scholarly journals Role of Montelukast in Asthma and Allergic rhinitis patients

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Faisal Faiyaz Zuberi ◽  
Muhammad Amir Haroon ◽  
Abdul Haseeb ◽  
Shafi Muhammad Khuhawar
Keyword(s):  
Allergic Rhinitis ◽  
Adverse Effects ◽  
Upper Respiratory Tract ◽  
Open Label ◽  
Night Time ◽  
Creative Commons ◽  
The Individual

Objectives: Our objective was to evaluate the effect of Montelukast on the symptoms of asthma and allergic rhinitis (AR), assess its effect on the individual quality of life (QoL), and estimate the proportion of participants having adverse effects. Methods: This prospective, open-label study conducted at Dow University of Health Sciences, Ankle Saria Hospital and Sindh Government Hospital Liaquatabad, Karachi, from August 2018 to September 2019, included patients aged >18 years with a clinical diagnosis of Asthma, AR, or both. Patients were given a 10 mg Montelukast tablet each day and then called for follow-up in the fourth week, where the questions related to the improvement in the symptoms of asthma or AR were asked. Patients were also asked about the improvement in QoL and any adverse effects. Results: A total of 694 patients were registered of which 138(19.8%) had AR, 294(42.4%) had asthma, while 273(39.3%) had both. Mean age was 41.1±14.63 years and 352 (50.7%) were male and 342(49.3%) were females. On a follow-up visit, there was a sufficient improvement in 351 asthmatics (63.9%), and 288 patients with AR (70.1%) overall, strong or marked improvement in the day (n=342,62.3%) and night time (n=331,60.3%) asthma symptoms. Overall improvements in QoL were very good or good in 419 patients. Montelukast was well-tolerated here with adverse effects (like abdominal discomfort, fever, fatigue, headache, rash, and upper respiratory tract symptoms) seen in 125 patients (18.01%). Conclusion: Montelukast was very effective in improving the symptoms and QoL of the individuals suffering from asthma and/or AR. doi: https://doi.org/10.12669/pjms.36.7.2657 How to cite this:Zuberi FF, Haroon MA, Haseeb A, Khuhawar SM. Role of Montelukast in Asthma and Allergic rhinitis patients. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2657 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Understanding coaching efficacy in education through activity systems: privileging the nuances of provision

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rachel M. Lofthouse ◽  
Anthea Rose ◽  
Ruth Whiteside
Keyword(s):  
Activity Systems ◽  
Content Type ◽  
Coaching Efficacy ◽  
Range Of Functions ◽  
Cultural Historical Activity ◽  
The Individual ◽  
Specific Challenge

PurposeThe research demonstrates the role of activity systems based in Cultural Historical Activity Theory as a means of analysing characteristics and efficacy of specific provisions of coaching in education.Design/methodology/approachThree examples of coaching in education were selected, involving 51 schools in England. The three examples were re-analysed using activity systems. This drew on existing evaluation evidence, gathered through interviews, questionnaires, focus groups and recordings of coaching.FindingsIn each example, the object of the coaching was to address a specific challenge to secure the desired quality of education. Using activity systems it is possible to demonstrate that coaching has a range of functions (both intended and consequential). The individual examples illustrate the potential of coaching to support change in complex and diverse education settings.Research limitations/implicationsThe use of existing data from evaluations means that direct comparisons between examples are not made. While data were collected throughout the duration of each coaching programme no follow-up data was available.Practical implicationsThe analysis of the examples of coaching using activity systems provides evidence of the efficacy of specific coaching provision in achieving individually defined objectives related to sustaining and improving specific educational practices.Originality/valueThe research offers insights into how coaching in education might be better tuned to the specific needs of contexts and the challenges experienced by the individuals working in them. In addition, it demonstrates the value of activity systems as an analytical tool to make sense of coaching efficacy.

