WorldWideScience

Sample records for oral hypoglycemic medications

  1. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Adisa R

    2009-09-01

    Full Text Available Objective: The overall goal of the study was to evaluate the probable reasons for patients’ nonadherence to prescribed oral hypoglycemic medications in an ambulatory care setting in Nigeria with a view to identifying points for necessary intervention to improve adherence and treatment outcomes. Also, the recommended non-drug management options for diabetes patients with emphasis on self monitoring of blood glucose were assessed.Methods: A cross-sectional study was conducted at a 200-bed secondary health care facility in Southwestern Nigeria between 2nd April and 31st May 2008. Copies of pre-tested questionnaire were administered directly to 121 ambulatory patients with type 2 diabetes at the study site. Information on socio-demographic characteristic, probable barriers that affect adherence to prescribed oral hypoglycemic medications, non-drug treatment options for diabetes, and patients’ self management efforts were obtained. Descriptive and chi-square statistics were used to evaluate the distribution of respondents’ opinion.Results: The response rate was almost 100%. The commonly cited intentional nonadherence practice included dose omission (70.2%. Almost 50% respondents were fed up with daily ingestion of drugs and 19.8% were inconvenienced with taking medications outside home and gave these as reasons for the dose omission. Forgetfulness (49.6% and high cost of medication (35.5% were mentioned as major non-intentional reasons for nonadherence. Aside oral medications, 82.6% and 95.0% of respondents respectively, reported moderate exercise and dietary restrictions as part of the prescribed treatment modalities. More than two third of respondents (81.8% had never monitored blood glucose by themselves. Significant association exist between sex, occupation and patients’ tendencies to forget doses of prescribed oral medications (p<0.05. Conclusion: Nonadherence behaviors among ambulatory patients with type 2 diabetes occur mostly, as

  2. Gestational diabetes mellitus management with oral hypoglycemic agents.

    Science.gov (United States)

    Ryu, Rachel J; Hays, Karen E; Hebert, Mary F

    2014-12-01

    Oral hypoglycemic agents such as glyburide (second-generation sulfonylurea) and metformin (biguanide) are attractive alternatives to insulin due to lower cost, ease of administration, and better patient adherence. The majority of evidence from retrospective and prospective studies suggests comparable efficacy and safety of oral hypoglycemic agents such as glyburide and metformin as compared to insulin when used in the treatment of women with gestational diabetes mellitus (GDM). Glyburide and metformin have altered pharmacokinetics during pregnancy and both agents cross the placenta. In this article, we review the efficacy, safety, and dosage of oral hypoglycemic agents for the treatment of gestational diabetes mellitus. Additional research is needed to evaluate optimal dosage for glyburide and metformin during pregnancy. Comparative studies evaluating the effects of glyburide and metformin on long-term maternal and fetal outcomes are also needed.

  3. Oral Medication

    Science.gov (United States)

    ... Size: A A A Listen En Español Oral Medication The first treatment for type 2 diabetes blood ... new — even over-the-counter items. Explore: Oral Medication How Much Do Oral Medications Cost? Save money ...

  4. Pharmacogenetics in type 2 diabetes: influence on response to oral hypoglycemic agents

    OpenAIRE

    Dawed AY; Zhou K.; Pearson ER

    2016-01-01

    Adem Yesuf Dawed, Kaixin Zhou, Ewan Robert Pearson  Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, Scotland, UK Abstract: Type 2 diabetes is one of the leading causes of morbidity and mortality, consuming a significant proportion of public health spending. Oral hypoglycemic agents (OHAs) are the frontline treatment approaches after lifestyle changes. However, huge interindividual variation in response to OHAs resu...

  5. 21 CFR 310.517 - Labeling for oral hypoglycemic drugs of the sulfonylurea class.

    Science.gov (United States)

    2010-04-01

    ... sulfonylurea class. 310.517 Section 310.517 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Devices § 310.517 Labeling for oral hypoglycemic drugs of the sulfonylurea class. (a) The University Group... to all other sulfonylurea drugs as well. Therefore, the labeling for oral hypoglycemic drugs of...

  6. 1294张口服降糖药处方分析%Analysis of 1294 prescriptions of oral hypoglycemic agents

    Institute of Scientific and Technical Information of China (English)

    谢雅君; 吴久鸿; 王杰松; 薛克昌; 许樟荣

    2011-01-01

    Objective: To investigate the utilization of oral hypoglycemic agents in outpatient in our hospital and provide reference for clinical medication. Methods: The prescriptions of oral hypoglycemic agents in outpatient in January 2010 were retrospectively analyzed, in respect of the numbers of prescriptions, recipe quantity and drug combination. The DDDs and DUI were analyzed. Results: Oral hypoglycemic agents used with high frequency were biguanide (54.87%), sulfonylurea (34.47%) and α -glycosidase inhibitor (34.47%). Metformin and acarbose were used most. The DUI of 16 drugs was close to 1 among 20 oral hypoglycemic agents. The proportion of combined oral hypoglycemic agents accounted for 45.98% in all prescriptions. The most common combination use of oral hypoglycemic agents were biguanide and sulfonylurea, sulfonylurea and α -glycosidase inhibitor. Conclusion: The utilization of oral hypoglycemic agents in outpatient of our hospital was reasonable.%目的:了解我院门诊口服降糖药的使用情况,为临床用药提供参考.方法:回顾性分析我院门诊2010年1月份的口服降糖药处方,对处方数、处方量和联合用药等进行统计,并计算用药频度(DDDs)和药物利用指数(DUI).结果:使用频次较多的降糖药分别是双胍类(54.87%)、磺酰脲类(34.47%)和α-葡萄糖苷酶抑制剂(34.47%);格华止和拜唐苹是处方量最多的药物品种;20种口服降糖药中,有16种药物的DUI值接近1;口服降糖药联合应用占总处方数的45.98%,最常见为磺酰脲类+双胍类和磺酰脲类+α-葡萄糖苷酶抑制剂.结论:我院门诊使用降糖药物基本合理.

  7. Pharmacogenetics in type 2 diabetes: influence on response to oral hypoglycemic agents

    Directory of Open Access Journals (Sweden)

    Dawed AY

    2016-04-01

    Full Text Available Adem Yesuf Dawed, Kaixin Zhou, Ewan Robert Pearson  Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, Scotland, UK Abstract: Type 2 diabetes is one of the leading causes of morbidity and mortality, consuming a significant proportion of public health spending. Oral hypoglycemic agents (OHAs are the frontline treatment approaches after lifestyle changes. However, huge interindividual variation in response to OHAs results in unnecessary treatment failure. In addition to nongenetic factors, genetic factors are thought to contribute to much of such variability, highlighting the importance of the potential of pharmacogenetics to improve therapeutic outcome. Despite the presence of conflicting results, significant progress has been made in an effort to identify the genetic markers associated with pharmacokinetics, pharmacodynamics, and ultimately therapeutic response and/or adverse outcomes to OHAs. As such, this article presents a comprehensive review of current knowledge on pharmacogenetics of OHAs and provides insights into knowledge gaps and future directions. Keywords: pharmacogenetics, type 2 diabetes, oral hypoglycemic agents, pharmacokinetics, pharmacodynamics, response

  8. Analysis of Influence Factors of Oral Hypoglycemic Drug Medication Ccompliance in Elderly Diabetic Patients%老年糖尿病患者口服降糖药物用药依从性的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王文慧; 王晓玲

    2015-01-01

    目的:研究老年糖尿病患者口服降糖药物用药依从性的影响因素。方法:将2011年3月~2013年5月期间在我院就诊的2型糖尿病患者纳入研究,调查患者的口服降糖药物用药依从性并分析影响因素。结果:(1)入组680例患者中,不完全依从268例,不完全依从率39.42%;(2)不同性别、年龄的患者,用药不完全依从率的差异无统计学意义(P>0.05);不同文化程度、BMI指数、吸烟、饮酒、医患关系、用药种类、用药频次、对疾病的认识、对药物的认识、家庭支持程度、医疗费用和家庭月收入的患者,用药不完全依从率的差异有统计学意义(P<0.05);(3)文化程度高、医患关系好、对疾病了解、对药物了解、家庭支持良好、家庭月收入高是用药依从性的保护因素(OR>1);BMI指数高、吸烟、饮酒、用药种类多、用药频次多、自费医疗是用药依从性的危险因素(OR<1)。结论:文化程度、肥胖程度、吸烟和饮酒史、医患关系、用药情况、医疗知识、家庭情况、经济情况是口服降糖药物用药依从性的影响因素,在临床治疗的实践中应及时筛选可能出现治疗依从性不佳的高风险患者并给予干预措施。%Objective: To study the influencing factors of oral hypoglycemic medication compliance in elderly diabetic patients.Methods:Elderly diabetic patients in our hospital from March,2011 to May 2013 were enrolled and compliance condition as well as its related factors were investigated.Results:(1)680 cases were enrolled,incomplete compliance cases were 268 and incomplete compliance rate was 39.42%;(2)There was no significant difference in patients with different gender and age(P>0.05);there were significant difference on incomplete compliance rate in patients with different cultural level,BMI index,smoking,drinking,doctor-patient relationship,drug category,medication

  9. Hypoglycemic efficacy of chitosan-coated insulin liposomes after oral administration in mice

    Institute of Scientific and Technical Information of China (English)

    Zheng-hong WU; Qi-neng PING; Yi WEI; Jia-ming LAI

    2004-01-01

    AIM: To evaluate the hypoglycemic efficacy of insulin liposomes coated by chitosan with different molecular weights and concentrations after oral administration in mice. METHODS: Insulin-liposomes were prepared by reversed-phase evaporation. Chitosan coating was carried out by incubation of the liposomal suspensions with the chitosan solution. The hypoglycemic efficacies of chitosan-coated insulin liposomes were investigated by monitoring the blood glucose level using the glucose oxidase method after oral administration to healthy mice. RESULTS:In all the insulin liposomes, the insulin liposomes coated by 0.2 % chitosan (M. 1000 kDa) showed a better hypoglycemic efficacy as compared with the other liposomes coated by chitosan. The minimum blood glucose level was 15.1%±6.0 % of the initial (n=6). The hypoglycemic efficacy lasted for 4 h after oral administration to mice.CONCLUSION: Chitosan-coated liposomes could reduce tryptic digestion on insulin, and enhance enteral absorption of insulin. The molecular weights and concentrations of chitosan had significant effects on hypoglycemic efficacy of chitosan-coated insulin liposomes after oral administration to healthy mice.

  10. Use of pharmacy dispensing data to measure adherence and identify nonadherence with oral hypoglycemic agents.

    Science.gov (United States)

    Sodihardjo-Yuen, Fong; van Dijk, Liset; Wensing, Michel; De Smet, Peter A G M; Teichert, Martina

    2017-02-01

    A framework for calculation of adherence for oral hypoglycemic agents (OHAs) based on data from health-insurance claims is available. Pharmacy dispensing data aid identification of nonadherent patients in pharmacy practices. However, use of these data for calculation of OHA adherence requires additional methodological categories. We examined the impact of different methodological choices on estimation of OHA adherence using pharmacy dispensing data. Four methodological categories were added to the framework available to be used for adherence calculation with pharmacy dispensing data. Three adherence measures were defined to supply pharmacists with significant information on OHA use of their patients: (i) percentage of days covered by use periods of dispensed medication (PDC), (ii) mean rate of adherent patients with a PDC ≥80 % (MRAP80), and (iii) mean number of nonadherent patients (MNNP80) per pharmacy with a PDC pharmacies in the Netherlands. For the basic scenario, mean PDC for OHA was 88.3 %. MRAP80 was 80.3 %, which corresponded to an average of 69 nonadherent patients per pharmacy. Different choices for parameter values resulted in score variations for PDC of 85.0-91.8 %, for MRAP80 of 75.3-86.1 %, and between 49 and 92 MNNP80 per pharmacy. Sixteen methodological categories specified calculation of OHA adherence based on pharmacy dispensing data. Adherence scores expressed as percentages were relatively robust to variation in parameter values, but differed substantially for the absolute numbers of nonadherent patients per pharmacy.

