Issues Impacting Therapeutic Outcomes in Pediatric Patients: An Overview

2014 ◽  
Vol 10 (3) ◽  
pp. 184-193 ◽  
Author(s):  
Atin Kalra ◽  
Shishu Goindi
Keyword(s):  
Pediatric Patients ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
Dosage Forms ◽  
World Health ◽  
Neglected Diseases ◽  
Therapeutic Outcomes ◽  
Immunodeficiency Virus ◽  
Academic Researchers ◽  
Child Friendly

The quest for achieving optimal therapeutic outcomes in pediatric patients has evaded the healthcare professionals for long and often lack of child specific dosage forms and the associated events that follow with it have been considered to be major contributor towards suboptimal outcomes. Consequently, there have been sustained efforts over the years to address this issue with the enactment of legislations like Best Pharmaceutical for Children Act (BPCA), Pediatric Research Equity Act (PREA) and Pediatric Regulation by European Union (EU) to incentivise the participation of pharmaceutical industry towards development of child friendly dosage forms. Initiatives taken in past by organisations like World Health Organisation (WHO) and Drugs for Neglected Diseases Initiative (DNDi) to spur the development of child friendly dosage forms has helped to address issues pertaining to management of Human Immunodeficiency Virus (HIV) and malaria in pediatric patients. Present efforts aimed at developing child friendly dosage forms include oro-dispersible platforms including thin films and mini-tablets. Despite these leaps and advancements in developing better dosage forms for children, lower therapeutic outcomes in pediatric patients continue to remain an unresolved issue because of detrimental effects of additional factors such as parents understanding of label instructions and complexities involved in executing pediatric clinical studies thus requiring a concerted effort from pharmaceutical companies, academic researchers, parents and healthcare providers to work for better treatment outcomes in children.

scholarly journals Knowledge, attitude, practice and stigma of tuberculosis among healthcare providers in hospital Sultan Haji Ahmad Shah, Temerloh, Pahang

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Nuralia Akma ◽  
Mohamad Mustafa ◽  
Siti Aishah Suran ◽  
Abdul Aziz Marwan ◽  
Mohd Rahman Omar
Keyword(s):  
Disease Transmission ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
World Health ◽  
Occupational Hazard ◽  
Perceived Stigma ◽  
Cross Sectional ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Knowledge And Practice

Malaysia is categorized as an intermediate tuberculosis (TB) burden country by World Health Organisation. This cause great challenge as an occupational hazard for healthcare providers (HCPs) in Malaysia, as they received two- to three-fold greater risk of contracting TB than the general population. This cross-sectional questionnaire study aimed to assess HCPs' knowledge, attitude, practice, and stigma (KAPS) towards TB in Hospital Sultan Haji Ahmad Shah, Temerloh. A pilot-tested questionnaire was designed based on the WHO recommendation for KAPS study in TB. A survey was carried out between September 2018 and February 2019. Data were analyzed using SPSS version 25.The majority of respondents have moderate knowledge (75%) and practice (93%) on tuberculosis whilst scored lower on attitude (49%). Average self-perceived stigma was observed (67%) with higher sympathy (73%). Overall knowledge and practice on tuberculosis among HCPs in HOSHAS was good with some misconceptions about disease transmission. However, more works needed to improve the attitude and stigma towards TB, as it may affect health services delivery towards TB patients.

scholarly journals Latent Tuberculosis Infection

2018 ◽  
Vol 4 (1) ◽  
pp. 21 ◽  
Author(s):  
Jean-Pierre Zellweger ◽  
Keyword(s):  
Latent Tuberculosis ◽  
Public Health Problem ◽  
World Health Organisation ◽  
Pulmonary Involvement ◽  
World Health ◽  
Global Public Health ◽  
Expert Interview ◽  
Immunodeficiency Virus ◽  
Latent Tb ◽  
Latent Tb Infection

Tuberculosis (TB) is a major global public health problem and is the leading cause of death linked to a single pathogen, ranking above human immunodeficiency virus (HIV).1 Clinically, TB has been categorised as active disease (patients who are generally symptomatic and may be infectious if pulmonary involvement is present) and latent infection (asymptomatic and not infectious, but at variable risk for progression to active TB disease). It is increasingly being recognised that latent TB infection (LTBI) reflects diverse responses to infection with Mycobacterium tuberculosis and may lead to heterogeneous clinical outcomes. In an expert interview, Jean-Pierre Zellweger discusses the latest World Health Organisation (WHO) guidelines on the management of LTBI.

