scholarly journals Initial drug prescription in outpatient department: principal approach

2021 ◽  
Vol 15 (3) ◽  
pp. 91-97
Author(s):  
A. E. Karateev
Keyword(s):  
Drug Prescription ◽  
Main Tool ◽  
Accurate Diagnosis ◽  
Outpatient Appointment ◽  
Therapeutic Concept ◽  
Clinical Observations ◽  
Pathogenetic Therapy ◽  
Inflammatory Drugs ◽  
First Time ◽  
Initial Drug

One of the primary tasks for a doctor when meeting a patient for the first time is to gain his affection and trust. It is not always possible during the first visit to make an accurate diagnosis and prescribe pathogenetic therapy, because this often requires a deep additional examination. However, it is imperative to demonstrate knowledge and confidence, provide psychological support and alleviate the suffering of the patient, especially in the case of rheumatic disease accompanied by severe pain. Such a patient should be immediately prescribed adequate analgesic therapy. The main tool for controlling pain in diseases of the joints and spine are non-steroidal anti-inflammatory drugs. Moreover, their prescription should be deliberate and balanced, taking into account the clinical picture and comorbid pathology.The article presents two clinical observations, illustrating the formation of a diagnostic and therapeutic concept at an outpatient appointment.

Untersuchungen zur Quantifizierung der Änderung der Skelettmuskeldurchblutung nach Gefäßrevaskularisationen mit einem 99mTechnetiummarkierten Tracer

1990 ◽  
Vol 29 (05) ◽  
pp. 215-220 ◽  
Author(s):  
R. Benning ◽  
K. Nagel ◽  
M. Jugenheimer ◽  
S. Fischer ◽  
S. Worthmann ◽  
...  
Keyword(s):  
Transluminal Angioplasty ◽  
Lower Limbs ◽  
Surgical Patients ◽  
Treadmill Test ◽  
Negative Results ◽  
Clinical Observations ◽  
Before And After ◽  
Comparative Results ◽  
First Time ◽  
Percutaneous Transluminal

A new 99mTc-labelled tracer (99mTc-Sestanriibi) was used for the first time to demonstrate the perfusion of the skeletal muscle. In 16 patients with obstructive atherosclerosis of the lower limbs the change of perfusion of thigh and lower leg was studied with SPECT before and after vascular surgery (n = 11) or percutaneous transluminal angioplasty (n = 5). Comparative results of scintigraphic measurements and clinical observations (ancle-arm pressure, treadmill test) in 10 surgical patients (14 operated legs) showed correct positive or negative results in 86% (12/14).

Bone Elastometric Measurements by Ultrasound Reflectometry: Observations on Physiology and Functional Organization of Bone

2000 ◽  
Author(s):  
Shreefal S. Mehta ◽  
Peter P. Antich ◽  
Billy Smith ◽  
Matthew A. Lewis ◽  
Edmond Richer
Keyword(s):  
Mechanical Properties ◽  
Functional Organization ◽  
Muscular Activity ◽  
Diagnostic Techniques ◽  
Rate Of Change ◽  
Activity Levels ◽  
Bone Material ◽  
Clinical Observations ◽  
First Time

Abstract Bone mechanical properties are strongly dependent on orientation and optimally adapted to the directional stresses induced by load bearing and muscular activity. Spatial and directional homogeneity and a slow rate of change of material mechanical properties are commonly assumed in the literature. The assumptions are based on limitations of widespread diagnostic techniques but are contradicted by results from several established techniques, including ultrasound reflectometry. A device based on the ultrasound reflectometry technique measures the mechanical elasticity of bone noninvasively at multiple sites and orientations, making it possible to carry out longitudinal studies at any chosen location in vivo. In vivo elastometric measurements over the length of a tibia were obtained with this device, demonstrating quantitatively for the first time the spatial and directional heterogeneity of bone material properties in vivo. Clinical observations made on two subjects also suggest that bone does exhibit rapid changes in response to altered activity levels.

scholarly journals Taenia solium Prevalence in Nepal: A Retrospective Review

2019 ◽  
Vol 36 ◽  
pp. 98-104
Author(s):  
B. K C ◽  
K. Kaphle
Keyword(s):  
Intestinal Parasites ◽  
Taenia Solium ◽  
Accurate Diagnosis ◽  
Striated Muscles ◽  
Porcine Cysticercosis ◽  
Cestode Parasite ◽  
Close Proximity ◽  
Affected Tissue ◽  
First Time ◽  
The Brain

