scholarly journals Does Integrative Medicine Reduce Prescribed Opioid Use for Chronic Pain? A Systematic Literature Review

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 836-859
Author(s):  
Samah Hassan ◽  
Qingping Zheng ◽  
Erica Rizzolo ◽  
Evrim Tezcanli ◽  
Sukriti Bhardwaj ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Integrative Medicine ◽  
Behavioral Therapy ◽  
Public Health Problem ◽  
Preliminary Evidence ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Cross Sectional ◽  
Opioid Crisis ◽  
Quasi Experimental

Abstract Background Chronic pain (CP) is a major public health problem. Many patients with CP are increasingly prescribed opioids, which has led to an opioid crisis. Integrative medicine (IM), which combines pharmacological and complementary and alternative medicine (CAM), has been proposed as an opioid alternative for CP treatment. Nevertheless, the role of CAM therapies in reducing opioid use remains unclear. Objectives To explore the effectiveness of the IM approach or any of the CAM therapies to reduce or cease opioid use in CP patients. Methods An online search of MEDLINE and Embase, CINAHL, PubMed supp., and Allied and Complementary Medicine Database (AMED) for studies published in English from inception until February 15, 2018, was conducted. The Mixed Methods Appraisal Tool (MMAT) was used to critically appraise selected studies. Results The electronic search yielded 5,200 citations. Twenty-three studies were selected. Eight studies were randomized controlled trials, seven were retrospective studies, four studies were prospective observational, three were cross-sectional, and one was quasi-experimental. The majority of the studies showed that opioid use was reduced significantly after using IM. Cannabinoids were among the most commonly investigated approaches in reducing opioid use, followed by multidisciplinary approaches, cognitive-behavioral therapy, and acupuncture. The majority of the studies had limitations related to sample size, duration, and study design. Conclusions There is a small but defined body of literature demonstrating positive preliminary evidence that the IM approach including CAM therapies can help in reducing opioid use. As the opioid crisis continues to grow, it is vital that clinicians and patients be adequately informed regarding the evidence and opportunities for IM/CAM therapies for CP.

scholarly journals Validation and Psychometric Properties of the Spanish Version of the Hopkins Symptom Checklist-25 Scale for Depression Detection in Primary Care

2021 ◽  
Vol 18 (15) ◽  
pp. 7843
Author(s):  
María Rodríguez-Barragán ◽  
María Isabel Fernández-San-Martín ◽  
Ana Clavería-Fontán ◽  
Susana Aldecoa-Landesa ◽  
Marc Casajuana-Closas ◽  
...  
Keyword(s):  
Primary Care ◽  
Psychometric Properties ◽  
Public Health Problem ◽  
Composite International Diagnostic Interview ◽  
Spanish Version ◽  
Major Public Health Problem ◽  
Symptom Checklist ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Hopkins Symptom Checklist

Depression constitutes a major public health problem due to its high prevalence and difficulty in diagnosis. The Hopkins Symptom Checklist-25 (HSCL-25) scale has been identified as valid, reproducible, effective, and easy to use in primary care (PC). The purpose of the study was to assess the psychometric properties of the HSCL-25 and validate its Spanish version. A multicenter cross-sectional study was carried out at six PC centers in Spain. Validity and reliability were assessed against the structured Composite International Diagnostic Interview (CIDI). Out of the 790 patients, 769 completed the HSCL-25; 738 answered all the items. Global Cronbach’s alpha was 0.92 (0.88 as calculated for the depression dimension and 0.83 for the anxiety one). Confirmatory factor analysis (CFA) showed one global factor and two correlated factors with a correlation of 0.84. Area under the curve (AUC) was 0.89 (CI 95%, 0.86–0.93%). For a 1.75 cutoff point, sensibility was 88.1% (CI 95%, 77.1–95.1%) and specificity was 76.7% (CI 95%, 73.3–79.8%). The Spanish version of the HSCL-25 has a high response percentage, validity, and reliability and is well-accepted by PC patients.

scholarly journals The prescription pattern and awareness about antibiotic prophylaxis and resistance among a group of Egyptian pediatric and general dentists: a cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam Mohsen Aly ◽  
Marwa Aly Elchaghaby
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Prescription ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
General Dentists

