Today, in the health care profession, all types of medication errors including missed dose, wrong dosage forms, wrong time interval, wrong route, etc., are a big deal for better patient care. Today, problems related to medications are common in the healthcare profession, and are responsible for significant morbidity, mortality, and cost. Several recent studies have demonstrated that patients frequently have difficulty in reading and understanding medication labels. According to the Institute of Medicine report, “Preventing Medication Errors”, cited poor labeling as a central cause for medication errors in the USA. Evidence suggests that specific content and format of prescription drug labels facilitate communication with and comprehension by patients. Efforts to improve the labels should be guided by such evidence, although an additional study assessing the influence of label design on medication-taking behavior and health outcomes is needed. Several policy options exist to require minimal standards to optimize medical therapy, particularly in light of the new Medicare prescription drug benefit.
Case reportA 62 year old postmenopausal woman attended with hirsutism, male type temporal baldness, receding hairline and hypertension developing over the previous year. She had had two normal deliveries in the past. She was 15 years postmenopausal and did not use any form of hormone replacement therapy. There was no other significant medical, surgical, family or social history. She was started by her general practitioner on ramipril 1.25mg daily (an angiotensin converting enzyme inhibitor) to control her blood pressure one year prior to her gynaecological referral. Two months later, this treatment was changed to atenolol 50 mg daily, since it was thought that alopecia could be one of the side effects of ramipril. However, her symptoms worsened over the next few months. External examination apart from the features noted above revealed plethoric facies and clitoromegaly. Pelvic examination revealed a left adnexal mass measuring 6 cm in diameter and a normal sized uterus.She had a markedly elevated plasma testosterone level of 28.5 nmol/L (normal: 0.5 ± 3.0). Dehydroepiandrosterone sulphate, cortisol and prolactin levels were normal. Her follicle stimulating hormone level was 6.4iu/L (normal: 3±12) and leuteinising hormone level was 5.5iu/L (normal: 2±14). Her haemoglobin concentration was 17.5 gm/dl (normal: 11.5±15.0gm/dl), haematocrit 0.536 (0.340±0.470), and red blood cell count 5.59 (3.88 ± 4.99). Her CA125 concentration was raised at 99 iu/L (, 30 iu/L). An ultrasound scan con®rmed a left ovarian tumour of mixed echogenicity measuring 6 cm in diameter. The adrenal glands were normal. A diagnosis of an Androgen secreting tumour of the ovary was made, with secondary polycythemia and hypertension.At laparotomy, there was no free¯uid in the pelvis and the abdominal organs were normal. Her left ovarian tumour was removed, and a total abdominal hysterectomy with bilateral salpingoophorectomy was carried out. On the third post-operative day her haemoglobin concentration was 14.0 gm/dl, haematocrit 0.412 and red cell count 4.26. On the fourteenth post-operative day her testosterone level was 1.1 nmol/L.Histological examination showed a borderline endometrioid tumour of the ovary. The stroma had extensive hyalinisation with prominent groups of luteinised cells. The epithelial tumour cells showed a negative reaction for G -inhibin, but this was strongly positive in the stromal cells. The epithelial tumour cells were strongly positive for the epithelial mambrane antigen and for mucin. These ®ndings strongly favour an epithelial tumour rather than a sex-cord stromal tumour (Figs. 1±3). Six months later her testosterone level was 0.7 nmol/L and her CA125 level was 15 iu/L. Her blood pressure was normal and she had stopped taking atenolol. Excessive growth of hair on her abdomen, thigh and chest had regressed, and hair had regrown in the temporal regions. Because of the borderline nature of the tumour of the ovary, we are following her up regularly. DiscussionEndocrine manifestations occur in less than 5 % of all ovarian ...
medicines. Some studies pointed out that many facilities lay weight on the frequency of prescription although they consider recommendations from clinical guidelines. In addition, several researches suggest the tendencies which they are more sensitive to medical cost, whereas quarter of them do not perform any pharmacoeconomic analysis. ConClusions: The paucity of research on development of HF suggests a lack of interest in the topic in Japan. In order to have a fair allocation of health and monetary resources, we need to review the role and making process of HF. Minimum requirements to develop Japanese HF should also be considered.
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.