To understand the current situation of institutional registration in Shaanxi Province after the implementation ofregistration system management in drug clinical trial institutions.Relevant information was collected on...To understand the current situation of institutional registration in Shaanxi Province after the implementation ofregistration system management in drug clinical trial institutions.Relevant information was collected on the“Announcement on the Accreditation of Drug Clinical Trial Institutions”issued by the National Medical Products Administration from 2005 to August 2022,the record management information system of drug and medical device clinical trial institutions,and the drug clinical trial registration and information publicity platform.A retrospective analysis was carried out in terms of institutional development,regional distribution,registered majors,principal investigators,and the number of drug clinical trials.After the implementation of institution registration,the number of drug clinical trial institutions in Shaanxi Province increased by 47.4%,884 principal investigators were registered,the number of registered majors expanded from 58 qualified to 117,and the professional scope increased by 50.4%.The policy of institution registration is conducive to promoting the rational use of medical resources and the development of drug clinical trial institutions and improving the healthy development of the pharmaceutical industry in Shaanxi Province.展开更多
Background and object:The burden of neurological disorders in India is expected to increase due to the rapid demographic and epidemiological transition,with irrational drug use,which is also a global concern.Thus,drug...Background and object:The burden of neurological disorders in India is expected to increase due to the rapid demographic and epidemiological transition,with irrational drug use,which is also a global concern.Thus,drug utilization evaluation is designed to ensure appropriate medicine use within the healthcare settings.The aim of the study was to assess the rate and pattern of drug utilization in the management of neurological disorders.Materials and methods:A hospital-based cross-sectional drug utilization evaluation study on neurological drugs was carried out at the Department of Neurology over a span of six months.All legible prescriptions consisting neurological medications irrespective of patient's gender,aged≥18 years were included for the study.The World Health Organization(WHO)core drug use indicators were used to assess the drug prescribing and utilization patterns.Results:A total of 310 prescriptions were reviewed,where male predominance was found to be 56.45%.Out of 310 prescriptions,drugs belonging to 26 neurological classes were prescribed for the management of various neurological disorders.The majority of patients were diagnosed with epilepsy and the most prescribed drugs per patient were phenytoin(14.8%)and valproic acid(6.45%).By following the WHO core drug prescribing indicators,65.47%of drugs prescribed from the India National List of Essential Medicines,2022,followed by 29.83%of drugs prescribed in generic name and 10.86%of prescriptions including injections.Conclusion:The study findings showed that the prescribing pattern in the Department of Neurology was in accordance with the WHO core prescribing indicators.But,the extent of polypharmacy prescriptions was very high.Therefore,interventions are very necessary to promote rational drug prescribing patterns and thus clinical pharmacists can contribute to assess and review the drug utilization pattern to optimize the drug therapy and improvement in patient safety.展开更多
Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in ...Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in society.The WHO recommends a physician to every 1000 people.According to the recent data from the Health Ministry in 2019,in which 1.16 million doctors are of active population with just 80%,or 0.9 million,practicing.As a result,a ratio of 0.68 doctors for every 1000 people,which is much below as per the WHO reports.This article describes history,types,WHO guidelines,need and purpose of DUE.Objective:The main aim of this paper is to provide information about the rational use of medication in outpatient and inpatient department with special emphasis of DUEs.It also provides awareness directly to healthcare professionals,researchers,academicians,pharmacist and nurses to reduce the irrationality of medicines.Methods:The method used to compile this review information gathered from websites,Google scholar,PubMed,Research gate,and studies published on DUE from July 20 to Oct 22 were included as source of information.Results:We studied more than 35 published study on DUE,that reveals most of the physicians prescribed branded drugs not generic drugs,but WHO prescribing indicator allows to prescribe generic drugs in the hospital pharmacy to maintain better inventory control.It may also help to prevent pharmacist misunderstanding during dispensing.Conclusion:The use of generic prescription names avoids the possibility of medication product duplication and lowers patient costs.It is important to remember that incorrect medication prescriptions have impact on both patients and their family members.WHO indicators identify irrational prescribing behaviours to make therapy more rational and cost-effective.展开更多
BACKGROUND:The role of prophylactic nonsteroidal anti- inflammatory drugs(NSAIDs)for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP)is debated.We performed a meta-analysis of all ...BACKGROUND:The role of prophylactic nonsteroidal anti- inflammatory drugs(NSAIDs)for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP)is debated.We performed a meta-analysis of all published randomized controlled trials to evaluate the efficacy of NSAIDs in the prevention of post-ERCP pancreatitis. DATA SOURCES:Searches were conducted in the databases PubMed,EMBASE and the Cochrane Library. Six randomized clinical trials that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed.Data were extracted by two independent observers according to predetermined criteria. RESULTS:The risk of pancreatitis was lower in the NSAID group than in the placebo group(OR:0.46,95%CI:0.32 to 0.65,P<0.0001).Two hours after ERCP,prophylactic administration of NSAIDs was associated with a lower serum amylase level(WMD:-91.09,95%CI:-149.78 to-32.40, P=0.002),but there was no difference in mean 24-hour serum amylase values(WMD:-379.00,95%CI:-805.75 to 47.76,P=0.08).No deaths or NSAID-related complications were noted. CONCLUSIONS:Prophylactic administration of NSAIDs can reduce the incidence of post-ERCP pancreatitis; this administration in patients undergoing ERCP is recommended.Further randomized controlled trials are required before its introduction into routine care.展开更多
