Current Issue : January - March Volume : 2013 Issue Number : 1 Articles : 9 Articles
This review highlights the various parameters like properties, applications and precautions of radiopharmaceuticals that are now days extensively used as a pharmaceutical formulations to treat high end diseases. Radiopharmaceuticals are used in the field of nuclear medicine as tracers in the diagnosis and treatment of several diseases. The potential of radionuclides in therapy has been recognized for many decades. A number of radionuclides such as iodine131, phosphorous32 and yttrium90 have been in use for the treatment of many benign and malignant disorders. Recently, however, there has been a significant growth of this branch of nuclear medicine with the introduction of a number of new radionuclides and radiopharmaceuticals for the treatment of metastatic bone pain, neuroendocrine and other tumors. In practice, the majority of radiopharmaceuticals are used for diagnosis, but increasingly, highly specific radiotherapeutic agents are being developed which have the potential for delivery of effective treatment, particularly in cancer therapy. Using products of proven quality is vital to achieve successful outcomes in both the diagnostic and therapeutic use of radiopharmaceuticals....
Background: One of the most important risk factors for stroke is hypertension. A number of studies have\r\nattempted to identify the most effective anti-hypertensive therapeutic group for stroke prevention. Using an\r\nepidemiologic approach we aimed to find correlations based on Hungarian data on stroke-mortality and on\r\nprescription routine of anti-hypertensive therapeutics in three different counties, showing significant difference in\r\nstroke mortality.\r\nMethods: We have used the official yearly reports on stroke-mortality for the period 2003-2008. Based on the\r\nsignificant differences in the change in mortality due to stroke three counties were selected: Baranya, Bekes and\r\nHajdu-Bihar. The usage of antihypertensive therapeutic groups was analyzed. The correlation of stroke mortality\r\ndifference and different antihypertensive treatment habits was analyzed by using normality test, time series\r\nanalyses, correlation coefficient, paired samples test, one sample test and chi-square test.\r\nResults: For the year 2003 stroke-mortality standardized with the county population number was highest in county\r\nBekes, followed by county Baranya and county Hajdu-Bihar. For each year stroke mortality has shown significant (p <\r\n0.0001) difference between the three counties and the ranking/order of the counties has been preserved over time.\r\nDuring the period of our study, an increase in the number of days of treatment was observed for most of the antihypertensive\r\ndrugs listed. We have observed that the increased use of high-ceiling diuretics resulted in a mortality\r\nadvantage, and the reduction in use of calcium channel blockers with direct cardiac effect had negative consequences.\r\nConclusions: The authors acknowledge that by limiting the study to three counties the findings cannot be\r\ngeneralized to the whole Hungarian population. Two trends can still be identified:\r\ni) increased number of days of treatment (and therefore the probable use) of high-ceiling diuretics is associated\r\nwith reduction in mortality due to stroke and its immediate complications; ii) reduction in the use of nondihidropiridin\r\nCCBs does not seem justified, as their use appears to be advantageous in stroke prevention. Authors\r\nput emphasis on the importance of the adherence of the patients to the preventive therapies. Health care\r\nprofessionals could provide an important added value to the life long preventive therapies by improving the\r\ncompliance of their patients, giving personalized care and advice....
Background: There is increasing concern that prescription stimulants may be associated with adverse\r\ncardiovascular events such as stroke, myocardial infarction, and sudden death. Public health concerns are amplified\r\nby increasing use of prescription stimulants among adults.\r\nMethods: The objective of this study was to conduct a systematic review of the evidence of an association\r\nbetween prescription stimulant use and adverse cardiovascular outcomes. PUBMED, MEDLINE, EMBASE and Google\r\nScholar searches were conducted using key words related to these topics (MESH): ADHD; Adults; Amphetamine;\r\nAmphetamines; Arrhythmias, Cardiac; Cardiovascular Diseases; Cardiovascular System; Central Nervous Stimulants;\r\nCerebrovascular; Cohort Studies; Caseââ?¬â??control Studies; Death; Death, Sudden, Cardiac; Dextroamphetamine; Drug\r\nToxicity; Methamphetamine; Methylphenidate; Myocardial Infarction; Stimulant; Stroke; Safety. Eligible studies were\r\npopulation-based studies of children, adolescents, or adults using prescription stimulant use as the independent\r\nvariable and a hard cardiovascular outcome as the dependent variable.\r\nResults: Ten population-based observational studies which evaluated prescription stimulant use with cardiovascular\r\noutcomes were reviewed. Six out of seven studies in children and adolescents did not show an association\r\nbetween stimulant use and adverse cardiovascular outcomes. In contrast, two out of three studies in adults found\r\nan association.\r\nConclusions: Findings of an association between prescription stimulant use and adverse cardiovascular outcomes\r\nare mixed. Studies of children and adolescents suggest that statistical power is limited in available study\r\npopulations, and the absolute risk of an event is low. More suggestive of a safety signal, studies of adults found an\r\nincreased risk for transient ischemic attack and sudden death/ventricular arrhythmia. Interpretation was limited due\r\nto differences in population, cardiovascular outcome selection/ascertainment, and methodology. Accounting for\r\nconfounding and selection biases in these studies is of particular concern. Future studies should address this and\r\nother methodological issues....
