Search results for: European treatment and outcome study score
53064 Effect of Low Calorie Sweeteners on Chemical, Sensory Evaluation and Antidiabetic of Pumpkin Jam Fortified with Soybean
Authors: Amnah M. A. Alsuhaibani, Amal N. Al-Kuraieef
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Introduction: In the recent decades, production of low-calorie jams is needed for diabetics that comprise low calorie fruits and low calorie sweeteners. Object: the research aimed to prepare low calorie formulated pumpkin jams (fructose, stevia and aspartame) incorporated with soy bean and evaluate the jams through chemical analysis and sensory evaluation after storage for six month. Moreover, the possible effect of consumption of low calorie jams on diabetic rats was investigated. Methods: Five formulas of pumpkin jam with different sucrose, fructose, stevia and aspartame sweeteners and soy bean were prepared and stored at 10 oC for six month compared to ordinary pumpkin jam. Chemical composition and sensory evaluation of formulated jams were evaluated at zero time, 3 month and 6 month of storage. The best three acceptable pumpkin jams were taken for biological study on diabetic rats. Rats divided into group (1) served as negative control and streptozotocin induce diabetes four rat groups that were positive diabetic control (group2), rats fed on standard diet with 10% sucrose soybean jam, fructose soybean jam and stevia soybean jam (group 3, 4&5), respectively. Results: The content of protein, fat, ash and fiber were increased but carbohydrate was decreased in low calorie formulated pumpkin jams compared to ordinary jam. Production of aspartame soybean pumpkin jam had lower score of all sensory attributes compared to other jam then followed by stevia soybean Pumpkin jam. Using non nutritive sweeteners (stevia & aspartame) with soybean in processing jam could lower the score of the sensory attributes after storage for 3 and 6 months. The highest score was recorded for sucrose and fructose soybean jams followed by stevia soybean jam while aspartame soybean jam recorded the lowest score significantly. The biological evaluation showed a significant improvement in body weight and FER of rats after six weeks of consumption of standard diet with jams (Group 3,4&5) compared to Group1. Rats consumed 10% low calorie jam with nutrient sweetener (fructose) and non nutrient sweetener (stevia) soybean jam (group 4& 5) showed significant decrease in glucose level, liver function enzymes activity, and liver cholesterol & total lipids in addition of significant increase of insulin and glycogen compared to the levels of group 2. Conclusion: low calorie pumpkin jams can be prepared by low calorie sweeteners and soybean and also storage for 3 months at 10oC without change sensory attributes. Consumption of stevia pumpkin jam fortified with soybean had positive health effects on streptozoticin induced diabetes in rats.Keywords: pumpkin jam, HFCS, aspartame, stevia, storage
Procedia PDF Downloads 18353063 Determination of the Effective Economic and/or Demographic Indicators in Classification of European Union Member and Candidate Countries Using Partial Least Squares Discriminant Analysis
Authors: Esra Polat
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Partial Least Squares Discriminant Analysis (PLSDA) is a statistical method for classification and consists a classical Partial Least Squares Regression (PLSR) in which the dependent variable is a categorical one expressing the class membership of each observation. PLSDA can be applied in many cases when classical discriminant analysis cannot be applied. For example, when the number of observations is low and when the number of independent variables is high. When there are missing values, PLSDA can be applied on the data that is available. Finally, it is adapted when multicollinearity between independent variables is high. The aim of this study is to determine the economic and/or demographic indicators, which are effective in grouping the 28 European Union (EU) member countries and 7 candidate countries (including potential candidates Bosnia and Herzegovina (BiH) and Kosova) by using the data set obtained from database of the World Bank for 2014. Leaving the political issues aside, the analysis is only concerned with the economic and demographic variables that have the potential influence on country’s eligibility for EU entrance. Hence, in this study, both the performance of PLSDA method in classifying the countries correctly to their pre-defined groups (candidate or member) and the differences between the EU countries and candidate countries in terms of these indicators are analyzed. As a result of the PLSDA, the value of percentage correctness of 100 % indicates that overall of the 35 countries is classified correctly. Moreover, the most important variables that determine the statuses of member and candidate countries in terms of economic indicators are identified as 'external balance on goods and services (% GDP)', 'gross domestic savings (% GDP)' and 'gross national expenditure (% GDP)' that means for the 2014 economical structure of countries is the most important determinant of EU membership. Subsequently, the model validated to prove the predictive ability by using the data set for 2015. For prediction sample, %97,14 of the countries are correctly classified. An interesting result is obtained for only BiH, which is still a potential candidate for EU, predicted as a member of EU by using the indicators data set for 2015 as a prediction sample. Although BiH has made a significant transformation from a war-torn country to a semi-functional state, ethnic tensions, nationalistic rhetoric and political disagreements are still evident, which inhibit Bosnian progress towards the EU.Keywords: classification, demographic indicators, economic indicators, European Union, partial least squares discriminant analysis
