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   2016| February-May  | Volume 7 | Issue 1  
    Online since January 16, 2017

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Drug related problems in elderly patients with type 2 diabetes mellitus
SZ Inamdar, RV Kulkarni
February-May 2016, 7(1):1-1
Ageing serves as a gatew ay for many co morbidities and complications. Elderly patients w ere found to use about three times more drugs than younger patients and therefore are at a higher risk of experiencing drug related problems and are associated w ith an increased risk of hospital readmissions, morbidity, and mortality. Elderly patients w ith type 2 diabetes mellitus as such are susceptible to the occurrence of Drug related problems. To assess Drug related problems in Elderly Patients w ith Type 2 Diabetes Mellitus and its possible contributing factors. A survey in Elderly type 2 diabetes inpatients w as carried out in the medicine department of a tertiary care hospital in North Karnataka. The study subjects w ere review ed and assessed w ith a specifically developed checklist tool to identify the occurrence of drug related problem. The mean and standard deviations for collected dat a w ere computed and reported. A total 123 patients w ere studied in w hom a total of 364 drug related problem w ere identified, having mean of 2.96΁2.2 drug related problem per patient, and are categories as related to; Drug w ithout indication 6.05%, Indicati on w ithout drug 7.15%, Drug not appropriate for therapy 3.85%, supra therapeutic dose 0.55%, Additive toxicity 0.82%, therapeutic duplication 1.92%, Adverse drug reactions 2.75%, Drug Interaction 40.93%,and 35.71% of potential inappropriate medications as per Beer's elderly prescribing criteria. The study reveals a high frequency of drug related problems in the study population, w ith an incidence of 2.96΁2.2 per patient. Majority of the drug related problems are reported w ith drug -drug interactions (40.93%), beers criteria (35.71%), drug w ithout indication (6.05%), and adverse drug reactions. Polypharmacy, characteristics of ageing, intricacy of the diabetes treatment and associated co -morbidity w ere potential risk factors identified for developing drug rel ated problems. Majority of clinical pharmacist recommendations (88%) to resolve drug related problems in study population w ere acknow ledged .
[ABSTRACT]   Full text not available  [PDF]
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Impact of Pharmaceutical Care in the Management of Drug Related Problems and Complications in the Treatment of Type II Diabetes Mellitus: A Review
SZ Inamdar, RV Kulkarni
February-May 2016, 7(1):4-4
Pharmaceutical care is a philosophy of practice, in w hich, the patient is the primary beneficiary of the pharm acist‟s actions. Pharm aceutical care involves the process through w hich a pharm acist cooperates w ith a patient and other professionals in designing, implementing and monitoring a therapeutic plan that will produce specific therapeutic outcomes for the patient. As the prevalence of type 2 diabetes mellitus (T2DM) continues to increase w orldw ide, there is an increased need for effective disease management. Since patients w ith diabetes mellitus gener ally receive multiple medications, the drug-related problems are likely to occur and can negatively influence the outcomes. The complexity of the condition requires the need for support from all healthcare professionals in the delivery of pharmaceutical ca re in collaboration w ith a pharmacist. In this review , 12 studies w ere included, w here pharmaceutical care in terms of interventions w as successful in reducing drug-related problems (DRPs), HbA1c, plasma glucose levels, plasma lipids, blood pressure and cost of the treatment. Pharmacists intervention w as successful at increased number of patients (73.5%) to achiev e the target value of HbA1c (≤7), reduction in plasma glucose level (maximum of 54.5mg %), blood pressure (mean reduction of 19.6/7 mmHg) and plasma lipids (mean reduction of 0.3 to 0.6m m ol/l). There w as a positive im pact of pharm acist‟s intervention on health, m edication adherence, the cost of the treatment, and diabetes-related patient‟s quality of life. The concept of pharmaceutical care w as effective in improving disease state management in diabetics by optimizing and resolving pharmaceutical care issues and reducing the econ omic burden of treatment on the patient.
[ABSTRACT]   Full text not available  [PDF]
  2,573 1,441 -
Circulating omentin-1 levels and its association with insulin resistance in newly diagnosed impaired glucose tolerant subjects
L Hossain, IA Hossain, MN Rahman, MZ Azam, MS Afroz, M Hasan, S.M.B. Rahman, L Ali
February-May 2016, 7(1):2-2
Adipose tissue derived a novel adipokine; omentin -1, w hich has recently been characterized as a potent insulin-sensitizing agent, but its pathophysiologic role in the development of insulin resistance among the impaired glucose tolerance (IGT) su bjects remains largely unknow n. The present study has been undertaken to explore the relationship of serum omentin -1 w ith insulin resistance in new ly diagnosed IGT subjects of Bangladeshi population. Fifty-five subjects w ith IGT and 50 (age, sex and body m ass index (BMI) matched) healthy control subjects w ere recruited in this study. Serum insulin and omentin-1 w ere measured by the ELISA technique. Insulin resistance (IR) w as calculated by homeostasis model assessment (HOMA). HOMA-IR w as significantly higher (p < 0.001) as w ell as log transformed omentin-1 w as significantly low er (p = 0.031) in IGT subjects compared to the control. Pearson's correlation analysis show ed a significant negative correlation of log omentin -1 w ith HOMA-IR (r = -0.290, p = 0.008) in all subjects. Multiple linear regression analysis show ed a significant negative association of HOMA-IR w ith log omentin-1 (β = -0.285, p = 0.017) in IGT subjects after adjusting the effects of potential confounders of glycated hemoglobin (HbA1c) and triglyceride (TG). Binary logistic regression analysis show ed that log omentin-1 [odds ratio (OR) = 0.631, p = 0.038] and HOMA-IR (OR = 1.998, p = 0.029) w ere found to be significant determinants of IGT after adjusting the effect of HbA1c and TG. Serum concentration of omentin-1 is decreased in the state of insulin resistance of IGT subjects and this reduction seemed to be mediated by adiposity and hyperglycemia among these subjects.
[ABSTRACT]   Full text not available  [PDF]
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Rising prevalence of diabetes and prediabetes among Bangladeshi factory workers
B Bhowmik, F Afsana, T Ahmed, S Akhter, HA Choudhury, T Ahmed, H Mahtab, A.K.A Khan
February-May 2016, 7(1):3-3
To determine the prevalence of type 2 diabetes (T2DM) and prediabetes - impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and associated risk determinants in Bangladeshi factory w orkers. A total of 791 male factory w orkers aged ≥20 years in the capital Dhaka city of Bangladesh w ere investigated. Anthropometric details, blood pressure and metabolic parameters w ere studied. We used the 2006 WHO diagnostic criteria for the diagnosis of T2DM and prediabetes. The age - standardized prev alence of T2DM, IFG and IGT w ere 15.4, 17.7, and 25.8%, respectively. The prevalence of IFG and IGT increased w ith age. Among the study population, 38.9% had family history of diabetes (F/H DM), 27.9% hypertension (HTN), general obesity defined by body mas s index (BMI) was 43.7% and central obesity defined by w aist circumference (WC) and w aist -hip ratio (WHR) w ere 35.3% and 78.3%, respectively. Poor agreement w as observed betw een fasting and 2 hr blood glucose. Employing logistic regression, it w as found that increased age, F/H DM, higher BMI and WHR, and HTN w ere independent risk indicators for T2DM. Increased age and higher BMI w ere also independent risk indicators for prediabetes. The prevalence of T2DM and prediabetes w ere found relatively high in these factory w orkers. Obesity and HTN w ere also observed high in this study population.
[ABSTRACT]   Full text not available  [PDF]
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