Introduction: The evaluation and prescription of psychotropic drugs in oncologic setting is of particular\r\nimportance because of cancer patient�´s susceptibility to drug interactions.\r\nObjectives: Describe the frequency and type of comorbidities and the standard prescription of pharmaceuticals\r\nin a sample of cancer patients. Secondarily, reflect on the importance of clinical pharmacological interactions in\r\nthis context, particularly in the prescription of psychotropic drugs. Material/methods: Descriptive study of a sample\r\nof patients referred for the first time to the Psycho-Oncology Unit of IPOCFG, between October and December\r\n2011. A retrospective collection of the socio-demographic and clinical variables was made by consulting the clinical\r\nprocesses.\r\nResults: From the sample of 60 patients included for analysis, 48,3% of the patients were on antineoplasic\r\nmedication, 46,7% had prior psychiatric history and 70% were on psychotropic drugs; 75% presented other\r\ncomorbidities. Only 8,3% of patients were free of medication and, from those under it, 63,6% consumed three or\r\nmore distinct pharmacological classes.\r\nConclusions: There is a high frequency of co-morbidities and co-prescription of several classes of drugs which\r\npose cancer patients at risk of interactions. It is important that physicians are able to predict these phenomena to\r\nprevent the loss of efficiency and minimize the adverse effects, particularly of antineoplastic....
Background: There are limited published studies on patient satisfaction towards endoscopy from Asian countries.\r\nDifferent methods of evaluation of patient satisfaction may yield different results and there is currently no study to\r\ncompare results of on-site versus phone-back interviews.\r\nMethod: On-site followed by phone-back interviews were carried out on consecutive patients attending the\r\noutpatient gastroscopy service of University of Malaya Medical Centre between July 2010 and January 2011 using\r\nthe modified Group Health Association of America-9 (mGHAA-9) questionnaire. The question on technical skill of\r\nendoscopist was replaced with a question on patient comfort during endoscopy.\r\nResults: Seven hundred patients were interviewed. Waiting times for appointment and on gastroscopy day, and\r\ndiscomfort during procedure accounted for over 90% of unfavorable responses. Favorable response diminished to\r\nundesirable level when waiting times for appointment and on gastroscopy day exceeded 1 month and 1 hour,\r\nrespectively. Satisfaction scores were higher for waiting time for appointment but lower for personal manner of\r\nnurses/staff and explanation given during phone-back interview. There was no significant difference in satisfaction\r\nscores for other questions, including overall rating between the two methods.\r\nConclusion: Waiting times and discomfort during procedure were main causes for patient dissatisfaction. Phoneback\r\ninterview may result in different scores for some items compared with on-site interview and should be taken\r\ninto account when comparing results using the different methods....
Psoriasis is a chronic, immuno-inflammatory condition that threatens life of individual on many fronts like self confidence, social functioning and interpersonal functioning and hence requires lifelong care. It is characterized by inflammation of affected skin followed by extensive scaling. This review has focused on comparison amongst various therapies and the recent advances available on the psoriasis. The alternative systems of medicines and modern systems have different approaches which forms the basis for treatment. Ayurveda, Unani and other biologic systems have answers for psoriasis. They not only treat root cause of condition but improves standard of life too. India has been gifted by a rich tradition of plant-based knowledge on healthcare. A large number of plants are used by tribes and folklore traditions in India for treatment of many skin diseases. Thus herbs can be used to treat psoriasis like conditions topically as well as systemically for long term treatment with less side effects....