Procedia PDF Downloads 28053062 A Radiomics Approach to Predict the Evolution of Prostate Imaging Reporting and Data System Score 3/5 Prostate Areas in Multiparametric Magnetic Resonance
Authors: Natascha C. D'Amico, Enzo Grossi, Giovanni Valbusa, Ala Malasevschi, Gianpiero Cardone, Sergio Papa
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Purpose: To characterize, through a radiomic approach, the nature of areas classified PI-RADS (Prostate Imaging Reporting and Data System) 3/5, recognized in multiparametric prostate magnetic resonance with T2-weighted (T2w), diffusion and perfusion sequences with paramagnetic contrast. Methods and Materials: 24 cases undergoing multiparametric prostate MR and biopsy were admitted to this pilot study. Clinical outcome of the PI-RADS 3/5 was found through biopsy, finding 8 malignant tumours. The analysed images were acquired with a Philips achieva 1.5T machine with a CE- T2-weighted sequence in the axial plane. Semi-automatic tumour segmentation was carried out on MR images using 3DSlicer image analysis software. 45 shape-based, intensity-based and texture-based features were extracted and represented the input for preprocessing. An evolutionary algorithm (a TWIST system based on KNN algorithm) was used to subdivide the dataset into training and testing set and select features yielding the maximal amount of information. After this pre-processing 20 input variables were selected and different machine learning systems were used to develop a predictive model based on a training testing crossover procedure. Results: The best machine learning system (three-layers feed-forward neural network) obtained a global accuracy of 90% ( 80 % sensitivity and 100% specificity ) with a ROC of 0.82. Conclusion: Machine learning systems coupled with radiomics show a promising potential in distinguishing benign from malign tumours in PI-RADS 3/5 areas.Keywords: machine learning, MR prostate, PI-Rads 3, radiomics
Procedia PDF Downloads 18853061 Interrogating Student-Teachers’ Transformative Learning Role, Resources and Journey Considering Pedagogical Reform in Teacher Education Continuums
Authors: Nji Clement Bang, Rosemary Shafack M., Kum Henry Asei, Yaro Loveline Y
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Scholars perceive learner-centered teaching-learning reform as roles and resources in teacher education (TE) and professional outcome with transformative learning (TL) continuum dimensions. But, teaching-learning reform is fast proliferating amidst debilitating stakeholder systemic dichotomies, resources, commitment, resistance and poor quality outcome that necessitate stronger TE and professional continuums. Scholars keep seeking greater understanding of themes in teaching-learning reform, TE and professional outcome as continuums and how policymakers, student-teachers, teacher trainers and local communities concerned with initial TE can promote continuous holistic quality performance. To sustain the debate continuum and answer the overarching question, we use mixed-methods research-design with diverse literature and 409 sample-data. Onset text, interview and questionnaire analyses reveal debilitating teaching-learning reform in TE continuums that need TL revival. Follow-up focus group discussion and teaching considering TL insights reinforce holistic teaching-learning in TE. Therefore, significant increase in diverse prior-experience articulation1; critical reflection-discourse engagement2; teaching-practice interaction3; complex-activity constrain control4 and formative outcome- reintegration5 reinforce teaching-learning in learning-to-teach role-resource pathways and outcomes. Themes reiterate complex teaching-learning in TE programs that suits TL journeys and student-teachers and students cum teachers, workers/citizens become akin, transformative-learners who evolve personal and collective roles-resources towards holistic-lifelong-learning outcomes. The article could assist debate about quality teaching-learning reform through TL dimensions as TE and professional role-resource continuums.Keywords: transformative learning perspectives, teacher education, initial teacher education, learner-centered pedagogical reform, life-long learning
Procedia PDF Downloads 7653060 Executive Functions Directly Associated with Severity of Perceived Pain above and beyond Depression in the Context of Medical Rehabilitation
Authors: O. Elkana, O Heyman, S. Hamdan, M. Franko, J. Vatine
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Objective: To investigate whether a direct link exists between perceived pain (PP) and executive functions (EF), above and beyond the influence of depression symptoms, in the context of medical rehabilitation. Design: Cross-sectional study. Setting: Rehabilitation Hospital. Participants: 125 medical records of hospitalized patients were screened for matching to our inclusion criteria. Only 60 patients were found fit and were asked to participate. 