 Taenia solium is a zoonotic cestode parasite which causes cysticercosis in human and porcine cysticercosis in pigs. The infective stage of T. solium develops in pig while that of T. saginata develop in cattle and buffalo. The adult stages of T. solium are obligatory intestinal parasites for man. In humans the cysticercus larvae commonly encyst in the brain, causing neurocysticercosis. The disease was first described in pig by Aristophanes and Aristotle in 3rd century B.C. In Nepal, Taenia cysts were observed for first time in pork meat slaughtered in Kangeswari, Kathmandu more than 30 years ago. T. solium is the cause of 30% of epilepsy cases in many endemic areas where people and roaming pigs live in close proximity. More than 50 million of the world’s populations are infected worldwide and 50000 die from Neurocysticercosis yearly. In Nepal, the prevalence ranges from 0.002-0.1% in general population. Accurate diagnosis required detailed post mortem examination involving slicing of affected tissue to determine the viability of cysts. Cysticerci occur most commonly in striated muscles tissues and brain of pigs. The application of vaccination with TSOL18 recombinant vaccine along with oral medication of oxfendazole can reduces the transmission by pigs whereas use of niclosamide is found effective in humans. Hence the use of medication eventually reduces the incidence of neurocysticercosis in human and procine cysticercosis in pigs.

SPCCTDM, a Catalogue for Analysis of Therapeutic Drug Monitoring Related Contents in the Drug Prescription Information

2010 ◽  
Vol 1 (2) ◽  
pp. 1-11
Author(s):  
Sven Ulrich ◽  
Pierre Baumann ◽  
Andreas Conca ◽  
Hans-Joachim Kuss ◽  
Viktoria Stieffenhofer ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Text Analysis ◽  
Scientific Evidence ◽  
Drug Prescription ◽  
Plasma Concentrations ◽  
Therapeutic Drug ◽  
Drug Reactions ◽  
First Time

Therapeutic drug monitoring (TDM) has consistently been shown to be useful for optimization of drug therapy. For the first time, a method has been developed for the text analysis of TDM in SPCs in that a catalogue SPC-ContentTDM (SPCCTDM) provides a codification of the content of TDM in SPCs. It consists of six structure-related items (dose, adverse drug reactions, drug interactions, overdose, pregnancy/breast feeding, and pharmacokinetics) according to implicit or explicit references to TDM in paragraphs of the SPC, and four theory-guided items according to the information about ranges of plasma concentrations and a recommendation of TDM in the SPC. The catalogue is regarded as valid for the text analysis of SPCs with respect to TDM. It can be used in the comparison of SPCs, in the comparison with medico-scientific evidence and for the estimation of the perception of TDM in SPCs by the reader. Regarding the approach as a model of text mining, it may be extended for evaluation of other aspects reported in SPCs.

Anaphylactic reaction to anakinra in a child with steroid-dependent idiopathic recurrent pericarditis and successful management with canakinumab

2019 ◽  
Vol 29 (4) ◽  
pp. 549-551 ◽  
Author(s):  
Serdar Epçaçan ◽  
Sezgin Sahin ◽  
Ozgur Kasapcopur
Keyword(s):  
Anaphylactic Reaction ◽  
Interleukin 1 ◽  
Subsequent Treatment ◽  
Efficacy And Safety ◽  
Recurrent Pericarditis ◽  
Successful Management ◽  
Steroid Dependent ◽  
Inflammatory Drugs ◽  
First Time ◽  
Conventional Algorithm

AbstractConventional algorithm for treatment of pericarditis and prevention of recurrences consists of non-steroid anti-inflammatory drugs and/or colchicine, followed by corticosteroids in resistant patients. Anakinra has emerged as a promising and safe treatment modality for steroid-dependent idiopathic recurrent pericarditis. However, the efficacy and safety of canakinumab, another anti-interleukin-1 agent, has not been assessed up to date. Herein, we present development of an anaphylactic reaction due to anakinra and a successful subsequent treatment with canakinumab for the first time in the literature.

scholarly journals Prescribing Pattern of NSAIDs in Orthopedic Department of Dhaka Medical College Hospital

