scholarly journals Rituximab Utilization Evaluation with Focused on Available Evidence for Off-Labeled Indications

2019 ◽  
Author(s):  
Maryam Farasatinasab ◽  
Sohrab Aghabeigi ◽  
Soodeh Ramezaninejad ◽  
Atefeh Amouzegar ◽  
Behrooz Ghanbari ◽  
...  
Keyword(s):  
Demographic Data ◽  
Cost Benefit ◽  
Dosage Level ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Medical Sciences ◽  
Expensive Drug ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
The Cost

Background: To investigate the on-labeled and off-labeled indications of rituximab according to available evidence and the cost benefit of using this expensive drug. Methods: This retrospective cross-sectional study was conducted between August 2016 and August 2017 at a teaching hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. Patients’ demographic data and disease, indication for rituximab use, its dosage and treatment regimen and previous and concurrent treatments was assessed. The collected data were compared with the current criteria for the pattern of rituximab use. The last version of Lexicomp® acquired by Wolters Kluwer was used as the reference for on-labeled and off-labeled indications of the prescribed drug and its dosage. Level of evidences for applied indications and cost has also been evaluated. Results: A total of 85 patients received rituximab during the study period. The most frequent reasons for rituximab prescription were: multiple sclerosis (50.58%), systemic sclerosis (10.58%), rheumatoid arthritis (7.05%) and Idiopathic inflammatory myopathies (4.70%).Rituximab was used in 8 (9.4%) cases according to on-labeled indications. There was level C evidence for rituximab use in off-labeled indications in 47 (55.29%) cases according to available evidences which accounts for the highest calculated cost. Conclusion:Based on our results, rituximab was frequently administrated for off-labeled indications most of which are not supported by established levels of evidence. The total cost was higher for level C evidence indications of off labeled rituximab than for indications with a higher level of evidence (A and B). So, strong evidence is necessary for decision making regarding its effectiveness and its cost benefit. J Pharm Care 2019; 7(1-2): 14-20.

scholarly journals The Prevalence of Substance Use Disorders Among University Students, a Cross-Sectional Study

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Ashraf Direkvand-Moghadam ◽  
Kosar Piri ◽  
AmirReza JamshidBeigi ◽  
Safoura Taheri ◽  
Yousef Veisani
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Demographic Data ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Iranian Students ◽  
Academic Year

Background: Substance use disorders (SUD) are serious social problems that cause physiological and psychological disorders. Adolescents and youth are known as high-risk groups for SUD. Objectives: The present study aimed to investigate the pattern, prevalence, incidence, and etiology of SUD among all students studying at the Ilam University of Medical Sciences, Ilam (Iran), during the academic year 2018 - 2019. Methods: In a cross-sectional study, a multistage random sampling method was used to select the participants. A self-administered questionnaire was used to collect data. This questionnaire was designed to collect information about the participant’s demographic data, social data, medical and behavioral data. Data were analyzed using descriptive and inferential statistics in SPSS 16 software. Results: Participants’ ages mean ± SD was 23.5 ± 3.2 years old. The incidence of substance abuse was higher among men compared to women. The main observed pattern of SUD was Marijuana among consumers. The curiosity and increased memory had the highest and lowest incidence, respectively. Conclusions: The incidence of SUD is high among Iranian students, and most of them have begun SUD in adolescence and because of curiosity. It is necessary to augment adolescents’ and young people’s awareness of the SUD and addiction consequences.

scholarly journals Awareness and knowledge of diabetes mellitus among diabetic patients in Puducherry, India

2017 ◽  
Vol 6 (5) ◽  
pp. 1211
Author(s):  
Benil V. ◽  
Dheepan Nayagam B.
Keyword(s):  
Demographic Data ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Health Programs ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Diet Control ◽  
Treatment Of Diabetes

Background: Diabetes prevalence is high in India and the numbers are increasing every year. Many patients are aware that they have diabetes only when they develop one of its complications. Since there is a paucity of literature on the level of awareness and knowledge about diabetes, this study was done.Methods: It is a cross-sectional study conducted on diabetic patients attending Sri Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry over a period of two months, using questionnaire. The demographic data were analyzed using descriptive statistics. Quantitative data were expressed as percentages.Results: Among 104 diabetics, 60%, 49% and 66% of the patients answered high sugar intake as the cause of diabetes, loss of vision as its complication and diet control as the important measure of treatment of diabetes respectively. Only 30.67% of the patients were aware of the name of the medicine they consume.Conclusions: Awareness and knowledge about diabetes were less in our study populations. Hence it is important to extend the diabetic health programs in mass campaigns to improve their knowledge.

scholarly journals Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet’s Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 18 (2) ◽  
pp. 673
Author(s):  
Hashim A. Mahdi ◽  
Hamza M. Assaggaf ◽  
Mohammad Alfelali ◽  
Omar B. Ahmed ◽  
Radi Alsafi ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Graduate Education ◽  
Formal Education ◽  
Demographic Data ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet’s Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants’ demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18–65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors’ mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.

scholarly journals Parathyroid Hormone in Pregnancy: Vitamin D and Other Determinants

