Drug promotional literature: Does pharmaceutical industry follow WHO guidelines?

Background: Promotional literature is an important tool for both pharmaceutical industry (marketing strategy) and physicians (up to date knowledge). Important ways of doing drug promotion are visual aids, leave behind, flip charts. World Health Organisation has laid down criteria for drug promotional literature.Methods: A cross sectional observational study was performed in Department of Pharmacology, Tertiary Care Teaching Hospital of Mumbai. Total 137 drug promotional Literatures were randomly collected from different outpatient departments out of which 37 were excluded. 100 drug promotional literatures were evaluated by using WHO guidelines.Results: None of drug promotional literature fulfilled all WHO criteria. Though name of the active ingredient and brand name featured in 100% of the literature, 69% of them lacked information related to adverse drug reactions, precautions, contraindications and warnings. The approved therapeutic uses were mentioned in 96% but the dosage regimen in 38% only. Majority of the literature (80%) did not mention the drug interactions. References were given in 76% of the literature of which 87% were from journal article.Conclusions: Pharmaceutical industries do not follow WHO guidelines in toto to promote their product. Thus more strict regulations need to be implemented for proper promotion and dissemination of information about new drugs

Subnatural linewidth using electromagnetically induced transparency in Doppler-broadened vapor

We obtain subnatural linewidth (i.e. $<\Gamma$) for probe absorption in room-temperature Rb vapor using electromagnetically induced transparency (EIT) in a $\Lambda$ system. For stationary atoms, the EIT dip for a resonant control laser is as wide as the control Rabi frequency $\Omega_c$. But in thermal vapor, the moving atoms fill the transparency band so that the final EIT dip remains subnatural even when $\Omega_c > \Gamma$. We observe linewidths as small as $\Gamma/7$ in the $D_2$ line of Rb.Comment: 6 pages, 7 figure

Enabling Automated, Rich, and Versatile Data Management for Android Apps with BlueMountain

Abstract Today&apos;s mobile apps often leverage cloud services to manage their own data as well as user data, enabling many desired features such as backup and sharing. However, this comes at a cost; developers have to manually craft their logic and potentially repeat a similar process for different cloud providers. In addition, users are restricted to the design choices made by developers; for example, once a developer releases an app that uses a particular cloud service, it is impossible for a user to later customize the app and choose a different service. In this paper, we explore the design space of an app instrumentation tool that automatically integrates cloud storage services for Android apps. Our goal is to allow developers to treat all storage operations as local operations, and automatically enable cloud features customized for individual needs of users and developers. We discuss various scenarios that can benefit from such an automated tool, challenges associated with the development of it, and our ideas to address these challenges

Temporal Patterns of Medications Dispensed to Children and Adolescents in a National Insured Population

This study aimed to comprehensively describe prevalence and temporal dispensing patterns for medications prescribed to children and adolescents in the United States. Participants were 1.6 million children (49% female) under 18 years old enrolled in a nation-wide, employer-provided insurance plan. All medication claims from 1999–2006 were reviewed retrospectively. Drugs were assigned to 16 broad therapeutic categories. Effects of trend over time, seasonality, age and gender on overall and within category prevalence were examined. Results: Mean monthly prevalence for dispensed medications was 23.5% (range 19.4–27.5), with highest rates in winter and lowest in July. The age group with the highest prevalence was one-year-old children. On average each month, 17.1% of all children were dispensed a single drug and 6.4% were dispensed two or more. Over time, prevalence for two or more drugs did not change, but the proportion of children dispensed a single drug decreased (slope -.02%, p = .001). Overall, boys had higher monthly rates than girls (average difference 0.9%, p = .002). However, differences by gender were greatest during middle childhood, especially for respiratory and central nervous system agents. Contraceptives accounted for a large proportion of dispensed medication to older teenage girls. Rates for the drugs with the highest prevalence in this study were moderately correlated (average Pearson r.66) with those from a previously published national survey. Conclusion: On average, nearly one quarter of a population of insured children in the United States was dispensed medication each month. This rate decreased somewhat over time, primarily because proportionally fewer children were dispensed a single medication. The rate for two or more drugs dispensed simultaneously remained steady

A pragmatic cluster randomized trial evaluating the impact of a community pharmacy intervention on statin adherence: rationale and design of the Community Pharmacy Assisting in Total Cardiovascular Health (CPATCH) study