19 decline to participate on personal basis. The 41 neurologically intact patients (mean age 46, SD 14.96) that participated in this study were in their sub-acute stage of recovery, with fluent Hebrew, with intact upper limb (to neutralize influence on psychomotor performances) and without an organic brain damage. Main Outcome Measures: EF were assessed using the Wisconsin Card Sorting Test (WCST) and the Stop-Signal Test (SST). PP was measured using 3 well-known pain questionnaires: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS). Perceived pain index (PPI) was calculated by the mean score composite from the 3 pain questionnaires. Depression symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Results: The results indicate that irrespective of the presence of depression symptoms, PP is directly correlated with response inhibition (SST partial correlation: r=0.5; p=0.001) and mental flexibility (WSCT partial correlation: r=-0.37; p=0.021), suggesting decreased performance in EF as PP severity increases. High correlations were found between the 3 pain measurements: SF-MPQ with PDI (r=0.62, p<0.001), SF-MPQ with PCS (r=0.58, p<0.001) and PDI with PCS (r=0.38, p=0.016) and each questionnaire alone was also significantly associated with EF; thus, no specific questionnaires ‘pulled’ the results obtained by the general index (PPI). Conclusion: Examining the direct association between PP and EF, beyond the contribution of depression symptoms, provides further clinical evidence suggesting that EF and PP share underlying mediating neuronal mechanisms. Clinically, the importance of assessing patients' EF abilities as well as PP severity during rehabilitation is underscored.Keywords: depression, executive functions, mental-flexibility, neuropsychology, pain perception, perceived pain, response inhibition
Procedia PDF Downloads 24853059 The Relationship between Osteoporosis-Related Knowledge and Physical Activity among Women Age over 50 Years
Authors: P. Tardi, B. Szilagyi, A. Makai, P. Acs, M. Hock, M. Jaromi
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Osteoporosis is becoming a major public health problem, particularly in postmenopausal women, as the incidence of this disease is getting higher. Nowadays, one of the most common chronic musculoskeletal diseases is osteoporosis. Osteoporosis-related knowledge is an important contributor to prevent or to treat osteoporosis. The most important strategies to prevent or treat the disease are increasing the level of physical activity at all ages, cessation of smoking, reduction of alcohol consumption, adequate dietary calcium, and vitamin D intake. The aim of the study was to measure the osteoporosis-related knowledge and physical activity among women age over 50 years. For the measurements, we used the osteoporosis questionnaire (OPQ) to examine the disease-specific knowledge and the global physical activity questionnaire (GPAQ) to measure the quantity and quality of the physical activity. The OPQ is a self-administered 20-item questionnaire with five categories: general information, risk factors, investigations, consequences, and treatment. There are four choices per question (one of them is the 'I do not know'). The filler gets +1 for a good answer, -1 point for a bad answer, and 0 for 'I do not know' answer. We contacted with 326 women (63.08 ± 9.36 year) to fill out the questionnaires. Descriptive analysis was carried out, and we calculated Spearman's correlation coefficient to examine the relationship between the variables. Data were entered into Microsoft Excel, and all statistical analyses were performed using SPSS (Version 24). The participants of the study (n=326) reached 8.76 ± 6.94 points on OPQ. Significant (p < 0.001) differences were found in the results of OPQ according to the highest level of education. It was observed that the score of the participants with osteoporosis (10.07 ± 6.82 points) was significantly (p=0.003) higher than participants without osteoporosis (9.38 ± 6.66 points) and the score of those women (6.49 ± 6.97 points) who did not know that osteoporosis exists in their case. The GPAQ results showed the sample physical activity in the dimensions of vigorous work (479.86 ± 684.02 min/week); moderate work (678.16 ± 804.5 min/week); travel (262.83 ± 380.27 min/week); vigorous recreation (77.71 ± 123.46 min/week); moderate recreation (115.15 ± 154.82 min/week) and total weekly physical activity (1645.99 ± 1432.88 min/week). Significant correlations were found between the osteoporosis-related knowledge and the physical activity in travel (R=0.21; p < 0.001), vigorous recreation (R=0.35; p < 0.001), moderate recreation (R=0.35; p < 0.001), total vigorous minutes/week (R=0.15; p=0.001) and total moderate minutes/week (R=0.13; p=0.04) dimensions. According to the results that were achieved, the highest level of education significantly determines osteoporosis-related knowledge. Physical activity is an important contributor to prevent or to treat osteoporosis, and it showed a significant correlation with osteoporosis-related knowledge. Based on the results, the development of osteoporosis-related knowledge may help to improve the level of physical activity, especially recreation. Acknowledgment: Supported by the ÚNKP-20-1 New National Excellence Program of The Ministry for Innovation and Technology from the Source of the National Research, Development and Innovation Fund.Keywords: osteoporosis, osteoporosis-related knowledge, physical activity, prevention
Procedia PDF Downloads 11353058 A Novel Treatment of the Arthritic Hip: A Prospective, Cross-Sectional Study on Changes Following Bone Marrow Concentrate Injection and Arthroscopic Debridement
Authors: A. Drapeaux, S. Aviles, E. Garfoot
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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment
Procedia PDF Downloads 6653057 A Systematic Review for the Association between Active Smoking and Latent Tuberculosis Infection
Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh
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Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.Keywords: latent tuberculosis infection, systematic review, active smoking, model
Procedia PDF Downloads 25653056 Biological Treatment of Tannery Wastewater Using Pseudomonas Strains
Authors: A. Benhadji, R. Maachi
