Current Issue : April - June Volume : 2012 Issue Number : 2 Articles : 10 Articles
Diabetes mellitus (DM) is a growing epidemic and the cost of treating diabetes is increasing disproportionately. The objective of this study was to evaluate the costs of illness for Type II DM in the out-patient diabetes clinic of a medical college hospital. A prevalence-based Cost-of-illness study for diabetes care was conducted in the diabetes clinic of Medical College, Calicut, Kerala from December, 2009 to April, 2010. A pre-tested questionnaire was administered to collect data from 191 randomly selected persons with diabetes. The annual mean direct cost for each person with diabetes was estimated to be Indian rupees Rs. Medicines accounted for the largest share of direct cost (76.25 %), followed by laboratory investigations (5.17 %). We found that increased age, the number of complications and the longer duration of the disease significantly increased the burden of the disease on the society (p < 0.001). Comparing cost with family income it was found that the poorest section of the society is spending 18% of total family income on diabetes care. This study concluded that substantial expenditure is incurred by people with diabetes; with the implication that resources could be saved by prevention, earlier detection and a reduction of diabetes co-morbidities and complications through improved diabetes care. Large scale and cost-effective prevention programs need to be initiated to maximize health gains and to reverse the cost implications of this epidemic....
The patient education and information about any disease largely depend upon on World Wide Web content now a days. It is easy to obtain and economical as compare to print media. Now a days, due to ease of availability of internet, patients, doctor, health professionals and family member move towards websites but it is not necessary that information available is appropriate so it is necessary to evaluate for its reliability and quality. Objective of this study was to evaluate the web-based HIV/AIDS patient education material for well-accepted evaluation criteria and core education concepts. Out of 118 web-sites retrieved from meta search engine, 30 sites themselves provide patient information and so considered for evaluation. Considerable variability in quality of HIV/AIDS education websites was found with respect to core educational concepts and HONcode. Inclusion of evidence-based medicine concepts, role of family support, and enhancement in customized content and easier feedback mechanism in the web-sites can be a signi?cant development in the direction of patient-centered AIDS care. Finally we suggest some top websites which provide quality muscular dystrophy patient education....
With the growth of literacy in the developing countries, more number of researchers carryout their research activity on the different drug formulations, which are often being ban in the other countries. The drug ban list of the country prior to the formulation could provide the basis for the formulation scientist to overcome such a huge loss to the firm. In India, some drugs are been banned are still been sold, the drug ban list could alert the prescribers, and the pharmacist about its possible severe adverse effects and provides the platform to combat it....
Lacosamide is a novel antiepileptic drug and is a member of a family of functionalized amino acids, more specifically, analogues of the endogenous amino acid and NMDA-receptor modulator D-serine. Various animal and human study shown that LCM have Antinociceptive efficacy, adjuvant analgesics efficacy and safety in cancer pain management¬¬, anti hyperalgesic efficacy, and successful treatment in childhood prolonged refractory status epilepticus, nonconvulsive status epilepticus after failure of first line therapy, in diabetic neuropathic pain. The LCM may be used for the treatment or prophylaxis of migraine, fibromyalgia syndrome, osteoarthritis, post herpetic neuralgia. LCM is a white to light yellow crystalline powder with a chiral purity of (R)-enantiomer and is a weak base. LCM is a BCS Class I substance and soluble in 2-propanol, ethanol, DMSO, Dimethylformamide and sparingly soluble in water and is not a hygroscopic. Commercial synthesis process comprises five steps and (R)--N-benzyl-2-(benzyloxy carbonylamino)-3-methoxypropionamide is an intermediate useful for preparing LCM. LCM are very stable at elevated temperature and high humidity. Under strong acidic condition pH 1 and alkaline condition pH 10 at a temperature of 60°C the substance rapidly decomposed. Moderate degradation reported after addition of 3% hydrogen peroxide to aqueous solution of pH 3, pH7, pH 10. Few HPLC methods are reported for LCM estimation in human’s and animal’s plasma, saliva and serum and in bulk and its formulation. LCM is avilable as film coated tablet, oral solution and solution for intravenous infusion forms in USA, Europe, Australia and in India...