  11. Oral Hypoglycemic Drugs: Pathophysiological Basis of Their Mechanism of ActionOral Hypoglycemic Drugs: Pathophysiological Basis of Their Mechanism of Action

    Directory of Open Access Journals (Sweden)

    Graziella Bruno

    2010-09-01

    Full Text Available Type 2 diabetes is a syndrome characterized by relative insulin deficiency, insulin resistance and increased hepatic glucose output. Medications used to treat the disease are designed to correct one or more of these metabolic abnormalities. Current recommendations of the American Diabetes Association (ADA and European Association for the Study of Diabetes (EASD include diet and exercise as first-line therapy plus hypoglycemic drugs. Actually there are seven distinct classes of anti-hyperglicemic agents, each of them displaying unique pharmacologic properties. The aim of this review is to describe the pathophysiological basis of their mechanism of action, a necessary step to individualize treatment of diabetic people, taking into proper consideration potential benefits and secondary effects of drugs.

  12. New Oral Hypoglycemic Agents and Cardiovascular Risk. Crossing the Metabolic Border.

    Science.gov (United States)

    Dalama, Belén; Mesa, Jordi

    2016-11-01

    Sodium-glucose cotransporter 2 inhibitors are a novel pharmacological class of oral hypoglycemic agents that lower glucose levels by increasing renal glucose excretion in an insulin-independent manner. However, this seemingly simple mechanism has more complex indirect metabolic effects. The results of randomized clinical trials have shown that these inhibitors effectively lower blood glucose and glycated hemoglobin levels without increasing the risk of hypoglycemia and, at the same time, also reduce bodyweight and systolic blood pressure. In this review, we describe the mechanism of action, efficacy, and safety of currently marketed drugs, as well as other risk factors besides glucose that can potentially be modulated positively. Recent data on empagliflozin showing a significant cardiovascular benefit have compelled us to update knowledge of this new therapeutic class for the treatment of type 2 diabetes. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Poor adherence with ACE inhibitors is a risk factor of CVA with oral hypoglycemic agents in diabetic patients.

    Science.gov (United States)

    Aftab, Muhammad Tariq; Dharamshi, Hasnain Abbas; Faraz, Ahmed; Shakeel, Saba; Shakeel, Osama

    2017-03-01

    Poor adherence with medicine declines the clinical outcome of pharmacotherapy. It may carry serious sequelae especially in case of antihypertensive drugs like cerebrovascular accident (CVA). This study has been planned to find the association of poor adherence with anti-hypertensive with CVA in diabetic and non- diabetic patients. One hundred CVA patients who were admitted through Emergency in Abbasi Shaheed hospital, a tertiary care hospital in Karachi, were recruited from Jun 2013 till Dec 2013. The criteria of inclusion was, diagnosed case of CVA, with primary hypertension, availability of patient's therapeutic record, consent of the patient or legal successor/heir. The criteria of exclusion was, secondary hypertension, newly diagnosed primary hypertensive patients and complete adherence with medication. Morisky medication adherence scale was applied. Therapeutic record was accessed. The mean age was 62.15 years with 3:1 male to female ratio. Adherence to medicine was graded 0.05) was seen in any combination (p>0.05). Thus it is concluded that poor adherence with ACE inhibitors may be a risk factor of CVA in diabetic patients using oral hypoglycemic agents.

  14. Weight change after initiation of oral hypoglycemic monotherapy for diabetes predicts 5-year mortality: An observational study.

    Science.gov (United States)

    Kocarnik, Beverly M; Moore, Kathryn P; Smith, Nicholas L; Boyko, Edward J

    2017-01-01

    To investigate whether weight change in the first year after initiating an oral hypoglycemic agent (OHA) for type 2 diabetes treatment is associated with mortality in a national cohort. We prospectively followed Veterans Health Administration patients with type 2 diabetes initiating treatment with an OHA and not receiving any other diabetes pharmacotherapy for at least one year. Information on OHAs, weight, co-morbidities, other medications, demographics, and laboratory measurements was obtained from electronic medical records. Logistic regression was used to estimate 5-year mortality odds by weight change during the first year after OHA treatment initiation. Patients (mean age 65years, 97% male, mean BMI 32.3kg/m(2)) initiating OHA monotherapy between 2003 and 2008 totaled 145,198 (metformin n=89,111, glipizide n=27,100, glyburide n=25,226, rosiglitazone n=3,761). Most patients (65%) maintained a stable weight (change ⩽5% from baseline) during the first year after OHA initiation. Those losing >5% of baseline weight had a significantly higher odds of death over the subsequent 5-years ranging from 1.64 to 2.13 depending on OHA type. In the metformin group, weight gain >5% of baseline was also associated with higher odds of 5-year mortality. The same results were obtained after conducting three sensitivity analyses that excluded patients for the following reasons: weight loss in the one year prior to OHA initiation, weight change >100lbs, or weight change >50lbs. Weight loss was associated with higher odds of 5-year mortality among patients initiating an OHA, as was weight gain for metformin only. Published by Elsevier B.V.

  15. 我院门诊口服降糖药应用情况分析%Analysis on Usage of Oral Hypoglycemic Agents by Outpatient in the Hospital

    Institute of Scientific and Technical Information of China (English)

    姜鹏; 鲁薇; 张少华

    2014-01-01

    Objective:To analyze the use of oral hypoglycemic agents by outpatient in the hospital during 2010~2012 , so as to pro-vide preference for clinical rational drug use.Methods:The information of various types of oral hypoglycemic by outpatient during 2010~2012 from the HIS system was obtained , the using frequency and cost per day were statistically analyzed and compared.Results:Acar-bose of sales amount for three consecutive years first row.Metformin of use frequency increased year by year , 2 years in first row, and the cost per day minimum.The serial number ratio greater than 1 is metformin.Conclusion:The use of oral hypoglycemic agent in the hospi-tal is reasonable , metformin of use frequency is high , conform to the principle of safe , effective and economic medication.%目的:分析我院2010~2012年门诊口服降糖药物的应用情况,为临床合理用药提供参考。方法:从HIS系统中调取2010~2012年中门诊各类口服降糖药物的使用数据,对其使用频率、日均费用等进行对比分析。结果:阿卡波糖销售金额连续3年排首位;二甲双胍的使用频率逐年上升,连续2年位居第一,且日平均费用最低;序号比大于1的药物为二甲双胍。结论:该院口服降糖药物的应用基本合理,二甲双胍使用频率高,符合安全、有效、经济的用药原则。

  16. Aderência de diabéticos ao tratamento medicamentoso com hipoglicemiantes orais Adhesión de diabéticos al tratamiento con hipoglucemiantes orales Adherence of diabetics patient to pharmacological treatment with oral hypoglycemic agents

    Directory of Open Access Journals (Sweden)

    Márcio Flávio Moura de Araújo

    2010-06-01

    hipoglucemiantes orales es fundamental para un buen control glicémico y para la prevención de complicaciones micro y macrovasculares.The objective was to identify the adherence of the diabetic from Sobral CE, Brazil, to pharmacological treatment with oral hypoglycemic agents. Were investigated 79 diabetics from six basic health units in Sobral-CE, Brazil, through home visits carried out between March and June 2007. For data collection, a structured form was used and the adapted Morisky-Green test was applied. Slightly more than half of the subjects (54.5% indicated being careful don't to comply with the pre-established time for medication intake; most of them does not forget to take the medication (66%. Moreover, 90% of the subjects regret forgetting to take the oral hypoglycemic agents. It was identified that 54.4% and 45.5% were less adherent and more adherent to the drug therapy with oral hypoglycemic agents, respectively. Adherence to pharmacological treatment with oral hypoglycemic agents is fundamental for good glucose control and to prevent micro and macrovascular complications.

  17. Role of oral hypoglycemic agents in the management of type 2 diabetes mellitus during Ramadan

    Directory of Open Access Journals (Sweden)

    Mir Iftikhar Bashir

    2012-01-01

    Full Text Available It is obligatory for all adult Muslims to observe fast during the holy month of Ramadan, but sick individuals including those with diabetes mellitus are exempted from the duty of fasting. Specific medical advice must be provided to individual patients concerning the potential risks they must accept if they decide to fast. Any alteration in medications deemed necessary to provide an effective and safe antidiabetic regimen should be instituted well before the start of Ramadan. Diet-controlled patients and those well controlled on insulin sensitizers have low risk of hypoglycemia and may safely fast with some modification in the timing of the doses. Newer generation sulfonylureas (gliclazide MR and glimepiride have reasonable safety profile during Ramadan fasting and are economical options for a large number of diabetics worldwide, especially in the developing countries; older, long acting sulfonylureas like glibenclamide and chlorpropamide should be avoided during fasting. Oral DPP-IV inhibitors are important substitutes to sulfonylureas for patients with diabetes mellitus during fasting owing to their glucose-dependent mechanism of action, efficacy, and tolerability. This group of drugs causes a moderate A1c reduction, are weight neutral, and have a very low risk of hypoglycemia. Short-acting insulin secretagogues are an option in the subset of fasting diabetic patients who have predominantly post-prandial hyperglycemia.

  18. Hypoglycemic activity and oral bioavailability of insulin-loaded liposomes containing bile salts in rats: the effect of cholate type, particle size and administered dose.

    Science.gov (United States)

    Niu, Mengmeng; Lu, Yi; Hovgaard, Lars; Guan, Peipei; Tan, Yanan; Lian, Ruyue; Qi, Jianping; Wu, Wei

    2012-06-01

    Oral delivery of protein or polypeptide drugs remains a challenge due to gastric and enzymatic degradation as well as poor permeation across the intestinal epithelia. In this study, liposomes containing bile salts were developed as a new oral insulin delivery system. The primary goal was to investigate the effect of cholate type, particle size and dosage of the liposomes on the hypoglycemic activity and oral bioavailability. Liposomes containing sodium glycocholate (SGC), sodium taurocholate (STC) or sodium deoxycholate (SDC) were prepared by a reversed-phase evaporation method. After oral administration, all liposomes elicited a certain degree of hypoglycemic effect in parallel with an increase in blood insulin level. The highest oral bioavailability of approximately 8.5% and 11.0% could be observed with subcutaneous insulin as reference for SGC-liposomes in non-diabetic and diabetic rats, respectively. Insulin-loaded liposomes showed slower and sustained action over a period of over 20 h with peak time around 8-12h. SGC-liposomes showed higher oral bioavailability than liposomes containing STC or SDC and conventional liposomes. The hypoglycemic effect was size-dependent with the highest at 150 nm or 400 nm and was proportionally correlated to the administered dose. The results supported the hypothesis of insulin absorption as intact liposomes.

