Self-reported adherence to pharmacotherapy in cancer patients

Background: Medication adherence is a challenging issue. Non-adherence has been found to be associated with increased healthcare costs. Pharmacological anticancer therapies are increasingly shifting to oral medications. Oral therapy is more convenient and easier to administer but various issues are related to oral anticancer therapy, the prominent one being adherence.Methods: Single group, non-randomized, self-report study conducted from December, 2019 to February, 2020 in SKIMS Hospital, Kashmir. A novel medication adherence scale, General Medication Adherence Scale (GMAS) was used to assess the adherence.Results: The study population consists of 58.7% males and 41.3% females. 54.7% patients were illiterate and 45.3% patients were literate. 13.3% patients received one drug, 14.7% two drugs, 40.0% three drugs, and 32.0% received more than three drugs. 13.3% patients had poor, 9.3% low, 42.7% partial, 12.0% good and 22.7% high adherence. In low income group, 6.7% patients had poor, 6.7% low, 13.3% partial, 26.7% good and 46.7% high adherence. Among middle income group, 10.0% patients had poor, 10.0% low, 53.3% partial, 10.0% good and 16.7% high adherence. In high income group, 20.0% patients had poor, 10.0% low, 46.7% partial, 6.7% good and 16.7% high adherence.Conclusions: Most of the cancer patients were partially adherent to the prescribed medication. Various associated factors were gender, socio-economic status, literacy, and place of residence. Considerable variation in adherence was found in this study

Attitude of Undergraduate Students in Rural Colleges of Kashmir Valley towards Experiential Learning

Experiential learning, which is the process of learning through direct experience and reflection, is a core component of contemporary education system. The present study attempted to explore the attitude of undergraduate students in rural degree colleges of Kashmir valley in the state of Jammu & Kashmir, towards experiential learning. Altogether, 150 undergraduate students pursuing bachelor’s programme in various rural government degree colleges, were identified for the study through randomization. The 25 item- questionnaire was administered to measure the attitude towards experiential learning. Various statistical techniques and graphical representations such as mean, standard deviation, percentage, 2x2 factorial design were employed. The study established that attitude towards experiential learning differs significantly with respect to gender and academic stream among the undergraduate students

Assessment of medication adherence among patients with chronic diseases: a descriptive cross-sectional study

Background: Adherence is a key factor associated with effectiveness of all pharmacological therapies. Medication non-adherence is a significant barrier to achieve positive health outcomes especially for patients suffering from chronic diseases. Improving medication adherence is a public health priority and could reduce economic and health burdens. The aim of the present study was to assess medication adherence to some common chronic ailments.Methods: Pre-validated questionnaires were distributed among 300 patients suffering from chronic illnesses, by simple randomization out of which 240 patients returned completely filled questionnaires. The analysis was done by manual calculators, VassarStats, and SPSS V20. Results were calculated using univariate linear regression, with each patient’s adherence score as the dependent variable and each predictor as the independent variable. Results are expressed in frequencies and percentages.Results: In this study, 46.66% patients were males and 53.33% females. The mean age was 56.69 years ranging from 24 to 90 years.65.00% patients were uneducated.40.00% were taking one drug, 53.33% two to four drugs and 6.66% more than four drugs. 63.33% had low medication adherence, 35.00% medium and only 1.66% had high adherence. Compared to 14.28% men, 43.75% women were moderately adherent to medications. 41.02% uneducated patients had medium adherence as compared to 14.28% educated patients. 92.30% young patients had low adherence as compared to 53.25% in adults. 44.79% of patients receiving a single drug had medium adherence as compared to 25.00% in those receiving multiple drugs. Linear regression analysis demonstrated that the level of medication adherence was associated with patient gender, age, educational level, and number of prescribed drugs.Conclusions: There are many challenges in understanding the reasons for non-adherence. In this study medication adherence in chronic diseases was found suboptimal and associated with patient`s socio-demographic characteristics. Patient-tailored interventions are required to achieve sufficient adherence to therapeutic drug regimens

Attitude of Undergraduate Students in Rural Colleges of Kashmir Valley towards Experiential Learning

Experiential learning, which is the process of learning through direct experience and reflection, is a core component of contemporary education system. The present study attempted to explore the attitude of undergraduate students in rural degree colleges of Kashmir valley in the state of Jammu & Kashmir, towards experiential learning. Altogether, 150 undergraduate students pursuing bachelor’s programme in various rural government degree colleges, were identified for the study through randomization. The 25 item- questionnaire was administered to measure the attitude towards experiential learning. Various statistical techniques and graphical representations such as mean, standard deviation, percentage, 2x2 factorial design were employed. The study established that attitude towards experiential learning differs significantly with respect to gender and academic stream among the undergraduate students

Comparative study to evaluate the effect of colloid coloading versus crystalloid coloading for prevention of spinal anaesthesia induced hypotension and effect on fetal Apgar score in patients undergoing elective lower segment caesarean section: a prospective observational study

