Malnutrition is widely prevalent among patients on hemodialysis. Malnutrition can be estimated using a fully quantitative scoring system Subjective Global Assessment-Dialysis Malnutrition Score which is simple, reliable and dynamic. The primary objective of the study was to assess the severity of malnutrition in patients with end stage renal disease and undergoing hemodialysis in a tertiary care teaching hospital in Chennai, using Subjective Global Asses sment-Dialysis Malnutrition Score and correlate it with standard indicators of malnutrition like anthropometric and biochemical parameters of the study population by Pearson's correlation. Anthropometric assessment included height, body weight, triceps skin fold thickness, mid arm circumference, mid arm muscle circumference % and biochemical parameters included serum albumin, transferrin, ferritin, total protein, total cholesterol, blood urea nitrogen and creatinine. Based on the scores, of the 66 patients, 91% were moderately malnourished. There was a significant negative correlation between modified Subjective Global Assessment-Dialysis Malnutrition Score and anthropometric measures such as triceps skin fold thickness, mid arm circumference, mid arm muscle circumference; biochemical markers such as albumin, transferrin and ferritin. The data obtained from this study confirm that a high degree of malnutrition was prevalent in patients on hemodialysis, as shown by anthropometric assessment, biochemical markers of malnutrition and Subjective Global Assessment-Dialysis Malnutrition Score. Nutritional status as determined by Subjective Global Assessment-Dialysis Malnutrition Score is a useful and reliable index for identifying patients at risk for malnutrition and it correlates well with anthropometric and biochemical assessment. may be integrated in regular assessment of malnutrition in patients on maintenance hemodialysis.
Aim:To determine the prevalence and the type of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients on maintenance hemodialysis (MHD).Materials and Methods:The study was conducted in 200 CKD patients who were on MHD. The patients were subjected to a validated interviewer-administered questionnaire adopted from the National Health Interview Survey Adult CAM. The knowledge on CAM and its usage by the patients were assessed based on the responses given by the patients.Results:Of the 200 patients, 52 (26%) patients were identified to be using CAM therapy. The most commonly used CAM modality by these patients was Ayurveda both alone (30.4%) and in combination with other CAM modalities (23.2%), followed by acupuncture in 17.3% patients. CAM usage was high in the age range of 50–64 years (67%). Of the CAM users, 21% of patients were from a rural area; 16.5% of patients were from upper middle class, and 24% were on dialysis for 1–4 years. There was a statistically significant association between CAM usage and age, gender, place of living, socioeconomic status, and duration of dialysis (P < 0.01).Conclusion:The present survey provides the data on the usage of CAM among dialysis patients and adds to the increasing evidence about CAM use. Because many products are at risk to either accumulate or cause interactions with medication, a better education on the risks and benefits of the CAM therapy by the health care providers to the end stage renal disease patients is needed.
Dapsone has been the principal drug in a multidrug regimen recommended by the World Health Organization for the treatment of leprosy. It is also widely used by dermatologists in varied skin conditions like dermatitis herpetiformis, bullous pemphigoid, Behcet's disease, lupus erythematous and a host of other skin diseases. Hence an attempt has been made to review the utilization and qualitative evaluation of dapsone over a period of 6 months in a tertiary care teaching hospital. The study consisted of 80 patients (54 leprosy and 26 non-leprosy patients), prescribed with dapsone 100 mg oral once daily. The prescribing patterns of dapsone in leprosy and other dermatological conditions (non-leprosy) were analyzed and the safety, efficacy and appropriateness of the doses prescribed were reviewed. The adverse drug reactions observed in the study population were type I Lepra reactions, gastrointestinal side effects (abdominal pain and anorexia), peripheral neuropathy, other nervous side effects (insomnia, headache and vertigo) and other adverse reactions (fever and tinnitus). Patient information leaflets were distributed to patients to educate on the appropriate use of dapsone.
