scholarly journals Analysis of Alprostadil Injection in Real-World Usage and a Review of Literatures

Author(s):  
Jingchao Yan ◽  
Jianwen Shen ◽  
Ling Li ◽  
Taomin Huang

Abstract Background:The irrational use of medicines has become a major problem worldwide. The World Health Organization (WHO) estimates that more than half of all medicines are prescribed, dispensed, or sold inappropriately, and advised the pursuit of the responsible use of medicines.In China regulations require that a pharmacist must audit the prescription.Alprostadil injection is a vasodilator and an inhibitor of platelet aggregation There is no obvious or clear indication for its use in the ear, nose and throat (ENT) Department. It came to our notice that in our hospital, alprostadil injection has been prescribed in the ENT Outpatient Department to treat some diseases. Aim: This utilization review on the use of alprostadil injection was carried out in the ear, nose and throat (ENT) Outpatient Department of our hospital to determine its utilization patterns and promote its rational use. Methods: A prescription survey was conducted, and detailed demographic information, including the patient’s age, gender, diagnosis and so on, were recorded in an Excel spreadsheet. The rationality for these prescriptions were retrospectively evaluated.Results: Based on the evaluation results, all alprostadil injections were found to be used off label in the Otolaryngology Department. Furthermore, 98.3% of the prescriptions were for the treatment of sudden hearing loss, 1.1% of the prescriptions for the diagnosis of hypoacusis were considered empirical and should have been more specific, and 0.6% of the prescriptions were for the treatment of Ménière’s disease and large vestibular aqueduct syndrome. There were various dosage regimens for alprostadil injection in clinical practice. However, there was no statistically significant difference in dosage between the different age groups. Moreover, most of the alprostadil injections were given by IV bolus, while 12.2% of patients received this by intravenous drip.Conclusion: The present review indicated that improvements should be made in the quality of prescriptions for alprostadil injection in the Otolaryngology Outpatient Department. Furthermore, there is no strong evidence to support the use of high doses. Future audits of such use may be combined with an awareness campaign to reduce and discourage the irrational use of off label medications.

Author(s):  
Katarzyna Dereń ◽  
Justyna Wyszyńska ◽  
Serhiy Nyankovskyy ◽  
Olena Nyankovska ◽  
Marta Yatsula ◽  
...  

Overweight and obesity, as well as underweight in children and adolescents, pose a significant public health issue. This study aimed to investigate the secular trend of the incidence of underweight, overweight, and obesity in children from Ukraine in 2013/2014 and 2018/2019. The studies were conducted in randomly selected primary and secondary schools in Ukraine. In total, 13,447 children (6468 boys and 6979 girls) participated in the study in 2013/2014 and 18,144 children (8717 boys and 9427 girls) participated in 2018/2019. Measurements of body weight and height were performed in triplicate. Underweight, overweight, and obesity were diagnosed according to the standards of the World Health Organization (WHO). In the group of girls, a significant difference between 2013/2014 and 2018/2019 measurements was found only among 7-year-olds. The percentage of girls at this age exceeding the body mass index (BMI) norm was lower in the 2018/2019 study. In boys, a significant difference was also found in 7-year-olds, and, as in girls, a lower share of overweight and obesity was found in 2018/2019. But for the ages of 12, 13, and 15, the significant differences had a different character—more overweight or obese boys were found in the 2018/2019 study. The proportion of underweight children was similar for the majority of age groups in both genders and did not differ in a statistically significant way.


2019 ◽  
Vol 76 (2) ◽  
pp. 123-128
Author(s):  
Zrinka Ivanisevic ◽  
Marko Matijevic ◽  
Zvonimir Uzarevic ◽  
Djordje Petrovic ◽  
Davor Jurlina ◽  
...  