Background: Spinal anesthesia for LSCS has a high incidence of maternal hypotension which can be severe and disastrous for the fetus and the mother. Coloading in these patients is a physiologically more appropriate method for preventing spinal anesthesia induced hypotension.Methods: 100 ASA I patients for elective LSCS were randomly divided into two equal groups to either receive 1000ml colloid (6% Hetastarch) or 1000ml crystalloids (Ringer lactate) as coload. NIBP, heart rate SPO2 and incidence of nausea and vomiting and use of ephedrine to treat any hypotension was recorded. Fetal outcome was measured using APGAR score at 0, 1 and 5 minutes.Results: The incidence of hypotension was lesser with colloid coload group (41.7%) as compared to the crystalloid coload group (58.3%) but the difference between the two groups was statistically insignificant. Similarly, no statistically significant difference was noted in the incidence of nausea and vomiting and Fetal APGAR score between the two groups.Conclusions: Both Colloid and Crystalloid coloading is effective in decreasing the incidence of spinal anesthesia induced hypotension during LSCS with lesser incidence of hypotension and nausea vomiting with colloid coloading

Effectiveness of sodium thiopentone, propofol, and etomidate as an ideal intravenous anesthetic agent for modified electroconvulsive therapy

Introduction: Electroconvulsive therapy (ECT) is a well-established psychiatric treatment in which seizures are electrically induced in patients for therapeutic effects. ECT can produce severe disturbances in the cardiovascular system and a marked increase in cerebral blood flow and intracranial pressure. These cardiovascular changes may be altered using various anesthetic drugs. Aim and Objectives: This study was undertaken to compare the effects of intravenous (IV) sodium thiopentone, propofol, and etomidate, used as IV anesthetic agents in modified ECT as regards, induction time and quality of anesthesia, alteration of hemodynamics, seizure duration, and recovery time. Materials and Methods: A total of 90 patients in the age group of 16–60 years of either sex, who had to undergo ECT therapy were divided randomly into three equal groups. Group A received propofol 1% - 1.5 mg/Kg, Group B received etomidate - 0.2 mg/Kg, and Group C received thiopentone 2.5% - 5 mg/Kg. All the patients were monitored for changes in heart rate, systolic blood pressure, diastolic blood pressure, and oxygen saturation at basal, after induction and 1 min, 2 min, 3 min, 5 min, 10 min, 20 min, and 30 min following ECT. Quality of anesthesia, seizure duration, and recovery times were also recorded. Conclusion: We found that propofol had the advantage of smooth induction, stable hemodynamic parameters and rapid recovery as compared to etomidate and thiopentone. Thiopentone had the advantage over propofol of having longer seizure duration at the cost of a relatively prolonged recovery period. Etomidate had a definite advantage of longer seizure duration

Comparative study to evaluate the effect of colloid coloading versus crystalloid coloading for prevention of spinal anaesthesia induced hypotension and effect on fetal Apgar score in patients undergoing elective lower segment caesarean section: a prospective observational study

Background: Spinal anesthesia for LSCS has a high incidence of maternal hypotension which can be severe and disastrous for the fetus and the mother. Coloading in these patients is a physiologically more appropriate method for preventing spinal anesthesia induced hypotension.Methods: 100 ASA I patients for elective LSCS were randomly divided into two equal groups to either receive 1000ml colloid (6% Hetastarch) or 1000ml crystalloids (Ringer lactate) as coload. NIBP, heart rate SPO2 and incidence of nausea and vomiting and use of ephedrine to treat any hypotension was recorded. Fetal outcome was measured using APGAR score at 0, 1 and 5 minutes.Results: The incidence of hypotension was lesser with colloid coload group (41.7%) as compared to the crystalloid coload group (58.3%) but the difference between the two groups was statistically insignificant. Similarly, no statistically significant difference was noted in the incidence of nausea and vomiting and Fetal APGAR score between the two groups.Conclusions: Both Colloid and Crystalloid coloading is effective in decreasing the incidence of spinal anesthesia induced hypotension during LSCS with lesser incidence of hypotension and nausea vomiting with colloid coloading

Water as monomer: Synthesis of an aliphatic polyethersulfone from divinyl sulfone and water

Using water as monomer in polymerization reactions presents a unique and exquisite strategy towards more sustainable chemistry. Herein, the feasibility thereof is demonstrated by the introduction of the oxa-Michael polyaddition of water and divinyl sulfone. Upon nucleophilic or base catalysis, the corresponding aliphatic polyethersulfone is obtained in an interfacial polymerization at room temperature in high yield (> 97%) within an hour. The polyethersulfone is characterized by relatively high molar mass averages and a dispersity around 2.5. The polymer was tested as a solid polymer electrolyte with lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) as salt. Free standing amorphous membranes were prepared by a melt process in a solvent free manner. The polymer electrolyte containing 15 wt.% LiTFSI featured an oxidation stability of up to 5.5 V vs. Li/Li+ at 45 °C and a conductivity of 1.45 × 10-8 S/cm at room temperature