A study to evaluate the impact of patient counselling on the quality of life of female patients with recurrent urinary tract infection

Background: Recurrence of urinary tract infections (UTI) are either due to re infection or relapse. Overall likelihood of developing UTI is approximately 30 times higher in women than men due to their anatomical peculiarities and are normally treated with antibiotics. To evaluate effectiveness of patient counselling in prevention of recurrent UTI in female patients to reduce the risk of developing Antibiotic resistance and assess the quality of life of patients.Methods: A prospective observational study was carried out for a period of 6 months and samples were taken from the urology department of cosmopolitan hospital, Trivandrum, Kerala. Patient counseling was given regarding the disease, drugs and lifestyle modifications. A suitably validated KAP questionnaire was provided to each patient at their visits. By using an EQ-5D-5L questionnaire the quality of life of patients were assessed and analyzed.Results: 84 patients were analyzed. After the counseling knowledge level significantly improved to good from 6.9% to 72.4%, the positive attitude level was improved from 35.6 to 57.5% and the practice level was improved to good from 25.3 to 43.7%. The QOL improved to best from 1.2 to 71.4%. After counseling incidence rate was decreased to zero. The mostly observed risk factor was decreased water intake (69%). The common age group observed was 31-50 (41.7%).Conclusions: Patient counseling had an important impact on medication adherence and QOL of female patients with recurrent UTI. Effective patient counseling and better compliance decreased the incidence of recurrence and improved the quality of life of patients

A study to evaluate the efficacy of cranberry extract supplements in prevention of recurrent urinary tract infections in female patients

Background: Recurrence of urinary tract infections (UTI) are either due to re infection or relapse. Overall likelihood of developing UTI is approximately 30 times higher in women than men due to their anatomical peculiarities. The objective was to evaluate efficacy of cranberry extract supplementations in prevention of recurrent UTI in female patients, assess the quality of life of patients, medication adherence of patients and effect of patient counselling.Methods: A prospective observational study was carried out for a period of 6 months and samples were taken from the Urology Department of Cosmopolitan Hospital, Trivandrum, Kerala. The selected patients were administered with cranberry extract supplements after their regular Antibiotic therapy and were observed for recurrence for a period of six months. Three follow ups were taken and the betterment was assessed using the score from prepared proforma.Results: 84 patients were analysed and among them we observed and concluded that 86.9% of patients were free of recurrent infection. Study shows that E. coli was the commonest infectious organism causing UTI. In this study the most commonly observed symptom of UTI was lower abdominal pain and the most common co morbidity was DM.Conclusions: Through this study it was concluded that the cranberry extract supplements significantly reduced the recurrence of UTI in women. Since the antibiotic prophylaxis is having the risk of developing resistance and side effects, the cranberry extract supplements can be suggested as a best alternative to antibiotics in recurrent UTI prophylaxis

A prospective study on assessment of risk factors and impact of patient counselling in health-related quality of life of patients with coronary artery diseases

Background: Cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. The aim of the study was to determine assessment of risk factors and impact of patient counseling in health-related quality of life of the patient.Method: This was a prospective observational study conducted in the department of cardiology. A suitably designed standard SF-36 questionnaire was given to all patients enrolled in the study before and after counseling. All information relevant to the study were collected in suitably designed proforma from case records and discussions conducted with the patients and bystanders during ward rounds. Proper counseling was given to patients and bystanders and the score was analyzed using SAS descriptive analysis.Result: The most common risk factors encountered in the study are diabetes mellitus, hypertension, dyslipidemia, irregular exercise, smoking, alcoholism, obesity and family history. The health-related quality of life of the patients were assessed, a total of 67 patients QOL was improved after counseling and 27 patients with no improvement. We found that patient counseling was effective for majority of patients.Conclusions: We can conclude that the role of clinical pharmacist has a significant role in improving the health-related quality of life of patients through proper counseling. And more than half of the patients have a modifiable risk factor which can be managed through lifestyle modifications

Assessment of medication adherence in Helicobacter pylori positive patients on standard triple therapy: a prospective study