Gabapentin is effective in treating nocturnal painful spasms in multiple sclerosis

2000 ◽  
Vol 6 (3) ◽  
pp. 192-193 ◽  
Author(s):  
C Solaro ◽  
M Messmer Uccelli ◽  
P Guglieri ◽  
A Uccelli ◽  
G L Mancardi
Keyword(s):  
Adverse Effects ◽  
Minimal Risk ◽  
Rapid Improvement ◽  
Open Label ◽  
Patient Reports ◽  
Period 2 ◽  
Pre Treatment ◽  
Subjective Discomfort

In-patients with MS nocturnal spasms (NPS) occur frequently, primarily during the night and may influence the ability to and/or quality of sleep. We enrolled in an open label trial with GBP (up to 600 mg/day) 24 MS patients with NPS. We obtained patient reports of subjective discomfort at pre-treatment and following 2- (T1) and 8 weeks (T2), utilizing a 3-point analogue scale. Twenty of the 22 patients who completed the study reported resolution or amelioration of discomfort. Clinical improvement occurred 1-5 days following initial treatment. Three patients experienced adverse effects but completed the minimal follow-up period (2 weeks). Two patient dropped out of the study due to no compliance or adverse effects. A very low dose of GBP may be effective treatment for MS patients with NPS who may benefit from rapid improvement of discomfort with minimal risk of adverse effects.

scholarly journals Efficacy and safety of two Ayurvedic dosage forms for Allergic rhinitis: Study protocol for an open-label randomized controlled trial

2019 ◽  
Author(s):  
JM Dahanayake ◽  
Pathirage Kamal Perera ◽  
P Galappaththy ◽  
D Samaranayake
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Allergic Rhinitis ◽  
Dosage Forms ◽  
Open Label ◽  
Randomized Controlled ◽  
Nasal Symptoms ◽  
Freeze Dried

Abstract Background Allergic rhinitis (AR) is an immune response of the nasal mucosa to airborne allergens and involves nasal congestion, watery nasal discharge, itching of the nose and sneezing. The symptoms of allergic rhinitis may significantly affect a patient’s quality of life and can be associated with conditions such as fatigue, headache, cognitive impairment and sleep disturbances. Various complementary and alternative medicine treatments have been used for this condition in clinical practice. The Ayurveda system of medicine is the most common complementary medicine system in Sri Lanka. The aim of this study is to find out whether the use of two preparations (decoction and its freeze dried powder) over a period of 4 weeks is able to cure the symptoms of allergic rhinitis. Study design This is a three arm open label non-inferiority randomized controlled clinical trial in patients with AR. The study duration is 28 days oral administration of the two Ayurvedic dosage forms (Decoction and freeze dried) and the antihistamine loratidine into the 3 arms allocated randomly. After a 1 week run-in period, eligible subjects are randomly assigned to the TMD12 decoction group, TMD12 freeze dried group and the antihistamine group. Total Nasal symptom Score (TNSS) of the patients are used as the primary efficacy outcome. TNSS is recorded and compared in all 3 arms prior to visit 1, at the end of 28 days, end of the first month of follow up and second month of follow up. Symptom scores of daytime nasal symptoms, night time nasal symptoms, non-nasal symptoms and Health Related Quality of Life questionnaire are used as secondary end points. Discussion This clinical trial will be able to provide supportive evidence based scientific data on classical Ayurvedic dosage forms and the new dosage forms developed as freeze dried powder in the treatment of allergic rhinitis. Also by this trial, it is expected to develop capacity to scientifically evaluate Ayurvedic treatments that may help patients having conditions such as allergic rhinitis.

scholarly journals A Importância do Farmacêutico no Acompanhamento Farmacoterapêutico em Pacientes Idosos Polimedicados / The Importance of the Pharmacist in the Pharmacotherapeutic Follow-Up in Polymedicate Elderly Patients

2021 ◽  
Vol 15 (58) ◽  
pp. 177-189
Author(s):  
Ariele Oliveira Arruda ◽  
Luciene Rodrigues da Silva ◽  
Luciano Hasimoto Malheiro
Keyword(s):  
Quality Of Life ◽  
Adverse Reactions ◽  
The Elderly ◽  
Integrative Approach ◽  
Self Medication ◽  
Inappropriate Use ◽  
The Individual

