DRUG UTILIZATION PATTERN IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE INPATIENTS AT A TERTIARY CARE HOSPITAL

Objective: Drug utilization studies provide useful insights into the current prescribing practices. In view of this, the present study was designed to establish the drug utilization pattern in hospitalized chronic obstructive pulmonary disease (COPD) patients.Methods: In this retrospective study, all patient data relevant to the study were obtained by examination of patient's medical records and hospital information system.Results: A total of 237 patients with acute exacerbation were evaluated. The population predominantly consisted of males (92.4%) and most of the patients were in the age group of 61 to 70 y (39.7%). Cough, sputum production and dyspnea were observed in 88.2%, 80.6% and 37.6% patients, respectively. Hypertension (49.4%) was the most common co-morbidity. Candida albicans (16%) and Pseudomonas aeruginosa (4.6%) were the most common microorganisms isolated from sputum samples. Majority of the patients were on multidrug therapy during both hospital stay (98.7%) and at the time of discharge (99.6%). During hospital stay, the most commonly prescribed drugs were ipratropium (91.6%) and levosalbutamol (88.2%); antibiotics and systemic corticosteroids were received by 96.2% and 83.1% patients, respectively. At discharge, antibiotics, inhaled corticosteroids, methyl xanthines, long acting beta-2 agonist and tiotropium were received by 94.1%, 93.7%, 92.4%, 86.1% and 56.5% patients, respectively.Conclusion: The prescribing trend observed at our hospital appears to be in concordance with the current guidelines for the management of COPD patients.Â

Co-design of health educational materials with people experiencing homelessness and support workers:a scoping review

Introduction: People experiencing homelessness are often marginalised and encounter structural barriers when seeking healthcare. Community-based oral health interventions highlighted the need of well-trained practitioners for the successful engagement of service users and behaviour change. However, a lack of adequate information and specific training has been previously reported. The adoption of inclusive approaches, such as co-design, to develop tailored and meaningful health promotion training and educational materials capable of addressing the specific needs of this group is required. Co-design entails active involvement of different groups in research processes that acknowledge participants’ needs and expectations. This scoping review aims to identify the available literature on the participation of people experiencing homelessness and/or their support workers in co-designing health and oral health promotion training/educational materials, approaches adopted, and barriers and enablers to develop these materials.Methods: The Joanna Briggs Institute (JBI) Scoping Review Methodology informed the development of the scoping review. The protocol was registered on the Open Science Framework. Six electronic databases (Medline (OVID), PsychInfo (OVID), Scopus, Web of Science, Applied Social Sciences Index and Abstracts (ASSIA) (ProQuest) and CINHAL) were systematically searched using MeSH terms. An extensive grey literature search, consultation with experts and hand searching of reference lists took place. Records were screened independently and in duplicate using the Rayyan Qatar Computing Research Institute (QCRI) online tool, followed by qualitative content analysis involving descriptive data coding.Results: Eight studies/materials were included. Key approaches adopted to codesign, enablers and barriers were captured. The enablers were inclusivity, a safe environment for positive participation, empowerment and flexibility, the barriers were difficulty in recruiting and sustaining participation, power differentials, and limited resources.Conclusion: The evidence in this area is limited. This scoping review provided foundations for further research to examine the impact of different components of the co-design process including the environment in which the co-design process is conducted. Further studies with experimental design and reported using appropriate study design frameworks detailing active components of the co-design process would strengthen the evidence base in this area

Evaluation of physico-mechanical properties of dental plaster modified with pulverized acrylic waste

Background: Dental plaster is most widely used to make temporary casts and as an investment medium during the fabrication of removable complete and partial denture prostheses. Dental plasters exhibit poor mechanical properties. Aim: This study aimed to evaluate the physico-mechanical properties of dental plaster modified with various concentrations of pulverized acrylic waste. Materials and Methods: A total of 120 specimens were fabricated using dental plaster and were divided into four groups of 30 specimens each to evaluate setting time, one-hour compressive strength, 24-hour compressive strength, and surface reproducibility. Each group was subdivided into five groups of six specimens (n=6), each with the incorporation of various concentrations of pulverized acrylic powder. The specimens incorporated with various concentrations of pulverized acrylic powder (0.5 wt%, 1.0 wt%, 5.0 wt% and 10.0 wt%) were considered as modified groups and the dental plaster with no additives was considered as a control group. The initial and final setting times were measured using a Gillmore needle apparatus, the compressive strength was measured using a universal testing machine, and the surface reproducibility was analyzed using a stereo microscope. The obtained data were subjected to statistical analysis using one-way ANOVA and post hoc analysis.   Results: The incorporation of 0.5 wt% resulted in more final and initial setting times. The one-hour and 24-hour compressive strengths of the dental plaster increased with increasing concentration of acrylic waste. Poor surface details were observed with an increase in the concentration of acrylic waste. Conclusions: The addition of acrylic waste resulted in an increase in the one-hour and 24-hour compressive strengths, decreased initial and final setting times, and poor surface reproducibility

Incidence rate trends of histological subtypes of nasopharyngeal carcinoma in Hong Kong

The overall decline in incidence rate of nasopharyngeal carcinoma in Hong Kong during 1988–2002 was limited primarily to a decrease in keratinising carcinoma, which could be explained by the decline in cigarette smoking. Genetic and Epstein–Barr virus interactions may explain the relatively stable incidence rate of non-keratinising carcinoma

Genetic Affinities within a Large Global Collection of Pathogenic Leptospira: Implications for Strain Identification and Molecular Epidemiology

