Current Issue : April - June Volume : 2012 Issue Number : 2 Articles : 10 Articles
There is scientific evidence of socio-demographic, behavioral and health risk factors associated with\r\ntuberculosis (TB) infection and TB disease. The primary objective of the study was to examine the\r\ncorrelation of TB risk factors at the state level in the United States (US) to obtain insights specific to the\r\nstate of TB in the US. Secondary data from the centers for disease control and prevention (CDC) and US\r\nCensus Bureau on line databases were used. Simple and multiple linear regressions were carried out.\r\nThe model created to represent the TB rate by state included the percent of the population which was\r\nnon-Hispanic white (p < 0.001), the AIDS diagnosis rate/100,000 (p = 0.067) and the percentage of the\r\npopulation which is foreign born. Per capita income, GINI, diabetes rates, smoking rates and alcohol\r\nabuse rates were excluded from the final model. Race/ethnicity acts as a marker for a number of risk\r\nfactors, and the focus of the fight against TB in the US should be on minority communities, those\r\npopulated by the foreign-born and those with high rates of AIDS particularly where a large degree of\r\nincome inequality is present....
Diabetes is a chronic metabolic disease which is characterized by absolute or relative deficiencies in insulin secretion and/or\r\ninsulin action. The key roles of oxidative stress and inflammation in the progression of vascular complications of this disease\r\nare well recognized. Accumulating epidemiologic evidence confirms that physical inactivity is an independent risk factor for\r\ninsulin resistance and type II diabetes. This paper briefly reviews the pathophysiological pathways associated with oxidative stress\r\nand inflammation in diabetes mellitus and then discusses the impact of exercise on these systems. In this regard, we discuss\r\nexercise induced activation of cellular antioxidant systems through ââ?¬Å?nuclear factor erythroid 2-related factor.ââ?¬Â We also discuss\r\nanti-inflammatory myokines, which are produced and released by contracting muscle fibers. Antiapoptotic, anti-inflammatory\r\nand chaperon effects of exercise-induced heat shock proteins are also reviewed....
Objective: To explore the best interventions and working patterns of clinical pharmacists in pediatrics and to determine the\r\neffectiveness of clinical pharmacists in pediatrics.\r\nMethods: We conducted a randomized controlled trial of 160 pediatric patients with nerve system disease, respiratory\r\nsystem disease or digestive system disease, who were randomly allocated into two groups, with 80 in each group.\r\nInterventions by clinical pharmacists in the experimental group included answering questions of physicians and nurses,\r\ngiving advice on treating patients, checking prescriptions and patient counseling at discharge. In the control group, patients\r\nwere treated without clinical pharmacist interventions.\r\nResults: Of the 109 interventions provided by clinical pharmacists during 4 months, 47 were consultations for physicians\r\nand nurses, 31 were suggestions of treatment, with 30 accepted by physicians (96.77%) and 31 were medical errors found in\r\n641 prescriptions. Five adverse drug reactions were submitted to the adverse drug reaction monitoring network, with three\r\nin the experimental group and two in the control group. The average length of stay (LOS) for patients with respiratory\r\nsystem diseases in the experimental group was 6.45 days, in comparison with 10.83 days in the control group, which was\r\nstatistically different (p value,0.05); Average drug compliance rate in the experimental group was 81.41%, in comparison\r\nwith 70.17% of the control group, which was statistically different (p value,0.05). Cost of drugs and hospitalization and rate\r\nof readmission in two weeks after discharge in the two groups were not statistically different.\r\nConclusion: Participation by clinical pharmacists in the pharmacotherapy of pediatric patients can reduce LOS of patients\r\nwith respiratory system disease and improve compliance rate through discharge education, showing no significant effects\r\non prevention of ADR, reduction of cost of drugs and hospitalization and readmission rate in two weeks....