Resumo: A atuação do profissional farmacêutico se tornou indispensável no cuidado com a saúde do idoso. principalmente na educação de um consumo de medicamentos consciente e seguro. Em decorrência do envelhecimento, o indivíduo se torna mais propenso a evoluções patológicas, e assim aumentando o consumo de medicamentos. Isso amplia as possibilidades de erros relacionados aos fármacos, como interações, reações adversas e incidentes relacionados a administração medicamentosa. Desta forma, o presente trabalho teve como objetivo realizar uma revisão integrativa sobre a importância do acompanhamento farmacêutico na promoção da qualidade de vida dos idosos polimedicados e detectar prováveis riscos relacionados ao uso de medicamentos. A metodologia empregada consiste em um estudo de pesquisa bibliográfica com abordagem integrativa. A busca pelas publicações foi realizada através das plataformas Biblioteca Virtual em Saúde (BVS), Pubmed, Google Acadêmico e Periódico CAPES. A literatura disponível indica que o farmacêutico possui papel fundamental na orientação medicamentosa do idoso polimedicado, garantindo um tratamento farmacoterapêutico mais eficaz e seguro, e assim proporcionando maior qualidade de vida durante o processo de envelhecimento.Palavras-chave: Automedicação; Polifarmácia; Uso Inadequado de medicamentos. Abstract: The role of the pharmacist has become essential in caring for the health of the elderly. mainly in the education of a conscious and safe consumption of medicines. As a result of aging, the individual becomes more prone to pathological developments, thus increasing the consumption of medications. This expands the possibilities of drug-related errors, such as interactions, adverse reactions and incidents related to drug administration. Thus, this study aimed to carry out an integrative review on the importance of pharmaceutical monitoring in promoting the quality of life of polymedicated elderly people and detecting probable risks related to the use of medication. The methodology used consists of a bibliographic research study with an integrative approach. The search for publications was performed using Biblioteca Virtual em Saúde (BVS), Pubmed, Google Scholar and Periódico CAPES. The available literature indicates that the pharmacist has a fundamental role in the medication guidance of the polymedicated elderly, ensuring a more effective and safer pharmacotherapeutic treatment, and thus providing a better quality of life during the aging process.Keywords: Inappropriate use of medications. Polypharmacy. Self-medication. 

scholarly journals The current state of the problem with the diagnosis and treatment of allergic rhinitis in pediatric practice

2021 ◽  
Vol 16 (5) ◽  
pp. 375-383
Author(s):  
T.O. Kruchko ◽  
O.Ya. Tkachenko ◽  
V.V. Sherbak ◽  
I.O. Kolenko ◽  
L.M. Bubyr
Keyword(s):  
Allergic Rhinitis ◽  
Pollen Allergy ◽  
Allergic Diseases ◽  
Individual Characteristics ◽  
Diagnosis And Treatment ◽  
Cochrane Library ◽  
Upper Respiratory Tract ◽  
Pediatric Practice

Among all allergic diseases in pediatric practice, allergic rhinitis is one of the most common pathologies of the upper respiratory tract. This review deals with the problem of modern principles for the diagnosis and treatment of allergic rhinitis in children based on the analysis of literature sources using electronic databases PubMed, Web of Science, MedLine, the Cochrane Library. Allergic rhinitis is an important medical and social problem of our time the importance of which has increased significantly in recent years. The growing number of people sensitized to pollen, the variety of symptoms and the negative impact on the quality of life of patients make pollen allergy one of the major problems in pediatrics. Despite the development of international national protocols and clinical guidelines, in many countries the control of allergic rhinitis in children remains insufficient. Therefore, it is necessary to take into account the individual characteristics of patients, pay attention to both nasal and extranasal symptoms, consider all pathognomonic diagnostic aspects, because the underdiagnosis of this allergic disease leads to inadequate therapy, complications, more severe atopy and reduced quality of children’s life in general. Recently, there is growing evidence of the need for personalized selection of the most effective therapy for allergic rhinitis in children. In-depth study of the pathogenetic role of circadian molecular clock in children with seasonal allergic rhinitis using informative molecular genetic methods may allow characterizing in detail the mechanism of regulation of allergic inflammation of the upper airway mucosa and evaluating the role of circadian genes in the development of allergic diseases, in particular allergic rhinitis. In the future, these studies may become an alternative to improve control over the course of allergy and the organization of a comprehensive monitoring system, development of new strategies for the treatment and prevention of allergic rhinitis in children.