India is a vast country with multi-ethnic population. It is therefore necessary to have a viable Adverse Drug Reaction (ADR) data capturing system. If any drug is found to have harmful side-effects, the government issues the ban order and all manufacturers and wholesalers are asked not to stock the particular medicine. The DCGI notifies all state drug authorities, chemist associations and manufacturers about the ban on the drug. Authorities are instructed to carry out inspections. Licences of chemists stocking banned drugs can be revoked under the Drugs and Cosmetics Act.. A number of individual drugs as well as fixed dose combinations are banned in India. Pharmacovigilance monitores the adverse effect of drug and hence after such monitoring the drug if found to be adversely effecting the mass population is ordered for and labeled as banned drug. Here are some of the drugs which affected the mass population an hence are labeled as banned drug....
Background: Opioid maintenance treatment (OMT) has a positive impact on substance use and health outcomes\r\namong HIV-infected opioid dependent patients. The present study investigates non-medical use of opioids by HIVinfected\r\nopioid-dependent individuals treated with buprenorphine or methadone.\r\nMethods: The MANIF 2000 study is a longitudinal study that enrolled a cohort of 476 HIV-infected opioid-dependent\r\nindividuals. Data were collected in outpatient hospital services delivering HIV care in France. The sample comprised\r\nall patients receiving OMT (either methadone or buprenorphine) who attended at least one follow-up visit with data\r\non adherence to OMT (N = 235 patients, 1056 visits). Non-medical use of opioids during OMT was defined as having\r\nreported use of opioids in a non-medical context, and/or the misuse of the prescribed oral OMT by an inappropriate\r\nroute of administration (injection or sniffing). After adjusting for the non-random assignment of OMT type, a model\r\nbased on GEE was then used to identify predictors of non-medical use of opioids.\r\nResults: Among the 235 patients, 144 (61.3%) and 91 (38.9%) patients were receiving buprenorphine and\r\nmethadone, respectively, at baseline. Non-medical use of opioids was found in 41.6% of visits for 83% of individual\r\npatients. In the multivariate analysis, predictors of non-medical use of opioids were: cocaine, daily cannabis, and\r\nbenzodiazepine use, experience of opioid withdrawal symptoms, and less time since OMT initiation.\r\nConclusions: Non-medical use of opioids was found to be comparable in OMT patients receiving methadone or\r\nbuprenorphine. The presence of opioid withdrawal symptoms was a determinant of non-medical use of opioids\r\nand may serve as a clinical indicator of inadequate dosage, medication, or type of follow-up. Sustainability and\r\ncontinuity of care with adequate monitoring of withdrawal symptoms and polydrug use may contribute to\r\nreduced harms from ongoing non-medical use of opioids....
Background: In the last few years there seems to be an emerging interest for including the patients� perspective\r\nin assessing methadone maintenance treatment (MMT), with treatment satisfaction surveys being the most\r\ncommonly-used method of incorporating this point of view. The present study considers the perspective of\r\npatients on MMT when assessing the outcomes of this treatment, acknowledging the validity of this approach as\r\nan indicator. The primary aim of this study is to evaluate the concordance between improvement assessment\r\nperformed by two members of the clinical staff (a psychiatrist and a nurse) and assessment carried out by MMT\r\npatients themselves.\r\nMethod: Patients (n = 110) and their respective psychiatrist (n = 5) and nurse (n = 1) completed a scale for\r\nassessing how the patient�s condition had changed from the beginning of MMT, using the Patient Global\r\nImpression of Improvement scale (PGI-I) and the Clinical Global Impression of Improvement scale (CGI-I),\r\nrespectively.\r\nResults: The global improvement assessed by patients showed weak concordance with the assessments made by\r\nnurses (Quadratic-weighted kappa = 0.13, p > 0.05) and by psychiatrists (Quadratic-weighted kappa = 0.19, p =\r\n0.0086), although in the latter, concordance was statistically significant. The percentage of improved patients was\r\nsignificantly higher in the case of the assessments made by patients, compared with those made by nurses (90.9%\r\nvs. 80%, Z-statistic = 2.10, p = 0.0354) and by psychiatrists (90.9% vs. 50%, Z-statistic = 6.48, p < 0.0001).\r\nConclusions: MMT patients� perception of improvement shows low concordance with the clinical staff�s\r\nperspective. Assessment of MMT effectiveness should also focus on patient�s evaluation of the outcomes or\r\nchanges achieved, thus including indicators based on the patient�s experiences, provided that MMT aim is to be\r\nmore patient centred and to cover different needs of patients themselves....