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 360
Author(s):  
Ola Hysaj ◽  
Patricia Marqués-Gallego ◽  
Aline Richard ◽  
Magdeldin Elgizouli ◽  
Alexandra Nieters ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Inflection Point ◽  
Demographic Data ◽  
Late Pregnancy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
25 Hydroxy Vitamin D ◽  
Maximal Suppression

We aimed to assess the parathyroid hormone (PTH) concentration in pregnant women at the beginning of pregnancy (1st trimester) and within days before delivery (3rd trimester) and evaluate its determinants. From September 2014 through December 2015 in a cross-sectional study, 204 women in the 1st trimester of pregnancy and 203 women in the 3rd trimester of pregnancy were recruited. Blood samples were collected to measure PTH and circulating 25-hydroxy-vitamin D (25(OH)D) concentrations. Lifestyle and demographic data were collected using a questionnaire. Serum 25(OH)D and PTH were inversely correlated in both early and late pregnancy. Our analyses suggest that in the 3rd trimester of pregnancy, a 25(OH)D level of 18.9 ng/mL (47.3 nmol/L) could serve as an inflection point for the maximal suppression of PTH. Statistically significant determinants of PTH concentrations in multiple regression were 25(OH)D concentrations, season, multiparity and education of the partner (all p < 0.05) in early pregnancy. In late pregnancy, 25(OH)D concentrations and country of origin were statistically significant determinants of PTH concentrations (all p < 0.05). These factors and their effect on PTH appear to be vastly determined by 25(OH)D; however, they might also affect PTH through other mechanisms besides 25(OH)D.

scholarly journals Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050629
Author(s):  
Vanessa W Lim ◽  
Hwee Lin Wee ◽  
Phoebe Lee ◽  
Yijun Lin ◽  
Yi Roe Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
The Cost

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.

scholarly journals Incentives and barriers to HIV testing in men who have sex with men in a metropolitan area in Brazil

2016 ◽  
Vol 32 (5) ◽  
Author(s):  
Valéria Freire Gonçalves ◽  
Ligia Regina Franco Sansigolo Kerr ◽  
Rosa Salani Mota ◽  
Raimunda Hermelinda Maia Macena ◽  
Rosa Lívia de Almeida ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Metropolitan Area ◽  
Low Income ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Respondent Driven Sampling ◽  
Sectional Study ◽  
Personal Network ◽  
Cross Sectional ◽  
Sex With Men

Abstract: This study aimed to identify incentives and barriers to HIV testing in men who have sex with men (MSM). This was a cross-sectional study of MSM who had lived at least three months in greater metropolitan Fortaleza, Ceará State, Brazil, 2010. The study recruited 391 men ≥ 18 years of age who reported sexual relations with men in the previous six months, using Respondent Driven Sampling. Personal network and socio-demographic data were collected and HIV testing was offered, analyzed with RDSAT 6.0 and Stata 11.0. The majority were young (40.3%), had 5 to 11 years of schooling (57.3%), were single (85.1%), had low income (37.6%), and 58.1% had tested for HIV some time in life. Incentive to test: certainty of not being infected (34.1%) and the exposure to national campaign Fique Sabendo [Know your Status] (34%). Barriers: trust in partner(s) (21%) and fear of discrimination if tested positive (20.3%). Policies should be developed to ensure test confidentiality and communication campaigns focusing on information gaps and encouragement for testing.

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals A study of the knowledge and attitude of physicians in the first aid management of epistaxis in Aseer region, Saudi Arabia

2019 ◽  
Vol 5 (6) ◽  
pp. 1457
Author(s):  
Abdullah Musleh ◽  
Sarah Ali AlShehri ◽  
Anas Mohammed AlShehri ◽  
Sultan Khalid Kadasah ◽  
Mohammed Sharaf Alshahrani ◽  
...  
Keyword(s):  
Demographic Data ◽  
Total Sample ◽  
First Aid ◽  
Cross Sectional Study ◽  
Nasolacrimal Duct ◽  
Medical Attention ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Common ◽  
Knowledge And Attitude

<p class="abstract"><strong>Background:</strong> Epistaxis is the common occurrence of bleeding from the nose. It is usually noticed when blood drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, more likely to require medical attention). Sometimes in more severe cases, the blood can come up the nasolacrimal duct and out from the eye<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> A cross-sectional study was conducted in main five hospitals in Aseer region targeting residents dealing with emergency room (ER) cases during the period from 1st July to 31st July, 2018. Data were collected using a pre-structured written questionnaire by the researchers. The questionnaire composed of three parts. First part was for residents’ demographic data. Second part considered epistaxis cases rate and treatment. Third part covered 10 questions for knowledge regarding epistaxis<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> A total sample of 165 residents was involved with ages ranged from 27 years to 32 years old and 65.5% of the sampled residents were males. Exact of 47.3% of the residents were ER residents and 24.2% were general practitioners (GPs)<span lang="EN-IN">. </span></p><p class="abstract"><strong><span lang="EN-IN">Conclusions:</span></strong><span lang="EN-IN"> Nearly one out of each four residents had good awareness level regarding epistaxis especially GPs and ER residents. Position of patients with epistaxis and sites of epistaxis were the only items well known by residents. </span></p>

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