Objective:The aim of this study was to evaluate the impact of pharmacist-conducted educational intervention on reducing errors related to inappropriate insulin pen use.Methods:This was a prospective, before-after study with an educational intervention component. The study was conducted on 122 elderly diabetic patients. Data were collected through interviews using researcher-administered questionnaires as well as patients’ medical records. Patients were asked about the preparation, injection, and storage techniques, they followed when using insulin pens. Blood glucose parameters were extracted from laboratory records. After the detection of errors, patients and their caregivers were instructed about the insulin pen use by the pharmacist. Patients were reevaluated after 12 weeks.Findings:Patients’ mean age was 67.2 ± 3.5 with male: female ratio of 71:51. Mean diabetes duration was 7.1 ± 2.8 years. Fifty-four patients (44.2%) stated that they had received instructions for insulin pen use previously. The majority of this group (24 cases, 44.4%) reported that the instructions were given by a pharmacist. The mean number of errors decreased from 3.99 ± 0.22 errors per patient to 1.49 ± 0.13 errors (odds ratio: 0.28, 95% confidence interval: 0.23–0.33,P < 0.05). Of eleven evaluated insulin pen-related medication error items, nine items experienced a significant decrease after patient education. Fasting plasma glucose (FPG) levels decreased significantly from 161.7 ± 12.5 to 147.3 ± 13.1 mg/dL (P < 0.05). However, glycated hemoglobin levels did not change significantly after 3 months (P = 0.18). Controlled FPG had a significant rise from 45% before education to 63.9% postintervention (P < 0.05).Conclusion:Pharmacists can play an important role in safe and efficient use of insulin pen in elderly diabetic patients by minimizing the likelihood of medication errors associated with insulin pen use.
Background Degenerative spinal conditions (DSCs) involve a diverse set of pathologies that significantly impact health and quality of life, affecting many individuals at least once during their lifetime. Treatment approaches are varied and complex, reflecting the intricacy of spinal anatomy and kinetics. Diagnosis and management pose challenges, with the accurate detection of lesions further complicated by age-related degeneration and surgical implants. Technological advancements, particularly in artificial intelligence (AI) and deep learning, have demonstrated the potential to enhance detection of spinal lesions. Despite challenges in dataset creation and integration into clinical settings, further research holds promise for improved patient outcomes. Methods This study aimed to develop a DSC detection and classification model using a Kaggle dataset of 967 spinal X-ray images at the Department of Neurosurgery of Arrowhead Regional Medical Center, Colton, California, USA. Our entire workflow, including data preprocessing, training, validation, and testing, was performed by utilizing an online-cloud based AI platform. The model's performance was evaluated based on its ability to accurately classify certain DSCs (osteophytes, spinal implants, and foraminal stenosis) and distinguish these from normal X-rays. Evaluation metrics, including accuracy, precision, recall, and confusion matrix, were calculated. Results The model achieved an average precision of 0.88, with precision and recall values of 87% and 83.3%, respectively, indicating its high accuracy in classifying DSCs and distinguishing these from normal cases. Sensitivity and specificity values were calculated as 94.12% and 96.68%, respectively. The overall accuracy of the model was calculated to be 89%. Conclusion These findings indicate the utility of deep learning algorithms in enhancing early DSC detection and screening. Our platform is a cost-effective tool that demonstrates robust performance given a heterogeneous dataset. However, additional validation studies are required to evaluate the model's generalizability across different populations and optimize its seamless integration into various types of clinical practice.
When laser in situ keratomileusis (LASIK) surgery is employed for myopia, hyperopia, and astigmatism, the process requires the usage of anesthetics to ensure that there is minimal patient harm and negative consequences once the procedure is complete. Statistical analysis was conducted as part of this review to evaluate the application of and distinctions between the different analgesics used for LASIK surgery by compiling and filtering information from multiple research studies. Topically administered oxybuprocaine and proparacaine were found to be the most commonly used anesthetics for LASIK, according to the data included in the review. It was also determined that there were no significant differences in terms of patient outcomes and drug concentrations when proparacaine was substituted for oxybuprocaine. This is particularly intriguing given their different chemical compositions. Temporary dry eyes were the most commonly reported adverse effect of LASIK when the anesthetic was employed. Perhaps cocaine derivatives produce similar anesthetic and post-surgical effects, but further investigations are needed to verify this hypothesis.
Desloratadine is a relatively new, second-generation, tricyclic antihistamine which came into medical use in 2001. This study aimed to review the available evidence in the literature around the clinical efficacy of desloratadine on a range of allergic conditions. A database search in Medline, PubMed, Embase, and Google Scholar was conducted for the research articles published until July 2020, using the keyword desloratadine. An additional reference lists search and citation tracking were also performed. Research articles in English pertaining to desloratadine and its efficacy were considered for inclusion. Study designs, including randomized controlled trials (RCT), observational/case-control studies, and case series were considered. The collective evidence from the current literature shows superior efficacy of desloratadine compared to placebo and some of the other treatment options in the management of seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR), chronic idiopathic urticaria (CIU), and asthmatic symptoms. There is also evidence for potential new roles introduced for desloratadine such as acne treatment, chronic otitis media, and chronic rhinosinusitis, which warrants further investigation. In most studies, desloratadine's safety and tolerability were comparable with placebo. Current evidence suggest that desloratadine is an ideal option for most of the allergic conditions due to its efficacy as well as favourable safety and tolerability profile. Further large-scale studies are needed to establish the efficacy and safety profile of desloratadine and to compare its effectiveness against other treatments in the management of allergic conditions.
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