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Environmental protection has become a major economic development issues. Indeed, the environment has become both market growth factor and element of competition. It is now an integral part of all industrial strategies. Ecosystem protection is based on the reduction of the pollution load in the treatment of liquid waste. The physicochemical techniques are commonly used which a transfer of pollution is generally found. Alternative to physicochemical methods is the use of microorganisms for cleaning up the waste waters. The objective of this research is the evaluation of the effects of exogenous added Pseudomonas strains on pollutants biodegradation. The influence of the critical parameters such as inoculums concentration and duration treatment are studied. The results show that Pseudomonas putida is found to give a maximum reduction in chemical organic demand (COD) in 4 days of incubation. However, toward to protect biological pollution of environment, the treatment is achieved by electro coagulation process using aluminium electrodes. The results indicate that this process allows disinfecting the water and improving the electro coagulated sludge quality.Keywords: tannery, pseudomonas, biological treatment, electrocoagulation process, sludge quality
Procedia PDF Downloads 36953055 Water Absorption Studies on Natural Fiber Reinforced Polymer Composites
Authors: G. L. Devnani, Shishir Sinha
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In the recent years, researchers have drawn their focus on natural fibers reinforced composite materials because of their excellent properties like low cost, lower weight, better tensile and flexural strengths, biodegradability etc. There is little concern however that when these materials are put in moist conditions for long duration, their mechanical properties degrade. Therefore, in order to take maximum advantage of these novel materials, one should have a complete understanding of their moisture or water absorption phenomena. Various fiber surface treatment methods like alkaline treatment, acetylation etc. have also been suggested for reduction in water absorption of these composites. In the present study, a detailed review is done for water absorption behavior of natural fiber reinforced polymer composites, and experiments also have been performed on these composites with varying the parameters like fiber loading etc. for understanding the water absorption kinetics. Various surface treatment methods also performed to reduce the water absorption behavior of these materials and effort is made to develop a proper understanding of water absorption mechanism mathematically and experimentally for full potential utilization of natural fiber reinforced polymer composite materials.Keywords: alkaline treatment, composites, natural fiber, water absorption
Procedia PDF Downloads 28753054 Role of Organic Wastewater Constituents in Iron Redox Cycling for Ferric Sludge Reuse in the Fenton-Based Treatment
Authors: J. Bolobajev, M. Trapido, A. Goi
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The practical application of the Fenton-based treatment method for organic compounds-contaminated water purification is limited mainly because of the large amount of ferric sludge formed during the treatment, where ferrous iron (Fe(II)) is used as the activator of the hydrogen peroxide oxidation processes. Reuse of ferric sludge collected from clarifiers to substitute Fe(II) salts allows reducing the total cost of Fenton-type treatment technologies and minimizing the accumulation of hazardous ferric waste. Dissolution of ferric iron (Fe(III)) from the sludge to liquid phase at acidic pH and autocatalytic transformation of Fe(III) to Fe(II) by phenolic compounds (tannic acid, lignin, phenol, catechol, pyrogallol and hydroquinone) added or present as water/wastewater constituents were found to be essentially involved in the Fenton-based oxidation mechanism. Observed enhanced formation of highly reactive species, hydroxyl radicals, resulted in a substantial organic contaminant degradation increase. Sludge reuse at acidic pH and in the presence of ferric iron reductants is a novel strategy in the Fenton-based treatment application for organic compounds-contaminated water purification.Keywords: ferric sludge recycling, ferric iron reductant, water treatment, organic pollutant
Procedia PDF Downloads 29453053 Downhole Corrosion Inhibition Treatment for Water Supply Wells
Authors: Nayif Alrasheedi, Sultan Almutairi
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Field-wide, a water supply wells’ downhole corrosion inhibition program is being applied to maintain downhole component integrity and keep the fluid corrosivity below 5 MPY. Batch treatment is currently used to inject the oil field chemical. This work is a case study consisting of analytical procedures used to optimize the frequency of the good corrosion inhibition treatments. During the study, a corrosion cell was fitted with a special three-electrode configuration for electrochemical measurements, electrochemical linear polarization, corrosion monitoring, and microbial analysis. This study revealed that the current practice is not able to mitigate material corrosion in the downhole system for more than three months.Keywords: downhole corrosion inhibition, electrochemical measurements, electrochemical linear polarization, corrosion monitoring
Procedia PDF Downloads 18353052 Prospective Study on the Efficacy of Bio Absorbable Screws in Treatment of Osteochondral Fractures
Authors: S. Anwar Sathik, K. Manoj Deepak, K. Venkatachalam
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Our study is a prospective study on the use of bio absorbable pins for the treatment of osteochondral fractures after patellar dislocation.22 patients who presented with osteochondral fractures were treated in our institution. They were followed for a minimum of 12 months by regular radiological evaluation. Of the 22 patients, 2 had fragments that detached from the fracture site which was treated arthroscopically. All the patients underwent open reduction and fixation of the pins using bio absorbable crews. They were immobilized in the cast for a minimum of 6 weeks after which mobilization was started according to our protocol. Fracture consolidation was found to occur in 20 of the 22 patients. Thus, Bio absorbable screws can be used as a reliable method of fixation of the osteochondral fragments.Keywords: osteochondral fracture, bio absorbable pins, patella dislocation, physiotherapy