Comparison of efficacy and tolerability of oral desloratadine, rupatadine and ketotifen in seasonal allergic rhinitis

2021 ◽  
Vol 4 (3) ◽  
pp. 106-114
Author(s):  
Syed Khadeer ◽  
B Jagannath
Keyword(s):  
Allergic Rhinitis ◽  
Adverse Events ◽  
Nasal Congestion ◽  
Primary Outcome Measure ◽  
Nasal Symptom ◽  
Secondary Outcome ◽  
Open Label ◽  
Non Allergic Rhinitis ◽  
The Individual ◽  
Change In Mean

Rhinitis is inflammation of nasal mucosa which characteristically presents as running nose, blocked nose, itching on nose or sneezing. Allergic rhinitis is more common than non-allergic rhinitis. Anti-histamines are the mainstay of SAR treatment. Desloratadine, rupatadine and ketotifen are the commonly prescribed anti histamines in our region. In this study, we have compared efficacy and tolerability of desloratadine, rupatadine and ketotifen in SAR. This was a prospective, randomized, three arm, open label comparative study of desloratadine, rupatadine and ketotifen in SAR, conducted at Department of ENT, Kempegowda Institute of Medical Sciences, Bangalore; between January 2014 and December 2014. Patients’ severity of SAR symptoms were assessed by TNSS, QoL was measured using Medical Outcomes Study questionnaire (SF-12). SF-12 was administered at the start of study and then at the end of study. Adverse effects were monitored during clinical examination at each visit. Study subjects were systemically randomized into three groups – desloratadine (DES), rupatadine (RUP) and ketotifen (KET). Based on the assigned group; desloratadine was given orally in dose of 10mg OD, rupatadine orally 10 mg OD and ketotifen orally 1mg BD. All medications were given for 4 weeks. Follow up was done for all patients every week during treatment period of 4 weeks. The primary outcome measure was change in mean TNSS from baseline; secondary outcome measures were changes in the individual nasal symptom scores, change in the quality of life and tolerability to the study medications. Total 150 patients were recruited for this study, divided into 3 groups. DES and RUP were equally effective but significantly better than KET in improving rhinorrhea, nasal congestion, TNSS and AEC. (p=0.05). All the drugs were equally effective with no statistically significant intergroup difference in improving sneezing, nasal itching and QoL. RUP appeared to have better tolerability as the total number of adverse events were marginally less. DES and RUP are comparatively more effective and faster acting than KET. All the study medications were well tolerated with few mild, self-limiting, transient adverse events requiring no intervention.

536 QUALITY OF LIFE AND FOLLOW-UP AFTER ESOPHAGEAL AND GASTRIC CANCER SURGERY. PROTOCOL FOR DEVELOPING AND TESTING A NEW FOLLOW-UP MODEL

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
I Hovdenak Jakobsen ◽  
D Kjaer
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Adverse Effects ◽  
Prospective Study ◽  
Patient Involvement ◽  
Complex Interventions ◽  
National Implementation ◽  
Patient Reported

Abstract   Esophageal and gastric cancers are aggressive diseases. Due to extensive treatment, many patients experience adverse effects such as dysphagia, dumping, pain, fatigue, fear of recurrence and depression—all negatively impacting quality of life (QoL). The purpose of this study is to develop and test a follow-up model for patients after surgery for esophageal and gastric cancer. The model targets handling of adverse effects and psychosocial distress, aiming at improving patients’ QoL and functional level. Methods Development of the model follows recognized principles for complex interventions by the Medical Research Counsil. Extensive patient involvement is included in the development process, by means of a national patient advisory board. The assumed effect of the new model will be tested in a national two-part prospective study, executed before and after national implementation of the model, in both parts including approximately200 patients. Participants will be recruited prior to surgery, and follow-up is one year. Patient-reported data will be collected pre-operatively, at 3, 6, 9 and 12 months postoperatively, along with clinical and sociodemographic data. Results Development of the follow-up model after surgery will be completed in august 2020 and inclusion of patients for the prospective study part one, before implementation of the model, will commence summer 2020. Conclusion The perspectives of this study may be crucial for future follow-up of esophageal and gastric cancer patients. First, the extensive patient involvement in developing the model will ensure a patient-centred approach to follow-up. And second, the follow-up studies will provide important and up-to-date knowledge about clinical and patient-reported outcomes in a population-based, national cohort.