COVID-19: Avoiding a second tragedy in a tuberculosis burdened country

2020 ◽  
Vol 90 (2) ◽  
Author(s):  
Siddharth Raj Yadav ◽  
Rohit Kumar ◽  
Nitesh Gupta ◽  
Pranav Ish ◽  
Shibdas Chakrabarti ◽  
...  
Keyword(s):  
Public Health ◽  
Human Immunodeficiency Virus ◽  
The Elderly ◽  
World Health Organisation ◽  
Public Health Emergency ◽  
World Health ◽  
Special Population ◽  
Global Public Health ◽  
Immunodeficiency Virus ◽  
The World

To the EditorNovel Coronavirus disease (COVID-19) was first notified in December 2019 from Wuhan, China. Now, it has spread rapidly and has been declared a pandemic affecting over 200 countries with widespread morbidity and mortality. It has been postulated that the most vulnerable population are the elderly, people living in crowded areas, children and immune-compromised individuals, such as people living with human immunodeficiency virus (HIV). The correlation of tuberculosis (TB), HIV and malnutrition are well documented and hence, people with tuberculosis should be considered as special population in this pandemic. TB is an ancient disease among humans recorded as far back as seventy thousand years which was declared a global public health emergency in 1993 by the World Health Organisation (WHO). India has the highest TB burden in the world.

Hepatitis C elimination in Pakistan is a distant dream unless government controls the health sector

2020 ◽  
pp. 1-8
Author(s):  
Arshad Altaf ◽  
Safdar Kamal Pasha
Keyword(s):  
Hepatitis C ◽  
Delivery System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Sector ◽  
World Health Organisation ◽  
World Health ◽  
Short Report ◽  
Healthcare Delivery System ◽  
The Government

Abstract The World Health Organisation (WHO) has set an ambitious target to eliminate hepatitis C virus (HCV) by 2030. Pakistan is one of the focused countries because of the high prevalence of HCV. The prices of direct-acting antiviral drugs(DAA)have significantly reduced to between 11-25 dollars for a month’s treatment. To achieve the 2030 elimination target, Pakistan has to provide treatment to one million HCV-infected patients every year, beginning from 2018. This short report highlights a key barrier to achieve this target,i.e. the unsafe practices by regulated and unregulated healthcare delivery system comprising trained and untrained healthcare providers who can continue to churn out new patients with their unsafe healthcare practices and increase the possibility of re-infection in those who have been treated. Only the government has the power and authority to regulate and control the healthcare delivery system. Continuous...  

scholarly journals Identification of Schistosoma mansoni eggs and other soil transmitted intestinal parasites in stool using Odongo-Aginya method

2019 ◽  
Author(s):  
John Paul Byagamy ◽  
Geoffrey Maxwell Malinga ◽  
Harriet Angwech ◽  
Richard Echodu ◽  
Emmanuel Igwaro Odongo-Aginya
Keyword(s):  
Cell Walls ◽  
Intestinal Parasites ◽  
Field Research ◽  
Cost Effective ◽  
World Health Organisation ◽  
World Health ◽  
Morphological Appearance ◽  
Immunodeficiency Virus ◽  
Long Time ◽  
Eggs And Larvae

Abstract Objective World Health Organisation recommends Kato-Katz technique for quantitative diagnosis of Schistosoma (S) mansoni and other soil transmitted intestinal parasites in field research. However, the prepared slides in Kato-Katz technique cannot be examined immediately and after 1 to 2 hours, the eggs of parasites with thin cell walls over clear in glycerine and morphology of the eggs are not preserved. These disadvantages are overcome using Odongo-Aginya method as illustrate by S. mansoni eggs and other soil transmitted intestinal parasites in stool in the results. Result The Odongo-Aginya method composed of compound stains of 7.5% nigrosin in 10% formalin and 0.5% eosin yellowin10% formalin mixed 1:1 ratio can be examined immediately. This method illustrated very clearly morphological appearance of S. mansoni and other soil transmitted intestinal parasites. This method showed a clear appearance of intestinal parasites eggs and larvae immediately after preparation and also after six weeks. The prepared slide also maintains the morphological appearance of the eggs even of the hookworm for a long time when the slides are kept in cool dry place. This method is reliable, reproducible, cost effective, easy to learn, quick and safe especially when handling specimens from Human Immunodeficiency virus infected patients.