Objective:To study the usage of anti-asthmatic dugs and enumerate the patients’ noncompliance. Methods:The study was conducted from 5th Feb,2006 to 5th Mar,2006.The samples were from the general medicine ward.All pat...Objective:To study the usage of anti-asthmatic dugs and enumerate the patients’ noncompliance. Methods:The study was conducted from 5th Feb,2006 to 5th Mar,2006.The samples were from the general medicine ward.All patients with respiratory tract infection who received anti-asthmatic drugs were included in the study.Data were collected from clinical notes and structured patient’s data,and patient interview utilizing a piloted questionnaire data collection form.The questionnaire included patient demographics,anti-asthmatics prescribed, dose,frequency and previous treatment if any and its duration,concomitant medications etc. Results:26.31%of patients were 61-70 years old.Among 57 patients,91.23%of patients received multi-therapy,8.77%of patients received mono-therapy,59.65%of patients took over the counter(OTC) drugs and 57.89%of patients were non compliant.Anti-asthmatic drugs were prescribed to asthmatic patients as oral,inhalation and others(injections),and more than one route were used for administration of drugs.Conclusion:The anti-asthmatics are used to treat breathing difficulties such as allergy.Poor compliance to treatment is common among the patients,which makes it difficult to manage asthma and increases both morbidity and mortality.It is suggested that interventions have to be done by providing counseling and improving the current prescribing trend for better and rational utilization.展开更多
Generally, the sequence decision of the development and utilization of Chinese mineral resources is based on national and provincial overall plan of the mineral resources. Such plan usually cannot reflect the relative...Generally, the sequence decision of the development and utilization of Chinese mineral resources is based on national and provincial overall plan of the mineral resources. Such plan usually cannot reflect the relative size of the suitability of the development and utilization of mineral resources. To solve the problem, the paper has selected the gift condition, the market condition, the technological condition,socio-economic condition and environmental condition as the starting-points to analyze the influential factors of the priority-sequence of mineral resources' development and utilization. The above 5 conditions are further specified into 9 evaluative indicators to establish an evaluation indicator system. At last,we propose a decision model of the priority sequence based on grey relational analysis method, and figure out the observation objects by the suitability index of development. Finally, the mineral resources of a certain province in China were analyzed as an example. The calculation results indicate that silver(2.0057), coal(1.9955), zinc(1.9442), cement limestone(1.9077), solvent limestone(1.5624) and other minerals in the province are suitable for development and utilization.展开更多
Background: Failure to demonstrate the presence of malaria parasites prior to treatment with anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of anti-malarial drugs to febrile ...Background: Failure to demonstrate the presence of malaria parasites prior to treatment with anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of anti-malarial drugs to febrile patients suspected of malaria. The aim of this study was to describe the role of utilization of malaria diagnostic tests and associated factors in the receipt of anti-malarial drugs among febrile patients suspected of malaria. Methods: In a cross-sectional study design, client-exit interviews with febrile patients and key-informant interviews with purposively selected health workers were conducted at outpatient clinics of health centre IV facilities in Mukono district. Data entry and analysis were done using EpiData 3.2 and STATA 10 respectively. Data were described using frequency distributions and proportions. Chi square was used in two by two tables, odds ratios as the measure of association and an alpha level of 0.05 was used in all significance tests. Results: Out of 408 respondents, the majority were female (252, 61.8%) and a third of the samples were aged five years and below. The mean age in years was 3.3 with a standard deviation of 2.1. More than half of the respondents (359, 88%) utilized malaria diagnostic tests and about half (241, 59%) received anti-malarial drugs. There were no statistically significant differences between utilizers and non-utilizers in most characteristics except age, history of indoor residual spraying and perceived satisfaction with services at outpatient clinics. Utilizers were 75% less likely to receive anti-malarial drugs than non-utilizers after controlling for age, sex and residence (OR: 0.25, 95%CI: 0.09, 0.66). Frequent power cut-offs as well as limited knowledge on malaria treatment guidelines amongst laboratory personnel were some of the major limitations to microscopic diagnosis of malaria. Conclusion: Utilizers were 75% less likely to receive anti-malarial drugs as opposed to non-utilizers. This implies that increasing utilization of malaria diagnostic tests can reduce the problem of over-prescription of anti-malarial drugs by 75% among those tested for malaria, since anti-malarial drugs would be received by only those with a parasi- tologically-confirmed diagnosis of malaria. Policy implications: To overcome the problem of over-prescription of anti-malarial drugs, there must be a policy that ensures a consistent power supply in all public health laboratories. Training of health workers should encompass all cadres and work-shifts for laboratory personnel should be established to enhance utilization of malaria diagnostic tests especially at night.展开更多