Neural cell transplantation and gene therapy have attracted considerable interest as promising therapeutic alternatives for patients\r\nwith Parkinson�s disease (PD). Preclinical and open-label studies have suggested that grafted fetal neural tissue or viral vector gene\r\ntransfer can achieve considerable biochemical and clinical improvements, whereas subsequent double-blind, placebo-controlled\r\nprotocols have produced rather more modest and variable results. Detailed evaluation of these discordant findings has highlighted\r\nseveral crucial issues such as patient selection criteria, details surrounding transplantation or gene therapy methodologies, as well\r\nas the study designs themselves that ought to be carefully considered in the planning phases of future clinical trials. Beyond the\r\nprovision of symptomatic efficacy and safety data, it also remains to be identified whether the possibilities offered by stem cell and\r\ngene therapy technological advances might translate to meaningful neuroprotection and/or disease-modifying effects or alleviate\r\nthe nonmotor aspects of PD and thus offer additional benefits beyond those achieved through conventional pharmacotherapy or\r\ndeep brain stimulation (DBS)....
Stroke progresses in stages from ischemia to actual infarction. In most common situation i.e. ischemia occurs due to middle cerebral artery occlusion forming the densely ischemic central focus and a less densely ischemic “penumbra.” Cells within the central focus are usually damaged irreversibly unless reperfusion is quickly re-established, whereas cells within the penumbra may remain viable but at risk for several hours (30). When regional cerebral blood flow falls below 15-18 ml /100 g per minute, electrical activity within human neurons ceases. Further decrease results in decreased production of adenosine triphosphate which leads to anaerobic glycolysis resulting in metabolic acidosis and ischemic cascade. At our institution patients with acute emergencies viz head injury, trauma, as well as various paralytic conditions are submitted to CT examination.Our study constituted of 100 cases in 1 year presenting with the symptoms of cerbro vascular accidents who underwent CT examination. CT remains the predominant imaging modality for initial evaluation of patients with suspected stroke. Lesions that clinically can mimic ischemic stroke, such as hemorrhages, tumors, infections, vascular malformations, etc., can be excluded....
Psoriasis is a chronic; T lymphocyte mediated autoimmune inflammatory disorder characterized by red patches covered by silvery white scales. These patches may itch and be quite uncomfortable as well as be a cosmetic embarrassment. More than 5.5 million people are affected by this disease in United States. Psoriasis rarely life threatening, It is related with significant healthcare costs, economic losses, and quality of life. The main parts of body involved are the elbows, knees, gluteal cleft and the scalp. There are mainly five types of psoriasis such as plaque psoriasis, guttate psoriasis, pustular psoriasis, inverse psoriasis, erythrodermic psoriasis. Nearly, 80% of patients suffering from psoriasis have plaque psoriasis. Treatment of psoriasis depends on the type and severity of the psoriasis. Mild forms of psoriasis can be adequately treated with over-the-counter or topical preparations. Patients with more severe forms of psoriasis, such as psoriatic arthritis, require intensive therapy with systemic drugs. In this article, we review various approaches for treatment of psoriasis. This review also includes various novel drug delivery system used o treat psoriasis....
Background: Recent studies have shown that recommended drugs for the treatment of chronic heart failure (CHF) are under-prescribed in daily practice. This gap between guidelines and clinical practice is even more pronounced in developing countries, including Romania.\r\n Aim: To compare the characteristics and the modality of treatment of patients with CHF discharged from a General Romanian Hospital in 2009, with those of an analogous patient population observed three years earlier, in 2006.\r\n Methods: There were studied two cohorts of patients (from 2006-415 patients, 67.08�±10.59 years old vs from 2009-500 patients, aged 67.31�±11.27 years) admitted in the Rehabilitation Hospital-Cardiology Department with a diagnosis of CHF class NYHA II-IV. The mean LVEF was 56.09�±14.83% in 2006 and 58.91�±15.41% in 2009. In all patients recommended drug therapy was compared with the recommendations made by the ESC 2005 and 2008 guidelines, respectively.\r\n Results: Inhibitors of the Renin-Angiotensin System were prescribed to the great majority of patients, the percentage being 74.4% in 2006 vs 77.20 % in 2009. A decrease of ACEI (71.3% vs 65.2%; p<0.01) and an important increase of ARBâ��s use (3.1% vs 12.20% p<0.01) were registered. Beta-blockers use increased (51.8% vs 69.2%), prescription of loop diuretics and aldosterone antagonistsâ�� slightly decreased (89.4% vs 85%, 80.2% vs 67.8%). Digoxin was less used in 2009 (57.10% vs 42.60 %) even though the percentage of patients with atrial fibrillation was no different between the two years. The use of antiplatelet drugs increased (32.23% vs 56.5 %).\r\n Conclusions: There was an improvement in guidelines adherence over a three-year period in Romania. Reninangiotensin inhibitors, beta-blockers and diuretics are used according to the guidelines recommendations, yet antiplatelets remain underused....