Web-Based Survey on Depression and Anxiety during COVID-19 Pandemic in View of Homoeopathic Perspective

2021 ◽  
Author(s):  
Vishwa Kumar Gupta ◽  
Niranjan Mohanty ◽  
Amulya Ratna Sahoo ◽  
Sujata Choudhury ◽  
Chintamani Nayak
Keyword(s):  
Influencing Factors ◽  
Psychological Symptoms ◽  
Influencing Factor ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
World Health ◽  
Depression And Anxiety ◽  
Web Based ◽  
The People ◽  
The World

Abstract Background The World Health Organisation (WHO) declared coronavirus disease 2019 (COVID-19) as a global pandemic in Feb 2020 after it emerged from Wuhan city of China and spread to most of the world. The most common psychological symptoms found during the pandemics are fear, anxiety, loss of sleep, depression, suicidal tendency, etc. Aim To collect various psychological symptoms, the people are presenting during this type of situations and their proposed homoeopathic treatment. Methodology A web-based survey was conducted to assess the mental health burden in public during the outbreak of COVID-19 pandemic and also to explore the potential influencing factors. The data of 314 volunteers were collected and assessed. Results It was found that the overall proportion of depression and anxiety was 34.4 and 31.21% respectively. About 23.9% of participants had both depression and anxiety. The proportion of depression and anxiety was more in males and age group of 21 to 30 years. Healthcare providers reported more depression and anxiety as compared with other occupations. Among the influencing factors, regular Yoga practice and adequate sleep of 7 hours in the day had good effects in controlling depression and anxiety. Spending time in social media for more than 3 hours a day regularly was also an influencing factor for more depression and anxiety. It was also found that people who frequently got worried about own health and of near and dear ones had developed more anxiety. The participants who had taken homoeopathic medicines during last month reported less depressive symptoms in comparison to others. Conclusion Homoeopathy has many remedies which can fit into these psychological symptoms as the principle of homoeopathy is based on individualisation which constitutes the physical as well as the mental sphere.

scholarly journals Healthcare Workforce in Indonesia

2017 ◽  
Vol 12 (3) ◽  
pp. 32-40 ◽  
Author(s):  
Suryanto Suryanto ◽  
Malcolm Boyle ◽  
Virginia Plummer
Keyword(s):  
Rural Areas ◽  
Grey Literature ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
Healthcare Services ◽  
World Health ◽  
Health Service Provision ◽  
Ovid Medline ◽  
The World ◽  
The Impact

Introduction: Imbalanced distribution of healthcare providers between urban and rural areas is one of the difficulties facing health service provision in Indonesia. Several regulations have been made by the governmentto solve the problem. The objective of this paper is to describe the provision of human resources for healthcare services in Indonesia. Methodology: A review of medical related electronic databases, CINAHL and Ovid MEDLINE, was undertaken from their commencement date until the end of January 2017. The grey literature from the Indonesian government, the World Health Organisation and the World Bank websites was also searched. Results: There were 92 articles identified from the CINAHL and 222 articles from the Ovid MEDLINE databases. Five articles were included from the two databases and five documents from grey literature with ten articles to be reviewed.  Discussion: Nurses and midwives account for the largest proportion of healthcare providers in Indonesia. The ratio of healthcare providers in Indonesia is lower than the average of South-East Asian and other lower middle income countries. More than half of the healthcare providers in Indonesia provide care in community health centres. Several regulations have been proclaimed to improve the imbalanced proportion of healthcare providers across the country. Conclusion: Indonesia continues to develop strategies towards successful distribution of healthcare providers across the country. A study investigating the impact of the programs reducing the imbalanced distribution of healthcare providers on health outcomes is essential for Indonesia.

scholarly journals Clinical Trial Highlights –Parkinson’s Disease Drug Therapies in the Clinical Trial Pipeline: 2021 Update