Background. Stiff porridge (ugali) made from unrefined maize flour has been a staple food in Tanzania. Recently, high intakes of\r\nrefined carbohydrates and energy-dense foods have been documented in urban areas in Tanzania. We assessed cultural acceptability,\r\nperceptions and barriers to consumption of unrefined carbohydrates in Tanzania. Methods. Twelve focus group discussions\r\n(FGDs) were conducted among 44 overweight and obese adults aged 40ââ?¬â??65 years. All FGDs were audio-recorded, and QSR N6\r\nsoftware was used for data analysis. Results. Most participants (77%) had tried and liked unrefined maize ugali prior to our study.\r\nFor unrefined sorghum ugali, 12 participants had tried it before, and 9 of them liked it. Brown rice was found to be unpopular\r\nand was considered a diet for diabetic patients; four participants had tried it before and all reported to like it. Sensory appeal,\r\navailability, and affordability were key facilitators whereas high cost, scarcity, and negative perceptions toward whole grains were\r\nmentioned as barriers to consumption of unrefined carbohydrates. Conclusion. Our study has identified facilitators and barriers to\r\nconsumption of unrefined carbohydrates in Tanzania. Educational strategies are recommended in order to increase consumption\r\nof unrefined carbohydrates and consequently reduce diet-related chronic diseases in Tanzania....
Background: Nonmedical prescription opioid use has emerged as a major public health concern in recent years,\r\nparticularly in rural Appalachia. Little is known about the routes of administration (ROA) involved in nonmedical\r\nprescription opioid use among rural and urban drug users. The purpose of this study was to describe rural-urban\r\ndifferences in ROA for nonmedical prescription opioid use.\r\nMethods: A purposive sample of 212 prescription drug users was recruited from a rural Appalachian county\r\n(n = 101) and a major metropolitan area (n = 111) in Kentucky. Consenting participants were given an intervieweradministered\r\nquestionnaire examining sociodemographics, psychiatric disorders, and self-reported nonmedical use\r\nand ROA (swallowing, snorting, injecting) for the following prescription drugs: buprenorphine, fentanyl,\r\nhydrocodone, hydromorphone, methadone, morphine, OxyContin�® and other oxycodone.\r\nResults: Among urban participants, swallowing was the most common ROA, contrasting sharply with substancespecific\r\nvariation in ROA among rural participants. Among rural participants, snorting was the most frequent ROA\r\nfor hydrocodone, methadone, OxyContin�®, and oxycodone, while injection was most common for hydromorphone\r\nand morphine. In age-, gender-, and race-adjusted analyses, rural participants had significantly higher odds of\r\nsnorting hydrocodone, OxyContin�®, and oxycodone than urban participants. Urban participants had significantly\r\nhigher odds of swallowing hydrocodone and oxycodone than did rural participants. Notably, among rural\r\nparticipants, 67% of hydromorphone users and 63% of morphine users had injected the drugs.\r\nConclusions: Alternative ROA are common among rural drug users. This finding has implications for rural\r\nsubstance abuse treatment and harm reduction, in which interventions should incorporate methods to prevent\r\nand reduce route-specific health complications of drug use....
Background: Injection drug use syringe filters (IDUSF) are designed to prevent several complications related to the\r\ninjection of drugs. Due to their small pore size, their use can reduce the solutionâ��s insoluble particle content and\r\nthus diminish the prevalence of phlebitis, talcosis.... Their low drug retention discourages from filter reuse and\r\nsharing and can thus prevent viral and microbial infections. In France, drug users have access to sterile cotton\r\nfilters for 15 years and to an IDUSF (the Sterifilt�®) for 5 years. This study was set up to explore the factors\r\ninfluencing filter preference amongst injecting drug users.\r\nMethods: Quantitative and qualitative data were gathered through 241 questionnaires and the participation of 23\r\npeople in focus groups.\r\nResults: Factors found to significantly influence filter preference were duration and frequency of injecting drug\r\nuse, the type of drugs injected and subculture. Furthermore, IDUâ��s rationale for the preference of one type of filter\r\nover others was explored. It was found that filter preference depends on perceived health benefits (reduced harms,\r\nprevention of vein damage, protection of injection sites), drug retention (low retention: better high, protective\r\nmechanism against the reuse of filters; high retention: filter reuse as a protective mechanism against withdrawal),\r\ntechnical and practical issues (filter clogging, ease of use, time needed to prepare an injection) and believes (the\r\nconviction that a clear solution contains less active compound).\r\nConclusion: It was concluded that the factors influencing filter preference are in favour of change; a shift towards\r\nthe use of more efficient filters can be made through increased availability, information and demonstrations....
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