  19. Uncovering undetected hypoglycemic events

    Directory of Open Access Journals (Sweden)

    Unger J

    2012-03-01

    Full Text Available Jeff UngerCatalina Research Institute, Chino, CA, USAAbstract: Hypoglycemia is the rate-limiting factor that often prevents patients with diabetes from safely and effectively achieving their glycemic goals. Recent studies have reported that severe hypoglycemia is associated with a significant increase in the adjusted risks of major macrovascular events, major microvascular events, and mortality. Minor hypoglycemic episodes can also have serious implications for patient health, psychological well being, and adherence to treatment regimens. Hypoglycemic events can impact the health economics of the patient, their employer, and third-party payers. Insulin treatment is a key predictor of hypoglycemia, with one large population-based study reporting an overall prevalence of 7.1% (type 1 diabetes mellitus and 7.3% (type 2 diabetes mellitus in insulin-treated patients, compared with 0.8% in patients with type 2 diabetes treated with an oral sulfonylurea. Patients with type 1 diabetes typically experience symptomatic hypoglycemia on average twice weekly and severe hypoglycemia once annually. The progressive loss of islet cell function in patients with type 2 diabetes results in a higher risk of both symptomatic and unrecognized hypoglycemia over time. Patients with diabetes who become hypoglycemic are also more susceptible to developing defective counter-regulation, also known as hypoglycemia awareness autonomic failure, which is life-threatening and must be aggressively addressed. In patients unable to recognize hypoglycemia symptoms, frequent home monitoring or use of continuous glucose sensors are critical. Primary care physicians play a key role in the prevention and management of hypoglycemia in patients with diabetes, particularly in those requiring intensive insulin therapy, yet physicians are often unaware of the multitude of consequences of hypoglycemia or how to deal with them. Careful monitoring, adherence to guidelines, and use of optimal

  20. An evaluation of patients’ adherence with hypoglycemic medications among Papua New Guineans with type 2 diabetes: influencing factors

    Directory of Open Access Journals (Sweden)

    Pihau-Tulo ST

    2014-09-01

    Full Text Available Stella Tilu Pihau-Tulo, Richard W Parsons, Jeffery D Hughes CHIRI and School of Pharmacy, Curtin University, Perth, WA, Australia Purpose: The aims of this study were to evaluate the extent of adherence to hypoglycemic medications, assess the relationship between adherence and glycemic control, and evaluate factors affecting adherence.Research design and methods: This was a cross-sectional study of patients with established type 2 diabetes attending the Port Moresby General Hospital Diabetes Clinic. Face-to-face interviews were conducted using a questionnaire designed for the study and data were collected concerning the 3 months prior to interview. The questionnaire covered demographic details, lifestyle, biochemical and physical measurements, and medication management. Glycemic control was investigated among patients adhering to their medications (not missing doses to different degrees (100%, 95%, 90%, and 80%. Results: Of a total of 356 participants who were prescribed hypoglycemic medications, 59.6% omitted some of their doses. Age appeared to have a significant impact on adherence at some levels of adherence, with those aged >60 years being more likely to be adherent (logistic regression. Those who were 95%–99% and those who were <80% adherent had a statistically significant risk of a high glycated hemoglobin of >10% (85.5 mmol/mol. Multiple factors were identified as contributors to nonadherence, with patient-based issues (86.0% and the health care system (21.7% being the most common.Conclusion: This study showed a significant level of nonadherence among patients with type 2 diabetes in Papua New Guinea. Nonadherence to medication appeared to be associated with poor glycemic control and was due to a variety of reasons. Future interventions aimed at improving adherence will need to take these into account. Keywords: adherence, type 2 diabetes, A1C, Papua New Guinea, age, sex, contributing factors

  1. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

    Directory of Open Access Journals (Sweden)

    Cárdenas-Elizalde MR

    2012-03-01

    Full Text Available Christian Díaz de León-Castañeda, Marina Altagracia-Martínez, Jaime Kravzov-Jinich, Ma del Rosario Cárdenas-Elizalde, Consuelo Moreno-Bonett, Juan Manuel Martínez-NúñezDepartment of Biological Systems and Health Care, Biological and Health Sciences Division, Universidad Autónoma Metropolitana-Xochimilco, Mexico DF, MexicoIntroduction: Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico's leading cause of death.Purpose: To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City.Design: A cross-sectional and analytic study was conducted in Mexico City.Methodology: Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled.Results: The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the

  2. Safety test of a supplement, 5-aminolevulinic acid phosphate with sodium ferrous citrate, in diabetic patients treated with oral hypoglycemic agents

    Directory of Open Access Journals (Sweden)

    Naohide Yamashita

    2014-09-01

    Full Text Available Objective: This study aimed to examine the safety of 5-aminolevulinic acid phosphate (5-ALA with sodium ferrous citrate (SFC in diabetic patients treated with one or more oral hypoglycemic agents (OHAs. Background: Recent intervention studies performed in the USA and Japan have shown that a nutritional supplement of 5-ALA with SFC efficiently reduced blood glucose levels in pre-diabetic population without any adverse events. Thus, it was anticipated that 5-ALA with SFC may potentially be taken as a beneficial supplement by diabetic patients who were being treated with OHA therapy. Nevertheless, it is important to examine its safety and efficacy in diabetic population. Methods: This study was a prospective single-blinded, randomized, placebo-controlled and parallel-group comparison study. Medically treated diabetic patients between the ages of 30 and 75 were recruited from the Tokyo metropolitan area of Japan and 45 subjects were selected after screening. These subjects were randomly assigned to three groups: daily intake of 15mg 5-ALA, 50mg 5-ALA, and a placebo (n=15, respectively. The supplement or placebo was administered for 12 weeks followed by a four week washout period. The primary endpoint was safety and occurrence of hypoglycemic attack, while the secondary endpoint was changes of fasting blood glucose (FBG and hemoglobin A1c (HbA1c. Results: Adverse events related to 5-ALA with SFC were not observed in all the groups. Abnormalities in blood and urine tests were not observed either. Significant decrease in FBG was not detected in all the groups. However, there was a small but significant decrease in HbA1c at 4 and 8 week in the 15 mg 5-ALA group. Significant decrease in HbA1c was not observed in the 50 mg 5-ALA group, although a tendency to decrease after 4 weeks was apparent. Conclusion: 5-ALA with SFC is a safe and potentially beneficial supplement if taken by diabetic patients treated with OHAs.

  3. Factors Associated with Long-Term Oral Hypoglycemic Agent Responsiveness in Korean Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Bo-Yeon Kim

    2011-06-01

    Full Text Available BackgroundThis study was performed to determine the factors associated with long-term oral hypoglycemic agent (OHA responsiveness in Korean type 2 diabetic patients.MethodsTwo groups of patients were selected among the type 2 diabetic patients who were followed for more than two years at a university hospital diabetes clinic. The OHA responsive group consisted of 197 patients whose HbA1c levels were maintained at ≤7% with OHA for more than two years. The OHA failure group consisted of 180 patients whose HbA1c levels were >8% in spite of optimal combined OHA therapy or patients who required insulin therapy within the two years of the study.ResultsThe OHA failure group had higher baseline values of fasting and postprandial glucose, HbA1c, and lower fasting, postprandial, and delta C-peptide compared to those of the OHA responsive group. The OHA failure group also had a higher proportion of female patients, longer diabetic duration, and more family history of diabetes. There were no significant differences in body mass index (BMI or insulin resistance index between the two groups. Multiple logistic regression analysis showed that the highest quartile of baseline fasting, postprandial glucose, and HbA1c and the lowest quartile of postprandial and delta C-peptide were associated with an increased odds ratio of OHA failure after adjustment for age, sex, body mass index, and family history of diabetes.ConclusionLower baseline values of postprandial and delta C-peptide and elevated fasting glucose and HbA1c are associated with long-term OHA responsiveness in Korean patients with type 2 diabetes mellitus.

  4. Analysis of Oral Hypoglycemic Agents Used in Our Hospital during 2008-2010%我院2008-2010年口服降糖药的用药分析

    Institute of Scientific and Technical Information of China (English)

    朱寅

    2011-01-01

    目的 了解医院口服降糖药的使用情况,促进合理用药.方法 对重庆医科大学附属第二医院2008年至2010年口服降糖药的应用频率、消耗金额进行统计分析.结果 该院口服降糖药的消耗金额逐年增长,其中二甲双胍增幅较大;临床最常用的口服降糖药是二甲双胍、阿卡波糖和格列吡嗪.结论 医院口服降糖药的使用呈增长趋势.%Objective To evaluate the application status of oral hypoglycemic agents used in the hospital for promoting rational drug use.Methods The frequency and sum of money in consumption of oral hypoglycemic agents during 2008 - 2010 were statistically analyzed.Results The sum of money in consumption of oral hypoglycemic agents in the hospital was increased year by year, in which, the increment of metformin was maximum. The commonest used oral hypoglycemic agents in clinic were metformin, glipizide and pioglipazong. Conclusion The use of oral hypoglycemic agents presents the increasing trend.

  5. Latent autoimmune diabetes of adults: From oral hypoglycemic agents to early insulin

    Directory of Open Access Journals (Sweden)

    Resham R Poudel

    2012-01-01

    Full Text Available Approximately 10% of phenotypic type 2 diabetics have islet autoantibodies and are referred to as having latent autoimmune diabetes of adults (LADA, and they land on early sulfonylurea failure and require insulin. Diagnosing LADA has treatment implications because of high risk of progression to insulin dependency. But often there is delay in insulin therapy, as there are no recommendations for islet antibody testing in adult-onset diabetes currently. LADA clinical risk score can identify adults at high risk who may benefit from antibody testing. The optimal treatment of LADA is not established. Early insulin therapy helps to achieve good metabolic control and better long-term outcomes by preserving b-cells and endogenous C-peptide secretion. Sulfonylureas are better avoided as they exhaust b-cells; glitazones and exenatide have favorable outcomes, whereas metformin needs to be used with caution. Understanding LADA will also bring new windows in managing type 1 diabetes. Information acquisition was done by reviewing the medical literature published since 1987, with particular attention to the natural history, genetic factors, and treatment of LADA.

  6. Oral hypoglycemics overdose

    Science.gov (United States)

    ... responsiveness) Confusion Convulsions (seizures, especially in infants and children) Increased appetite Nausea Nervousness Rapid heartbeat Stupor (decreased level of consciousness plus confusion) Sweating Tingling of ...

  7. Erectile Dysfunction: Viagra and Other Oral Medications

    Science.gov (United States)

    ... loss or vision loss. Some men have had sudden loss of hearing or loss of vision after taking one of ... taking an oral erectile dysfunction medication and have sudden loss of hearing or vision, seek prompt medical attention. An erection ...

  8. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

    Science.gov (United States)

    de León-Castañeda, Christian Díaz; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Cárdenas-Elizalde, Ma del Rosario; Moreno-Bonett, Consuelo; Martínez-Núñez, Juan Manuel

    2012-01-01

    Introduction Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico’s leading cause of death. Purpose To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA) in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City. Design A cross-sectional and analytic study was conducted in Mexico City. Methodology Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY) were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled. Results The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the following: 5.82 (glibenclamide), 3.86 (metformin), 3.5 (acarbose), and 6.76 (metformin–glibenclamide). The cost-effectiveness ratios found were US$272.63/QALY (glibenclamide), US$296.48/QALY (metformin), and US$409.86/QALY (acarbose). Sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or

  9. Retrospective Analysis of Application of Oral Hypoglycemic Agents in a Hospital of Chongqing in Recent 3 Years%重庆市某医院近3年口服降糖药应用分析

    Institute of Scientific and Technical Information of China (English)

    苏湲淇; 龙波

    2012-01-01

    Objective To analyze the application situation and the development trend of oral hypoglycemic agents in a grade A class 3 hospital of Chongqing. Methods The sale amount,DDDs and other indicators of the oral hypoglycemic agent application in the hospital during the year 2007-2009 were statistically analyzed. Results In the last three years,the hospital's total sales of oral hypoglycemic agents and the total amount of DDDs were increased year by year. Biguanide, a - glucosidase inhibitors, thiazolidinediones were mainly selected in clinical use. Conclusion The overall structure of hospital clinical use of oral hypoglycemic agents is reasonably stable.%目的 分析医院口服降糖药的应用情况与发展趋势.方法 对医院2007年至2009年口服降糖药的销售金额、用药频度等指标进行统计分析.结果 口服降糖药的总销售金额和总用药频度逐年增长,临床主要选用双胍类、α-葡萄糖苷酶抑制剂、噻唑烷二酮类药物.结论 口服降糖药临床用药整体结构合理稳定.

