Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus : A Cost-Utility Analysis

Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.OBJECTIVES: To assess the cost-effectiveness of basal insulin regimens for adults with type 1 diabetes mellitus in England. METHODS: A cost-utility analysis was conducted in accordance with the National Institute for Health and Care Excellence reference case. The UK National Health Service and personal and social services perspective was used and a 3.5% discount rate was applied for both costs and outcomes. Relative effectiveness estimates were based on a systematic review of published trials and a Bayesian network meta-analysis. The IMS CORE Diabetes Model was used, in which net monetary benefit (NMB) was calculated using a threshold of £20,000 per quality-adjusted life-year (QALY) gained. A wide range of sensitivity analyses were conducted. RESULTS: Insulin detemir (twice daily) [iDet (bid)] had the highest mean QALY gain (11.09 QALYs) and NMB (£181,456) per patient over the model time horizon. Compared with the lowest cost strategy (insulin neutral protamine Hagedorn once daily), it had an incremental cost-effectiveness ratio of £7844/QALY gained. Insulin glargine (od) [iGlarg (od)] and iDet (od) were ranked as second and third, with NMBs of £180,893 and £180,423, respectively. iDet (bid) remained the most cost-effective treatment in all the sensitivity analyses performed except when high doses were assumed (>30% increment compared with other regimens), where iGlarg (od) ranked first. CONCLUSIONS: iDet (bid) is the most cost-effective regimen, providing the highest QALY gain and NMB. iGlarg (od) and iDet (od) are possible options for those for whom the iDet (bid) regimen is not acceptable or does not achieve required glycemic control.Peer reviewe

Dermal Filler types, Effect on soft tissue and Life Style correlation

One of the most common manifestation in our time, especially among girls, is those procedures on the skin or maintaining or to modify some of the changes in the skin, such as those that come due to aging or any other cosmetic reasons. Fillers and Botox are two of the most popular procedures. Dermal fillers are effective treatments used to soften and reduce wrinkles and deep lines, fill out the cheeks and smooth facial contours. There are four main types of injectable dermal fillers, including fat, collagen, hyaluronic acid, and microsphere-containing carriers of another material such as polymethyl methacrylate (PMMA). So that to understand any type of injection, it is important to look at its history for valuable lessons and for successful progress. Honestly, it is very interesting to see what and where the world gets in the last 40 years of injectable. Today, we will be examining the brief history of dermal fillers from their bovine collagen roots, to the advanced fillers that are available today. In this review, we aimed to show some types of dermal fillers including a variety of its complication in soft tissue. Also, we try to correlate the factor of lifestyle  with its variant effects

Sleep Quality and Its Health Correlates Among Egyptian Secondary School Students

The objective of the recent study was to determine the prevalence of poor sleep quality and to assess its psychological and general health correlates among secondary school students in the city of Assiut, Egypt. A cross sectional study was conducted among 829 secondary school students (selected by multistage stratified random sampling) aged 15–19 years in Assiut. Students filled in a self-administered questionnaire that included demographic data, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, general perception of health, and the short form of Depression Anxiety and Stress Scale. The prevalence of poor sleep quality (PSQI \u3e5) was 72.5%. The mean PSQI score was 7.35 ± 2.94 standard deviation. Poor sleep quality was higher among females, urban residents and public school students. Correlates of poor sleep by multivariate analysis were age, urban residence, public education, mild to moderate and severe to very severe anxiety symptoms, severe to very severe depressive symptoms, excessive daytime sleepiness, and feeling fully active sometimes and not active at any time. Poor sleep quality was alarmingly highly prevalent among secondary school students, with significant health consequences. Increasing the awareness of the community especially adolescents, parents, and school teachers about healthy sleep is an essential priority

Stage-specific, Nonlinear Surface Ozone Damage to Rice Production in China.

China is one of the most heavily polluted nations and is also the largest agricultural producer. There are relatively few studies measuring the effects of pollution on crop yields in China, and most are based on experiments or simulation methods. We use observational data to study the impact of increased air pollution (surface ozone) on rice yields in Southeast China. We examine nonlinearities in the relationship between rice yields and ozone concentrations and find that an additional day with a maximum ozone concentration greater than 120 ppb is associated with a yield loss of 1.12% ± 0.83% relative to a day with maximum ozone concentration less than 60 ppb. We find that increases in mean ozone concentrations, SUM60, and AOT40 during panicle formation are associated with statistically significant yield losses, whereas such increases before and after panicle formation are not. We conclude that heightened surface ozone levels will potentially lead to reductions in rice yields that are large enough to have implications for the global rice market