2021 ◽  
pp. 1-13
Author(s):  
Kevin McFarthing ◽  
Gary Rafaloff ◽  
Marco Baptista ◽  
Richard K. Wyse ◽  
Simon R. W. Stott
Keyword(s):  
Parkinson’S Disease ◽  
Clinical Trial ◽  
Parkinson's Disease ◽  
Clinical Trials ◽  
Active Drug ◽  
World Health Organisation ◽  
Considerable Change ◽  
World Health ◽  
Clinical Phase ◽  
Academic Researchers

Background: Despite the COVID-19 pandemic, there has been considerable activity in the clinical development of novel and improved drug-based therapies for the neurodegenerative condition of Parkinson’s disease (PD) during 2020. The agents that were investigated can be divided into “symptomatic” (alleviating the features of the condition) and “disease modifying” (attempting to address the underlying biology of PD) treatments, ST and DMT respectively, with further categorisation possible based on mechanism of action and class of therapy. Objective: Our goal in this report was to provide an overview of the pharmacological therapies –both ST and DMT - in clinical trials for PD during 2020–2021, with the aim of creating greater awareness and involvement in the clinical trial process. We also hope to stimulate collaboration amongst commercial and academic researchers as well as between the research and patient communities. Methods: We conducted a review of clinical trials of drug therapies for PD using trial data obtained from the ClinicalTrials.gov and World Health Organisation (WHO) registries, and performed a breakdown analysis of studies that were active as of February 18th 2021. We also assessed active drug development projects that had completed one clinical phase but were yet to start the next. Results: We identified 142 trials on ClinicalTrials.gov and 14 studies on the WHO registries that met our analysis criteria. Of these 156 trials, 91 were ST and 65 were DMT, Of the 145 trials registered on ClinicalTrials.gov in our 2020 analysis, 45 fell off the list and 42 were added. Despite this change, the balance of ST to DMT; the distribution across phases; the profile of therapeutic categories; and the proportion of repurposed therapies (33.5%); all remained very similar. There are only two DMTs in phase 3, and we identified 33 in-between-phase projects. Conclusions: Despite the effects of the coronavirus pandemic, investment and effort in clinical trials for PD appears to remain strong. There has been little change in the profile of the clinical trial landscape even though, over the past year, there has been considerable change to the content of the list.

scholarly journals Assessing the new ICD-MM classification for assigning the cause of maternal mortality at a tertiary centre in Western India: a retrospective study

2019 ◽  
Vol 8 (9) ◽  
pp. 3629
Author(s):  
Tosha M. Sheth ◽  
Palak P. Vaishnav ◽  
Nandita K. Maitra
Keyword(s):  
Cause Of Death ◽  
Maternal Death ◽  
Health Centre ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
World Health ◽  
Western India ◽  
Maternal Deaths ◽  
In Pregnancy

Background: The World Health Organisation (WHO) in 2012 introduced the 10th revision of International Classification of Disease (ICD 10) to deaths in pregnancy, labour and puerperium (ICD-MM) for consistent collection, analysis and interpretation of information on maternal deaths. The proper use of this classification requires training to avoid heterogeneity and error in the classification of maternal deaths.Methods: We analysed the Maternal Death Review (MDR) forms of 295 deaths over a period of 5 years (January 2014 to December 2018 inclusive) occurring at a tertiary health centre in Western India. The ICD-MM classification was used to reassign the cause of death.Results: There were 295 deaths in women during pregnancy, childbirth and puerperium during the 5 year period. Of these there were 294 maternal deaths and one coincidental death. There were 173 deaths of the direct type (58.84%), 105 deaths of the indirect type (35.71%) and 16 deaths (5.44%) of the unspecified type. Obstetric haemorrhage was  the highest contributor to direct deaths (23.8%) and anaemia contributed to the maximum deaths from indirect causes (13.6%) followed by liver diseases in pregnancy (10.54%).Unanticipated complications of management accounted for 2% of the total deaths. There was considerable inaccuracy in assigning cause of death by consultants who were untrained in the use of the ICD-MM classification.Conclusions: ICD-MM classification promotes an accurate assignment of the cause of death. Training of healthcare providers performing maternal death reviews in the use of this classification is essential to identify accurate underlying cause of death and contributory conditions. 

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