  10. 2008年至2010年我院口服降血糖药使用情况分析%Analysis on Use Status of Oral Hypoglycemic Agents in Our Hospital during 2008-2010

    Institute of Scientific and Technical Information of China (English)

    向光芳; 郑姣妮; 姜宁

    2012-01-01

    Objective To provide fundamental basis for rational use of medicines in clinic, we investigated the application of oral hypo-glycemic agents at our hospital. Methods The statistic analysis was carried out to study the use of oral hypoglycemic agents in our hospital during 2008 - 2010 using order of consumption sum and frequency degree analysis methods. Results Thiazolidinediones, a - glucosidase inhibitor and biguanides ranked the top three among all the oral hypoglycemic agents in consumption sum. The highest DDDs is rosiglita-zone, followed by glimepiride and acarbose. Conclusion The use of oral hypoglycemic agents in our hospital is basically reasonable.%目的 了解医院口服降血糖药的使用情况,为临床合理用药提供参考.方法 采用金额排序和频度分析法,对医院2008年至2010年口服降血糖药进行统计分析.结果 口服降糖药用药金额排前3位的分别是噻唑烷二酮类、a-糖苷酶抑制剂和双胍类;用药频度最高的是罗格列酮,其次是格列美脲和阿卡波糖.结论 医院口服降血糖药的使用基本合理.

  11. Hypoglycemic effect of Opuntia cactus.

    Science.gov (United States)

    Ibañez-Camacho, R; Roman-Ramos, R

    1979-01-01

    Nopal (Opuntia sp.) has been traditionally used by the Mexican population for the treatment of diabetes mellitus. The purpose of this work is to describe effects produced by directly liquified nopal and extracts from this plant in healthy and pancreatectomized rabbits. Preliminary results allow us to conclude that Opuntia streptacantha, Lemaire, has hypoglycemic properties when orally administered, in animals with experimentally induced diabetes as well as in healthy ones with physiologic hyperglycemia.

  12. 2003~2005年我院口服降糖药物利用分析%Drug utilization analysis of oral hypoglycemic agents in our hospital during the period of 2003 ~ 2005

    Institute of Scientific and Technical Information of China (English)

    辛海莉; 蔡雯雯; 郭蔚

    2007-01-01

    To assess the drug utilization and tendency of progress of oral hypoglycemic agents in our hospital and to provide references for rational administration clinically. Methods: DDDs, sales quantities, sales expenses and the ratio of sales expenses sequencing to that of DDDs in our hospital during the period of 2003 ~ 2005 were analyzed statistically with the method of DDDs analysis. Results:The top two antidiabetic drugs according to DDDs were melbine ( dimethyl diguanide) and gliclazide three successive years. The DDDs of acarbose increased dramatically. Which blood glucose regulatsry drugs ranked lower, the ratio of sales expenses sequencing to that of DDDs of glipizide and gliclazide controlled release pellets was equal or about, whereas that of rosiglitazone, acarbose(glucobay) and glimepiride was less than 1. Conclusion:The study shows that the drug utilization of oral hypoglycemic agents in our hospital is basically rational and is in accordance with the trend of advancement and drug therapeutic strategies of diabetes mellitus.

  13. Stress free oral medication in captive cervids

    OpenAIRE

    G.M. Das; A. Srivastav; Chakraborty, D.; Gupta, S. K.; Nigam, P

    2009-01-01

    Efficacy of oral administration of fenbendazole was studied against gastrointestinal helminthes in captive Cheetal (Axis axis) at Hisar Deer Park from November 2006- January 2007. A novel method of administration of oral medication that included acclimatizing cheetal to feed individually from specific containers and providing drugs in feed after habituation was developed. Efficacy of fenbendazole was assessed by egg per gram EPG count of faecal sample on day 11 and 19 post 1st treatment and 4...

  14. Oral anticancer agent medication adherence by outpatients.

    Science.gov (United States)

    Kimura, Michio; Usami, Eiseki; Iwai, Mina; Nakao, Toshiya; Yoshimura, Tomoaki; Mori, Hiromi; Sugiyama, Tadashi; Teramachi, Hitomi

    2014-11-01

    In the present study, medication adherence and factors affecting adherence were examined in patients taking oral anticancer agents. In June 2013, 172 outpatients who had been prescribed oral anticancer agents by Ogaki Municipal Hospital (Ogaki, Gifu, Japan) completed a questionnaire survey, with answers rated on a five-point Likert scale. The factors that affect medication adherence were evaluated using a customer satisfaction (CS) analysis. For patients with good and insufficient adherence to medication, the median ages were 66 years (range, 21-85 years) and 73 years (range, 30-90 years), respectively (P=0.0004), while the median dosing time was 131 days (range, 3-3,585 days) and 219 days (24-3,465 days), respectively (P=0.0447). In 36.0% (62 out of 172) of the cases, there was insufficient medication adherence; 64.5% of those cases (40 out of 62) showed good medication compliance (4-5 point rating score). However, these patients did not fully understand the effects or side-effects of the drugs, giving a score of three points or less. The percentage of patients with good medication compliance was 87.2% (150 out of 172). Through the CS analysis, three items, the interest in the drug, the desire to consult about the drug and the condition of the patient, were extracted as items for improvement. Overall, the medication compliance of the patients taking the oral anticancer agents was good, but the medication adherence was insufficient. To improve medication adherence, a better understanding of the effectiveness and necessity of drugs and their side-effects is required. In addition, the interest of patients in their medication should be encouraged and intervention should be tailored to the condition of the patient. These steps should lead to improved medication adherence.

  15. Application of oral hypoglycemic agent in Our Hospital in 2013%我院2013年门诊口服降糖药临床应用分析

    Institute of Scientific and Technical Information of China (English)

    余彬; 王述蓉

    2014-01-01

    Objective:To make out the current situation and trend of oral hypoglycemic agent used in hospital and to make objective evaluation. Methods:The use of oral hypoglycemic agent in our hospital in 2013 was analyzed retrospectively in respect of consumption sum, DDDs .RESULTS:The top 3 oral hypoglycemic agent of consumption sum were Repaglinide, Acarbose and Glipizide.The top 3 oral hypoglycemic agent in respect of DDDs were Glipizide, Gliclazide Sustained-release Tablets and Glibenclamide. DDDc of Glibenclamide Glipizide and Gliclazide Sustained-release Tablets were the top 3.Conclusion:The use of oral hypoglycemic agent used in our hospital is rational on the whole, Acarbose of Glycosidase inhibitors and Gliclazide of Sulfonylureas are the most common because their good effects and few adverse reactions.%目的:对我院2013年门诊口服降糖药临床应用情况及趋势作出客观评价。方法:统计我院2013年门诊口服降糖药的销售金额、用药频度(DDDs)等,进行回顾性分析。结果:我院2013年口服降糖药销售金额排序前3位的是瑞格列奈片、阿卡波糖、格列吡嗪;DDDs排序前3位是格列吡嗪、格列齐特缓释片、格列苯脲片;日均费用前3位为格列苯脲片、格列吡嗪片、格列齐特缓释片。结论:我院口服降糖药使用较合理,糖苷酶抑制剂阿卡波糖、磺脲类药物的格列齐特因其疗效好、不良反应较少等居主导地位。

  16. 2012-2014年南京地区34家医院常用口服降糖药利用分析%Utilization of Oral Hypoglycemic Drugs in 34 Hospitals in Nanjingfrom 2012 to 2014

    Institute of Scientific and Technical Information of China (English)

    王璐璐; 刘慧; 陶祥

    2016-01-01

    目的:了解南京地区口服降糖药的最新应用近况和发展趋势,为临床合理使用口服降糖药提供参考。方法:根据长江流域医药情报研究所提供的南京地区2012-2014年口服降糖药的销售数据,采用限定日剂量分析法,对该地区34家医院近三年口服降糖药的销售金额、用药频度(DDDs)和限定日费用(DDC)等进行回顾性统计与分析。结果:销售金额排名前三位的药物是阿卡波糖、格列美脲、二甲双胍,DDDs排名前三位的药物是格列美脲、二甲双胍、阿卡波糖,总销售金额和总DDDs均呈逐年增长趋势,销售金额与DDDs的序号比值在0.3~2.3之间。结论:2012-2014年南京地区口服降糖药需求量逐年增加,药物使用符合安全、有效、经济的用药原则。%Objective:To evaluate the utilization and trend of oral hypoglycemic drugs in Nanjing area, and provideclinical references for the rational use of drugs.Methods:According to the sales data of oral hypoglycemic drugs in 34 hospitals in Nanjing area from 2012 to 2014,its utilization was analyzed retrospectively in aspects of consumption sum,DDDs and DDC bymeans of defined daily dose.Results:The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose, glimepiride and metformin. In terms of DDDs, glimepiride, metformin and acarbose ranked top 3. The consumption sum and DDDs of oral hypoglycemic drugs increased year by year in Nanjing area. The ratio of serial number of consumption sum and DDDs was from 0.3 to 2.3.Conclusion:Thedemand of oral hypoglycemic drugs increased year by year from 2012 to 2014, and its utilization conformed to safe,effective and economic principles.

  17. 上海市同济医院2011-2014年口服降糖药物使用情况分析%Utilization of oral hypoglycemic agents in Tongji hospital of Shanghai during 2011-2014

    Institute of Scientific and Technical Information of China (English)

    叶显撑; 张玉臣; 祝德秋

    2016-01-01

    The utilization of oral hypoglycemic agents (OHAs) in Shanghai Tongji Hospital during 2011-2014 was statistically analyzed in respect of consumption sum, DDDs, and DDC so as to provide references for clinical medication. There were various categories of OHAs in our hospital. The consumption sum of OHAs showed an upward trend, yet the proportion of the consumption sum of OHAs in the consumption sum of hypoglycemic agents and the total drug consumption sum showed a downward trend. The top 3 of OHAs were a-glycosidase inhibitors, sulfonylureas and biguanides in the list of consumption and sulfonylureas, biguanides and a-glycosidase inhibitors in the list of DDDs, respectively. Metformin occupied the ifrst place in the list of DDDs. The use of OHAs is basically rational with various categories of OHAs.%本文对上海市同济医院2011—2014年口服降糖药物(OHAs)的用药金额、用药频度、日用药金额等进行统计分析,为临床合理用药提供参考。4年来上海市同济医院OHAs品种全面,使用金额呈上升趋势,但OHAs占降糖药使用金额比例、OHAs占全部用药金额比例均处于微降趋势。a-糖苷酶抑制剂、磺脲类、双胍类4年来稳居销售金额排名1~3位;DDDs排序中,磺脲类、双胍类、a-糖苷酶抑制剂稳居1~3位。二甲双胍位列单品种DDDs排序的首位。上海市同济医院2011—2014年OHAs的临床使用基本合理,药物种类全面。

  18. 吉非罗齐对临床几种常用口服降糖药的作用%Effects of Gemfibrozil on several commonly used oral hypoglycemic agents

    Institute of Scientific and Technical Information of China (English)

    淡海丽; 易飞

    2011-01-01

    Drug interactions, particularly the studies of interaction between pharmacokinetics become a hot spot in recent years.Gemfibrozil is a lipid-lowering drugs commonly used in clinical, and there are many opportunities hyperlipidemia be in diabetes clinical situation, so whether there are interactions between gemfibrozil and oral agents should also be the concern of clinicians.We review the effect of Gemfibrozil to the pharmacokinetics and pharmacodynamics of several commonly used oral hypoglycemic drug, and to analyze its mechanism.Gemfibrozil inhibited CYP2C and significant effect the pharmacokinetics and pharmacodynamics of oral hypoglycemic drug, so monitoring the blood glucose concentrations in time or adjust the dosage of oral hypoglycemic agents when they are combined in clinical is necessary.%药物相互作用,尤其是药代学的相互作用的研究近年来成为热点.吉非罗齐是一个临床常用的降脂药物,而在临床高脂血症合并糖尿病情况较多,所以吉非罗齐与口服降糖药合用后是否有相互作用也应该是临床医生的关注点.本文综述吉非罗齐对临床几种常用口服降糖药的药代学和药效学的影响,及从其机制上予以分析.吉非罗齐通过对CYP2C的抑制作用而明显影响口服降糖药的药代学及药效学,所以在临床上合用时需及时监测血糖的浓度或调整口服降糖药的用量.