Purpose\r\nUnderstanding important facts about medicine therapy is needed to improve patient safety and therapy\r\noutcomes. Media advertising of medical products draws the patientââ?¬â?¢s attention to the importance of reading the\r\npatient information leaflet. Despite this, some patients interrupt or change their therapy without prior consultation\r\nwith a health care professional.\r\nThe purpose of this study was to examine if patients read the leaflet, if they understand it, and in case of any\r\ndoubts, if they consult to a pharmacist or doctor for advice.\r\nMethods\r\nResponses to a patient questionnaire (n=708), designed specifically for this study, were analysed to compare\r\npatient attitudes towards medical information. The survey was conducted in 55 pharmacies in Croatia in February\r\n2010.\r\nResults\r\n95.2% of those surveyed stated that they read the patient leaflet when using a medicinal product for the first\r\ntime. The meaning of ââ?¬Å?contraindicationââ?¬Â was known to 37.7% patients, and ââ?¬Å?interactionââ?¬Â to 65.4%. Furthermore, the\r\nterm ââ?¬Å?side effectsââ?¬Â was understood by 91.8% patients of those surveyed, 74.6% of patients consulted a doctor or\r\npharmacist for advice in case of doubts after reading the leaflet, while 78.2% of patients interrupted or changed their\r\ntherapy without prior consultation with a health care professional.\r\nConclusion\r\nInforming patients about medicinal products through a leaflet could be insufficient for successful therapy. The\r\npatient information leaflet should be easily understandable for the patient. The identification of patient needs for\r\ninformation, education and consultation about proper drug administration is a key pharmacist competency that is\r\nstill to be developed....
Drug prescribing is a skill that needs to be developed on a continuing basis. It reflects physician's skills and approach toward diagnosis of disease and selection of appropriate treatment.Antibacterial drugs are among the most commonly prescribed therapeutic agents. The aim of this study was to analyze the prescribing pattern in hospitalized pediatric population. A prospective, observational study was carried out in a pediatrics in-patient department at mehsana, Gujarat for 3 months. The relevant data on drug prescription of each patient was collected, recorded and converted into Microsoft excel sheet. The data was analyzed to determine WHO recommended indicators. A total of 262 patients, 173 (66.03%) males and 89 (33.96%) females were enrolled. A large number of patients were prescribed (64.5%) two antibiotics. A most prevalent indications for the use of ABDs were acute bronchitis (46%), fever-cough (32%), pneumonia (30%), convulsion (30%) diarrhoea (23%). All the ABDs were widely prescribed by brand name over generic name in the parenteral dosage form and cephalosporins (41.44%), aminoglycoside (32.75%), penicillin derivatives (17.81) were remained the prefer choice for pediatric patients. The prescribing from National List of Essential Medicine (NLEM-2011) was found to be (80.49%). The average cost of drug per prescription was INR 291.77, while cost spent on injection 65.44%. A wide spectrum of clinical disorder was noticed in the pediatric patients below 5 years. More number of ABDs were prescribed by parenteral route from NLEM list, showing good essentiality....
Intra-abdominal pressure (IAP) is seldom measured by default in intensive care patients. This review summarises the\r\ncurrent evidence on the prevalence and risk factors of intra-abdominal hypertension (IAH) to assist the decisionmaking\r\nfor IAP monitoring.\r\nIAH occurs in 20% to 40% of intensive care patients. High body mass index (BMI), abdominal surgery, liver\r\ndysfunction/ascites, hypotension/vasoactive therapy, respiratory failure and excessive fluid balance are risk factors of\r\nIAH in the general ICU population. IAP monitoring is strongly supported in mechanically ventilated patients with\r\nsevere burns, severe trauma, severe acute pancreatitis, liver failure or ruptured aortic aneurysms. The risk of\r\ndeveloping IAH is minimal in mechanically ventilated patients with positive end-expiratory pressure < 10 cmH2O,\r\nPaO2/FiO2 > 300, and BMI < 30 and without pancreatitis, hepatic failure/cirrhosis with ascites, gastrointestinal\r\nbleeding or laparotomy and the use of vasopressors/inotropes on admission. In these patients, omitting IAP\r\nmeasurements might be considered.\r\nIn conclusions, clear guidelines to select the patients in whom IAP measurements should be performed cannot be\r\ngiven at present. In addition to IAP measurements in at-risk patients, a clinical assessment of the signs of IAH\r\nshould be a part of every ICU patient�s bedside evaluation, leading to prompt IAP monitoring in case of the\r\nslightest suspicion of IAH development....
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