Current Issue : January - March Volume : 2017 Issue Number : 1 Articles : 8 Articles
Post stroke complications are common and occur at a rate of 40-96% in acute stroke patients. The most common\ncomplications seen are respiratory tract infection, constipation, aspiration pneumonia and urinary tract infection.\nCerebrovascular complications make diabetic patients 2ââ?¬â??6 times more susceptible to a stroke event. In addition, patients with\ndiabetes are more likely to die or become severely disabled. So this study was aimed to find out the occurrence of complications\nin first-ever stroke patients and the association between risk factors and complications. The study was designed as a\nprospective observational study by collecting various data of patients who were newly diagnosed with stroke. A total of 211\ncases were included in the study. Preliminary data such as demographic details, past medical history, past medication history,\nlaboratory investigations, prescribing patterns and drug related problems were collected using data entry forms. Bed side\ninterview were performed and their social history were collected. Subjects were followed up for a period of 1-3 months. Both\nimmediate hospitalization complications and complications seen in the acute phase of stroke were monitored and evaluated.\nStatistical analysis was performed using Graph pad software. Male patients (60.19%) were more prone to stroke attack than\nfemale patients (38.81%). Ischaemic stroke were most prevalently found (91%) when compared to hemorrhagic stroke (9%).\nThe age group under 60-69 yrs were most affected with complications (27.17%) followed by 50-59 yrs (22.83%). In our study,\nneuropsychiatric complications were more prevalent (26.09%) followed by urinary tract infection (21.20%) and respiratory\ntract infection (13.56%). 84% of respiratory tract infection was found in smokers compared to non-smokers. And 74.36% of\nurinary tract infection was found in diabetic patients compared to non diabetic cases. Patients having risk factors of stroke are\nmore likely to develop complications and prolong their hospitalization. The most commonly found post stroke complication in\nour study was dementia. Many journals suggest that the frequency of cognitive disorders in the acute phase of stroke is over\n70%....
Cephalosporins are alternative drugs for patients who have previous allergy to penicillins but they may be allergic to\ncephalosporins too. Hence, this study was undertaken to compare the allergic reactions caused by penicillins and\ncephalosporins. This study also has objectives of analyzing the clinical profile of these allergic reactions, grading them and trying\nto figure out ways to prevent these allergic reactions. ADR forms pertaining to penicillins and cephalosporins were included in\nthis study. These forms were analyzed by using a standardized questionnaire. The clinical profile and preventability aspects of\nthe ADRs were analyzed. Cefotaxime (50%) was found to produce more ADR�s followed by amoxicillin (18%), cefixime (10%)\nand piperacillin /tazobactam (7%). All the ADR�s reported are already known (100%) from the literature and no new kind of\nADR has been reported. When considering the duration of action, many events were cured in 1 or 2 days (46.28%), whereas few\nevents were continuing for more than 10 days and a maximum of 13 days (3.5%). When comparing with the severity of the\nevents most of the cases were mild (60.74%) followed by moderate (32.14%). Only 2 cases were severe (7%) which produced\nanaphylaxis. The reports show that most of the patients have recovered (78.57%) from the events and some are recovering\n(17.85%). No deaths have been reported in this study. Some ADRs were preventable (14.28%) (by considering the previous\nhistory of the patients and looking at the ideal dose of the drug). Most of the reactions are dermatological and no other systems\nhave been involved. Noting the previous history of allergy and adhering to ideal dose range would help in the prevention of\nADRs. Cefotaxime was responsible for the highest number of ADRs but we have not seen deaths in this study. Readymade list of\nalternative drugs for use in patients with known history of allergy can be provided to health care providers. Patients have to be\nencouraged to carry with them the details of the drugs to which they are known to be allergic. There is always a need for\ndissemination of guidelines to treat patients showing previous history to penicillins and cephalosporins. By reducing the\nadverse reactions, health care providers can reduce the fatalities and also the total cost of treatment in non-fatal adverse\nreactions....