Procedia PDF Downloads 31253051 Mathematical Model of Cancer Growth under the Influence of Radiation Therapy
Authors: Beata Jackowska-Zduniak
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We formulate and analyze a mathematical model describing dynamics of cancer growth under the influence of radiation therapy. The effect of this type of therapy is considered as an additional equation of discussed model. Numerical simulations show that delay, which is added to ordinary differential equations and represent time needed for transformation from one type of cells to the other one, affects the behavior of the system. The validation and verification of proposed model is based on medical data. Analytical results are illustrated by numerical examples of the model dynamics. The model is able to reconstruct dynamics of treatment of cancer and may be used to determine the most effective treatment regimen based on the study of the behavior of individual treatment protocols.Keywords: mathematical modeling, numerical simulation, ordinary differential equations, radiation therapy
Procedia PDF Downloads 40853050 Understanding and Political Participation in Constitutional Monarchy of Dusit District Residents
Authors: Sudaporn Arundee
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The purposes of this research were to study in three areas: (1) to study political understanding and participating of the constitutional monarchy, (2) to study the level of participation. This paper drew upon data collected from 395 Dusit residents by using questionnaire. In addition, a simple random sampling was utilized to collect data. The findings revealed that 94 percent of respondents had a very good understanding of constitution monarchy with a mean of 4.8. However, the respondents overall had a very low level of participation with the mean score of 1.69 and standard deviation of .719.Keywords: political participation, constitutional monarchy, management and social sciences
Procedia PDF Downloads 25153049 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study
Authors: Omer Ibrahim Abdallh Omer
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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.Keywords: cancer, medications adherence, medication therapy management, pharmacist
Procedia PDF Downloads 6453048 Effect of Different Levels of Dried Citrus Sinensis Peel on Blood Parameters of Broilers
Authors: Abbas Ebrahimi, Zohreh Pourhossein, Nariman Miraalami
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The experiment was conducted to evaluate the effects of different levels of dried citrus sinensis peel (DCSP) on the blood parameters of broilers. Four hundred Ross 308 strain day old broiler in a completely randomized design with five treatments (four replicates per treatment and each replicate had 20 chicks) were categorized. Each treatment used either regulatory diet including 1.5% and 3% DCSP in the base diet and in two periods of 1st to 21st day and 1st to 42nd day and base diet without any additive for six weeks. Data analysis was performed using SAS software and mean comparison was conducted by Duncan method. The results determined that using different level of DCSP has significant effects on blood plasma parameters (P<0.05). Cholesterol, glucose, triglyceride, low density lipoprotein (LDL) at the rearing period was significantly influenced by experimental treatments (P<0.05). However, uric acid, alkaline phosphatase and high density lipoprotein (HDL) was not affected by experimental treatments (P>0.05). The lowest rate of blood cholesterol was concerned to the treatment which was used 3% DCSP 1st to 42nd day and the highest mean of blood cholesterol were concerned to the control treatment. The lowest rate of blood triglyceride was concerned to the treatment which was used 3% DCSP 1st to 42nd day and the highest mean of blood triglyceride were concerned to the control treatment. The lowest rate of blood alkaline phosphatase was concerned to the treatment which was used 3% DCSP 1st to 42nd day and the highest mean of blood alkaline phosphatase were concerned to the treatment which was used 3% DCSP 1st to 21st day.Keywords: blood parameters, broilers, dried citrus sinensis peel, regulatory diet
Procedia PDF Downloads 56053047 Outcome of Dacryocystorhinostomy with Peroperative Local Use of Mitomycin-C
Authors: Chandra Shekhar Majumder, Orin Sultana Jamie
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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction
Procedia PDF Downloads 4553046 The Effectiveness of Traditional Music as Therapy and Alternative to Traditional Forms of Therapy in Treatment of Anxiety and Depression
Authors: Helen Johnson-Egemba