Quality of life in allergic rhinitis

2011 ◽  
Vol 6 (1) ◽  
pp. 25-39 ◽  
Author(s):  
Tunis Ozdoganoglu ◽  
Murat Songu ◽  
Hasan Mete Inancli
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
School Performance ◽  
Work Performance ◽  
Upper Respiratory Tract ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Allergic rhinitis is a global health problem that causes major illness and disability worldwide. Although nasal and nonnasal symptoms are directly attributable to inflammation in the upper respiratory tract, individuals also experience generalized symptoms that include fatigue, mood changes, depression, anxiety and impairments of work and school performance, and cognitive function. Health-related quality of life focuses on patients’ perceptions of their disease and measures impairments that have a significant impact on the patient. The burden of disease, as the patient perceives it, forms the basic motivation to seek medical aid or to undergo therapy. Adherence to therapy requires changes in health, perceived by patients as relevant and outweighing eventual disadvantages of intervention. Because so many factors are involved in health-related quality of life, there are multiple ways in which it can be measured. A variety of validated and standardized questionnaires have been developed including assessments of school performance, work performance, productivity, and other parameters that quantify the impact of allergic rhinitis and its treatment on quality of life. The aim of this review is to highlight the impact of allergic rhinitis on the quality of life and to analyze the most commonly used health-related quality of life instruments.

scholarly journals Immune Checkpoints Expression in Chronic Lung Allograft Rejection

2021 ◽  
Vol 12 ◽  
Author(s):  
Ilaria Righi ◽  
Valentina Vaira ◽  
Letizia Corinna Morlacchi ◽  
Giorgio Alberto Croci ◽  
Valeria Rossetti ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
Bronchiolitis Obliterans Syndrome ◽  
Immune Checkpoints ◽  
Hla Antibodies ◽  
Restrictive Allograft Syndrome ◽  
And Function ◽  
Shed Light

Chronic lung allograft dysfunction (CLAD) is the main cause of poor survival and low quality of life of lung transplanted patients. Several studies have addressed the role of dendritic cells, macrophages, T cells, donor specific as well as anti-HLA antibodies, and interleukins in CLAD, but the expression and function of immune checkpoint molecules has not yet been analyzed, especially in the two CLAD subtypes: BOS (bronchiolitis obliterans syndrome) and RAS (restrictive allograft syndrome). To shed light on this topic, we conducted an observational study on eight consecutive grafts explanted from patients who received lung re-transplantation for CLAD. The expression of a panel of immune molecules (PD1/CD279, PDL1/CD274, CTLA4/CD152, CD4, CD8, hFoxp3, TIGIT, TOX, B-Cell-Specific Activator Protein) was analyzed by immunohistochemistry in these grafts and in six control lungs. Results showed that RAS compared to BOS grafts were characterized by 1) the inversion of the CD4/CD8 ratio; 2) a higher percentage of T lymphocytes expressing the PD-1, PD-L1, and CTLA4 checkpoint molecules; and 3) a significant reduction of exhausted PD-1-expressing T lymphocytes (PD-1pos/TOXpos) and of exhausted Treg (PD-1pos/FOXP3pos) T lymphocytes. Results herein, although being based on a limited number of cases, suggest a role for checkpoint molecules in the development of graft rejection and offer a possible immunological explanation for the worst prognosis of RAS. Our data, which will need to be validated in ampler cohorts of patients, raise the possibility that the evaluation of immune checkpoints during follow-up offers a prognostic advantage in monitoring the onset of rejection, and suggest that the use of compounds that modulate the function of checkpoint molecules could be evaluated in the management of chronic rejection in LTx patients.

scholarly journals Peran Supervisi Kepala Madrasah dalam Meningkatkan Mutu Pendidikan di MTs Negeri Kulon Progo

2020 ◽  
Vol 4 (2) ◽  
pp. 211-220
Author(s):  
Legiman
Keyword(s):  
Quality Improvement ◽  
Learning Objectives ◽  
Learning Activities ◽  
Quality Of Education ◽  
Factors Affecting ◽  
Qualitative Descriptive ◽  
Education Personnel

This research aims to determine the role of the head of Madrasah in improving the quality of education in MTs Negeri 4 Kulon Progo, and to help improve the competency of teachers in the learning activities with a real, measurable, controlled, directional program to achieve learning objectives. This research uses qualitative descriptive methods with data collection through observation, interviews and documentation. The results of this research are: 1) supervision of the head of the district of the state of the principal of the school 4 Kulon Progo includes education, managerial, administrator, supervisor, leader, innovator, and motivator; 2) The role of quality improvement is done by increasing the professionalism of teachers by giving opportunities to teachers; 3) Factors affecting the implementation of the head of the Madrasah include: the planning, implementation and follow-up that is carried out continuously to the teachers and education personnel.

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