Abstract Background The use of antibiotics in dentistry as prophylaxis and treatment is frequent. Their misuse has led to a major public health problem globally known as antibiotic resistance. This study aimed to assess the pattern of antibiotic prescription and its prophylactic use for systemic conditions. Besides, this study evaluated the awareness and adherence to antibiotic prescription guidelines and antibiotic prophylaxis guidelines along with awareness of antibiotic resistance across pediatric and general dentists. Methods An overall of 378 pediatric and general dentists meeting the required eligibility criteria, fulfilled a pre-designed validated questionnaire. Data were collected, tabulated, and statistically analyzed. Results A significant statistical difference was found among the pediatric and general dentists regarding antibiotics prescription for most of the oral conditions where Amoxicillin with clavulanic acid was the most frequently prescribed antibiotic among the two groups (53% pediatric dentist and 52% general dentist). The majority of pediatric and general dentists, on the other hand, were aware of antibiotic resistance and prescribing recommendations. Conclusions The present study showed a tendency to overprescribe and overuse antibiotics in certain dental conditions among the participants. The vast majority of dentists, especially general dentists do not have adherence to professional guidelines for antibiotics prescription in children despite their awareness of antibiotic resistance and prescription guidelines.

scholarly journals Predictive risk factors towards liver fluke infection among the people in Kamalasai District, Kalasin Province, Thailand

2019 ◽  
Vol 7 ◽  
pp. 205031211984020 ◽  
Author(s):  
Woragon Wichaiyo ◽  
Wirat Parnsila ◽  
Wisit Chaveepojnkamjorn ◽  
Banchob Sripa
Keyword(s):  
Risk Factors ◽  
Liver Fluke ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
The People ◽  
Fluke Infection ◽  
Raw Fish ◽  
Predictive Risk ◽  
Liver Fluke Infection

Background: Liver fluke disease caused by Opisthorchis viverrini remains a major public health problem with its crucial risk factors caused by some individual habits or false beliefs among the people in northeastern Thailand concerning the consumption of raw fish meat dishes. Objectives: This study explores the predictive risk factors for the infection of liver fluke disease. Methods: The sample consisted of 400 people aged 30 years and above in Thanya sub-district, Kamalasai district, Kalasin province. A cross-sectional analytic study, using the χ2 test, odds ratio and 95% confidence interval, was used to find the influence of each variable, along with the use of multiple logistic regression (p = 0.05). A questionnaire form was used as the research instrument. Results: Factors found in the results are as follows: households with a cat were 7.00 times more at risk than households without a cat; eating raw fish dishes prepared by themselves increases the risk of infection by 2.58 times; eating raw fish dishes prepared by family members increases the risk by 4.74 times; and raw fish dishes bought from a community market increases the risk by 2.33 times. Conclusion: A campaign should be launched to educate people not to eat raw or undercooked fish dishes, but to fully cook fish dishes before eating, as the food is still delicious, but also safe, healthy, and free from liver fluke infection.

A review of the evidence to explain pharmacological basis of injection (ab)use of buprenorphine–naloxone tablets

2021 ◽  
Vol 17 (7) ◽  
pp. 141-152
Author(s):  
Tamoud Modak, MD, DM ◽  
Siddharth Sarkar, MD, MRCPsych ◽  
Yatan Pal Singh Balhara, MD
Keyword(s):  
Public Health Problem ◽  
Opioid Use Disorder ◽  
Critical Examination ◽  
Evidence Based ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Evidence Based Treatment ◽  
Opioid Replacement Therapy ◽  
Pharmacological Basis

Opioid use disorder is a major public health problem, and opioid replacement therapy with buprenorphine (BPN) is a clinically effective and evidence-based treatment for it. To deter misuse of the tablet through the injecting route, BPN coformulated with naloxone (BNX) in 4:1 ratio is available in many countries. Despite this, significant diversion and injecting use of the BNX combination has been reported from across the world. In this article, the pharmacological properties of BPN and BNX and the evidence for their diversion are reviewed. Also, a critical examination is made of the evidence supporting the role of naloxone in reducing the agonist effects of BPN when used through the injecting route. Based on this evidence, a hypothesis explaining the continued diversion of BNX has been proposed.

scholarly journals An evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain

2019 ◽  
Vol 194 ◽  
pp. 460-467 ◽  
Author(s):  
Declan T. Barry ◽  
Mark Beitel ◽  
Christopher J. Cutter ◽  
David A. Fiellin ◽  
Robert D. Kerns ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Opioid Use Disorder ◽  
Cognitive Behavioral ◽  
Opioid Use

scholarly journals A study on mosquito density in rural Kerala before and after floods