AIM:To investigate the effect of nonsteroidal antiinflammatory drugs(NSAIDs)on the incidence of postendoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).METHODS:Two independent reviewers searched pub ...AIM:To investigate the effect of nonsteroidal antiinflammatory drugs(NSAIDs)on the incidence of postendoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).METHODS:Two independent reviewers searched pub Med(1966 to October 2013),Embase(1984 to October2013)and the Cochrane Central Register of Controlled Trials(CENTRAL;Issue 4,2013)for relevant randomized controlled trials(RCTs)studying the effectiveness of prophylactic NSAID administration in the prevention of PEP.Using the Cochrane Collaboration Handbook,meta-analyses were conducted to evaluate the overall effect of NSAIDs in preventing the incidences of PEP and moderate to severe pancreatitis.RESULTS:Eight RCTs were identified from the literature search and included 1883 patients that underwent ERCP,with 971 patients in the NSAID group and 912patients in the placebo group.Sixty-nine out of 971(7.11%)patients developed PEP in the NSAID group in comparison to 143 out of 912(15.68%)patients in the placebo group.The pooled RR of PEP incidence with prophylactic NSAID administration was 0.43(95%CI:0.33-0.56),which demonstrates that NSAID administration after ERCP significantly reduced the incidence of PEP when compared to the placebo group(p<0.0001).Subgroup analysis was performed and revealed that the presence(NSAID group)or absence(placebo group)of NSAIDs had no significant effect on the development of moderate to severe pancreatitis(RR=0.79,95%CI:0.52-1.18).Moreover,the administration of NSAIDs as a rectal suppository(RR=0.35,95%CI:0.26-0.48;p<0.0001)was more effective than oral administration(RR=0.97,95%CI:0.53-1.80)or through infusion(RR=0.43,95%CI:0.12-1.54).CONCLUSION:NSAIDs effectively reduce the incidence of PEP but not of moderate to severe pancreatitis.展开更多
Different antiepileptic drugs(AEDs) may cause similar adverse effects,one of which is diplopia.However,the AEDs causing diplopia and the dose-response effect of each drug remains uncertain.In this study,we compared se...Different antiepileptic drugs(AEDs) may cause similar adverse effects,one of which is diplopia.However,the AEDs causing diplopia and the dose-response effect of each drug remains uncertain.In this study,we compared several second-generation AEDs to find out whether they would contribute to the risk of diplopia and their effect-causing dose.A meta-analysis was performed on 19 studies in agreement with our inclusion criteria.The results showed that eight commonly used second-generation AEDs(gabapentin,levetiracetam,oxcarbazepine,lamotrigine,pregabalin,topiramate,vigabatrin and zonisamide) could cause diplopia.The reported odds ratios(ORs) ranged from 1.406 to 7.996.Ranking risks from the highest to the lowest ORs of the eight AEDs of any dose resulted in the following order:use of oxcarbazepine(7.996),levetiracetam(7.472),lamotrigine(5.258),vigabatrin(3.562),pregabalin(3.048),topiramate(2.660),gabapentin(1.966),zonisamide(1.406).Taking into account the ORs above,we can conclude that second-generation AEDs of any dose may cause diplopia.However,the levetiracetam-caused diplopia needs to be further studied according to the data(OR,7.472;95% confidence interval,0.375-148.772).These findings ask for better concerns about patients' quality of life when giving antiepileptic treatments.展开更多
The paper discusses the market by seeing two medicines which are Niaspan and Zetia that decrease the cholesterol in the body.Through the paper,we will see that both the drugs are considered to be oligopoly market comp...The paper discusses the market by seeing two medicines which are Niaspan and Zetia that decrease the cholesterol in the body.Through the paper,we will see that both the drugs are considered to be oligopoly market competition followed by the market analysis of the cholesterol medicine in the US from 2011 till 2013 and to check the elasticity of demand from the demand the curve for both the drugs.Later,we come to see the factors that affect the demand and supply for Niaspan and Zetia.Lastly,we end the paper with a conclusion about future expectations and suggestions for the pharmaceutical medicines that can enhance their performances.展开更多
Coals are carbon-rich materials with excellent aromatic nature and macro- molecular structure. They pose great potential as the source of organic chemical feed- stock and high value-added carbonaceous materials in the...Coals are carbon-rich materials with excellent aromatic nature and macro- molecular structure. They pose great potential as the source of organic chemical feed- stock and high value-added carbonaceous materials in the 21st century. As some of the most important analytical methods, thermal analysis (TA) techniques with strong com- petence in materials characterization and reaction mechanism research, have been ex- tensively employed to accumulate the knowledge about coal conversion and utilization in a most effective, efficient and responsible way. Unfortunately, some efforts did not promote the sound growth of a systematic discipline, which might arise from the intrinsic drawback of conventional TA. Proposals on acquiring much more reliable understanding of the mechanism and kinetics of reactions were made in this review.展开更多
Objective To study the domestic market environment and its advantages and disadvantages of angiotensin receptor-neprilysin inhibitor(ARNI)anti-heart failure drugs so as to provide reference for the promotion of this s...Objective To study the domestic market environment and its advantages and disadvantages of angiotensin receptor-neprilysin inhibitor(ARNI)anti-heart failure drugs so as to provide reference for the promotion of this sort of drugs in Chinese market.Methods Based on SWOT model,the anti-heart failure drugs were analyzed from four aspects:strength,weakness,opportunity and threat.Results and Conclusion ARNI anti-heart failure drugs have greater opportunities than threats in China,and their advantages outweigh the disadvantages.However,in order to gain more market share,it is still necessary to pay attention to the clinical verification of their long-term safety and effectiveness.In addition,consumers are interested in the price of ARNI anti-heart failure drugs and its popularity.展开更多
Irrigation water became the limiting factor to the persistent improvement of grain production. Based on the data from Gannan County, a semiarid area in the west of Heilongjiang Province, the present situation of the d...Irrigation water became the limiting factor to the persistent improvement of grain production. Based on the data from Gannan County, a semiarid area in the west of Heilongjiang Province, the present situation of the development and utilization of water resources and the suitable water saving irrigation mode were analyzed by using SPA model, which was significant to the efficient and rational utilization of water resources and the improvement of agriculture productivity. The result showed that the model could be applied well to the assessment of development and utilization of water resources and the multi-project optimal selection. Through calculation, it could be found that the utilization of water resources in Gannan County was still in the primary stage, and the integration technology of the optimized water saving irrigation should be combined to support the sustainable development of agriculture in the semiarid area.展开更多