Background: It is well-documented that chronic kidney disease (CKD) often results in end-stage renal failure and\nputs patients at extremely high risk for developing cardiovascular disease. Educational hospitalization at medical\ninstitutions in Japan is important for patients with CKD because it facilitates treatment in earlier stages of CKD\nwhen subjective symptoms are not apparent. However, some patients who have achieved their educational targets\ntend to have poor compliance at home after discharge from the hospital, resulting in rehospitalization shortly. In\nthis study, we examined the factors for early rehospitalization of patients after initial CKD educational hospitalization\ncompared with non-rehospitalized patients.\nMethods: One hundred thirty-seven patients after discharge from CKD educational hospitalization in Japan\nbetween March 2011 and December 2012 were included in the analyses. The subjects were classified into two\ngroups: the early rehospitalization group and control group. We adjusted for confounding variables and performed\nmultiple logistic regression analysis with the presence or absence of early rehospitalization as a dependent variable\nto investigate the association of early rehospitalization with patient background features, laboratory data, vital signs,\ninstruction-related items, and home environment.\nResults: Study subjects included 22 patients in the early hospitalization group and 115 patients in control group.\nMultivariable analysis for early rehospitalization indicated that insufficient instruction by physician, pharmacist, and\ndietitians was independent explanatory variable. Analyzing by Kaplanââ?¬â??Meier method, the probability of nonrehospitalization\nin the instruction group was significantly higher than that in the non-instruction group. Therefore,\nwe believe it is necessary to involve a competent, multidisciplinary medical team (consisting of physicians,\npharmacists, and dietitians) in addressing the early rehospitalization issue in patients with CKD.\nConclusion: These findings confirm the importance of care by a multidisciplinary medical team in patients with\nCKD. Therefore, we suggest that care by a multidisciplinary medical team reduces the increase of early\nrehospitalization in patients with CKD....
Background: Annual immunization is the most effective way to prevent influenza and its associated complications.\nHowever, optimal immunization rates are not being met in Nova Scotia, Canada. Additional providers, such as\npharmacists, may improve access and convenience to receive vaccines. Pharmacists began immunizing patients\n5 years of age and older within the publicly funded universal influenza vaccination program during the 2013-2014\ninfluenza season. The objective of this study was to evaluate influenza immunization coverage rates before and\nafter pharmacists in Nova Scotia gained authority to immunize as part of the publicly funded universal influenza\nvaccination program.\nMethods: Influenza immunization data was obtained from the Department of Health and Wellness from 2010 to\n2015. Data included billing data from physicians and pharmacists, and local public health data. Vaccination\ncoverage was calculated as proportion of vaccinations received in comparison to the total population.\nResults: Prior to pharmacists immunizing, overall vaccination coverage for Nova Scotia residents 6 months of age\nand older was 35.8 % in 2012-2013, increasing to 41.8 % coverage in 2013-2014 the year pharmacists began\nimmunizing. A decrease of 1.9 to 39.9 % was observed in 2014-2015. In patients 65 years of age and older living in\nthe community, coverage has increased from 61.8 % in 2012-2013 to 71.6 % in 2013-2014, and again to 73.3 % in\n2014-2015 with the addition of pharmacists immunizing. Prior to pharmacists immunizing the highest coverage\nnoted for this portion of the population was 61.8 %.\nConclusions: The addition of pharmacists as immunizers within a publicly funded universal influenza vaccination\nprogram was found to increase overall vaccination coverage in the first year and to maintain higher coverage rates\nin the second year than those observed before pharmacists began immunizing. Increases in coverage in both years\nwere observed in the elderly. Future research will be required to determine the ongoing impact of the addition of\npharmacists as immunizers and other strategies to improve vaccination coverage....
Management of blood pressure (BP) in the patients with chronic kidney disease (CKD) receiving dialysis (stage 5D)\nprovides a significant confront for healthcare professionals. The association between BP and cardiovascular disease risk has\nbeen well studied in the general population; however, in dialysis patients physiological and dialysis-related mechanisms\ninfluencing BP are complex and the associated risk is poorly understood. Hence present study was conducted to verify the\nprescribing patterns of antihypertensive in patients undergoing maintenance haemodialysis therapy and assess the factors that\nare influencing the outcome. A prospective cross sectional observational study was conducted in end stage renal disease (ESRD)\npatients undergoing maintenance haemodialysis in two nephrology wards of Varma Hospitals, Bhimavarm with study period of\nsix months. Morisky medication Adherence Scale (MMAS-8) was used to assess the medication adherence of patients to\nantihypertensive regimen. A total 104 patients were undergoing haemodialysis out of which 76 patients were undergoing\nmaintenance (at least 3 month on start of dialysis) were taken into consideration. Present study reveals that out of the 76\npatients in the study population 40 patients found to be pre-existing with hypertension. It shows that more than half the study\npopulation (52.63%) might have developed chronic kidney disease with hypertension as risk factor. Diabetes stands next to\nhypertension in the risk factors causing renal disease. 23 (30.26%) patients are pre-existing with diabetes. 11 (14.4%) patients\nare having the history of both diabetes and hypertension. Our study findings conclude that most of the patients undergoing\nhaemodialysis have their blood pressure uncontrolled; the major reason for this is lack of adherence to medication due to\npolypharmacy and increasing incidence of resistant hypertension....