2017 ◽  
Vol 25 (1) ◽  
pp. 58-60
Author(s):  
Kazi Afzalur Rahman ◽  
AHM Mostafa Kamal ◽  
Sanjida Akhter ◽  
Khadeza Khatun ◽  
Rumana Afroz ◽  
...  
Keyword(s):  
Drug Prescription ◽  
Medical College Hospital ◽  
List Type ◽  
Antiinflammatory Drugs ◽  
Prescribing Pattern ◽  
College Hospital ◽  
Medical College ◽  
Orthopedic Department ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Context : Drug therapy is the most commonly used method in disease treatment in general practice. The pattern of drug prescription are often inappropriate and need for registration of these patterns is essentian in an effort to improve prescribing standard. Nonsteroidal antiinflammatory drugs (NSAIDs) are a drug class that groups together drugs that provide analgesic (pain-killing) and antipyretic (fever-reliefing) effects, and, in higher doses, anti-inflammatory effects. Non steroidal anti inflammatory drugs are the most common drugs prescribed in the world over specially in the orthopedic department. The study of prescribing pattern of NSAIDs in the orthopedic department was conducted to monitor, evaluate and if necessary suggest modification in the prescribing behavior of the medical practitioner to make it rational and cost effective.Material and Methods: The present study was performed on 300 (Three hundred) prescriptions from both admitted and outpatients (OPD) of the orthopedic department of Dhaka Medical College Hospital, Dhaka. The check list type of data was collected with prior permission from the concern department and the authority. The study was cross sectional analytical type and was conducted in the department of Pharmacology, Dhaka Medical College, Dhaka, from July 2010 to June 2011.Result : In case of OPD patients most common NSAIDs prescribed to the patients were aceclofenac (44.7%); followed by diclofenac (23.3%). Other NSAIDs were naproxen, ketorolac and ibuprofen 8%, 15.3% and 5.4% respectively. In case of admitted patients most common NSAIDs prescribed to the patients were ketorolac (54.7%) followed by diclofenac (24.0%).Conclusion: Non steroidal anti inflammatory drugs were the main prescription drug for both indoor and outdoor patients in the orthopedic department. Aceclofenac in outdoor and ketorolac in indoor were the most common NSAIDs drug used.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 58-60

scholarly journals Causes of primary refractoriness to the treatment of erectile dysfunction with phosphodiesterase type 5 inhibitors and means to overcome it

2011 ◽  
Vol 57 (5) ◽  
pp. 42-45
Author(s):  
R V Rozhivanov ◽  
D G Kurbatov
Keyword(s):  
Erectile Dysfunction ◽  
Diabetic Neuropathy ◽  
Combined Treatment ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Glucose Levels ◽  
Combined Application ◽  
Testing And Measurement ◽  
Pathogenetic Therapy ◽  
Phosphodiesterase Type ◽  
First Time

Aim: to elucidate causes of primary refractoriness to phosphodiesterase type 5 inhibitors. Materials and methods: 28 men aged from 38 to 59 (mean 46) years suffering from erectile dysfunction and primary refractoriness to the treatment with phosphodiesterase type 5 inhibitors were interviewed using the International Index of Erectile Function (IIEF-5) questionnaire. In addition, they were examined by ultrasound dopplerography of penile vessels, subjected to neurologic testing and measurement of blood testosterone, TSH, prolactin, and glucose levels. Results and discussion: The primary refractoriness to the treatment with phosphodiesterase type 5 inhibitors was attributable to hypothyroidism in 3.5% of the cases, to diabetic neuropathy in 3.5%, to complications of radical prostatectomy in 3.5%, to hyperprolactinemia in 7%, to atherosclerosis of cavernous arteries in 7%, to venogenic erectile dysfunction in 7%, to hypogonadism in 11%, to combination of hypogonadism, diabetic neuropathy and angiopathy in 57%. Hypothyroidism, hyperprolactinemia, hypogonadism, and type 2 diabetes mellitus (12.5% of the cases) were detected for the first time in the examined patients. Pathogenetic therapy resulted in the elimination of erectile dysfunction in the patients presenting with hypothyroidism, hyperprolactinemia, and isolated hypogonadism. Combined treatment of erectile dysfunction with Nebido and Levitra proved efficacious in 14 of the 16 patients with combined hypogonadism, diabetic neuropathy, and angiopathy. Conclusion: The main causes of primary refractoriness to phosphodiesterase type 5 inhibitors appear to be endocrinopathies and diabetic neuro/angiopathy. Combined examination of the patients in these conditions makes it possible to reveal dangerous disorders. Self-treatment with phosphodiesterase type 5 inhibitors is undesirable. Medicamental therapy (including combined application of testosterone preparations and phosphodiesterase type 5 inhibitors) permits to cope with erectile dysfunction in 75% of the patients.