2019 ◽  
Vol 6 (2) ◽  
pp. 659
Author(s):  
V. T. Krishnadas Menon ◽  
Jerry Rachel ◽  
C. R. Saju ◽  
M. Mohamed Rafi ◽  
Vidhu M. Joshy
Keyword(s):  
Disease Outbreaks ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Mosquito Density ◽  
Cross Sectional ◽  
Training Centre ◽  
Before And After ◽  
Initial Survey ◽  
Rural Training

Background: Mosquito borne diseases are a major public health problem in Kerala. Mosquito density assessed by larval surveys is easier and quicker to perform. The larval indices are an important practical predictor of outbreaks of mosquito borne disease and are valuable in taking preventive measures. This study is done to calculate standardized larval indices namely house index, container index and Breteau index and to identify the major breeding sources of mosquitoes in the residential environment in a rural of Thrissur, Kerala.Methods: A cross-sectional study selecting 80 houses from 1 wards of Konnikara village under Thrikkur Panchayath under the field practice area of rural training centre, Amala Institute of Medical Sciences Thrissur. Every water holding container indoors and outdoors was counted and searched for larval presence and noted on a pretested format.Results: In this study, 80 houses were surveyed in 2 days initially in June and in September. All the entomological indices were found to be above the critical level in the initial survey in June. House index=36% container index=44%; Breteau index=143% showing high chances for outbreaks of mosquito borne diseases. In September though the indices were very low house index 1.25% container index 2.77% and Breteau index.Conclusions: The area is prone for mosquito borne disease outbreaks like dengue fever and after interventions the vector indices and potential risks came down.

scholarly journals “A STUDY OF MICROALBUMINURIA IN NON DIABETIC HYPERTENSIVE PATIENTS”

2020 ◽  
pp. 1-3
Author(s):  
Anup Latne ◽  
Prabhakar Jirvankar
Keyword(s):  
Cardiovascular Risk ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Major Public Health Problem ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Hypertensive Patients

Hypertension is a major public health problem all over the world. The incidence of hypertension is increasing year after year and the prevalence of hypertension is increasing day by day due to increased life expectancy and aging population and their sedentary lifestyle. Hypertension is known to cause microvascular changes and increased cardiovascular risk from it. Microalbuminuria possibly reflects a state of increased renal endothelial permeability and is an easily measured marker of rather diffuse endothelial dysfunction, low grade inflammation and vascular disease burden2. Microalbuminuria has been determined as an important prognostic indicator and has been reported to be associated with increased cardiovascular risk and progressive renal damage. Reliable data on the prevalence of microalbuminuria in the general population and its association with cardiovascular risk factors is limited. Till now, there is little data available regarding screening and early treatment of hypertensive patients with microalbuminuria, as in the case of microalbuminuric non diabetic subjects. With these perspective this cross sectional study of microalbuminuria in non-diabetic hypertensive patients was undertaken to study prevalence of microalbuminuria in Non Diabetic hypertensive patients. Objectives: To determine the prevalence of microalbuminuria in non-diabetic hypertensive patients and to correlate the presence of microalbuminuria with the patients of different clinical profiles. Materials and Methods: This was observational, cross sectional study of Patients diagnosed with hypertension either admitted in ward or attending OPD of Medical College and Tertiary Care Centre. Urine microalbumin creatinine ratio was used for estimation of microalbuminuria. Conclusion: It was proved that microalbuminuria prevalence was directly proportional to the duration of hypertension, the stage of hypertension. Prevalence of microalbuminria was low in ACE inhibitor and ARB treated hypertensive patients.

scholarly journals Opportunistic Infections and Associated Factors among HIV/AIDS Patients taking Ante-Retroviral Therapy at Selected Hospitals in Sidama Zone, Southern Ethiopia: A facility-based cross-sectional study

2019 ◽  
Author(s):  
Demelash Wachamo ◽  
Fisseha Bonja
Keyword(s):  
Associated Factors ◽  
Opportunistic Infections ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Sectional Study ◽  
Aids Patients ◽  
Cross Sectional ◽  
Hiv Aids