  19. Adherence to targeted oral anticancer medications.

    Science.gov (United States)

    Geynisman, Daniel M; Wickersham, Karen E

    2013-04-01

    The use of targeted oral anticancer medications (OAMs) is becoming increasingly prevalent in cancer care. Approximately 25-30% of the oncology drug pipeline involves oral agents and there are now over 50 OAMs approved by the Food and Drug Administration. This change represents a major shift in management of patients with cancer from directly observed, intermittent intravenous therapy to self-administered, oral chronic therapy. The increased prevalence of OAMs raises the issue of adherence in oncology, including understanding the challenges of adherence to OAMs. This review focuses on studies of adherence for patients taking molecularly targeted OAMs for breast cancer, chronic myelogenous leukemia (CML), gastrointestinal stromal tumors (GIST), non-small cell lung cancer (NSCLC), and renal cell carcinoma (RCC). We then discuss barriers to adherence and studies performed to date testing interventions for improving adherence. Finally, we discuss future areas of investigation needed to define and improve adherence to OAMs in targeted therapy for cancer.

  20. 社区医院2008~2010年口服降糖药物应用分析%Analysis of oral hypoglycemic drug use in community hospitals: 2008 ~ 2010

    Institute of Scientific and Technical Information of China (English)

    赵大贵; 杜伟

    2011-01-01

    目的 分析社区医院口服降糖药的应用特点和发展趋势,为临床合理用药提供参考.方法对宜宾市南岸文化广场社区卫生服务中心2008~2010年口服降糖药应用品种、销售金额、用药频度(DDDs)和日均费用(DDC)进行回顾性分析.结果 3年口服降糖药销售金额占抗糖尿病药总金额80%以上;销售金额、DDDs排序前3位的依次是:双胍类、磺酰脲类、餐时血糖调节剂;3年中,二甲双胍缓释片、格列吡嗪缓释片、瑞格列奈位列单品种销售金额前3位;噻唑烷二酮类DDC最高,二甲双胍缓释片、格列吡嗪缓释片DDC较低,在使用上占主导地位.结论社区口服降糖药用药较合理,双胍类、磺酰脲类、餐时血糖调节剂的应用,与社区医院药物治疗糖尿病策略是相符的.%Objective To analyze retrospectively the status quo and tendency of oral hypoglycemic drug use in community hospitals,and provide basis for rational drug use. Methods The article analyzed statistically oral hypoglycemic drugs used during the period of 2008 ~ 2010 in respect of varieties, sales amount,drug daily dosages (DDDS) and defined daily consumption ( DDC). Results The sales amount of oral hypoglycemic drug accounted for more than 80% of the total sales amount of antidiabetic for three successive years. The top three oral hypoglycemic drugs according to sales amount and DDDS were Biguanide,sulfonylurea and prandial glucose regulator. The top three oral hypoglycemic drugs according to sale of single-species were Biguanide,Glipizide Sustained-Release Tablets and Repaglinide. The DDC of thiazolidinediones was the highest,and those of Glipizide Sustained-Release Tablets and Repaglinide were lower,which became the most frequently used drugs in clinic. Conclusion The study shows that the utilization of oral hypoglycemic a-gents in community hospitals is basically rational. Biguanide, sulfonylurea and prandial glucose regulator are used in the way

  1. Comparison of baseline characteristics and clinical course in Japanese patients with type 2 diabetes among whom different types of oral hypoglycemic agents were chosen by diabetes specialists as initial monotherapy (JDDM 42)

    Science.gov (United States)

    Fujihara, Kazuya; Igarashi, Risa; Matsunaga, Satoshi; Matsubayashi, Yasuhiro; Yamada, Takaho; Yokoyama, Hiroki; Tanaka, Shiro; Shimano, Hitoshi; Maegawa, Hiroshi; Yamazaki, Katsuya; Kawai, Koichi; Sone, Hirohito

    2017-01-01

    Abstract Little is known about the relationships between patient factors and the antihyperglycemic agents that have been prescribed as initial therapy by diabetes specialists for patients with type 2 diabetes. Moreover, there has been little clarification of the subsequent usage patterns and related factors that influenced the continuation or discontinuation of the drug or the addition of another drug. To provide information on these issues, we evaluated the clinical characteristics of Japanese patients with type 2 diabetes for whom different types of oral hypoglycemic agents (i.e., either sulfonylureas, biguanides, or DPP-4 inhibitors (DPP-4Is)) were chosen as initial monotherapy by diabetes specialists and evaluated subsequent usage patterns. Prescription data on 3 different antidiabetic agents from December 2009 to March 2015 from diabetes specialists’ patient registries were used to identify variables at baseline related to initial prescriptions; also, the addition of another hypoglycemic drug or discontinuation of the initial therapy was evaluated 1 year after the initial prescription. Analyzed were data on 2666 patients who received initial monotherapy with either a sulfonylurea (305 patients), biguanide (951 patients), or DPP-4I (1410 patients). Patients administered sulfonylureas were older, had a lower body mass index (BMI), longer duration of diabetes, and worse glycemic control than recipients of biguanides. Use of biguanides was related to younger age, short duration of diabetes, and obesity but was negatively associated with poor glycemic control. Older age but neither obesity nor poor glycemic control was associated with DPP-4Is. In all 3 groups a high HbA1c value was related to adding another hypoglycemic agent to the initial therapy. Moreover, adding another drug to a DPP-4I was related to a younger age and higher BMI. Patients’ age, duration of diabetes, obesity, and glycemic control at baseline influenced the choice of hypoglycemic agents

  2. The Effect of Oral Medication on Wound Healing.

    Science.gov (United States)

    Levine, Jeffrey M

    2017-03-01

    The purpose of this learning activity is to provide information about the effects of oral medications on wound healing. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify oral medications that aid in wound healing.2. Recognize oral medications that interfere with wound healing. Given the accelerated medical discoveries of recent decades, there is a surprising lack of oral medications that directly improve wound healing. Of the oral medications available, most target ancillary aspects of wound care such as pain management, infection mitigation, and nutrition. This article describes oral pharmacologic agents intended to build new tissue and aid in wound healing, as well as an introduction to oral medications that interfere with wound healing. This review will not discuss the pharmacology of pain management or treatment of infection, nor will it address nutritional supplements.

  3. Stress free oral medication in captive cervids

    Directory of Open Access Journals (Sweden)

    G.M. Das

    2009-09-01

    Full Text Available Efficacy of oral administration of fenbendazole was studied against gastrointestinal helminthes in captive Cheetal (Axis axis at Hisar Deer Park from November 2006- January 2007. A novel method of administration of oral medication that included acclimatizing cheetal to feed individually from specific containers and providing drugs in feed after habituation was developed. Efficacy of fenbendazole was assessed by egg per gram EPG count of faecal sample on day 11 and 19 post 1st treatment and 4 days after 2nd treatment i.e. on 22nd day and compared with pre-treatment counts. Fenbendazole was efficacious against Strongyles sp., Strongyloides sp., Ascaris sp., Trichuris sp. and Moniezia sp. and significantly reduced the mean EPG of faeces, decreasing p< 0.01 after provision of drug at doses of 7.5 mg/kg body weight. The method was efficacious and provided adequate dosage to individual animals irrespective of their social hierarchy.

  4. DRUG INDUCED HYPOGLYCEMIC COMA IN A NONDIABETIC WITH CHRONIC LIVER DISEASE: A CASE REPORT OF DRUG DISPENSING ERROR

    Directory of Open Access Journals (Sweden)

    Krishna M

    2014-08-01

    Full Text Available Hypoglycemia is a common, potentially fatal, yet preventable problem. Drug-induced hypoglycemia remains the commonest cause of hypoglycemia. A 63 year old non-diabetic male, a known case of chronic liver disease, on regular medications, presented with unconsciousness, unresponsiveness since two hours. Immediate random blood sugar was 11 mg/dl. On proper history and clinical examination, diagnosis of oral hypoglycemic agent induced hypoglycemic coma was made and immediately intravenous dextrose resuscitation was started. Patient regained consciousness after four hours and became fully oriented after 24 hours. Throughout his hospital course, strict and frequent glucose monitoring was done and dextrose infused accordingly. Patient remained hemodynamically stable throughout the hospital course. He was discharged from the hospital after 72 hours in an otherwise healthy condition. Drug induced hypoglycemia is now so relatively common that virtually every unconscious patient should be considered hypoglycemic until immediate estimation of the blood sugar level rules the condition in or out.

  5. Analysis of Application of Oral Hypoglycemic Drugs in Outpatient Department of the Central Hospital of Nanchong during 2012-2014%2012—2014年南充市中心医院门诊口服降糖药应用分析

    Institute of Scientific and Technical Information of China (English)

    徐秀华; 冯婧; 王龙飞

    2015-01-01

    目的:分析南充市中心医院(以下简称"我院")2012—2014年门诊口服降糖药的应用情况和发展趋势,为糖尿病药物治疗提供参考.方法:回顾性统计分析我院2012—2014年门诊降糖药的销售数量、销售总金额、用药频度( defined daily dose system,DDDs)、限定日费用( daily drug cost,DDC),并根据各药的DDDs排序和销售金额排序,算出排序比.结果:我院门诊口服降糖药销售金额整体呈上升趋势,磺酰脲类、双胍类、α-葡萄糖苷酶抑制剂的销售金额增幅大;二甲双胍使用频率高,连续3年居第1位;二甲双胍日平均费用较低,排序比连续3年大于1.结论:我院2012—2014年门诊口服降糖药临床使用基本合理,二甲双胍使用频率高,符合安全、有效、经济的用药原则.%OBJECTIVE:To analyze the status quo and development tendency of oral hypoglycemic drugs for outpatients in the Central Hospital of Nanchong( hereinafter referred to as "our hospital") during 2012-2014,and to provide reference for the medication of diabetes.METHODS: Retrospective analysis was conducted in terms of the consumption amount,consumption sum,defined daily dose system ( DDDs ),and daily drug cost ( DDC ); and the ranking ratio was calculated based on the ranking of DDDs and medication cost of oral hypoglycemic drugs.RESULTS:The consumption sum of oral hypoglycemic drugs for outpatients in our hospital showed an increase tendency in general,especially for sulfonylurea,biguanides and alpha glucosidase inhibitors.The use frequency of metformin continuously dominated the first place during the three years,which had a low cost per day,and the ranking ratio was over 1 during the three years.CONCLUSIONS: The application of oral hypoglycemic drugs for inpatients in our hospital is basically rational during 2012-2014,and metformin has a high frequency of usage,which is conform to the principle of safe,effective and economic medication.

  6. Analysis on the adverse drug reaction signal and its impact factors induced by oral hypoglycemic agents%口服抗糖尿病药物不良反应信号及其相关因素分析

    Institute of Scientific and Technical Information of China (English)

    柯俊; 汤文璐; 薛浩; 庞露微

    2012-01-01

    ,but new ADR reports marked as moderate and severe which were not recorded in drug instructions and references increased significantly during the period of 2009 to 2010,and the most frequently involved agents were biguanides and sulfonylureas (SU).The logistic regression analysis of ADR and its influence factors showed female,the high frequency of taking drug and single medication were risk factors of gastrointestinal damage,weight was the risk factor of skin damage,and combined medication and patients' age were the risk factors of hypoglycemia caused by SU.The results of measures of disproportionality found some ADR signals induced by OHAs.CONCLUSION The ADR of oral hypoglycemic agents could involve multiple systems and organs.Risk factors such as gender,age,weight,frequency of taking drug and drug combination had effects on the occurrence of ADR in different degree,so in order to take OHAs safely and reasonably,we should strengthen the ADR monitoring and put emphasis on controlling the risk factors of ADR in clinical practice.