scholarly journals History of the study of hemorrhagic disease of newborns

2017 ◽  
Vol 8 (4) ◽  
pp. 118-125
Author(s):  
Dmitry O. Ivanov
Keyword(s):  
Vitamin K ◽  
High Efficiency ◽  
Water Soluble ◽  
Hemorrhagic Disease ◽  
Treatment Techniques ◽  
Clinical Observations ◽  
History Of ◽  
Haemorrhagic Disease ◽  
First Time

The article describes the main historical periods of the study of hemorrhagic disease of newborns. Clinical observations, describing bleeding of newborns, which occurs without visible damage, known since the seventeenth century and are found in the works of Francois Mauriceau and Georg Wolfgang Wedel. The role of the liver injury in the development of bleeding of infants noticed English physicians John Huxham (1672-1768) and John Cheyne (1777-1836). In 1871 Ludwig Grandidier conducted differential diagnosis between umbilical bleeding of neonates and the hemophilia clinic. Later I.P. Pavlov showed, that the clotting time of dog’s blood significantly prolongs when you turn off the liver from the blood circulation. In that way, partly began to understand the etiology of hemorrhagic syndrome, but the pathogenesis of this suffering, in diseases of the liver remained unknown. Charles Wendell Townsend in 1894, describing 50 cases of coagulopathy of newborns, at the first time paid attention to the connection between breastfeeding and development of bleeding and offered to call this nosological form as "hemorrhagic disease of newborns". In the late 20s of the last century Henrik Dam have identified the unknown substances from green lucerne leaves and described them as the fat-soluble vitamin K (coagulation). In 1943 H. Dam and E. Doisy received the Nobel prize for the discovery and establishment of the chemical structure of vitamin K. In 1943, a group of Soviet biochemists have synthesized a water-soluble analogue of vitamin K (K3, vicasolum), quickly introduced into clinical practice and showed their high efficiency in patients with hypovitaminosis K. In 1945 Yu.F. Dombrovskaya suggested that haemorrhagic disease of newborns caused by deficit of vitamin K. Further researching of the development of haemorrhagic disease of newborns is associated with the study of the biochemistry of the pathogenesis of the disease, identify its various forms and development of treatment techniques and prevention, depending on the identified features.

scholarly journals Nutraceutical Properties of Mulberries Grown in Southern Italy (Apulia)

Antioxidants ◽  
2019 ◽  
Vol 8 (7) ◽  
pp. 223 ◽  
Author(s):  
Carmine Negro ◽  
Alessio Aprile ◽  
Luigi De Bellis ◽  
Antonio Miceli
Keyword(s):  
High Performance ◽  
Southern Italy ◽  
Morus Alba ◽  
Array Detector ◽  
Morus Nigra ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Mulberry Fruits ◽  
First Time ◽  
Gallic Acid Equivalent

In this work, for the first time, were analyzed mulberry genotypes grown in Apulia (Southern Italy, Salento region) were analyzed. Two local varieties of Morus alba (cv. Legittimo nero and cv. Nello) and one of Morus nigra were characterized for content in simple sugars, organic acids, phenols, anthocyanins; fruit antioxidant activity (AA) was also evaluated by three different methods (2,2-Diphenyl-1-picrylhydrazyl, DPPH; 2,2′-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), ABTS; and Ferric reducing antioxidant potential, FRAP test). The results showed that the sugars amount ranged between 6.29 and 7.66 g/100 g fresh weight (FW) while the malic and citric acids content was low, at about 0.1–1 g/100 g FW. Mulberries are a good source of phenols which are present in higher values in M. nigra and M. alba cv. Legittimo nero (485 and 424 mg Gallic Acid Equivalent (GAE)/ 100 g FW, respectively). The high performance liquid chromatography/diode array detector/mass spectrometry (HPLC/DAD/MS) analysis identified 5 main anthocyanin compounds present in different concentrations in each variety of mulberry: cyanidin 3-sophoroside, cyanidin 3-glucoside, cyanidin 3-rutinoside, pelargonidin 3-glucoside, pelargonidin 3-rutinoside. The highest concentration of anthocyanins was determined in Morus alba Legittimo (about 300 mg/100 g FW) while the lowest content (about 25 mg/100 g FW) was measured in M. alba cv. Nello. Morus nigra showed a good AA in comparison with the different M. alba genotypes with all the used methods; its AA was equal to 33, 26 and 21 μmols Trolox/g FW when using DPPH, ABTS and FRAP tests, respectively. All genotypes showed an anti-inflammatory activity (measured by cyclooxygenase (COX) inhibitory assay) which was also compared with two commercial anti-inflammatory drugs. The data obtained support the high biological qualities of mulberry fruits and their diffusion in human nutrition.

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