BACKGROUND: While medication is an integral component of the effective management of COPD, contemporary studies report that more than half of all people who are prescribed medication for the management of their COPD do not adhere to therapy. Enhancing medication adherence and improving health outcomes for those living with COPD are among the key challenges for the global health community. This systematic review aims to identify the rate of nonadherence among people who are prescribed controller medication for the management of their COPD, and identifies the barriers and facilitators that influence their medication use behavior. METHODS: A systematic search of medical databases (ie, MEDLINE, CINHAL, and EMBASE) was conducted using key words to identify literature in the English language, published between January 2003 and December 2019. Included studies were assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. RESULTS: A total of 1,474 studies were identified from the initial database search, of which 38 met the inclusion criteria. Of these 38 studies, 37 reported on rates of nonadherence (ranging from 22% to 93%), 30 reported on barriers to adherence, 24 reported on enablers to adherence, and 16 reported on both. The majority (33) of the studies were conducted in high-income nations. The quality of articles ranged from 47% to 90%. Medication-taking behavior was reported to be influenced by several factors such as subjects' beliefs about medication, their experiences of and satisfaction with medication effectiveness, their concerns regarding medication side effects, their personal circumstances, habits and health status, and their relationships with health care providers. CONCLUSIONS: Adherence to COPD medication was generally low, with the majority of studies identifying the presence of depression and subjects' concern about the harmful effects of the medicine as barriers to adherence. Variability exists on the reported rates of nonadherence, possibly due to different measures utilized to assess adherence. Future research in low-income nations is needed.

Background:Induction of labour is the process of initiating the labour by artificial means from 24 weeks of gestation. The main aim of this study is to find out the maternal and foetal outcomes after induction of labour with misoprostol and oxytocin beyond 37 weeks of gestation.Methods:This was a hospital-based observational study carried out at Paropakar Maternity and Women’s Hospital, Nepal. Misoprostol of 25 µg was inserted in posterior fornix of vagina or oxytocin infusion was started from 2.5 units on whom induction was decided. Maternal and foetal/neonatal outcomes were observed. Collected data were analysed using SPSS and MS Excel.Results:General induction rate was found to be 7.2%. In this study, post-term pregnancy was found to be the most common reason for induction of labour. Analysis of onset of labour led to the finding that mean onset of labour was much rapid in oxytocin (6.6 h) than misoprostol (13.6 h). However, there is similarity in induction–delivery interval in both groups. Overall, the rate of normal delivery and caesarean section was found to be 64.9% and 33.2%, respectively. Similarly, normal delivery within 12 h was seen in 18.4% of the patients given with misoprostol and 43.5% in oxytocin group. Foetal distress was found as the most common reason for caesarean section. The overall occurrence of maternal complication was found to be similar in misoprostol and oxytocin groups, nausea/vomiting being the most common (36.7%) complication followed by fever (24.1%). Besides this, the most common neonatal complication found in overall cases was meconium stained liquor (49.2%).Conclusion:It was found that misoprostol was used most frequently for induction of labour compared to oxytocin. The onset of labour was found to be rapid in oxytocin than misoprostol. However, the occurrence of side effects was found to be similar in both misoprostol and oxytocin groups.

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Gastric ulcer is one of the major health problems in developing countries. Furthermore, high cost and of adverse effects are seen with the long term use of allopathic drugs in treatment of ulcer which are diminished by the use of herbal drugs. The aim of this study is to evaluate antiulcer activity of crude extract of Dalbergia sissoo leaves on experimentally induced gastric ulcer in wistar albino rats. Methodology involves screening for antiulcer activity of the plant using pylorus ligation and Indomethacin induced ulcer models in albino rats using 4 groups as; control (Tween 80 1 % v/v solution, 5 ml/kg), standard (Ranitidine 80 mg/kg), 250 mg/kg leaves extract and 500 mg/kg leaves extract given respective doses orally (p.o.). The parameters viz. mean ulcer index, percentage protection, gastric pH, protein, carbohydrate, pepsin, free and total acidity and ratio of total carbohydrates and proteins (TC:TP) were determined. The result showed the significant decrease in mean ulcer index of the leaves extract treated group in both the models compared to control. Furthermore, as obvious from pylorus ligation model the offensive factors like free and total acidity, pepsin content and protein content were decreased to significant levels whereas the defensive factors like total carbohydrate content and TC:TP ratio were increased significantly compared to control in dose dependent manner. The study concluded that leaves extract of Dalbergia sissoo had significant antiulcer activity and was not only effective in reducing the development of gastric ulcer but also increasing the healing of the gastric ulcer in dose dependent manner.

Background: Polypharmacy is of wide concern in drug interaction. It is the leading cause of adverse drug reaction, and consequently, increasing the possibility of hospitalization and escalating the cost of care. The incidence of coexisting depression and hyperlipidemia in patients is generally managed by providing numerous drugs for a longer period of time. Aims and Objectives: This study was conducted to observe the effect of atorvastatin on pharmacokinetic parameters of fluoxetine in healthy albino rabbits and to find possible interactions of atorvastatin on the antidepressant activity of fluoxetine using animal screening test. Materials and Methods: Two drugs: Fluoxetine and atorvastatin used concurrently were selected. Healthy male albino rabbits were used to determine the effect of atorvastatin on fluoxetine addressing its pharmacokinetic parameters, whereas rats and mice were used to assess the antidepressant activity of fluoxetine. Two animal models were used to determine its antidepressant activity. Forced swim test (FST) and tail suspension test (TST) were employed in exploring antidepressant activity. High-performance liquid chromatography was used to estimate fluoxetine concentration. Results: The concentration of serum fluoxetine showed slight increment after the atorvastatin treatment for 7 days at 2