Background/Aim. Oral health is an integral part of general health and an important factor in the overall quality of life. The purpose of this study was to investigate the prevalence of dental caries among the children from the SOS Children?s Village in Croatia. Methods. The dental examinations based on the World Health Organization criteria were performed on 88 children from SOS Children?s Village in Croatia. The teeth were clinically examined with standard dental instruments using the visual-tactile method under standard light. The clinical indexes of decayed, missed, and filled (dmft and DMFT, for primary and permantnt teeth, respectively) and decayed, missed, and filled surfaces (DMFS), as well as the significant caries index (SiC) were recorded. Results. Among the children from the SOS Children?s Village caries incidence were 57.94%. The mean dmft, DMFT and DMFS of all children was 1.82, 1.90 and 2.82, respectively. The highest mean dmft and DMFT score of 4.24 and 2.56 was found among 7?10 and 11?14 years old children, respectively. The highest mean DMFS score of 3.85 and 3.90 was found among 11?14 years old children and among the children from the SOS Children?s Village Lekenik, respectively. Among all children, the SiC index was 4.69. There was a significant difference between age groups and children?s place of residence in DMFT, DMFS and SiC. Conclusion. Prevalence of dental caries is low among the children from the SOS Children?s Village in Croatia compared to the children who lived with biological families.


2019 ◽  
Vol 7 (5) ◽  
pp. 856-861 ◽  
Author(s):  
Nuha H. Fatani ◽  
Manal Ahmed Ba Hammam ◽  
Hana’a Oraif ◽  
Sara Taher ◽  
Waleed Taju ◽  
...  

BACKGROUND: The prevalence of malocclusion varies from one region to another and among different age groups and ethnicities. According to the World Health Organization, malocclusion is the third most common abnormal dental condition. AIM: This study aims to establish the prevalence of malocclusion among schoolchildren in the Holy City of Makkah, Saudi Arabia. METHODS: A cross-sectional study was conducted among 400 Saudi schoolchildren, 12-15 years of age, of both genders, randomly selected from 15 schools in different regions of Makkah. Molar and canine relationships were examined, in addition to traits such as crowding, spacing, overjet, overbite, cross-bite, scissor bite, and maxillary diastema. RESULTS: The most prevalent molar relationship was Class I (52.3%), followed by Class II (25%), and Class III (20.5%). Crowding was the most prevalent malocclusion trait (74%), and scissor bite was the least common (2.5%). A statistically significant difference was found between males and females in most of the recorded criteria (P < 0.005). CONCLUSION: Among schoolchildren in Makkah, Class I molar relationship was the most prevalent type of occlusion, and the most prevalent malocclusion trait was crowding.


Author(s):  
Simon Christopher Fernandez ◽  
John Percival Fernandez

Introduction: World Health Organization declared Coronavirus SARS-CoV-2 a pandemic after two months of its propagation in China. The lack of coordination among people about the new Coronavirus threat is evident mainly due to the dearth of knowledge. Objective: To assess the knowledge of people in the East London district of South Africa about Coronavirus SARS-CoV-2. Methods: The study was anchored on a quantitative method approach and adopted a descriptive research design. The sample consisted of 160 adults. Using the virtual snowball sampling technique, people who were 18 years and above of age and can read English were selected for the online survey. The data were collected using a 3-point Likert scale questionnaire which was uploaded in Google Form. Data were analyzed using descriptive and inferential statistics. Results: The majority of the participants knew the myths and facts about the news. They were aware that wearing a face mask prevents Coronavirus transmission, drinking liquor and using hand dryers would not kill the virus. Some people were not sure whether eating garlic or rinsing the nose regularly with saline water would help to prevent from being affected by Coronavirus. The findings also showed that there was a significant difference (p<0.05) among different age groups of people on their knowledge about the Coronavirus. Conclusion: By comparing the overall findings with the facts issued by World Health Organization, people in the East London district of South Africa had sound knowledge about Coronavirus SARS-CoV-2 on its transmission and what preventive measures should be taken.


Author(s):  
Kirti Sundar Sahu ◽  
Arlene Oetomo ◽  
Niloofar Jalali ◽  
Plinio P. Morita

The World Health Organization declared the coronavirus outbreak as a pandemic on March 11, 2020. To inhibit the spread of COVID-19, governments around the globe, including Canada, have implemented physical distancing and lockdown measures, including a work-from-home policy. Canada in 2020 has developed a 24-Hour Movement Guideline for all ages laying guidance on the ideal amount of physical activity, sedentary behaviour, and sleep (PASS) for an individual in a day. The purpose of this study was to investigate changes on the household and population-level in lifestyle behaviours (PASS) and time spent indoors at the household level, following the implementation of physical distancing protocols and stay-at-home guidelines. For this study, we used 2019 and 2020 data from ecobee, a Canadian smart Wi-Fi thermostat company, through the Donate Your Data (DYD) program. Using motion sensors data, we quantified the amount of sleep by using the absence of movement, and similarly, increased sensor activation to show a longer duration of household occupancy. The key findings of this study were; during the COVID-19 pandemic, overall household-level activity increased significantly compared to pre-pandemic times, there was no significant difference between household-level behaviours between weekdays and weekends during the pandemic, average sleep duration has not changed, but the pattern of sleep behaviour significantly changed, specifically, bedtime and wake up time delayed, indoor time spent has been increased and outdoor time significantly reduced. Our data analysis shows the feasibility of using big data to monitor the impact of the COVID-19 pandemic on the household and population-level behaviours and patterns of change.