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This paper will discuss the current effectiveness of music therapy for a range of conditions, such as depression and anxiety. Indeed, traditional forms of therapy have often been effective in treating various mental and physical health conditions. However, they are not with their limitations. Music therapy, on the other hand, is a non-invasive and cost-effective alternative that can produce similar or even better results. Music therapy can produce longer-lasting results. The research also highlights the underlying mechanisms of traditional music therapy, such as its complementary treatment. A systematic review of existing literature was conducted to gather relevant studies and establish a comprehensive understanding of the topic. Various research methods, including experimental studies, qualitative research, surveys, were utilized to explore the therapeutic potential of traditional music interventions. The findings reveal that traditional music therapy shows promise in managing anxiety and depression symptoms, with positive outcomes impacting brain activity, emotions, and stress regulation. The outcomes of this study contribute to evidence-based practice, providing insights for clinicians and therapists to incorporate traditional music therapy into their treatment approaches. Furthermore, the research promotes awareness and acceptance of traditional music as a legitimate and effective therapeutic intervention for anxiety and depression, potentially enhancing access to alternative and complementary treatment options. Overall, this study demonstrates the potential benefits of traditional music therapy in addressing anxiety and depression, offering valuable implications for mental health care and improving the well-being of individuals struggling with these conditions.Keywords: anxiety, effectiveness, depression, traditional music, therapy, treatment
Procedia PDF Downloads 4553045 Drivers and Barriers to the Acceptability of a Human Milk Bank Among Malaysians: A Cross Sectional Study
Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid
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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.Keywords: acceptability, attitude, human milk bank, knowledge
Procedia PDF Downloads 10253044 Role of Moderate Intensity Exercises in the Amelioration of Oxidant-Antioxidant Status and the Levels of Inflammatory Cytokines in Rheumatoid Arthritis Patients
Authors: Somaiya Mateen, Shagufta Moin, Abdul Qayyum, Atif Zafar
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Cytokines and reactive species play an important role in the pathophysiology of rheumatoid arthritis (RA). This study was done to determine the levels of reactive oxygen and nitrogen species (ROS and RNS), inflammatory cytokines and the markers of protein, DNA and lipid oxidation in the blood of RA patients, with the aim to study the antioxidant and anti-inflammatory role of moderate intensity exercises in the management of RA. RA patients were subdivided into two groups- first group (n=30) received treatment with conventional RA drugs while the second group (n=30) received moderate exercise therapy along with the conventional drugs for a period of 12 weeks. The levels of ROS, RNS, inflammatory cytokines and markers of biomolecule oxidation were monitored before and after 12 weeks of treatment. RA patients showed a marked increase in the levels of ROS, RNS, inflammatory cytokines, lipid, protein and DNA oxidation as compared to the healthy controls. These parameters were ameliorated after treatment with drugs alone and exercise combined with drugs, with the amelioration being more significant in patients given drugs along with the moderate intensity exercise treatment. In conclusion, the role of ROS, RNS and inflammatory cytokines in the pathogenesis of RA has been confirmed by this study. These may also serve as potential biomarker for assessing the disease severity. Finally, the addition of moderate intensity exercises in the management of RA may be of great value.Keywords: rheumatoid arthritis, reactive oxygen species, inflammatory cytokines, moderate intensity exercises
Procedia PDF Downloads 33353043 Efficacy of Botulinum Toxin in Alleviating Pain Syndrome in Stroke Patients with Upper Limb Spasticity
Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.
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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.Keywords: botulinum toxin, pain syndrome, spasticity, stroke
Procedia PDF Downloads 30953042 Cytotoxicity thiamethoxam Study on the Hepatopancreas and Its Reversibility under the Effect of Ginger in Helix aspersa
Authors: Samira Bensoltane, Smina Ait Hamlet, Samti Meriem, Semmasel Asma
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Living organisms in the soil are subject to regular fluctuations of abiotic parameters, as well as a chemical contamination of the environment due to human activities. They are subject to multiple stressors they face. The aim of our work was to study the effects of insecticide: thiamethoxam (neonicotinoid), and the potential reversibility of the effects by an antioxidant: ginger on a bioindicator species in ecotoxicology, the land snail Helix aspersa. The effects were studied by a targeted cell approach of evaluating the effect of these molecules on tissue and cellular aspect of hepatopancreas through histological study. Treatment with thiamethoxam concentrations 10, 20, and 40 mg/l shows signs of inflammation even at low concentrations and from the 5th day of treatment. Histological examination of the hepatopancreas of snails treated with thiamethoxam showed significant changes from the lowest concentrations tested , note intertubular connective tissue enlargement, necrosis deferent types of cells (cells with calcium , digestive, excretory) , also damage acini, alteration of the apical membrane and lysis of the basement membrane in a dose- dependent manner. After 10 days of treatment and with 40 mg/l, the same changes were observed with a very advanced degeneration of the wall of the member that could be confused with the cell debris. For cons, the histological study of the hepatopancreas in Helix aspersa treated with ginger for a period of 15 days after stopping treatment with thiamethoxam has shown a partial regeneration of hepatopancreatic tissue snails treated with all concentrations of thiamethoxam and especially in the intertubular connective tissue of the wall and hepatopancreatic digestive tubules. Finally, we can conclude that monitoring the effect of the insecticide thiamethoxam showed significant alterations, however, treatment with ginger shows regeneration of damaged cells themselves much sharper at low concentration (10 mg/L).Keywords: Helix aspersa, insecticides, thiamethoxam, ginger, hepatopancreas