<p>Abstract</p> <p>Background</p> <p>Traditional randomized controlled trials are considered the gold standard for evaluating the efficacy of a treatment. However, in adherence research, limitations to this study design exist, especially when evaluating real-world applicability of an intervention. Although adherence interventions by community pharmacists have been tested, problems with internal and external validity have limited the usefulness of these studies, and further well-designed and well-conducted research is needed. We aimed to determine the real-world effectiveness of a community pharmacy adherence intervention using a robust study design. This novel design integrates cluster randomization and an outcome evaluation of medication adherence using a population-based administrative data source in the province of Saskatchewan, Canada.</p> <p>Methods/Design</p> <p>Community pharmacies from across the province of Saskatchewan, Canada were randomized to deliver an adherence intervention to their patients or usual care. Intervention pharmacies were trained to employ a practical adherence strategy targeted at new users of statin medications. While randomization and implementation of the intervention occurred at the community pharmacy level, the outcome analysis will occur at the level of the individual subjects. The primary outcome is the mean statin adherence among all eligible new users of statin medications. Secondary outcomes include the proportion of new statin users who exhibit adherence ≥80%, and persistence with statin use.</p> <p>Discussion</p> <p>This novel study design was developed to combine the rigor of a randomized trial with a pragmatic approach to implementing and capturing the results in a real-world fashion. We believe this approach can serve as an example for future study designs evaluating practice-based adherence interventions.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov no. NCT00971412.</p

A Methodological Perspective on Genetic Risk Prediction Studies in Type 2 Diabetes: Recommendations for Future Research

Fueled by the successes of genome-wide association studies, numerous studies have investigated the predictive ability of genetic risk models in type 2 diabetes. In this paper, we review these studies from a methodological perspective, focusing on the variables included in the risk models as well as the study designs and populations investigated. We argue and show that differences in study design and characteristics of the study population have an impact on the observed predictive ability of risk models. This observation emphasizes that genetic risk prediction studies should be conducted in those populations in which the prediction models will ultimately be applied, if proven useful. Of all genetic risk prediction studies to date, only a few were conducted in populations that might be relevant for targeting preventive interventions

Malonylation of GAPDH is an inflammatory signal in macrophages.

Macrophages undergo metabolic changes during activation that are coupled to functional responses. The gram negative bacterial product lipopolysaccharide (LPS) is especially potent at driving metabolic reprogramming, enhancing glycolysis and altering the Krebs cycle. Here we describe a role for the citrate-derived metabolite malonyl-CoA in the effect of LPS in macrophages. Malonylation of a wide variety of proteins occurs in response to LPS. We focused on one of these, glyceraldehyde-3-phosphate dehydrogenase (GAPDH). In resting macrophages, GAPDH binds to and suppresses translation of several inflammatory mRNAs, including that encoding TNFα. Upon LPS stimulation, GAPDH undergoes malonylation on lysine 213, leading to its dissociation from TNFα mRNA, promoting translation. We therefore identify for the first time malonylation as a signal, regulating GAPDH mRNA binding to promote inflammation

How to screen for non-adherence to antihypertensive therapy

The quality of assessment of non-adherence to treatment in hypertensive is poor. Within this review, we discuss the different methods used to assess adherence to blood-pressure-lowering medications in hypertension patients. Subjective reports such as physicians’ perceptions are inaccurate, and questionnaires completed by patients tend to overreport adherence and show a low diagnostic specificity. Indirect objective methods such as pharmacy database records can be useful, but they are limited by the robustness of the recorded data. Electronic medication monitoring devices are accurate but usually track adherence to only a single medication and can be expensive. Overall, the fundamental issue with indirect objective measures is that they do not fully confirm ingestion of antihypertensive medications. Detection of antihypertensive medications in body fluids using liquid chromatography–tandem mass spectrometry is currently, in our view, the most robust and clinically useful method to assess non-adherence to blood-pressure-lowering treatment. It is particularly helpful in patients presenting with resistant, refractory or uncontrolled hypertension despite the optimal therapy. We recommend using this diagnostic strategy to detect non-adherence alongside a no-blame approach tailoring support to address the perceptions (e.g. beliefs about the illness and treatment) and practicalities (e.g. capability and resources) influencing motivation and ability to adhere