Quality of life among parents of children with heart disease

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Egyptian students’ guardians knowledge, attitude and predictors of negative attitude of epilepsy in Assiut city

AbstractBackgroundEpilepsy is very prevalent in Egypt, approaching 6.98 per 1000 population. This study was designed to assess the knowledge and attitudes towards epilepsy among guardians of Egyptian high school students.MethodsA cross-sectional study was made among guardians (parents/guardians) of high school students in Assiut city, Egypt. A 15-item questionnaire was self-administered by 1257 students’ guardians who were randomly selected.ResultsAll recruited parents/guardians of high school students had heard about epilepsy. Families with a patient with epilepsy (PWE) had significantly better information about epilepsy and its aetiology than other families. The predictors of negative attitudes towards PWE were: age group ranging from 40 to 49years, no work, skilled work, male sex and incorrect knowledge.ConclusionHaving a patient with epilepsy is a predictor to having greater knowledge and a better attitude towards epilepsy. However, people still have a concept that PWE are stigmatized and are different from others. Raising awareness about epilepsy and its aetiology will increase the knowledge and improve the attitudes towards PWE

CARDIOVASCULAR RISK SCREENING SERVICES IN SUDANESE COMMUNITY PHARMACIES

Objectives: The objective of this study was to investigate the Sudanese community pharmacists' knowledge and practice of cardiovascular disease risk assessment services.Methods: The study was conducted as a non-interventional, descriptive, cross sectional community-pharmacy based survey.Results: The Response rate was 91%. The obese and the elderly received the highest ratings for cardiovascular disease risk assessment. Hypertension, type 1 and type 2 diabetes mellitus and ages >55 and 36-55 years were mostly targeted for screening. Variable responses were reported regarding the type of fasting lipid profile that is screened. One third of the participants claimed to have screening evaluation forms. Most participants had the appropriate equipment for screening but only a few had cholesterol measures. Only 27% reported the use of cardiovascular risk charts or calculator for the evaluation. Overwhelming majority had no documentation records and the most available reference was the BNF.Conclusion: The current knowledge and practice of cardiovascular disease risk assessment is poor and need fundamental development. Community pharmacy practice in the Sudan is still product oriented. These services were provided by respondents on voluntary bases without full knowledge or appropriate training on proper assessment and evaluation of the risks that they measured. This needs to change if pharmacy's potential is to be reached. Collaboration between health authorities and universities is essential to acknowledge the new roles of the pharmacist and provide the appropriate knowledge and training needed to promote and implement the change process that is required

Passive Components for Ultra-Wide Band (UWB) Applications

UWB technology brings the convenience and mobility of wireless communications to very high-speed interconnects in the home and office due to the precision capabilities combined with the low power. This makes it ideal for certain radio frequency sensitive environments such as hospitals and healthcare as well as radars. UWB intrusion-detection radar is used for detecting through the wall and also used for security with fuse avoidance radar, precision locating and tracking (using distance measurements between radios), and precision time-of-arrival-based localization approaches. The FCC issued a ruling in 2002 that allowed intentional UWB emissions in the frequency range between 3.1 and 10.6 GHz, subject to certain restrictions for the emission power spectrum. Other definitions for ultra-wideband range of frequency are also used such as any device that has 500 MHz bandwidth or fractional bandwidth greater than 25% is considered an UWB enable high data rate to be transferred with a very low power that does not exceed −41.3 dBm

Equilibrium modeling, kinetic and thermodynamic studies on the adsorption of basic dye by low-cost adsorbent

In this study, the removal of methylene blue (MB) dye from aqueous solutions using low-cost material as adsorbent by a batch system was investigated. Experiments were carried out as a function of contact time, initial concentration (50-300 mg/L), pH (2-12) and temperature (303-323K). The equilibrium adsorption of MB dye on petai (Parkia speciosa) seed adsorbent was analyzed by Langmuir and Freundlich models. The results indicate that the Freundlich model provides the best correlation of the experimental data. The adsorption capacities of the petai seed adsorbent for removal of MB dye was determined with the Langmuir equation and found to be 91.74, 94.34 and 100.03 mg/g at 303, 313, and 323 K, respectively. The kinetic data was found to follow closely the pseudo-second-order model. Various thermodynamic parameters such as enthalpy (ΔH°), entropy (ΔS°) and free energy (ΔG°) were evaluated. The positive value of the enthalpy change (17.89 kJ/mol) indicates that the adsorption is endothermic process. The results indicate that petai seed adsorbent is suitable as adsorbent material for adsorption of MB dye from aqueous solutions