A demand for renewable alternatives that would be able to deal with the problems related to well-being is directly linked to the world’s growing needs to save energy and reduce environmental costs. For a project impl...A demand for renewable alternatives that would be able to deal with the problems related to well-being is directly linked to the world’s growing needs to save energy and reduce environmental costs. For a project implementation addressing these issues, it is essential to know the climatic conditions of the target area. Taking natural ventilation, climatic factors, and renewable alternatives as important sources of comfort, in this work, passive strategies, through the utilization of microclimate elements as well as the location of outside obstacles, were imposed on an initial and specific project. The objective was to introduce obstacles which could interfere in the field of external wind and evaluate whether this outside intervention is able to make changes in indoor air circulation. The wind fields for the studied cases were obtained by computational simulations, and their consequences were analyzed to attain thermal comfort. The method adopted to obtain the wind fields was a Petrov-Galerkin type method, which is a stabilized mixed finite element method of the Navier-Stokes equations considering the incompressibility and formulated in primitive variables, velocity and pressure. The obtained results point to the solutions that promote the increase or decrease of the wind-field intensity.展开更多
[Objectives] To make a systematic evaluation on the therapeutic efficacy and safety of Yiqi Huoxue traditional Chinese drugs combined with western medicine in treatment of coronary heart disease( CHD) after coronary r...[Objectives] To make a systematic evaluation on the therapeutic efficacy and safety of Yiqi Huoxue traditional Chinese drugs combined with western medicine in treatment of coronary heart disease( CHD) after coronary revascularization. [Methods] The literatures were retrieved from China Knowledge Infrastructure( CNKI),Chinese science and technology journal full-text database( VIP database,VIP),Wanfang Data,the Chinese biomedical Database,Pub Med,Embase,and the Cochrane Library. The retrieval time was set to the creation of the database to January 2017. The randomized controlled trial( RCT) was conducted on the comparison between Yiqi Huoxue Chinese drugs combined with western medicine and the western medicine alone in the treatment of CHD after coronary revascularization. The literature information was extracted and the methodological quality of the included literature was evaluated according to the bias risk assessment tool developed by the Cochrane Collaboration. Meta-analysis was performed with the aid of Rev Man 5. 3 software. Coronary artery restenosis rate,angina pectoris treatment efficiency,left ventricular ejection fraction( LVEF),left ventricular end-diastolic volume( LVEDV),B-type natriuretic peptide( BNP),6-minute walk test( 6 MWT),and adverse reactions were analyzed. [Results] A total of 29 articles were included,a total of2 518 patients,the literature quality was low. Meta-analysis results showed that compared with the treatment by western medicine alone,Yiqi Huoxue Chinese drugs combined with western medicine could further reduce coronary restenosis rate[RR = 0. 45,95% CI( 0. 34,0. 60),P <0. 000 01],improve the angina pectoris treatment efficiency[RR = 1. 13,95% CI( 1. 05,1. 21),P = 0. 000 5],raise LVEF[WMD = 4. 25,95% CI( 3. 46,5. 04),P < 0. 000 01],reduce LVEDV[WMD =-10. 41,95% CI(-17. 88,-2. 95),P = 0. 006],decrease the plasma BNP level[WMD =-32. 32,95% CI(-44. 92,-19. 72),P < 0. 000 01],and increase 6 MWT distance(WMD = 62. 25,95% CI( 21. 71,102. 78),P = 0. 003)[Conclusions]Yiqi Huoxue Chinese drugs combined with western medicine can alleviate the symptoms of angina pectoris,reduce the rate of coronary restenosis,improve heart function and improve exercise capacity,thereby improving clinical efficacy in patients with CHD after coronary revascularization.展开更多
Ferroptosis plays a key role in aggravating the progression of spinal cord injury(SCI),but the specific mechanism remains unknown.In this study,we constructed a rat model of T10 SCI using a modified Allen method.We id...Ferroptosis plays a key role in aggravating the progression of spinal cord injury(SCI),but the specific mechanism remains unknown.In this study,we constructed a rat model of T10 SCI using a modified Allen method.We identified 48,44,and 27 ferroptosis genes that were differentially expressed at 1,3,and 7 days after SCI induction.Compared with the sham group and other SCI subgroups,the subgroup at 1 day after SCI showed increased expression of the ferroptosis marker acyl-CoA synthetase long-chain family member 4 and the oxidative stress marker malondialdehyde in the injured spinal cord while glutathione in the injured spinal cord was lower.These findings with our bioinformatics results suggested that 1 day after SCI was the important period of ferroptosis progression.Bioinformatics analysis identified the following top ten hub ferroptosis genes in the subgroup at 1 day after SCI:STAT3,JUN,TLR4,ATF3,HMOX1,MAPK1,MAPK9,PTGS2,VEGFA,and RELA.Real-time polymerase chain reaction on rat spinal cord tissue confirmed that STAT3,JUN,TLR4,ATF3,HMOX1,PTGS2,and RELA mRNA levels were up-regulated and VEGFA,MAPK1 and MAPK9 mRNA levels were down-regulated.Ten potential compounds were predicted using the DSigDB database as potential drugs or molecules targeting ferroptosis to repair SCI.We also constructed a ferroptosis-related mRNA-miRNA-lncRNA network in SCI that included 66 lncRNAs,10 miRNAs,and 12 genes.Our results help further the understanding of the mechanism underlying ferroptosis in SCI.展开更多
·AIM:To evaluate visual outcomes and changes in fluid after administering monthly anti-vascular endothelial growth factor(VEGF)injections to treat neovascular agerelated macular degeneration(n AMD)with subretinal...·AIM:To evaluate visual outcomes and changes in fluid after administering monthly anti-vascular endothelial growth factor(VEGF)injections to treat neovascular agerelated macular degeneration(n AMD)with subretinal fluid(SRF)and pigment epithelial detachment(PED).·METHODS:This prospective study included eyes with n AMD previously treated with as-needed anti-VEGF injections.The patients were treated with six monthly intravitreal injections of ranibizumab.Quantitative volumetric segmentation analyses of the SRF and PED were performed.The main outcome measures included best-corrected visual acuity(BCVA),and SRF and PED volumes.·RESULTS:Twenty eyes of 20 patients were included in this study.At the 6-month follow-up,BCVA and PED volume did not change significantly(P=0.110 and 0.999,respectively)but the mean SRF volume decreased from 0.53±0.82 mm3 at baseline to 0.08±0.23 mm3(P=0.002).The absorption rate of the SRF volume was negatively correlated with the duration of previous antiVEGF treatment(P=0.029).Seven of the 20 eyes(35%)showed a fluid-free macula and significant improvement in BCVA(P=0.036)by month 6.·CONCLUSION:Quantifying the SRF can precisely determine the patient’s responsiveness to anti-VEGF treatment of n AMD.展开更多