  7. A Single Blinded Randomized Controlled Study of the Effect of Conventional Oral Hypoglycemic Agents Versus Intensive Short-Term Insulin Therapy on Pure Tone Audiometry in Type II Diabetes Mellitus.

    Science.gov (United States)

    Asma, A; Azmi, M Nor; Mazita, A; Marina, M B; Salina, H; Norlaila, M

    2011-04-01

    Neuropathy is frequently a late complication of diabetes mellitus. Auditory neuropathy and microangiopathy of inner ear are the possible causes of hearing loss in diabetics. To study the correlation between glycaemic control and hearing threshold in patients with type 2 diabetes mellitus and to determine the differences of hearing threshold between groups treated with different modality. This single blind randomized controlled study was performed at the Department of Medicine and Department of Otorhinolaryngology, Hospital Universiti Kebangsaan Malaysia (UKM) between 1st May 2003 and 31st September 2004. This study was approved by Research Ethics Committee (code number FF-137). Subjects were randomized into two groups. Group 1 were patients treated with conventional oral hypoglycemic agents. The patients in group 2 were those treated with insulin injection. The subjects were seen 4 weekly for 3 months. Audiometric test were performed in all subjects at each visit. Blood were taken for fasting blood glucose, Hb1Ac, and fructosamine at every visit to determine the glycaemic controls of the subject. They were 11 patients (22 ears) treated with oral hypoglycemic agents and 17 patients treated (34 ears) with subcutaneous insulin. There is no significant difference between mean pure tone threshold before and after treatment at all frequencies in both groups. There is also no significance different in fasting glucose level and fructosamine. However, there is significant difference HbA1c levels between the two groups after treatment (P < 0.05). This study has shown that glycaemic control does not have significant impact on hearing. The hearing threshold is neither affected by insulin treatment nor by the glycaemic control.

  8. Curative effect and safety discussion of long-acting insulin combined with oral hypoglycemic drugs in the treatment of type 2 diabetes mellitus%长效胰岛素联合口服降糖药治疗2型糖尿病的疗效与安全性探讨

    Institute of Scientific and Technical Information of China (English)

    陈晨

    2015-01-01

    Objective:To explore the curative effect and medication safety of long-acting insulin combined with oral hypoglycemic drugs in the treatment of type 2 diabetes mellitus.Methods:100 patients with type 2 diabetes mellitus were selected. They were randomly divided into the observation group and the control group with 50 cases in each.The patients of two groups were given Rui Yi Ning treatment.On this basis,the observation group was given insulin glargine treatment,the control group was given human seminal protein zinc low neutral protamine zinc human insulin(NPH) treatment.Results:The fasting glucose, glycosylated hemoglobin,2 hours postprandial blood glucose and urine trace amount of proteins of the observation group were significantly lower than those of the control group(P<0.05).The incidence rate of hypoglycemia in the observation group was significantly lower than that of the control group(P<0.05).Conclusion:Long-acting insulin combined with oral hypoglycemic drugs in the treatment of type 2 diabetes mellitus has a significant effect,and the incidence rate of hypoglycemia is low.%目的:探讨长效胰岛素联合口服降糖药治疗2型糖尿病的临床疗效及用药的安全性.方法:收治2型糖尿病患者100例,随机分成观察组和对照组各50例.两组患者均给予瑞易宁治疗,观察组给予甘精胰岛素治疗,对照组给予人精蛋白锌中性低精蛋白锌人胰岛素(NPH)治疗.结果:观察组空腹血糖、糖化血红蛋白、餐后2 h血糖和尿微量蛋白量明显低于对照组(P<0.05).观察组低血糖发生率明显低于对照组(P<0.05).结论:长效胰岛素联合口服降糖药治疗2型糖尿病疗效显著,低血糖发生率低.

  9. Hypoglycemic Activity of Jatrorrhizine

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The hypoglycemic activity and its mechanism of Jatrorrhizine (Jat) were studied. The normal mice and alloxan-induced hyperglycemic mice were given with different doses of Jat. Blood glucose and liver glycogen levels were determined by spectrophotometry with glucose-oxidase and iodine reagents respectively. The levels of blood lactic acid (LC) and liver lactate dehydrogenase (LDH) activity were measured to explore the effect of Jat on anaerobic glycolysis. Succinate dehydrogenase (SDH) activity in liver was measured to evaluate the effect of Jat on aerobic glycolysis in liver. It was found that Jat (50 mg/kg, 100 mg/kg) could significantly decrease blood glucose level in a dose- and time-dependent manner in both normal and alloxan-diabetic mice, increase the activity of SDH, but had no significant effects on the LC level and LDH activity. Jat could significantly reduce the content of liver glycogen in normal mice. Moreover, Jat could inhibit the platelet aggregation in rabbits in vitro in a dose-effect relationship. It was concluded that Jat induced the pronounced decrease in blood glucose in normal and hyperglycemic mice. The hypoglycemic activity of Jat may be attributed to the enhancement of aerobic glycolysis.

  10. Phloretin exerts hypoglycemic effect in streptozotocin-induced diabetic rats and improves insulin resistance in vitro

    Directory of Open Access Journals (Sweden)

    Shen X

    2017-02-01

    Full Text Available Xin Shen,1,* Nan Zhou,1,* Le Mi,1 Zishuo Hu,2 Libin Wang,1 Xueying Liu,1 Shengyong Zhang1 1Department of Medicinal Chemistry, School of Pharmacy, 2Student Brigade, The Fourth Military Medical University, Xi’an, Shaanxi, People’s Republic of China *These authors contributed equally to this work Abstract: The present study investigated the possible antiobesity and hypoglycemic effects of phloretin (Ph. In an attempt to discover the hypoglycemic effect and potential mechanism of Ph, we used the streptozotocin-induced diabetic rats and (L6 myotubes. Daily oral treatment with Ph for 4 weeks significantly (P<0.05 reduced postprandial blood glucose and improved islet injury and lipid metabolism. Glucose consumption and glucose tolerance were improved by Ph via GOD–POD method. Western blot results revealed that the expression of Akt, PI3K, IRS-1, and GLUT4 were upregulated in skeletal muscle of T2D rats and in L6 myotubes by Ph. The immunofluorescence studies confirmed that Ph improved the translocation of GLUT4 in L6 myotubes. Ph exerted hypoglycemic effects in vivo and in vitro, hence it may play an important role in the management of diabetes. Keywords: phloretin, diabetes, insulin sensitivity, blood glucose consumption, skeletal muscle

  11. Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

    Science.gov (United States)

    Badar, Ahmed; Kaatabi, Huda; Bamosa, Abdullah; Al-Elq, Abdulmohsen; Abou-Hozaifa, Bodour; Lebda, Fatma; Alkhadra, Akram; Al-Almaie, Sameeh

    2017-01-01

    Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). Single-blind, nonrandomized. Diabetes clinic of a university hospital in Saudi Arabia. Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. Lipid and cardiovascular parameters, and BMI. Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. There were 9 subjects in each group lost to follow up

  12. Oral health promotion interventions on oral yeast in hospitalised and medically compromised patients: a systematic review.

    Science.gov (United States)

    Lam, Otto L T; Bandara, H M H N; Samaranayake, Lakshman P; McGrath, Colman; Li, Leonard S W

    2012-03-01

    Yeast are major aetiological agents of localised oral mucosal lesions, and are also leading causes of nosocomial bloodstream infections. The purpose of this systematic review was to examine the effectiveness of oral health promotion interventions on the prevalence and incidence of these opportunistic oral pathogens in hospitalised and medically compromised patients. The PubMed, ISI Web of Science and Cochrane Library databases were searched for clinical trials assessing the effect of oral health promotion interventions on oral yeast. Chlorhexidine delivered in a variety of oral hygiene products appeared to have some effect on oral yeast, although some studies found equivocal effects. Although a wide array of other compounds have also been investigated, their clinical effectiveness remains to be substantiated. Likewise, the utility of mechanical oral hygiene interventions and other oral health promotion measures such as topical application of salivary substitute, remains unsettled. Although many chemical agents contained in oral hygiene products have proven in vitro activity against oral yeast, their clinical effectiveness and potential role as adjuncts or alternative therapies to conventional treatment remains to be confirmed by further high-quality randomised controlled trials. This is pertinent, given the recent emergence of yeast resistance to conventional antifungal agents.

  13. Oral health impacts of medications used to treat mental illness.

    Science.gov (United States)

    Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

    2017-12-01

    Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Hypoglycemic activity of several seaweed extracts.

    Science.gov (United States)

    Lamela, M; Anca, J; Villar, R; Otero, J; Calleja, J M

    1989-11-01

    The hypoglycemic activity of several seaweed extracts on rabbits was studied. Ethanol extracts of Laminaria ochroleuca, Saccorhiza polyschides and Fucus vesiculosus were administered orally to normal animals and their effects on glycemia and triglyceridemia evaluated. Crude polysaccharides and protein solutions from Himanthalia elongata and Codium tomentosum were also assayed. Polysaccharides and proteins from H. elongata caused a significant reduction in blood glucose 8 h after intravenous administration. A case of 5 mg/kg of crude polysaccharide lowered glycemia about 18% in normal rabbits and by about 50% in alloxan-diabetic animals, while the protein solution lowered glycemia in diabetic rabbits by about 30%.

  15. Medical outcomes associated with prescription opioid abuse via oral and non-oral routes of administration.

    Science.gov (United States)

    Green, Jody L; Bucher Bartelson, Becki; Le Lait, M Claire; Roland, Carl L; Masters, Elizabeth T; Mardekian, Jack; Bailey, J Elise; Dart, Richard C

    2017-06-01

    Prescription opioid abuse and misuse is a serious and growing public health issue. While the most common form of abuse is swallowing intact tablets/capsules, some abusers manipulate, or tamper with, these medications by altering the dosage form to allow for non-oral routes of administration (e.g., injection, inhalation) in order to achieve more rapid or enhanced psychoactive effects. Because administration of opioids via non-oral routes results in greater systemic availability and more rapid central nervous system penetration, we hypothesized that death and major medical outcomes occur more frequently with non-oral routes compared to oral route alone. This retrospective cohort study analyzed data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System Poison Center Program to investigate relative risk of prescription opioid abuse via oral and non-oral routes. While the oral route was the most commonly reported route of abuse (64.0%), non-oral routes were reported in 14.6% exposures and unknown routes in 21.4% exposures. The relative risk of an exposure resulting in death or major effect was 2.43 (95% CI 1.97, 2.99) if non-oral routes were reported compared to exposures involving oral route only. Analysis of acute health events recorded by poison centers indicates that death or major effects are twice as likely to occur with intentional abuse of prescription opioids via non-oral routes of administration than ingestion alone. Effective interventions to prevent abuse via non-oral routes of solid dosage forms of prescription opioids, such as abuse-deterrent formulations could have a significant public health impact. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Oral antioxidants for radioprotection during medical imaging examinations

    Science.gov (United States)

    Velauthapillai, Nivethan

    The oncogenic effect of ionizing radiation (IR) is clearly established and occurs in response to DNA damage. Many diagnostic imaging exams make use of IR and the oncogenic risk of IR-based imaging has been calculated. We hypothesized that the DNA damage sustained from IR exposure during medical imaging exams could be reduced by pre-medicating patients with antioxidants. First, we tested and validated a method for measuring DNA double-strand breaks (DSBs) in peripheral blood mononuclear cells (PBMCs) exposed to low doses of ionizing radiation. Afterwards, we conducted a pilot clinical study in which we administered oral antioxidants to patients undergoing bone scans, prior to radiotracer injection. We showed that oral antioxidant pre-medication reduced the number of DSBs in PBMCs induced by radiotracer injection. Our study shows proof-of-principle for this simple and inexpensive approach to radioprotection in the clinical setting.