Leptospirosis is an important zoonosis with widespread human health implications. The non-availability of accurate identification methods for the individualization of different Leptospira for outbreak investigations poses bountiful problems in the disease control arena. We harnessed fluorescent amplified fragment length polymorphism analysis (FAFLP) for Leptospira and investigated its utility in establishing genetic relationships among 271 isolates in the context of species level assignments of our global collection of isolates and strains obtained from a diverse array of hosts. In addition, this method was compared to an in-house multilocus sequence typing (MLST) method based on polymorphisms in three housekeeping genes, the rrs locus and two envelope proteins. Phylogenetic relationships were deduced based on bifurcating Neighbor-joining trees as well as median joining network analyses integrating both the FAFLP data and MLST based haplotypes. The phylogenetic relationships were also reproduced through Bayesian analysis of the multilocus sequence polymorphisms. We found FAFLP to be an important method for outbreak investigation and for clustering of isolates based on their geographical descent rather than by genome species types. The FAFLP method was, however, not able to convey much taxonomical utility sufficient to replace the highly tedious serotyping procedures in vogue. MLST, on the other hand, was found to be highly robust and efficient in identifying ancestral relationships and segregating the outbreak associated strains or otherwise according to their genome species status and, therefore, could unambiguously be applied for investigating phylogenetics of Leptospira in the context of taxonomy as well as gene flow. For instance, MLST was more efficient, as compared to FAFLP method, in clustering strains from the Andaman island of India, with their counterparts from mainland India and Sri Lanka, implying that such strains share genetic relationships and that leptospiral strains might be frequently circulating between the islands and the mainland

Can Global Variation of Nasopharynx Cancer Be Retrieved from the Combined Analyses of IARC Cancer Information (CIN) Databases?

BACKGROUND: The international nasopharynx cancer (NPC) burdens are masked due to the lack of integrated studies that examine epidemiological data based on up-to-date international disease databases such as the Cancer Information (CIN) databases provided by the International Agency for Research on Cancer (IARC). METHODS: By analyzing the most recently updated NPC epidemiological data available from IARC, we tried to retrieve the worldwide NPC burden and patterns from combined analysis with GLOBOCAN2008 and the Cancer Incidence in Five Continents (CI5) databases. We provide age-standardized rates (ASR) for NPC mortality in 20 highest cancer registries from GLOBOCAN2008 and the World Health Organization (WHO) mortality databases, respectively. However, NPC incidence data can not be retrieved since it is not individually listed in CI5 database. The trend of NPC mortality was investigated with Joinpoint analysis in the selected countries/regions with high ASR. RESULTS: GLOBOCAN 2008 revealed that the highest NPC incidence rates in 2008 were in registries from South-Eastern Asia, Micronesia and Southern Africa with Malaysia, Indonesia and Singapore ranking the top 3. WHO mortality database analysis revealed that China Hong Kong, Singapore and Malta ranks the top 3 regions with the highest 5-year mortality rates. CONCLUSIONS: NPC mortality rate is about 2-3 times higher in male than that in female, and shows decrease tendency in those selected countries/regions during the analyzed periods. However, the integrated analyses of the current IARC CIN databases may not be suitable to retrieve epidemiological data of NPC. Much effort is required to improve the local cancer entry and regional death-reporting systems so as to aid similar studies

Effect of Wood-derived Charcoal Content on Properties of Wood Plastic Composites

The effect of wood-derived charcoal flour on the water resistance and mechanical properties of wood plastic composite (WPC) panels was investigated. The hot press molded WPC panels were produced from polypropylene (37 wt%) with maleic anhydride-grafted polypropylene (MAPP, 3 wt%) and different mixtures of wood flour and charcoal flour. The amount of charcoal flour was gradually increased up to 60 wt%. The thickness swelling and water absorption of WPC panels considerably decreased with increasing charcoal flour content. The internal bond strength and bending properties of the WPC panels significantly improved with increasing charcoal flour content. This was mainly attributed to the high amount of pores and gaps in the charcoal flour. Melted polypropylene could get into the pores and gaps during the hot press molding, which lead to a better interfacial adhesion between polymer matrix and wood filler. The results showed that the charcoal flour could be partially substituted for the wood flour in the production of WPC panels having higher dimensional stability and internal bond strength

Can Global Variation of Nasopharynx Cancer Be Retrieved from the Combined Analyses of IARC Cancer Information (CIN) Databases?

BACKGROUND: The international nasopharynx cancer (NPC) burdens are masked due to the lack of integrated studies that examine epidemiological data based on up-to-date international disease databases such as the Cancer Information (CIN) databases provided by the International Agency for Research on Cancer (IARC). METHODS: By analyzing the most recently updated NPC epidemiological data available from IARC, we tried to retrieve the worldwide NPC burden and patterns from combined analysis with GLOBOCAN2008 and the Cancer Incidence in Five Continents (CI5) databases. We provide age-standardized rates (ASR) for NPC mortality in 20 highest cancer registries from GLOBOCAN2008 and the World Health Organization (WHO) mortality databases, respectively. However, NPC incidence data can not be retrieved since it is not individually listed in CI5 database. The trend of NPC mortality was investigated with Joinpoint analysis in the selected countries/regions with high ASR. RESULTS: GLOBOCAN 2008 revealed that the highest NPC incidence rates in 2008 were in registries from South-Eastern Asia, Micronesia and Southern Africa with Malaysia, Indonesia and Singapore ranking the top 3. WHO mortality database analysis revealed that China Hong Kong, Singapore and Malta ranks the top 3 regions with the highest 5-year mortality rates. CONCLUSIONS: NPC mortality rate is about 2-3 times higher in male than that in female, and shows decrease tendency in those selected countries/regions during the analyzed periods. However, the integrated analyses of the current IARC CIN databases may not be suitable to retrieve epidemiological data of NPC. Much effort is required to improve the local cancer entry and regional death-reporting systems so as to aid similar studies

Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period