基金Project of Xi’an Science and Technology Plan(23YXYJ0163)Education and Teaching Reform Research Project of Xi’an Medical University in 2023(S202311840061)+1 种基金First Affiliated Hospital of Xi’an Medical University of China(XYYFY-2023-01)2021 Xi’an Medical University University-Level Science and Technology Innovation Team(2021TD14)。
文摘To understand the current situation of institutional registration in Shaanxi Province after the implementation ofregistration system management in drug clinical trial institutions.Relevant information was collected on the“Announcement on the Accreditation of Drug Clinical Trial Institutions”issued by the National Medical Products Administration from 2005 to August 2022,the record management information system of drug and medical device clinical trial institutions,and the drug clinical trial registration and information publicity platform.A retrospective analysis was carried out in terms of institutional development,regional distribution,registered majors,principal investigators,and the number of drug clinical trials.After the implementation of institution registration,the number of drug clinical trial institutions in Shaanxi Province increased by 47.4%,884 principal investigators were registered,the number of registered majors expanded from 58 qualified to 117,and the professional scope increased by 50.4%.The policy of institution registration is conducive to promoting the rational use of medical resources and the development of drug clinical trial institutions and improving the healthy development of the pharmaceutical industry in Shaanxi Province.
文摘Background and object:The burden of neurological disorders in India is expected to increase due to the rapid demographic and epidemiological transition,with irrational drug use,which is also a global concern.Thus,drug utilization evaluation is designed to ensure appropriate medicine use within the healthcare settings.The aim of the study was to assess the rate and pattern of drug utilization in the management of neurological disorders.Materials and methods:A hospital-based cross-sectional drug utilization evaluation study on neurological drugs was carried out at the Department of Neurology over a span of six months.All legible prescriptions consisting neurological medications irrespective of patient's gender,aged≥18 years were included for the study.The World Health Organization(WHO)core drug use indicators were used to assess the drug prescribing and utilization patterns.Results:A total of 310 prescriptions were reviewed,where male predominance was found to be 56.45%.Out of 310 prescriptions,drugs belonging to 26 neurological classes were prescribed for the management of various neurological disorders.The majority of patients were diagnosed with epilepsy and the most prescribed drugs per patient were phenytoin(14.8%)and valproic acid(6.45%).By following the WHO core drug prescribing indicators,65.47%of drugs prescribed from the India National List of Essential Medicines,2022,followed by 29.83%of drugs prescribed in generic name and 10.86%of prescriptions including injections.Conclusion:The study findings showed that the prescribing pattern in the Department of Neurology was in accordance with the WHO core prescribing indicators.But,the extent of polypharmacy prescriptions was very high.Therefore,interventions are very necessary to promote rational drug prescribing patterns and thus clinical pharmacists can contribute to assess and review the drug utilization pattern to optimize the drug therapy and improvement in patient safety.
文摘Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in society.The WHO recommends a physician to every 1000 people.According to the recent data from the Health Ministry in 2019,in which 1.16 million doctors are of active population with just 80%,or 0.9 million,practicing.As a result,a ratio of 0.68 doctors for every 1000 people,which is much below as per the WHO reports.This article describes history,types,WHO guidelines,need and purpose of DUE.Objective:The main aim of this paper is to provide information about the rational use of medication in outpatient and inpatient department with special emphasis of DUEs.It also provides awareness directly to healthcare professionals,researchers,academicians,pharmacist and nurses to reduce the irrationality of medicines.Methods:The method used to compile this review information gathered from websites,Google scholar,PubMed,Research gate,and studies published on DUE from July 20 to Oct 22 were included as source of information.Results:We studied more than 35 published study on DUE,that reveals most of the physicians prescribed branded drugs not generic drugs,but WHO prescribing indicator allows to prescribe generic drugs in the hospital pharmacy to maintain better inventory control.It may also help to prevent pharmacist misunderstanding during dispensing.Conclusion:The use of generic prescription names avoids the possibility of medication product duplication and lowers patient costs.It is important to remember that incorrect medication prescriptions have impact on both patients and their family members.WHO indicators identify irrational prescribing behaviours to make therapy more rational and cost-effective.
文摘BACKGROUND:The role of prophylactic nonsteroidal anti- inflammatory drugs(NSAIDs)for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP)is debated.We performed a meta-analysis of all published randomized controlled trials to evaluate the efficacy of NSAIDs in the prevention of post-ERCP pancreatitis. DATA SOURCES:Searches were conducted in the databases PubMed,EMBASE and the Cochrane Library. Six randomized clinical trials that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed.Data were extracted by two independent observers according to predetermined criteria. RESULTS:The risk of pancreatitis was lower in the NSAID group than in the placebo group(OR:0.46,95%CI:0.32 to 0.65,P<0.0001).Two hours after ERCP,prophylactic administration of NSAIDs was associated with a lower serum amylase level(WMD:-91.09,95%CI:-149.78 to-32.40, P=0.002),but there was no difference in mean 24-hour serum amylase values(WMD:-379.00,95%CI:-805.75 to 47.76,P=0.08).No deaths or NSAID-related complications were noted. CONCLUSIONS:Prophylactic administration of NSAIDs can reduce the incidence of post-ERCP pancreatitis; this administration in patients undergoing ERCP is recommended.Further randomized controlled trials are required before its introduction into routine care.