Background: The prevalence of metabolic syndrome is increasing in Indian population, predisposing an increased risk for the development of diabetes mellitus and cardiovascular diseases. Methods: A case control study was conducted to assess the prevalence of MS and the association between the components of MS in 250 patients, diagnosed by angiography to have CAD (125 patients) as cases and no CAD (125 patients) as control group. MS was diagnosed based on the modified ATP III guidelines, if three or more of the following were present: abdominal obesity, hypertension, glucose intolerance, hypertriglyceridemia or low HDL-C levels. SPSS Version 15 was used for statistical analysis and Chi-square analysis was used to estimate the prevalence of MS with respect to the severity of CAD, family history of CAD and smoking history. The association between individual risk factor and outcome was estimated using univariate logistic regression. The multivariate logistic regression analysis was used to estimate the components of MS as a risk factor for CAD, controlling the other confounders. A P value of <0.05 was considered as statistically significant. Results: The prevalence of MS was higher in CAD (70.4%) than in subjects without CAD (66.4%). Diabetic subjects with (88.24%) and without (87.93%) CAD had significantly higher % of MS when compared with non-diabetic subjects with CAD (49.12%) and without CAD (47.76%) (P < 0.001). Of 125 patients with CAD, 3% patients had no functional markers of MS; 11.2 % had an expression of one; 20 % had two; 32 % had three and 33.8% had four functional markers of MS. The level of MS mounted high with the increasing severity of CAD when compared with normal coronary arteries but was not statistically significant (P=0.176). The percentage of MS was higher in patients with family history of CAD (78.18%) which was statistically significant (P<0.001) and was comparatively lower in non-smokers (46.7%) and ex-smokers (62.2%) than smokers (65.2%). Conclusion: A higher prevalence of MS was observed in diabetics with and without CAD. This is suggestive of an increased risk of CAD in diabetic patients with MS than in non-diabetic patients.
The gut enzymes are released in response to intake of meal, those are GLP-I (glucagon link peptide-I) & GIP (glucose-dependent insulin tropic polypeptide) along with DPP-4(Dipeptidyl peptidase-4). GLP-I has vital role in control of glucose levels and it may also has capacity reduce body weight and it can manage some micro & macro-vascular complications. Unfortunately it has very shorter half-life 1-2 min, and eventually it was degraded by DPP-4 enzyme. Therefore GLP-I has ineffective to perform its tasks. To overcome this incidence essential to inhibit DPP-4 enzyme is benefited in diabetics and in non diabetics suffering with micro, macro vascular complications. Ubiquitous Dipeptidyl peptidase (DPP) - 4 has pleiotropic effects because it is widely distributed other than intestine. DPP-4 enzyme inhibition has a promising effect on glycemic control. DPP-4 inhibition is also involved in the improvement of non-glycemic effects as directly or indirectly the DPP-4 enzyme is linked with some pathological conditions of particular organs, such as DPP-4 is linked with the intestinal secretion of triglycerides, and DPP-4 is expressed in the glomerulus in uncontrolled diabetics which in turn leads to nephritis. DPP-4 release strongly correlates with adipocyte size, potentially representing an important source of DPP-4 in obesity. DPP-4 inhibition produces an anti-inflammatory activity because the activity of DPP-4 results in reduced production of cytokines including interleukins and interferon-G. All these anti-inflammatory agents are inhibited by the DPP-4 enzyme which can lead to pathogenesis of cardiovascular diseases and provokes atherosclerosis & psoriasis. Serum sodium and brain natriuretic peptide (BNP) levels are also regulated by inhibition of the DPP-4 enzyme and which can produce vascular protection & regulates blood pressure. Teneligliptin is a recently developed oral DPP-4 inhibitor indicated for the management of T2DM in adults along with diet and exercise. Teneligliptin is recently available in India and is also available in combination with other oral hypoglycemic agents at affordable prices. This review is aimed at exploring the status of teneligliptin with emphasis on its glycemic effects and non-glycemic clinical benefits associated with increasing GLP-1 & GIP.
Objective: A study was conducted to analyse the applicability of the tools of inventory control of drugs, and the awareness of hospital pharmacists on the inventory tools in the central pharmacy of a tertiary care hospital. Methods: Always Better Control (ABC) and High Moderate Low (HML) analysis were carried out for 4057 drugs purchased in the central pharmacy during the financial year of 2017-2018. The drugs were classified as A, B and C category based on their annual usage value and as Category High (H), Moderate (M) and low (L) drugs based on their unit price respectively. The knowledge of the 80 hospital pharmacists on the tools of inventory control was assessed using a structured questionnaire. Results: Based on ABC analysis, of 4057 drugs, 330 drugs were classified under “A” category accounting to 8.13% of the total number of drugs purchased which was 70.91 % of total annual consumption in money value. The category “B” consisted of 667 drugs accounting to 16.44% of the total number of drugs which was 20.01% of total annual money consumption. Category “C” had 3060 drugs which accounted to 75.42% of the total number of drugs purchased which reflected on 9.01% of annual money consumption. Based on HML analysis, 440 drugs (10%) had a unit price above Rs. 500 and were classified under ‘H’ category. The drugs with unit price between Rs.500 and Rs.100 were grouped as ‘M’ items. There were 695 drugs (17.13%) in ‘M’ category. The ‘L’ category consisted of 2922 drugs (72.02%) with their unit price below Rs.100. Of 80 pharmacists, 84 % had good overall knowledge on the inventory control tools and 59 participants were willing to acquire additional training on inventory control techniques. Conclusion: The study explained the need for the application of ABC and HML analysis, and the involvement of hospital pharmacists in the regular implementation of inventory analysis towards effective management of Pharmacy stores in a hospital setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.