Evidence on the long-term incidence and risk factors of hypertension and congestive heart failure in diabetic patients is scarce and mainly derived from studies in developed countries. Epidemiological study on diabetes and diabetes induces complications is required for planning a well-co-ordinated approach to this public health problem in various region of Gujarat. The objectives of present study were to estimate the prevalence and risk factors for the development of hypertension and congestive heart failure in people with type 2 diabetes mellitus using routinely collected data from a clinical information system at tertiary care hospital from various region of Gujarat. During this retrospective study we have analysed the data of 5403 patients who were utilizing the medical care in a private tertiary care hospital. The data was collected from 260 doctors’ clinics on prevalence of diabetes and diabetes induces complications like hypertension and congestive heart failure. In our study prevalence of hypertension (71.6%) was found more common than congestive heart failure 25.8%, coronary artery disease 46.43%, renal disorder 16.2%, neuropathy 39.53%, stroke 19.6%, retinopathy 22.98%, and nontraumatic lower limb amputations 54.83%. This shows the higher prevalence of hypertension, congestive heart failure and coronary artery disease among diabetic patients in different territory of Gujarat state. This indicates that the awareness of diabetes was quite less in the Gujarat and there could be many other asymptomatic diabetic patients who may not aware about whether he/she has diabetes....
To find out prevalence of menstrual morbidities and to study health seeking behavior of women living in slums of Ujjain city. Cross sectional study was carried out using structured questionnaire to interview 339 sampled populations of women living in slums of Ujjain city for perceived menstrual morbidities and health seeking behavior. Study participants were compared for their socio demographic characteristics. Prevalence of menstrual morbidity was 81.7% (CI at 95%: 78-86) and was significantly higher among illiterate (P<0.05) and working women (P<0.001).The commonest morbidity was dysmenorrhea (91.7%). Only 48 (17.3%) sought health care for menstrual complaints and majority sought health care from private providers. Burden of menstrual morbidity is very high in the study population but health care seeking is very poor and need to be intervened....
No study has ever examined the effect of vitamin C with metformin on fasting (FBS) and postmeal blood glucose (PMBG) as well\nas glycosylated hemoglobin (HbA1c) in the treatment of type 2 diabetes mellitus (DM). The goal was to examine the effect of\noral vitamin C with metformin on FBS, PMBG, HbA1c, and plasma ascorbic acid level (PAA) with type 2 DM. Seventy patients\nwith type 2 DMparticipated in a prospective, double-blind, placebo-controlled, 12-week study. The patients with type 2 DMwere\ndivided randomly into placebo and vitamin C group of 35 each. Both groups received the treatment for twelve weeks. Decreased\nPAA levels were found in patients with type 2 diabetes mellitus. This level was reversed significantly after treatment with vitamin\nC along with metformin compared to placebo with metformin. FBS, PMBG, and HbA1c levels showed significant improvement\nafter 12 weeks of treatment with vitamin C. In conclusion, oral supplementation of vitamin C with metformin reverses ascorbic\nacid levels, reduces FBS, PMBG, and improves HbA1c. Hence, both the drugs in combination may be used in the treatment of type\n2 DM to maintain good glycemic control....
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