文摘Objective:To study the usage of anti-asthmatic dugs and enumerate the patients’ noncompliance. Methods:The study was conducted from 5th Feb,2006 to 5th Mar,2006.The samples were from the general medicine ward.All patients with respiratory tract infection who received anti-asthmatic drugs were included in the study.Data were collected from clinical notes and structured patient’s data,and patient interview utilizing a piloted questionnaire data collection form.The questionnaire included patient demographics,anti-asthmatics prescribed, dose,frequency and previous treatment if any and its duration,concomitant medications etc. Results:26.31%of patients were 61-70 years old.Among 57 patients,91.23%of patients received multi-therapy,8.77%of patients received mono-therapy,59.65%of patients took over the counter(OTC) drugs and 57.89%of patients were non compliant.Anti-asthmatic drugs were prescribed to asthmatic patients as oral,inhalation and others(injections),and more than one route were used for administration of drugs.Conclusion:The anti-asthmatics are used to treat breathing difficulties such as allergy.Poor compliance to treatment is common among the patients,which makes it difficult to manage asthma and increases both morbidity and mortality.It is suggested that interventions have to be done by providing counseling and improving the current prescribing trend for better and rational utilization.
基金Financial support from the key project of the National Natural Science Foundation of China(No.71273118)is gratefully acknowledged
文摘Generally, the sequence decision of the development and utilization of Chinese mineral resources is based on national and provincial overall plan of the mineral resources. Such plan usually cannot reflect the relative size of the suitability of the development and utilization of mineral resources. To solve the problem, the paper has selected the gift condition, the market condition, the technological condition,socio-economic condition and environmental condition as the starting-points to analyze the influential factors of the priority-sequence of mineral resources' development and utilization. The above 5 conditions are further specified into 9 evaluative indicators to establish an evaluation indicator system. At last,we propose a decision model of the priority sequence based on grey relational analysis method, and figure out the observation objects by the suitability index of development. Finally, the mineral resources of a certain province in China were analyzed as an example. The calculation results indicate that silver(2.0057), coal(1.9955), zinc(1.9442), cement limestone(1.9077), solvent limestone(1.5624) and other minerals in the province are suitable for development and utilization.
文摘Background: Failure to demonstrate the presence of malaria parasites prior to treatment with anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of anti-malarial drugs to febrile patients suspected of malaria. The aim of this study was to describe the role of utilization of malaria diagnostic tests and associated factors in the receipt of anti-malarial drugs among febrile patients suspected of malaria. Methods: In a cross-sectional study design, client-exit interviews with febrile patients and key-informant interviews with purposively selected health workers were conducted at outpatient clinics of health centre IV facilities in Mukono district. Data entry and analysis were done using EpiData 3.2 and STATA 10 respectively. Data were described using frequency distributions and proportions. Chi square was used in two by two tables, odds ratios as the measure of association and an alpha level of 0.05 was used in all significance tests. Results: Out of 408 respondents, the majority were female (252, 61.8%) and a third of the samples were aged five years and below. The mean age in years was 3.3 with a standard deviation of 2.1. More than half of the respondents (359, 88%) utilized malaria diagnostic tests and about half (241, 59%) received anti-malarial drugs. There were no statistically significant differences between utilizers and non-utilizers in most characteristics except age, history of indoor residual spraying and perceived satisfaction with services at outpatient clinics. Utilizers were 75% less likely to receive anti-malarial drugs than non-utilizers after controlling for age, sex and residence (OR: 0.25, 95%CI: 0.09, 0.66). Frequent power cut-offs as well as limited knowledge on malaria treatment guidelines amongst laboratory personnel were some of the major limitations to microscopic diagnosis of malaria. Conclusion: Utilizers were 75% less likely to receive anti-malarial drugs as opposed to non-utilizers. This implies that increasing utilization of malaria diagnostic tests can reduce the problem of over-prescription of anti-malarial drugs by 75% among those tested for malaria, since anti-malarial drugs would be received by only those with a parasi- tologically-confirmed diagnosis of malaria. Policy implications: To overcome the problem of over-prescription of anti-malarial drugs, there must be a policy that ensures a consistent power supply in all public health laboratories. Training of health workers should encompass all cadres and work-shifts for laboratory personnel should be established to enhance utilization of malaria diagnostic tests especially at night.