Abstract Background Opportunistic infections are late complications of HIV infection is the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, this study aimed to assess the burden and associated factors of opportunistic infections.Method A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data was collected from selected hospitals in Sidama Zone based on population proportion to size. Data was collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The magnitude of opportunistic infections was 39.6%. Major identified OIs was oral candidacies 23.2%, recurrent bacterial pneumonia 21.5%, Herpes zoster 6.3%, and Pulmonary Tuberculosis 6.0%.The magnitude of opportunistic associated with; older age [AOR=2.69, 95% CI: 1.33-5.43], No formal education [AOR=3.12, 95% CI: 1.06-9.25], Low monthly income [AOR=2.27, 95%CI:1.35-3.83], initial CD4 count less than 200 cells/mm3 [AOR=1.91, 95% CI:1.05-3.46), WHO clinical stage II [AOR=2.43, 95% CI:1.34-4.42] and stage III and IV [AOR=4.27, 95% CI: 2.12-8.59], had no extra medicine additional to ART (prophylaxis) had [AOR= 5.91, 95% CI: 3.31-10.56], who interrupt ART medicines [AOR=2.03, 95% CI: 1.09- 3.80] and Khat chewing [AOR=5.48, 95% CI: 2.32-12.96] when compared to their counterparts.Conclusions The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention on the strengthening of the provision if ART with prophylaxis on early-stage and adhrerence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.

scholarly journals Anaemia among Egyptian adolescents: prevalence and determinants

2000 ◽  
Vol 6 (5-6) ◽  
pp. 1017-1025
Author(s):  
F. El Sahn ◽  
S. Sallam ◽  
A. Mandif ◽  
O. Galal
Keyword(s):  
Public Health ◽  
Rural Areas ◽  
Educational Level ◽  
Inverse Relationship ◽  
Public Health Problem ◽  
Public Health Education ◽  
Major Public Health Problem ◽  
Socioeconomic Level ◽  
Cross Sectional ◽  
Wide Scale

We aimed to estimate the nationwide prevalence of anaemia among adolescents in Egypt and to study possible risk factors. A cross-sectional approach was used. Blood samples were collected from 1980 adolescents for haemoglobin estimation. The overall prevalence of anaemia was 46.6%, most of which was mild or moderate, with severe cases in less than 1.0% of the sample. Gender difference was almost nonexistent. A significant inverse relationship was observed between the level of anaemia and age [especially among boys], socioeconomic level and educational level. Anaemia was more prevalent in rural areas and in Upper [southern] Egypt. Anaemia is a major public health problem among Egyptian adolescents and wide-scale public health education is warranted.

scholarly journals Prevalence of anaemia and visual impairment among primary school children of South Gujarat region of India: a cross sectional study

2019 ◽  
Vol 7 (1) ◽  
pp. 30
Author(s):  
Bharatkumar Balkrishna Pandya ◽  
Upendrakumar Rameshbhai Chaudhari ◽  
Avirat A. Bhatt ◽  
Nilesh Thakor
Keyword(s):  
Visual Impairment ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Primary School Children ◽  
School Age Children ◽  
Major Public Health Problem ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutritional Anemia ◽  
Prevalence Of Anemia

Background: Nutritional Anemia and visual impairment among school age children are recognized as major public health problem in India. Authors objective was to study prevalence of anemia and visual impairment among school going adolescents of Vadodara and Surat city of Gujarat, India.Methods: This cross sectional study was carried during period from April 2015 to March 2016. Total 8 schools were selected from Vadodara and Surat city by purposive sampling. After taking the permission of principals of schools and informed written consent of the parents of children, 859 children from these schools were examined for anaemia and visual impairment. The data was collected by predesign, pretested proforma and analysed using SPSS version 17 (Trial version).Results: Out of total 859 children 421(49.1%) were female. Mean age of the study children was 8.95±1.52 years. The prevalence of anemia in children in present study was 61.6 % (529 children). The prevalence of anemia in female (274, 65.1%) was higher than males (255, 58.2%). Moderate visual impairment and blindness was 5.9% in girls and 8.2% in boys respectively. Severe visual impairment and blindness was 2.1% in girls and 2.7% in boys respectively and the gender difference was not statistically significant. Though 61(7.1%) children had moderate to severe visual impairment to blindness only 21 (2.4%) children were wearing spectacles.Conclusions: High prevalence of anaemia and visual impairment among these children needs great attention and health education.

Sign in / Sign up

Export Citation Format

Share Document