Procedia PDF Downloads 21653041 Outcome of Using Penpat Pinyowattanasilp Equation for Prediction of 24-Hour Uptake, First and Second Therapeutic Doses Calculation in Graves’ Disease Patient
Authors: Piyarat Parklug, Busaba Supawattanaobodee, Penpat Pinyowattanasilp
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The radioactive iodine thyroid uptake (RAIU) has been widely used to differentiate the cause of thyrotoxicosis and treatment. Twenty-four hours RAIU is routinely used to calculate the dose of radioactive iodine (RAI) therapy; however, 2 days protocol is required. This study aims to evaluate the modification of Penpat Pinyowattanasilp equation application by the exclusion of outlier data, 3 hours RAIU less than 20% and more than 80%, to improve prediction of 24-hour uptake. The equation is predicted 24 hours RAIU (P24RAIU) = 32.5+0.702 (3 hours RAIU). Then calculating separation first and second therapeutic doses in Graves’ disease patients. Methods; This study was a retrospective study at Faculty of Medicine Vajira Hospital in Bangkok, Thailand. Inclusion were Graves’ disease patients who visited RAI clinic between January 2014-March 2019. We divided subjects into 2 groups according to first and second therapeutic doses. Results; Our study had a total of 151 patients. The study was done in 115 patients with first RAI dose and 36 patients with second RAI dose. The P24RAIU are highly correlated with actual 24-hour RAIU in first and second therapeutic doses (r = 0.913, 95% CI = 0.876 to 0.939 and r = 0.806, 95% CI = 0.649 to 0.897). Bland-Altman plot shows that mean differences between predictive and actual 24 hours RAI in the first dose and second dose were 2.14% (95%CI 0.83-3.46) and 1.37% (95%CI -1.41-4.14). The mean first actual and predictive therapeutic doses are 8.33 ± 4.93 and 7.38 ± 3.43 milliCuries (mCi) respectively. The mean second actual and predictive therapeutic doses are 6.51 ± 3.96 and 6.01 ± 3.11 mCi respectively. The predictive therapeutic doses are highly correlated with the actual dose in first and second therapeutic doses (r = 0.907, 95% CI = 0.868 to 0.935 and r = 0.953, 95% CI = 0.909 to 0.976). Bland-Altman plot shows that mean difference between predictive and actual P24RAIU in the first dose and second dose were less than 1 mCi (-0.94 and -0.5 mCi). This modification equation application is simply used in clinical practice especially patient with 3 hours RAIU in range of 20-80% in a Thai population. Before use, this equation for other population should be tested for the correlation.Keywords: equation, Graves’disease, prediction, 24-hour uptake
Procedia PDF Downloads 13953040 The Effect of Environmental, Social, and Governance (ESG) Disclosure on Firms’ Credit Rating and Capital Structure
Authors: Heba Abdelmotaal
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This paper explores the impact of the extent of a company's environmental, social, and governance (ESG) disclosure on credit rating and capital structure. The analysis is based on a sample of 202 firms from the 350 FTSE firms over the period of 2008-2013. ESG disclosure score is measured using Proprietary Bloomberg score based on the extent of a company's Environmental, Social, and Governance (ESG) disclosure. The credit rating is measured by The QuiScore, which is a measure of the likelihood that a company will become bankrupt in the twelve months following the date of calculation. The Capital Structure is measured by long term debt ratio. Two hypotheses are test using panel data regression. The results suggested that the higher degree of ESG disclosure leads to better credit rating. There is significant negative relationship between ESG disclosure and the long term debit percentage. The paper includes implications for the transparency which is resulting of the ESG disclosure could support the Monitoring Function. The monitoring role of disclosure is the increasing in the transparency of the credit rating agencies, also it could affect on managers’ actions. This study provides empirical evidence on the material of ESG disclosure on credit ratings changes and the firms’ capital decision making.Keywords: capital structure, credit rating agencies, ESG disclosure, panel data regression
Procedia PDF Downloads 36053039 Assessment of the Association between Serum Thrombospondin-1 Levels at the Time of Admission and the Severity of Neurological Deficit in Patients with Ischemic Stroke
Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares
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Introduction: Despite improvements in stroke management, it remains the leading cause of disability worldwide. It has been suggested that enhancing brain angiogenesis after stroke will improve stroke outcome. Promoting post stroke angiogenesis requires the upregulation of angiogenic factors with a simultaneous reduction of anti-angiogenic factors. Thrombospondin-1 is the main anti-angiogenic protein in the living cells. Counterintuitively, it has been shown that animals with Thrombospondin-1 knockdown will have better stroke outcome. Data about the clinical significance of Thrombspondin-1 levels at the time of admission is still lacking. The objective of this work is to assess the association between serum Thrombospondin-1 levels measured at the time of admission and baseline neurologic severity after stroke. Patients and Methods: Blood samples were collected from patients admitted to the King Abdullah University Hospital (KAUH) with ischemic stroke at the time of admission and serum Thrombopsondin-1 levels were measured using ELISA. Patients neurologic severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). Results: Samples from 50 patients admitted between January 2016 and December 2016 were collected. The median age of participants was 68 years and the median NIHSS was 3. Multinomial regression identified serum Thrombospondin-1 as an independent predictor of stroke outcome (p=0.003). Baseline serum Thrombsopondin-1 was negatively associated with NIHSS at the time of admission (spearman rho correlation coefficient=0.272, p=0.032). Conclusion: Serum Thrombospondin-1 at the time of admission may be a useful marker of stroke severity that predicts more severe neurologic severity.Keywords: thrombospondin, stroke, neuroprotection, biomarkers