  17. Postprandial hypoglycemic syndrome

    Directory of Open Access Journals (Sweden)

    Т.V. Chaychenko

    2017-06-01

    Full Text Available Postprandial hypoglycemic syndrome, or reactive hypoglycemia, — vegetative symptoms, such as weakness, fatigue, hunger, nausea, palpitations, anxiety, tremor, sweating occurring one to two hours after ingestion. The syndrome is poorly described in literature and most of the information is disparate. Laboratory criteria for the diagnosis of postprandial reactive hypoglycemia are quite controversial, but most authors tend to consider that it is a blood glucose level, which is below 3.9 mmol/l for two hours after meal. Hypoglycemia is an unbalance between glucose influx to the circulation (from endogenous glucose production or exogenous glucose delivery and glucose efflux. The balance between glucose intake and consumption is controlled by a complex balance of glycoregulatory hormones. Insulin, glucagon and adrenaline are effective for several minutes, but cortisol and growth hormone — for seve-ral hours. This explains the presence of immediate and delayed various effects: adrenergic, neuroglycopenic ones and gastroin-testinal discomfort. Postprandial syndrome mechanisms are similar to post-gastric bypass patients with morbid obesity. The most likely cause of reactive hypoglycemia is post-prandial hypersecretion of insulin under the influence of glucose and glucagon-like peptide-1 (GLP-1, which is a component of the enteroendocrine system and acts at the cephalic phase of satiety. Both post-gastric bypass and relatively healthy individuals have symptoms after the meal rich of simple carbohydrates. Symptoms could be effectively reduced by low glycemic index diet rich of dietary fibers. When the effect is insufficient, it is recommended to use acarbose as an α-glucosidase inhibitor, which is the main stimulation of GLP-1 secretion. Thus, obesity epidemics based on the inadequate nutritional habits in the children makes the postprandial syndrome feasible, and it requires further studies. At the same time, healthy diet can significantly improve

  18. Oral Hygiene Practices and Teeth Cleaning Techniques Among Medical Students.

    Science.gov (United States)

    Naseem, Sajida; Fatima, Syeda H; Ghazanfar, Haider; Haq, Sana; Khan, Najeeb A; Mehmood, Moeez; Ghazanfar, Ali

    2017-07-18

    Objectives Oral health is essential for general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infections and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual's capacity to bite, chew, smile, and speak; it affects psychosocial well-being too. The objective of our study was to assess teeth cleaning techniques and oral hygiene practices among medical students. Methods The data of the study were collected in two stages. The first stage involved the administration of a self-constructed questionnaire among medical students. In the second step, the students were asked to demonstrate their teeth cleaning techniques on a model. A standard teeth cleaning checklist was used to evaluate the students. The students were then given the checklist and a video on teeth cleaning techniques was shown to them. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21.  Results Out of a total of 444 students, 256 (57.7 percent) were males while 188 (42.3 percent) were females. About 254 (57.2 percent) participants were preclinical medical students while 190 (42.8 percent) were clinical year medical students. A majority of medical students used medium consistency toothbrushes (177; 39.9 percent) and soft consistency toothbrushes (137; 30.9 percent). Most medical students (248; 55.9 percent) brushed two times a day while 163 (36.7 percent) brushed only one time. About 212 (47.7 percent) of the medical students used mouthwash along with a toothbrush while only 36 (8.1 percent) used floss along with a toothbrush. About 157 participants (35.4 percent) changed their toothbrush once in two months while 132 (26.7 percent) changed their toothbrush once in three months. The mean duration that participants brushed their teeth was 134.99 ± 69.01 seconds. Conclusion Medical students were found to have a faulty teeth

  19. Management recommendations for invasive dental treatment in patients using oral antithrombotic medication, including novel oral anticoagulants

    NARCIS (Netherlands)

    van Diermen, D.E.; van der Waal, I.; Hoogstraten, J.

    2013-01-01

    Objective The aims were (1) to search the scientific literature from 2007 to 2012 for guidelines and new studies on the dental management of patients using oral antithrombotic medication; (2) to summarize the articles' evidence and recommendations; and (3) to propose an updated clinical practice gui

  20. Oral health and medical conditions among Amish children

    Science.gov (United States)

    Harrison, Marc-Allen; Milgrom, Peter

    2017-01-01

    Background: The Amish are a growing population who live a traditional, rural way of life, which makes them less accepting of modernism. Most Amish live in poverty and are detached from modern health care. In addition, the recent change of their lifestyle has been reported, such as consuming a nontraditional diet and the usage of electronic devices. As a result, their lifestyle change may have impacted their oral health. However, since only a single report about oral health among Amish children has been published approximately three decades ago it has not yet been updated. This study describes oral health among Amish children and their medical conditions during visits to a mobile dental unit (MDU). Material and Methods: The dental records of all patients (N=216) who visited a mobile dental unit were reviewed, which covers 1 year from May 20, 2011, the first date of service. The following factors were taken into consideration during the review process: parental perceptions of their children’s oral health care, dental care experiences, and general health information. Results: Fifty-four (27.8%) children, ages 3 to 17, have never received dental treatment before visiting the MDU; the average number of untreated decayed teeth was 6.8. In spite of this, most parents rated their children’s oral health as good or very good (87.7%). The high cost and long distance travel associated with routine, professional dental care makes it difficult for children to maintain good oral hygiene. Our analysis revealed that bleeding disorders were more prevalent among this gene pool compared to the nation at large; however, asthma was less common. Conclusions: There are oral and general health disparities among Amish children. There is a lack of awareness among Amish parents with regard to their children’s oral health. Key words:Amish, child, dental caries, mobile health units. PMID:28298971

  1. 本社区卫生服务中心2011-2013年口服降糖药的应用分析%Analysis of the application of oral hypoglycemic agents in a community health service center during 2011-2013

    Institute of Scientific and Technical Information of China (English)

    李旭琴

    2014-01-01

    目的:了解本社区卫生服务中心口服降糖药的应用情况和趋势。方法:对本社区卫生服务中心2011-2013年口服降糖药的主要品种、销售金额、用药频度(DDDs)、限定日费用(DDC)等进行分类统计、综合分析。结果:口服降糖药销售总金额逐年上升,α-葡萄糖苷酶抑制剂3年来均占据销售金额排名第1位,格列齐特缓释片和二甲双胍片连续3年DDDs居第一、第二,DDC最大的3位依次是阿卡波糖片、伏格列波糖片、瑞格列奈片。结论:本中心口服降糖药应用合理,需求量逐年增加,主要以磺酰脲类为主。安全、有效、良好的依从性是糖尿病治疗药物发展的必然趋势。%Objective: To know the usage and trend of oral hypoglycemic agents in our hospital during 2011-2013. Methods: The main species, sales, DDDs and DDC of oral hypoglycemic agents were statistically classiifed and their utilization was comprehensively analyzed.Results: The sales for oral hypoglycemic agents had been increased year by year during 2011-2013 and α-glucosidase inhibitors were ranked number 1. Metformin was ranked ifrst and gliclazide zyban second in DDDs, and the largest three tablets in DDC were acarbose, voglibose and repaglinide.Conclusion: Use of oral hypoglycemic agents was basically reasonable in our hospital. Their demand has been increasing year by year. Sulfonylurea is a mainly used oral antidiabetic drug. The drugs with safety, effectiveness and good compliance are an inevitable development trend for diabetes therapy.

  2. Application Analysis of Oral Hypoglycemic Drugs in 34 Hospitals of Nanjing during 2011-2013%南京地区34家医院2011~2013年常用口服降糖药用药分析

    Institute of Scientific and Technical Information of China (English)

    王璐璐; 刘慧

    2014-01-01

    Objective:To evaluate the utilization of oral hypoglycemic drugs in 34 hospitals of Nanjing to provide clinical reference for the drug rational use. Methods: According to the sales data of oral hypoglycemic drugs in 34 hospitals of Nanjing from 2011 to 2013,the utilization of oral hypoglycemic drugs was analyzed retrospectively in respect of consumption sum,DDDs and defined daily cost ( DDC) by daily dose limit analysis method. Results: The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose,glimepiride and metformin. In terms of DDDs,glimepiride, metformin and gliclazide ranked the top 3. The consumption sum and DDDs of oral hypoglycemic drugs were increased year by year in Nanjing. The ratio of serial number of consumption sum and DDDs was from 0. 3 to 2. 0. Conclusion: The demanded quantity of oral hypoglycemic drugs is increased year by year from 2011 to 2013. The application conforms to the safe, effective and economic principle. The drugs should be chosen according to the drug characteristics in order to improve the abnormal glucose metabolism and prevent and treat the complications.%目的::了解南京地区口服降糖药的应用近况和发展趋势,为临床合理使用口服降糖药提供参考。方法:根据长江流域医药情报研究所提供的南京地区2011~2013年口服降糖药的销售数据,采用限定日剂量分析法,对该地区34家医院近三年口服降糖药的销售金额、用药频度( DDDs)和限定日费用( DDC)等进行统计分析。结果:销售金额排名前三位的药物是阿卡波糖、格列美脲、二甲双胍,DDDs排名前三位的药物是格列美脲、二甲双胍、格列齐特,总销售金额和总DDDs均呈逐年增长趋势,销售金额与DDDs的序号比值在0.3~2.0之间。结论:2011~2013年南京地区口服降糖药需求量逐年增加,口服降糖药使用符合安全、有效、经济的用药原则,建议治疗时根据药物的特点进行选择,

  3. Phloretin exerts hypoglycemic effect in streptozotocin-induced diabetic rats and improves insulin resistance in vitro

    Science.gov (United States)

    Shen, Xin; Zhou, Nan; Mi, Le; Hu, Zishuo; Wang, Libin; Liu, Xueying; Zhang, Shengyong

    2017-01-01

    The present study investigated the possible antiobesity and hypoglycemic effects of phloretin (Ph). In an attempt to discover the hypoglycemic effect and potential mechanism of Ph, we used the streptozotocin-induced diabetic rats and (L6) myotubes. Daily oral treatment with Ph for 4 weeks significantly (PGLUT4 were upregulated in skeletal muscle of type 2 diabetes (T2D) rats and in L6 myotubes by Ph. The immunofluorescence studies confirmed that Ph improved the translocation of GLUT4 in L6 myotubes. Ph exerted hypoglycemic effects in vivo and in vitro, hence it may play an important role in the management of diabetes. PMID:28223777

  4. Medication adherence to oral anticancer drugs: systematic review.

    Science.gov (United States)

    Huang, Wen-Chuan; Chen, Chung-Yu; Lin, Shun-Jin; Chang, Chao-Sung

    2016-01-01

    Many studies have demonstrated that non-adherence to oral anticancer drugs (OACDs) has challenged treatment efficacy. Otherwise, few validated tools exist to measure patients' adherence to medication regimen in clinical practice. To synthesize previous studies on adherence by cancer patients taking OACDs, especially in targeted therapy, a systematic search of several electronic databases was conducted. We analyzed existing scales' contents for various cancer patients and outcomes of studies assessing adherence. However, a well-validated scale designed particularly for OACD adherence is still lacking. Most adherence scales used in the studies reviewed contain items focused on measuring patients' medication-taking behavior more than their barriers to medication compliance and beliefs. However, non-adherence to OACDs is a complex phenomenon, and drug-taking barriers and patient beliefs significantly affect patients' non-adherence. To understand the key drivers and predisposing factors for non-adherence, we need to develop a well-validated, multidimensional scale.