文摘AIM:To investigate the effect of nonsteroidal antiinflammatory drugs(NSAIDs)on the incidence of postendoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).METHODS:Two independent reviewers searched pub Med(1966 to October 2013),Embase(1984 to October2013)and the Cochrane Central Register of Controlled Trials(CENTRAL;Issue 4,2013)for relevant randomized controlled trials(RCTs)studying the effectiveness of prophylactic NSAID administration in the prevention of PEP.Using the Cochrane Collaboration Handbook,meta-analyses were conducted to evaluate the overall effect of NSAIDs in preventing the incidences of PEP and moderate to severe pancreatitis.RESULTS:Eight RCTs were identified from the literature search and included 1883 patients that underwent ERCP,with 971 patients in the NSAID group and 912patients in the placebo group.Sixty-nine out of 971(7.11%)patients developed PEP in the NSAID group in comparison to 143 out of 912(15.68%)patients in the placebo group.The pooled RR of PEP incidence with prophylactic NSAID administration was 0.43(95%CI:0.33-0.56),which demonstrates that NSAID administration after ERCP significantly reduced the incidence of PEP when compared to the placebo group(p<0.0001).Subgroup analysis was performed and revealed that the presence(NSAID group)or absence(placebo group)of NSAIDs had no significant effect on the development of moderate to severe pancreatitis(RR=0.79,95%CI:0.52-1.18).Moreover,the administration of NSAIDs as a rectal suppository(RR=0.35,95%CI:0.26-0.48;p<0.0001)was more effective than oral administration(RR=0.97,95%CI:0.53-1.80)or through infusion(RR=0.43,95%CI:0.12-1.54).CONCLUSION:NSAIDs effectively reduce the incidence of PEP but not of moderate to severe pancreatitis.
基金supported by grants from the National Natural Science Foundation of China (No. 30700244 and 81170022)
文摘Different antiepileptic drugs(AEDs) may cause similar adverse effects,one of which is diplopia.However,the AEDs causing diplopia and the dose-response effect of each drug remains uncertain.In this study,we compared several second-generation AEDs to find out whether they would contribute to the risk of diplopia and their effect-causing dose.A meta-analysis was performed on 19 studies in agreement with our inclusion criteria.The results showed that eight commonly used second-generation AEDs(gabapentin,levetiracetam,oxcarbazepine,lamotrigine,pregabalin,topiramate,vigabatrin and zonisamide) could cause diplopia.The reported odds ratios(ORs) ranged from 1.406 to 7.996.Ranking risks from the highest to the lowest ORs of the eight AEDs of any dose resulted in the following order:use of oxcarbazepine(7.996),levetiracetam(7.472),lamotrigine(5.258),vigabatrin(3.562),pregabalin(3.048),topiramate(2.660),gabapentin(1.966),zonisamide(1.406).Taking into account the ORs above,we can conclude that second-generation AEDs of any dose may cause diplopia.However,the levetiracetam-caused diplopia needs to be further studied according to the data(OR,7.472;95% confidence interval,0.375-148.772).These findings ask for better concerns about patients' quality of life when giving antiepileptic treatments.
文摘The paper discusses the market by seeing two medicines which are Niaspan and Zetia that decrease the cholesterol in the body.Through the paper,we will see that both the drugs are considered to be oligopoly market competition followed by the market analysis of the cholesterol medicine in the US from 2011 till 2013 and to check the elasticity of demand from the demand the curve for both the drugs.Later,we come to see the factors that affect the demand and supply for Niaspan and Zetia.Lastly,we end the paper with a conclusion about future expectations and suggestions for the pharmaceutical medicines that can enhance their performances.
文摘Coals are carbon-rich materials with excellent aromatic nature and macro- molecular structure. They pose great potential as the source of organic chemical feed- stock and high value-added carbonaceous materials in the 21st century. As some of the most important analytical methods, thermal analysis (TA) techniques with strong com- petence in materials characterization and reaction mechanism research, have been ex- tensively employed to accumulate the knowledge about coal conversion and utilization in a most effective, efficient and responsible way. Unfortunately, some efforts did not promote the sound growth of a systematic discipline, which might arise from the intrinsic drawback of conventional TA. Proposals on acquiring much more reliable understanding of the mechanism and kinetics of reactions were made in this review.
文摘Objective To study the domestic market environment and its advantages and disadvantages of angiotensin receptor-neprilysin inhibitor(ARNI)anti-heart failure drugs so as to provide reference for the promotion of this sort of drugs in Chinese market.Methods Based on SWOT model,the anti-heart failure drugs were analyzed from four aspects:strength,weakness,opportunity and threat.Results and Conclusion ARNI anti-heart failure drugs have greater opportunities than threats in China,and their advantages outweigh the disadvantages.However,in order to gain more market share,it is still necessary to pay attention to the clinical verification of their long-term safety and effectiveness.In addition,consumers are interested in the price of ARNI anti-heart failure drugs and its popularity.
基金Supported by Heilongjiang Province Technological and Scientific Research Project(12531051)
文摘Irrigation water became the limiting factor to the persistent improvement of grain production. Based on the data from Gannan County, a semiarid area in the west of Heilongjiang Province, the present situation of the development and utilization of water resources and the suitable water saving irrigation mode were analyzed by using SPA model, which was significant to the efficient and rational utilization of water resources and the improvement of agriculture productivity. The result showed that the model could be applied well to the assessment of development and utilization of water resources and the multi-project optimal selection. Through calculation, it could be found that the utilization of water resources in Gannan County was still in the primary stage, and the integration technology of the optimized water saving irrigation should be combined to support the sustainable development of agriculture in the semiarid area.
基金the FAPERJ(State of Rio de Janeiro research supporting foundation)
文摘A demand for renewable alternatives that would be able to deal with the problems related to well-being is directly linked to the world’s growing needs to save energy and reduce environmental costs. For a project implementation addressing these issues, it is essential to know the climatic conditions of the target area. Taking natural ventilation, climatic factors, and renewable alternatives as important sources of comfort, in this work, passive strategies, through the utilization of microclimate elements as well as the location of outside obstacles, were imposed on an initial and specific project. The objective was to introduce obstacles which could interfere in the field of external wind and evaluate whether this outside intervention is able to make changes in indoor air circulation. The wind fields for the studied cases were obtained by computational simulations, and their consequences were analyzed to attain thermal comfort. The method adopted to obtain the wind fields was a Petrov-Galerkin type method, which is a stabilized mixed finite element method of the Navier-Stokes equations considering the incompressibility and formulated in primitive variables, velocity and pressure. The obtained results point to the solutions that promote the increase or decrease of the wind-field intensity.