Background: A new formulation of olanzapine available for terminally ill patients is needed. Rectal administration\nusing suppositories is an alternative for patients for whom administration via the oral route is not feasible. In the\npresent study, we prepared olanzapine suppositories, and confirmed using pharmaceutical tests. Furthermore, we\ndemonstrated the efficacy and safety of olanzapine suppositories in terminally ill patients.\nMethods: We prepared olanzapine suppositories using bases consisting of different compositions of Witepsol H-15,\nWitepsol S-55, and Witepsol E-75. The suppository release test was performed, and the olanzapine suppository with\nthe best dissolution rate was selected. The suppository was assessed using the content uniformity test, content test\nin suppositories, hardness test, stability test, and clinical efficacy and safety.\nResults: The dissolution rate at 360 min of olanzapine suppositories with Witepsol H-15 was the best (77.0 �± 3.3 %).\nThe suppositories prepared had a uniform weight (2.47 �± 0.02 g) and content (2.11 �± 0.07 mg). The power required\nto break suppositories was 7.96 �± 0.55 kgf. When olanzapine suppositories were stored with protection from light,\ntheir contents were maintained regardless of whether the temperature was at 4 �°C or room temperature. The\nnumbers of patients administered 2.5 mg, 5 mg, and 10 mg of olanzapine suppositories were 4, 19, and 1. The\npercentages of patients with delirium or nausea and vomiting cured with olanzapine suppositories were 82 and\n57 %, respectively.\nConclusion: We suggest that olanzapine suppositories prepared in the hospital by pharmacists will improve the\nquality of life of terminally ill patients....
This paper presents the results of the second European Delphi round on the ranking\nof competences for pharmacy practice and compares these data to those of the first round\nalready published. A comparison of the numbers of respondents, distribution by age group,\ncountry of residence, etc., shows that whilst the student population of respondents changed from\nRound 1 to 2, the populations of the professional groups (community, hospital and industrial\npharmacists, pharmacists in other occupations and academics) were more stable. Results are given\nfor the consensus of ranking and the scores of ranking of 50 competences for pharmacy practice.\nThis two-stage, large-scale Delphi process harmonized and validated the Quality Assurance in\nEuropean Pharmacy Education and Training (PHAR-QA) framework and ensured the adoption\nby the pharmacy profession of a framework proposed by the academic pharmacy community.\nThe process of evaluation and validation of ranking of competences by the pharmacy profession\nis now complete, and the PHAR-QA consortium will now put forward a definitive PHAR-QA\nframework of competences for pharmacy practice....
Background: Providing patient-centred care requires pharmacy students to learn how to interact effectively and\nunderstand individual differences that can influence patients� health. The School of Pharmacy at The University of\nAuckland, New Zealand (NZ), developed a virtual teaching platform, called NZ Pharmville, which consisted of\ntwenty-one community-based patients who are members of six families; each family had a video vignette\nassociated with it. Bachelor of Pharmacy (BPharm) students, enrolled in the third year pharmacy practice course,\nwere able to view these recorded vignettes as part of their weekly pre-laboratory work for the course. All the\nclinical cases within the course were based on this community, with the aim of increasing the realism in the\npractical sessions and increasing patient-centred learning. This study aimed to explore the perspectives of\npharmacy students regarding the integration of this virtual community into a third year undergraduate pharmacy\npractice course.\nMethods: An anonymous, voluntary survey which consisted of twenty-one items, 13 requiring a Likert scale\nresponse and 8 requiring free text responses, was distributed to all students who had completed the third year\npharmacy practice course. The responses to the questions were collated and analysed. Responses to questions one\nto thirteen were recorded in Excel, and results were presented as the combination of strongly agree and agree,\nstrongly disagree and disagree and neutral. Responses to free text questions were read multiple times before being\ncoded by two members of the research team into broad themes aligned to the overall aims of the evaluation.\nResults: Eighty-six (80.4 %) of the eligible students completed the survey and the majority of responses were\npositive towards the benefits of using the virtual community in the course. Responses indicated that many of the\nstudents found the integration of the virtual community to be useful preparation for their practical sessions and the\nmajority of students felt that the vignettes made it easier to develop empathy for the patients rather than reading\nabout them.\nConclusion: The use of virtual communities, for example, NZ Pharmville, show promise as a platform to aid in\nteaching and learning. The resources in NZ Pharmville allow students ongoing access to patient video clips that\nattempt to depict a real life situation, and enable students to engage with the fictional characters. The virtual\ncommunity provided an educational experience which was well received by students. This teaching method\nappeared to promote active patient-centered learning and allowed students to reflect on and revisit these skills on\na weekly basis....
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