2021 ◽  
pp. 135245852110302
Author(s):  
Joanna Laurson-Doube ◽  
Nick Rijke ◽  
Anne Helme ◽  
Peer Baneke ◽  
Brenda Banwell ◽  
...  

Background: Off-label disease-modifying therapies (DMTs) for multiple sclerosis (MS) are used in at least 89 countries. There is a need for structured and transparent evidence-based guidelines to support clinical decision-making, pharmaceutical policies and reimbursement decisions for off-label DMTs. Objectives/Results: The authors put forward general principles for the ethical use of off-label DMTs for treating MS and a process to assess existing evidence and develop recommendations for their use. Conclusion: The principles and process are endorsed by the World Federation of Neurology (WFN), American Academy of Neurology (AAN), European Academy of Neurology (EAN), Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Middle-East North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS) and Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS), and we have regularly consulted with the Brain Health Unit, Mental Health and Substance Use Department at the World Health Organization (WHO).


2017 ◽  
Vol 39 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Fan-Fen Wang ◽  
Kam-Tsun Tang ◽  
Wen-Harn Pan ◽  
Justin Ging-Shing Won ◽  
Yao-Te Hsieh ◽  
...  

Background: In 2003, Taiwan’s iodine policy changed from mandatory to voluntary. The Nutrition and Health Survey in Taiwan (NAHSIT) 2001-2002 for schoolchildren showed adequate iodine nutrition, while NAHSIT 2005-2008 for adults showed the iodine status was at borderline adequacy. Objective: To investigate the iodine status of the Taiwanese population from schoolchildren to adulthood 10 years after the change of the salt iodization policy. Method: Urinary iodine was measured in samples from subjects in NAHSIT 2013. Results: The median urinary iodine concentration (UIC) of the Taiwanese population aged 6 years and above in 2013 was 96 μg/L, indicating mild iodine deficiency. The median UIC of 6- to 12-year-old schoolchildren was 124 μg/L (interquartile range [IQR]: 92-213 μg/L), and 115 μg/L (IQR: 80-166 μg/L), 125 μg/L (IQR: 74-161 μg/L), 73 μg/L (IQR: 52-131 μg/L), and 78 μg/L (IQR: 52-132 μg/L) in populations aged 13 to 18 years, 19 to 44 years, 45 to 64 years, and ≥65 years, respectively. Declining iodine nutrition in age groups ≥45 years old was noted that the median UIC of populations aged 45 to 64 years and ≥65 years was 99 and 88 μg/L, respectively, in NAHSIT 2005-2008. The median UIC of schoolchildren was not lower than that during the mandatory salt fortification period, but the distribution of urinary iodine levels signified a dietary pattern change. Conclusion: Wide-ranging variation in iodine nutrition levels was observed in different age groups. Universal salt iodization, as suggested by the World Health Organization, should be the best strategy to achieve adequate iodine nutrition.


2020 ◽  
Vol 69 (7-8) ◽  
pp. 371-376
Author(s):  
Šuhreta Delibašić ◽  
Jasna Huremović ◽  
Sabina Žero ◽  
Sabina Gojak-Salimović