Procedia PDF Downloads 13753038 A Comparative Study in Acute Pancreatitis to Find out the Effectiveness of Early Addition of Ulinastatin to Current Standard Care in Indian Subjects
Authors: Dr. Jenit Gandhi, Dr. Manojith SS, Dr. Nakul GV, Dr. Sharath Honnani, Dr. Shaurav Ghosh, Dr. Neel Shetty, Dr. Nagabhushan JS, Dr. Manish Joshi
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Introduction: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) and causing distant organ involvement and its function and ending up with multiple organ dysfunction syndromes (MODS). Aim: A comparative study in acute pancreatitis to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects . Methodology: A current prospective observational study is done during study period of 1year (Dec 2018 –Dec 2019) duration to evaluate the effect of early addition of Ulinastatin to the current standard treatment and its efficacy to reduce the early complication, analgesic requirement and duration of hospital stay in patients with Acute Pancreatitis. Results: In the control group 25 were males and 05 were females. In the test group 18 were males and 12 females. Majority was in the age group between 30 - 70 yrs of age with >50% in the 30-50yrs age group in both test and control groups. The VAS was median grade 3 in control group as compared to median grade 2 in test group , the pain was more in the initial 2 days in test group compared to 4 days in test group , the analgesic requirement was used for more in control group (median 6) to test group( median 3 days ). On follow up after 5 days for a period of 2 weeks none of the patients in the test group developed any complication. Where as in the control group 8 patients developed pleural effusion, 04-Pseudopancreatic cyst, 02 – patient developed portal vein and splenic vein thrombosis, 02 patients – ventilator with ARDS which were treated symptomatically whereas in test group 02 patient developed pleural effusions and 01 pseudo pancreatic cyst with splenic artery aneurysm, 01 – patient with AKI and MODS symptomatically treated. The duration of hospital stay for a median period of 4 days (2 – 7 days) in test group and 7 days (4 -10 days) in control group. All patients were able to return to normal work on an average of 5days compared 8days in control group, the difference was significant. Conclusion:The study concluded that early addition of Ulinastatin to current standard treatment of acute Pancreatitis is effective in reducing pain, early complication and duration of hospital stay in Indian subjectKeywords: Ulinastatin, VAS – visual analogue score , AKI – acute kidney injury , ARDS – acute respiratory distress syndrome
Procedia PDF Downloads 12253037 Wastewater Treatment from Heavy Metals by Nanofiltration and Ion Exchange
Authors: G. G. Kagramanov, E. N. Farnosova, Linn Maung Maung
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The technologies of ion exchange and nanofiltration can be used for treatment of wastewater containing copper and other heavy metal ions to decrease the environmental risks. Nanofiltration characteristics under water treatment of heavy metals have been studied. The influence of main technical process parameters - pressure, temperature, concentration and pH value of the initial solution on flux and rejection of nanofiltration membranes has been considered. And ion exchange capacities of resins in removal of heavy metal ions from wastewater have been determined.Keywords: exchange capacity, heavy metals, ion exchange, membrane separation, nanofiltration
Procedia PDF Downloads 28853036 Optimal Hedging of a Portfolio of European Options in an Extended Binomial Model under Proportional Transaction Costs
Authors: Norm Josephy, Lucy Kimball, Victoria Steblovskaya
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Hedging of a portfolio of European options under proportional transaction costs is considered. Our discrete time financial market model extends the binomial market model with transaction costs to the case where the underlying stock price ratios are distributed over a bounded interval rather than over a two-point set. An optimal hedging strategy is chosen from a set of admissible non-self-financing hedging strategies. Our approach to optimal hedging of a portfolio of options is based on theoretical foundation that includes determination of a no-arbitrage option price interval as well as on properties of the non-self-financing strategies and their residuals. A computational algorithm for optimizing an investor relevant criterion over the set of admissible non-self-financing hedging strategies is developed. Applicability of our approach is demonstrated using both simulated data and real market data.Keywords: extended binomial model, non-self-financing hedging, optimization, proportional transaction costs
Procedia PDF Downloads 25253035 Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia
Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad
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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.Keywords: glyceryl trinitrate, knowledge, adherence, patient education
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