Background: In the current study patient compliance to the standard triple therapy were assessed. The objective behind this research was to assess the patient medication adherence to the standard triple therapy in Helicobacter pylori infection.Methods: A prospective study was carried out for a period of 1 year and samples were taken from the gastroenterology department. Patient who was RUT (rapid urease test) positive by endoscopy were considered as H. pylori infected and they were prescribed with standard triple therapy. This regimen involves amoxicillin 1000 mg and clarithromycin 500 mg and proton pump inhibitor (PPI) twice a day for 14 days. Adherence to this triple therapy was assessed during the study. Medication adherence assessed using Morisky, Green and Levine (MGL) adherence scale. MGL adherence questionnaire was given to patients during first week and second week of therapy. The patients will be counselled regarding the drug administration, drug related problems and the infection. They were also provided with written instructions in leaflets. 88 patients were analyzed.Results: In this study, 84 patients had a good adherence 95.5%; but other 4.5% didn't fully comply with the physician's order. After the first week of standard triple therapy, adherence was increased to a mean score from 2.193±0.1301 to 3.5227±0.0704 in the second week. The medication adherence score significantly increased along with patient counselling.Conclusions: Medication adherence was improved in the 14 days course along with patient education helped to comply with the standard triple therapy

The Repertoire of Heterotrimeric G Proteins and RGS Proteins in Ciona intestinalis

BACKGROUND:Heterotrimeric G proteins and regulators of G protein signaling (RGS) proteins are key downstream interacting partners in the G protein coupled receptor (GPCR) signaling pathway. The highly versatile GPCR transmembrane signaling system is a consequence of the coupling of a diverse set of receptors to downstream partners that include multiple subforms of G proteins and regulatory proteins including RGS proteins, among others. While the GPCR repertoire of Ciona intestinalis, representing the basal chordate is known, the repertoire of the heterotrimeric G proteins and RGS proteins is unknown. METHODOLOGY/PRINCIPAL FINDINGS:In the present study, we performed an in-silico genome-wide search of C. intestinalis for its complement of G proteins and RGS proteins. The identification of several one-to-one orthologs of human G proteins at the levels of families, subfamilies and types and of homologs of the human RGS proteins suggests an evolutionarily conserved structure function relationship of the GPCR signaling mechanism in the chordates. CONCLUSIONS:The C. intestinalis genome encodes a highly conserved, albeit, limited repertoire of the heterotrimeric G protein complexes with the size of subunit types comparable with that in lower eukaryotes

A STUDY ON THE USE OF MUSA SPECIES IN THE MANAGEMENT OF RENAL CALCULI

Objective:To study the use of Musa species in the management of renal calculi.Methods: Formulation and evaluation of Musa AAB.Results:A significant decrease in the size of kidney stone under invitro condition was observed. This is due to the presence of organic constituents like β-sitosterol, quercetin, tannins, saponins and  inorganic constituents like magnesium, potassium and nitrate. The result from these experiment demonstrate the potential of concentrated Musa AAB formulations extract was a good natural remedy against kidney stone.Conclusion:The recent treatment of urolithiasis involves NSAID's, Antidiuretics and Extracorporeal Shock Wave Lithotripsy. Recurrence is quite common with these therapies. The liquid formulation of the Musa AAB formulations may be useful to overcome the major drawback of surgical procedures which is recurrence of stones.Keywords: Allopurinol, Cystone, Kidney stones, Musa AAB , Urolithiasi

Pharmacognostical, Phytochemical Characterisation and Formulative Study of Trichodesma indicum R. Br

The aim of the proposed study was to collect the useful information of the traditional medicinal plant Trichodesma indicum and upgrade the knowledge about the plant. It belongs to family Boraginaceae. Pharmacognostic studies of plant drug are carried out for the evaluation of drug and to detect the adulteration. It includes dermal characters like stomata, trichomes and anatomical features. Phytochemical studies of this plant shows presence of steroids, triterpenoids, tannins, flavonoids, saponins etc. In the formulative studies, cream has been prepared and shows with good washability, solubility and smooth greasy texture. Ethanobotanical studies shows various uses such as anti-inflammatory, antimitotic, antioxidant, anti-diabetic etc

Thermodynamics of charged Lovelock: AdS black holes

We investigate the thermodynamic behavior of maximally symmetric charged, asymptotically AdS black hole solutions of Lovelock gravity. We explore the thermodynamic stability of such solutions by the ordinary method of calculating the specific heat of the black holes and investigating its divergences which signal second-order phase transitions between black hole states. We then utilize the methods of thermodynamic geometry of black hole spacetimes in order to explain the origin of these points of divergence. We calculate the curvature scalar corresponding to a Legendre-invariant thermodynamic metric of these spacetimes and find that the divergences in the black hole specific heat correspond to singularities in the thermodynamic phase space. We also calculate the area spectrum for large black holes in the model by applying the Bohr–Sommerfeld quantization to the adiabatic invariant calculated for the spacetime