The present study was conducted to investigate the water quality of the Trstionica River, Bosnia and Herzegovina. The physicochemical properties (temperature, pH, conductivity, total solids after evaporation at 105 °C), content of metals (calcium (Ca), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), sodium (Na), nickel (Ni), lead (Pb) and zinc (Zn)), and anions (chloride (Cl–), and phosphate (PO43–)) were determined in water samples collected at seven locations during two sampling periods: unstable weather conditions (precipitation), and stable weather conditions (without precipitation). There was a significant difference in the content of individual parameters in the river water depending on the sampling time. For determination of metals concentrations, which were below the limit of detection, a preconcentration method using an ion-exchange resin was applied. The metals concentrations during the rainy day were in the order Ca &gt; Mg &gt; Na &gt; Fe &gt; Cu &gt; Zn &gt; Pb &gt; Mn with mean values of 343, 6.03, 1.94, 0.18, 0.20, 0.03, 0.02, 0.01 mg dm–3, respectively, and during stable weather conditions: Ca &gt; Mg &gt; Na &gt; Cu &gt; Fe &gt; Mn &gt; Zn with mean values of 288, 7.62, 2.38, 0.11, 0.10, 0.01, 0.01 mg dm–3, respectively. Cd, Cr, and Ni concentrations were below limit of detection in both cases. Obtained values were compared with World Health Organization (WHO) regulations. The results showed that the Trstionica River in the investigated part of the stream meets most of the parameters required by the regulations. The correlation between analysed parameters was assessed, as well. Based on the calculated water quality index values, the water of Trstionica River falls into the category of excellent water.


2017 ◽  
Vol 98 (3) ◽  
pp. 433-439
Author(s):  
O A Zhdanova

Aim. To investigate physical development of children in Voronezh region in different age groups in 2011-2014 in comparison with the regional studies data in 1997-1999. Methods. The study was performed on 5644 children aged 1-18 years of health groups I and II in comparison with the data of 10 247 children aged 1-14 years examined in 1997-1999. Body height, weight and body mass index Z-scores, calculated using WHO AnthroPlus software, were evaluated. Results. Children’s Z-score values for body height in 2011-2014 were higher than in 1997-1999 in all age groups and at the age of 1-9 years these values exceeded World Health Organization (WHO) standards. Girls’ height approached the standards in 10-14 and 15-18 years, and boys’ height - in 15-18 years. Body weight of children aged 2-8 years was higher than the regional data in 1997-1999 and WHO standards approaching them at the age of 9. Body mass index increase compared to WHO standards was revealed in children aged 1-4 years (p=0.000), and in 2011-2014 the reported differences were less prominent than in 1997-1999. In 2011-2014 among 15-18-years-old girls the shift of body mass index values to the lack of body weight was noted, in 1997-1999 the same changes were found out for 10-14-years-old girls. Conclusion. In 2011-2014 specific attention was required to be paid to physical development of children at the age from 1 to 4 years due to overweight risk of and girls aged 15-18 years due to probable underweight risk.


Author(s):  
Shaun Purkiss ◽  
Tessa Keegel ◽  
Hassan Vally ◽  
Dennis Wollersheim

BackgroundQuantifying the mortality risk for people with diabetes is challenging because of associated comorbidities. The recording of cause specific mortality from accompanying cardiovascular disease in death certificate notifications has been considered to underestimate the overall mortality risk in persons with diabetes. Main AimDevelop a technique to quantify mortality risk from pharmaceutical administrative data and apply it to persons diagnosed with diabetes, and associated cardiovascular disease and dyslipidaemia before death. MethodsPersons with diabetes, cardiovascular disease and dyslipidaemia were identified in a publicly available Australian Pharmaceutical data set using World Health Organization anatomic therapeutic codes assigned to medications received. Diabetes associated multi-morbidity cohorts were constructed and a proxy mortality (PM) event determined from medication and service discontinuation. Estimates of mortality rates were calculated from 2004 for 10 years and compared persons with diabetes alone and associated cardiovascular disease and dyslipidemia. ResultsThis study identified 346,201 individuals within the 2004 calendar year as having received treatments for diabetes (n=51,422), dyslipidaemia (n=169,323) and cardiovascular disease including hypertension (n=280,105). Follow up was 3.3 x 106 person-years. Overall crude PM was 26.1 per 1000 person-years. PM rates were highest in persons with cardiovascular disease and diabetes in combination (47.5 per 100 person years). Statin treatments significantly improved the mortality rates in all persons with diabetes and cardiovascular disease alone and in combination over age groups >44 years (p<.001). Age specific diabetes PM rates using pharmaceutical data correlated well with Australian data from the National Diabetes Service Scheme (r=0.82) ConclusionProxy mortality events calculated from medication discontinuation in persons with chronic conditions can provide an alternative method to estimate disease mortality rates. The technique also allows the assessment of mortality risk in persons with chronic disease multi-morbidity.


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