\npharmacists use these counseling techniques on a larger scale. It seems likely that many pharmacists\nare embracing more additional roles to ensure their population receives the best clinical ser-vices. Before dispensing an OTC medication, pharmacists use their clinical knowledge....
When compared to general population, individuals with HIV/AIDS are more prone to depression and remain undiagnosed in majority of the individuals. The overall health of an individual with HIV/AIDS can be improved when the depression starts getting treated and the recovery may vary from patient to patient based on the drug adherence. Major depression negatively affects the drug adherence and disease progression that influences the morbidity and mortality rates in HIV disease. In about 80% - 90% of the patients, major depression can be alleviated with effective treatment. Our review outlines the treatment options of depression with HIV/AIDS. The same class of antidepressants (selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs)) which can be used for treating the depression patients without HIV/AIDS also shows a positive pharmacological response in depression patients with HIV. Due to the anticholinergic adverse effects of the tricyclic antidepressants, selective serotonin reuptake inhibitors have been considered to be the first line treatment for depression in the HIV population. Fluoxetine, citalopram, sertraline, amitriptyline, bupropion, nortriptyline and desipramine are some of the antidepressants that can be used to treat depression during pregnancy with HIV. Among SSRI’s, paroxetine should not be prescribed during pregnancy as it shows foetal heart defects when administered during the first trimester. Drugs such as MAOI’s including phenelzine and tranylcypromine should be avoided during pregnancy because MAOI’s aggravate maternal hypertension. Combination of pharmacotherapy and psychotherapy is the optimal treatment for major depression with HIV. Other complementary and alternative treatments of major depression in HIV disease are exercise, massage therapy and acupuncture which are beneficial especially for those who do not respond or adversely respond to pharmacological treatment. It is the responsibility of all the health care professionals to counsel the patients in such a way to show the acceptance towards taking the treatment for depression to improve their quality of life....
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