Background and purposeClinical guidelines recommend the prescribing of gastroprotective strategies in nonsteroidal anti-inflammatory drug (NSAID) users with risk factors for gastrointestinal (GI) ulcer or ulcer complications. However, these guidelines are not often translated into clinical practice. Therefore, the aim of this study was to investigate the utilization of gastroprotective strategies for NSAID-induced upper GI events in at-risk users in a major teaching hospital.Patients and methodsA cross-sectional, observational, pharmacy-based study was conducted in a major Asian institution with both primary and secondary health care services. This study involved the screening of prescriptions for regular NSAIDs, and patients who met the inclusion criteria were recruited and interviewed using a questionnaire.ResultsOf the 409 participants recruited, 83.1% had at least one GI risk factor, of whom 70.3% did not receive appropriate gastroprotection. The most common GI risk factor was the use of high-dose NSAIDs (69.2%), followed by participants aged 65 years and older (22%) and concomitant use of low-dose aspirin (11.7%). Appropriate gastroprotective strategies utilized consisted of the use of a cyclooxygenase (COX)-2 inhibitor alone or a nonselective NSAID plus a proton pump inhibitor (PPI) in the moderate-risk group and a COX-2 inhibitor plus a PPI in the high-risk group. Gastroprotective strategies were underutilized in 67.1% of at-risk participants and overutilized in 59.4% of those without risk factors. Co-prescription of a histamine-2 receptor antagonist at lower-than-recommended doses constituted 59% of the inappropriate gastroprotective agents used. Logistic regression analysis revealed patients aged 65 years and older (odds ratio, 1.89; 95% CI =1.15–3.09) as a predictor for the prescribing of gastroprotection by the clinicians.ConclusionApproximately 70% of at-risk NSAID users, mainly on high-dose NSAIDs, were not prescribed appropriate gastroprotective strategies. Further measures are warranted to improve the safe prescribing of regular NSAIDs.

Liquid crystal cells have always been an important part of commercially available displays, modulators and projectors. In this paper, Jones matrix representation including four independent parameters for twisted nematic liquid crystal (TN-LC) cell has been demonstrated. The physical parameters of the TN-LC cell such as twist angle, birefringence and director orientation at the input face of cell has been calculated using intensity transmittance of an experimental set-up that includes circularly polarized light and TN-LC cell sandwiched between two polarizers. The physical parameters have been calculated without any ambiguity using three different wavelengths.The knowledge from above measurement gives the general information about the birefringence and hence liquid crystal cell gap thickness. To acquire full-field liquid crystal cell gap thickness measurement phase shift polariscope has been adopted. The four phase shifted images through the rotating analyzer gives the full-field cell gap thickness measurement. The experimental results have been compared with the commercial point wise measurement and are in good agreement.

The use of GPA in patients on regular NSAIDs does not improve their overall dyspepsia, but it reduces abdominal pain and burping. Poor adherence to GPA may be a contributing factor.