基金Supported by Project of National Natural Science Foundation of China(81460675)
文摘[Objectives] To make a systematic evaluation on the therapeutic efficacy and safety of Yiqi Huoxue traditional Chinese drugs combined with western medicine in treatment of coronary heart disease( CHD) after coronary revascularization. [Methods] The literatures were retrieved from China Knowledge Infrastructure( CNKI),Chinese science and technology journal full-text database( VIP database,VIP),Wanfang Data,the Chinese biomedical Database,Pub Med,Embase,and the Cochrane Library. The retrieval time was set to the creation of the database to January 2017. The randomized controlled trial( RCT) was conducted on the comparison between Yiqi Huoxue Chinese drugs combined with western medicine and the western medicine alone in the treatment of CHD after coronary revascularization. The literature information was extracted and the methodological quality of the included literature was evaluated according to the bias risk assessment tool developed by the Cochrane Collaboration. Meta-analysis was performed with the aid of Rev Man 5. 3 software. Coronary artery restenosis rate,angina pectoris treatment efficiency,left ventricular ejection fraction( LVEF),left ventricular end-diastolic volume( LVEDV),B-type natriuretic peptide( BNP),6-minute walk test( 6 MWT),and adverse reactions were analyzed. [Results] A total of 29 articles were included,a total of2 518 patients,the literature quality was low. Meta-analysis results showed that compared with the treatment by western medicine alone,Yiqi Huoxue Chinese drugs combined with western medicine could further reduce coronary restenosis rate[RR = 0. 45,95% CI( 0. 34,0. 60),P <0. 000 01],improve the angina pectoris treatment efficiency[RR = 1. 13,95% CI( 1. 05,1. 21),P = 0. 000 5],raise LVEF[WMD = 4. 25,95% CI( 3. 46,5. 04),P < 0. 000 01],reduce LVEDV[WMD =-10. 41,95% CI(-17. 88,-2. 95),P = 0. 006],decrease the plasma BNP level[WMD =-32. 32,95% CI(-44. 92,-19. 72),P < 0. 000 01],and increase 6 MWT distance(WMD = 62. 25,95% CI( 21. 71,102. 78),P = 0. 003)[Conclusions]Yiqi Huoxue Chinese drugs combined with western medicine can alleviate the symptoms of angina pectoris,reduce the rate of coronary restenosis,improve heart function and improve exercise capacity,thereby improving clinical efficacy in patients with CHD after coronary revascularization.
基金supported by National Key Research and Development Project of Stem Cell and Transformation Research,No.2019YFA0112100Tianjin Key Research and Development Plan,Key Projects for Science and Technology Support,No.19YFZCSY00660(both to SQF)。
文摘Ferroptosis plays a key role in aggravating the progression of spinal cord injury(SCI),but the specific mechanism remains unknown.In this study,we constructed a rat model of T10 SCI using a modified Allen method.We identified 48,44,and 27 ferroptosis genes that were differentially expressed at 1,3,and 7 days after SCI induction.Compared with the sham group and other SCI subgroups,the subgroup at 1 day after SCI showed increased expression of the ferroptosis marker acyl-CoA synthetase long-chain family member 4 and the oxidative stress marker malondialdehyde in the injured spinal cord while glutathione in the injured spinal cord was lower.These findings with our bioinformatics results suggested that 1 day after SCI was the important period of ferroptosis progression.Bioinformatics analysis identified the following top ten hub ferroptosis genes in the subgroup at 1 day after SCI:STAT3,JUN,TLR4,ATF3,HMOX1,MAPK1,MAPK9,PTGS2,VEGFA,and RELA.Real-time polymerase chain reaction on rat spinal cord tissue confirmed that STAT3,JUN,TLR4,ATF3,HMOX1,PTGS2,and RELA mRNA levels were up-regulated and VEGFA,MAPK1 and MAPK9 mRNA levels were down-regulated.Ten potential compounds were predicted using the DSigDB database as potential drugs or molecules targeting ferroptosis to repair SCI.We also constructed a ferroptosis-related mRNA-miRNA-lncRNA network in SCI that included 66 lncRNAs,10 miRNAs,and 12 genes.Our results help further the understanding of the mechanism underlying ferroptosis in SCI.
文摘·AIM:To evaluate visual outcomes and changes in fluid after administering monthly anti-vascular endothelial growth factor(VEGF)injections to treat neovascular agerelated macular degeneration(n AMD)with subretinal fluid(SRF)and pigment epithelial detachment(PED).·METHODS:This prospective study included eyes with n AMD previously treated with as-needed anti-VEGF injections.The patients were treated with six monthly intravitreal injections of ranibizumab.Quantitative volumetric segmentation analyses of the SRF and PED were performed.The main outcome measures included best-corrected visual acuity(BCVA),and SRF and PED volumes.·RESULTS:Twenty eyes of 20 patients were included in this study.At the 6-month follow-up,BCVA and PED volume did not change significantly(P=0.110 and 0.999,respectively)but the mean SRF volume decreased from 0.53±0.82 mm3 at baseline to 0.08±0.23 mm3(P=0.002).The absorption rate of the SRF volume was negatively correlated with the duration of previous antiVEGF treatment(P=0.029).Seven of the 20 eyes(35%)showed a fluid-free macula and significant improvement in BCVA(P=0.036)by month 6.·CONCLUSION:Quantifying the SRF can precisely determine the patient’s responsiveness to anti-VEGF treatment of n AMD.
