Background: This study aims to identify adherence rate of methotrexate (MTX) therapy in rheumatoid arthritis (RA) patients of Eastern India and recognize factors contributing to treatment adherence in those patients.Methods: In this cross-sectional observational study, a total of 140 patients (17 males, 123 females; mean age 37.6±7.4 years) with pre-diagnosed RA attending the rheumatology outpatients clinic between February 2019 and January 2020 fulfilling the inclusion and exclusion criteria, were included. The patients were evaluated in terms of sociodemographic factors, clinical and medication details, disease activity score (DAS28-CRP) values and patient - doctor considerations that might contribute to treatment adherence. They filled out a series of standardised present questionnaires including the Morisky 8-item Medication Adherence Scale (MMAS-8). Data was analysed statistically and compounded.Results: Of the patients, 29 (20.7%) were adherent and 111 (79.3%) were non-adherent to medication with MTX. 65% were on MTX monotherapy and 35% on polytherapy with csDMARDs. 45.7% of the non-adherent forgot taking medication, 50.7% skipped during travel, 79.3% intentionally did not comply with strict regimen. The DAS28-CRP scores were much higher amongst non-adherent group and fewer reached remission as compared to adherent participants. Commonest reason for non-adherence being adverse drug reaction and financial constraints. Conclusions: This study showed a significantly higher adherence to MTX treatment compared to most previous studies. Adverse drug reactions, financial constraints, complex treatment regimen, long treatment duration, and frequent travel history significantly affect medication adherence in this patient population. Higher the adherence better the treatment response.
Introduction: The coronavirus disease 2019 (COVID-19) pandemic, which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a novel and serious global health threat and has dramatically spread worldwide 1. COVID-19 is transmitted primarily through respiratory droplet and direct contact. At the time of this article's drafting, 188,616,093 conrmed cases and 4,065,804 deaths have been reported worldwide with new conrmed cases and deaths occurring per day Materials And Methods: All COVID-19 patients consecutively admitted to the hospital between June 1, 2020, and July 31, 2021, were collected. The diagnosis and clinical classication (mild, moderate, severe, and critical) of COVID-19 patients were carried out by two independent doctors based on the Guideline of Novel Coronavirus Pneumonia (8 th revised Edition) issued by the Chinese National Health Commission. Result: Among 202 diagnosed COVID-19 patients from June 2020 to July 2021, some patients were excluded for age < 18 years (n = 5), pregnant women (n = 3), combined with malignant tumor (n = 1), no available or incomplete laboratory data (n = 120), no FPG data available at admission (n = 44), and patients diagnosed before June or discharged in August (n = 29) were excluded. Finally, 99 cases were included in the study Conclusion: Higher FPG was an independent predictor of prolonged duration of SARS-CoV-2 RNA shedding/clearance in the present study. Our ndings indicate that screening FPG level is an effective and simple method to evaluate the prognosis of patients with COVID-19, and intervention should be taken in time when patients with FPG ≥ 6:1 mmol/l regardless of a history of diabetes.
Static Modeling of deep water sand rich reservoir of braided fluvial origin, deposited in syn-rift set up is challenging in order to capture the reservoir complexities like presence of low permeability facies and complex fault geometry. It becomes more difficult with limited well controls and lack of effective seismic attributes. To characterize such complexities, a robust rocktype based modeling approach is considered with effective spatial control on properties. A rocktype based static modeling approach using geostatistical techniques guided by conceptual depositional model is adopted here as a case study. Five rocktypes are classified based on hydraulic units (HU), defined by FZI (Flow Zone Indicator) technique using porosity and permeability measurements from core data. A depositional model of braided fluvial setup is conceptualized based on integrated analysis of core data, well log and overall reservoir architecture. Using this conceptual depositional model, trend analysis for different rocktypes is carried out to derive vertical proportion curve (VPC) and variograms which are then used to populate reservoir properties away from the wells. The static model was simulated for dynamic studies to depict production profile scenarios for assessing the commercial viability of the field. Pressure data from appraisal wells has established three different fluid contacts separating the reservoir into different segments. Surgically interpreted faults are used to define the segment boundaries and build a detail as well as appropriate fault network model. Use of rocktypes based on FZI method, instead of Sand-Shale classification scheme, helped in capturing the reservoir heterogeneities within a sand rich system. A property modeling approach using trend analysis along with concept based variogram models have provided better control on properties away from the well especially when the seismic attributes are not that effective. The model was validated in a recently drilled appraisal well. The reservoir properties at this well location have shown great match with the pre drill predictions from the model.
INTRODUCTION: With the increasing trend of nuclear families in the society, the care of older persons in the families gets difcult and they are forced to shift to old age homes. There are lack of close family ties and reduced connections with their culture of origin, which leads to high risk of depression among olders. OBJECTIVE:Determine the Prevalence of depression among the inmates of old-age home and identify associated factors METHODS: Study type and design: 7 Observational study, Cross sectional design Study setting:The study was conducted in Aapnaghar old-age home of Siliguri, West Bengal (The old age home was chosen by lottery method). Study population:In-mates of Aapnaghar old-age home Study period: 2 months Sample size: All inmates of Aapnaghar old-age home was included by complete enumeration method; total 75 participants DISCUSSION:In Mild mood disturbance to borderline clinical depression, 28 (54.9%) patients were Male and 9 (37.5%) patients were Female. In Moderate to severe depression, 15 (29.4%) patients were Male and 15 (62.5%) patients were Female. Association of Gender vs Normal, Mild mood disturbance to borderline clinical depression and Moderate to severe depression was statistically signicant (p<0.0001). In Normal, 6 (42.9%) patients were married, 1 (4.2%) patients were unmarried and 1 (2.7%) patients were others. In Mild mood disturbance to borderline clinical depression, 7 (50%) patients were married, 19 (79.2%) patients were unmarried and 11 (29.7%) patients were others. CONCLUSION: In the current study, the BDI has been utilized to detect the prevalence of depression. Although it is not designed for diagnostic purposes, its epidemiologic utility has been evaluated in several studies. Depression was a common nding among the elderly in old-age home. These results could help to clarify the attributes of target populations for depression and provide insight to prevent depression among elderly
Bickerstaff brainstem encephalitis (BBE) is a rare neurological disorder characterised by the presence of the triad of ophthalmoplegia, ataxia and altered consciousness. It is thought to be associated to an autoimmune condition triggered by an antecedent infection. Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, and it is associated with myriads of neurological complications. We hereby present an unusual case of BBE in a young lady, who was probably a sequalae of scrub typhus infection. Bickerstaff brainstem encephalitis in association with scrub typhus has not been reported till date.
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