  5. Effects of oral hypoglycemic drugs on vascular endothelial function in type 2 diabetes%口服降糖药对2型糖尿病血管内皮功能的影响

    Institute of Scientific and Technical Information of China (English)

    郑仁东; 任安; 陈若平; 刘超

    2013-01-01

    目的 观察不同口服降糖药对2型糖尿病(T2DM)血管内皮功能的影响.方法 初诊T2DM患者82例,分别给予吡格列酮(A组,28例)、二甲双胍(B组,30例)或格列吡嗪(C组,24例)治疗,疗程3个月.健康体检者32例作为正常对照组(D组).检测四组血清内皮素1(ET-1)、一氧化氮(NO))和总一氧化氮合酶(T-NOS)的水平.结果 与D组比较,A组、B组、C组ET-1水平升高,NO、T-NOS水平下降(P<0.05).与治疗前比较,A组、B组治疗后ET-1水平降低,而NO、T-NOS水平明显升高(P<0.05).结论 吡格列酮与二甲双胍具有更好的改善血管内皮功能的作用.%To investigate the effects of different oral hypoglycemic drugs on vascular endothelial function-related indicators in patients with type 2 diabetes (T2DM). Methods Eighty-two cases with newly diagnosed T2DM were treated with pioglitazone(group A, 28 cases), metformin(group B,30 cases) or glipizide(group C,24 cases), respectively, for 3 months. Another 32 healthy persons were taken as the controls. Serum endothelin-1 (ET-1), nitric oxide (NO) and total nitric oxide synthase(T-NOS) were measurred before and after treatment. Results Serum ET-1 level was significantly higher, while NO,T-NOS were lower,in groups of A,B and C than those in group D (P<0. 05). Compared to before, serum ET-1 levels in groups of A and B were decreased while NO and T-NOS increased significantly after treatment(P<0. 05). Conclusion Pioglitazone and metforrnin have better protective effects on vascular endothelial function than glipizide in T2DM patients.

  6. Remembrance of conversations past: oral advance statements about medical treatment.

    Science.gov (United States)

    Sommerville, A.

    1995-01-01

    Polls show increasing public interest in advance statements or directives about medical treatment ("living wills") but that few people, apart from Jehovah's Witnesses, carry such documents. Patients' firm, witnessed oral decisions are often sufficient to aid clinical decision making but should still be recorded in medical notes. Without documentation, dilemmas arise when others claim to know patients' views on the basis of past unrecorded conversations and demand withdrawal of treatment when patients are not terminally ill and cannot speak for themselves. Legal and ethical considerations oblige doctors to act in the best interests of an incapacitated patient; these considerations are now formally defined in draft legislation as including consideration of the patient's past wishes. The practicalities of ascertaining the strength and validity of such wishes from conversations reported second hand are complex. The paucity of legal and ethical guidance on reported oral advance statements makes debate imperative and renders the alternative of having designated surrogate decision makers increasingly attractive. Images p1664-a PMID:7795460

  7. Improving Pediatric Outcomes through Intravenous and Oral Medication Standardization

    Science.gov (United States)

    MacKay, Mark W.; Cash, Jared; Farr, Fred; Holley, Marc; Jones, Kevin; Boehme, Sabrina

    2009-01-01

    BACKGROUND Standardization is an invaluable tool to promote safety, improve care, and decrease costs, which ultimately improves outcomes. However, a pediatric setting presents unique challenges with its wide variety of weights, medications, and needs that are distinctly different. Our goal was to develop and implement standards in complex high risk areas that show improved outcomes and safety. PROGRAM DESCRIPTION A computerized prescriber order entry program with decision support for pediatrics was developed for parenteral nutrition prescribing. The program included dosing, calculations, calcium phosphate compatibility checks, automated IV compounder interface, osmolarity route calculation, end product testing verification, aluminum exposure and many other quality improvements. This same electronic order program, interface to sterile compounders, and end product testing was used to standardize and make common non-manufactured intravenous solutions. The drip compounding process was reengineered to include standard concentrations, label changes, and beta-testing of a smart syringe pump with dosing ranges for pediatrics. Common standard oral doses were developed along with standard oral formulations. CONCLUSIONS Total parenteral nutrition (TPN) error rates decreased from 7% to less than 1% and compatibility issues decreased from 36 to 1 per year. Neonatal osteopenia rates decreased from 15% to 2%. Results from end product testing of TPN solutions were within USP standards showing statistical correlation (pdrug concentration and smart pump standardization and decreased drip errors by 73% from 3.1 to 0.8 per 1000 doses. Compounding errors decreased from 0.66 to 0.16 per 1000 doses and ten-fold errors decreased from 0.41 to 0.08 per 1000 doses. Eleven oral liquids, including 329 different doses, were standardized, decreasing the number of doses to 59 (83% change). This decreased workload 15%, wastage 90%, improved turnaround time 32%, and saved $15,000/year. One hundred

  8. In vivo hypoglycemic study of Manilkara zapota leave and seed extracts

    Directory of Open Access Journals (Sweden)

    Saikat Ranjan Paul

    2015-03-01

    Full Text Available The hypoglycemic activity of pet-ether extracts of leaves and methanol extracts of seeds of Manilkara zapota was evaluated in the study. The oral glucose tolerance test was performed in mice treated with 2 mg/kg glucose solution and the blood glucose level was determined after 15, 30, 60, 90 and 120 min of administration. Alloxan (70 mg/kg was injected intravenously to induce diabetes in mice. The hypoglycemic study was carried out 7 days. In glucose tolerance test all extracts achieved significant p values (p<0.0001 at 60, 90 and 120 minutes compared to the glucose control. In hypoglycemic study all extracts started to reduce the blood glucose level rapidly even starting from the 2nd day of treatment and significant p values (p<0.0001 were achieved. So, the study evinced the hypoglycemic potency of the leave and seed extracts of M. zapota.

  9. A Randomized, Controlled Trial to Assess the Efficacy of Arthroscopic Debridement in Combination with Oral Medication Versus Oral Medication in Patients with Gouty Knee Arthritis.

    Science.gov (United States)

    Wang, Xin; Wanyan, Pingping; Wang, Jian Min; Tian, Jin Hui; Hu, Long; Shen, Xi Ping; Yang, Ke Hu

    2015-12-01

    Gouty knee arthritis refers to a form of inflammatory diseases caused by deposits of needle-like crystals of uric acid in knee joint. The aim of this study was to assess the efficacy and safety of arthroscopic debridement in combination with oral medication versus oral medication alone for the treatment of gouty knee arthritis. A total of 60 patients with gouty knee arthritis were randomized to receive either arthroscopic surgery in combination with oral medication or oral medication alone. Efficacy was assessed with the angle of motion, functions, and visual analog scale (VAS). These indices were measured prior to treatment and at 2, 4, 12, 24, and 48 weeks posttreatment. Surgery- and medication-related complications were observed. Significant differences in flexion and extension of the knee joint, lymphoma scores, and VAS were detected between the two groups at 2, 4, and 12 weeks posttreatment (P  0.05) . Significant differences in these indices were detected at different time points in each group (P  0.05). Arthroscopic surgery in combination with oral medication is superior to single oral medication in the flexion and extension of the knee joint, lymphoma scores, and pain relief (VAS) before 24 weeks, although no statistical differences were detected in the efficacy after 24 weeks, and in medication-related safety between the two groups. Although arthroscopic debridement cannot replace systemic uric acid-lowering treatments such as medication and dietary control, it is still an effective approach.

  10. A review of economic impact of targeted oral anticancer medications.

    Science.gov (United States)

    Shen, Chan; Chien, Chun-Ru; Geynisman, Daniel M; Smieliauskas, Fabrice; Shih, Ya-Chen T

    2014-02-01

    There has been a rapid increase in the use of targeted oral anticancer medications (OAMs) in the past decade. As OAMs are often expensive, economic consideration play a significant role in the decision to prescribe, receive or cover them. This paper performs a systematic review of costs or budgetary impact of targeted OAMs to better understand their economic impact on the healthcare system, patients as well as payers. We present our review in a summary table that describes the method and main findings, take into account multiple factors, such as country, analytical approach, cost type, study perspective, timeframe, data sources, study population and care setting when we interpret the results from different papers, and discuss the policy and clinical implications. Our review raises a concern regarding the role of sponsorship on findings of economic analyses as the vast majority of pharmaceutical company-sponsored studies reported cost advantages toward the sponsor's drugs.

  11. The observation of curative effect of combined with insulin therapy after failure treatment with oral hypoglycemic agents for type 2 diabetes%口服降糖药治疗2型糖尿病失效联合甘精胰岛素治疗疗效观察

    Institute of Scientific and Technical Information of China (English)

    熊东林

    2013-01-01

    目的:观察口服降糖药治疗2型糖尿病失效后,联合甘精胰岛素治疗糖尿病的疗效。方法筛选68例单用口服降糖药血糖控制不理想的2型糖尿病患者,睡前(2130)加用甘精胰岛素(来得时),治疗14周,比较前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹C肽、餐后2hC肽、体重变化及低血糖的发生。结果加用甘精胰岛素组治疗14周后,患者FPG、2hPG、HbA1c较治疗前明显下降(P<0.01),餐后2hC肽较治疗前明显升高(P<0.01),未见低血糖发生,体重指数影响不大。结论对单用口服药效果不佳的2型糖尿病,需及时加用甘精胰岛素治疗。%Objective To observe the curative effect of combined with insulin therapy after failure treatment with oral hypoglycemic agents for type 2 diabetes. Method Screening 68 cases with oral hypoglycemic agents alone with no ideal blood sugar control in type 2 diabetes, patients bedtime(9 30 pm) plus insulin glargine(Lantus) treatment with 14 weeks treatment, compared before and after FPG, 2hPG, HbA1c, fasting C peptide, 2h postprandial C-peptide, weight changes and the occurrence of low blood sugar. Results Combined with insulin treatment after 14 weeks , patients’s FPG, 2hPG, HbA1c significantly decreased than that before treatment(P<0.01), and with postprandial 2h C-peptide significantly higher(P<0.01). Conclusion It should be timely combined with insulin after failure treatment with oral hypoglycemic agents alone for type 2 diabetes.

  12. Gas gangrene following intra-arterial injection of oral medication in a drug abuser.

    Science.gov (United States)

    Haiart, D C; Andrade, B; Murie, J A

    1992-09-01

    We report a patient in whom intra-arterial injection of oral medication led to the development of fulminating gas gangrene and death, despite the initial clinical symptoms being minor. We believe that prophylactic antibiotics should be administered to patients following intra-arterial injection of oral medication especially if immunocompetence, such as from human immunodeficiency virus (HIV) infection, is likely.

  13. Hypoglycemic Activity through a Novel Combination of Fruiting Body and Mycelia of Cordyceps militaris in High-Fat Diet-Induced Type 2 Diabetes Mellitus Mice

    Directory of Open Access Journals (Sweden)

    Sung-Hsun Yu

    2015-01-01

    Full Text Available Diabetes mellitus (DM is currently ranked among leading causes of death worldwide in which type 2 DM is reaching an epidemic proportion. Hypoglycemic medications for type 2 DM have either proven inadequate or posed adverse effects; therefore, the Chinese herbal products are under investigation as an alternative treatment. In this study, a novel combination of fruiting body and mycelia powder of herbal Cordyceps militaris number 1 (CmNo1 was administered to evaluate their potential hypoglycemic effects in high-fat diet- (HFD- induced type 2 DM in C57BL/6J mice. Body weight, fasting blood glucose (FBG, oral glucose tolerance test (OGTT, and blood biochemistry indexes were measured. Results indicated that CmNo1 lowered the blood glucose level by increasing insulin sensitivity, while no change in body weight was observed. Increased protein expression of IRS-1, pIRS-1, AKT, pAKT, and GLUT-4 in skeletal muscle and adipose tissue was found indicating restoration of insulin signaling. Additionally, PPAR-γ expression in adipose tissue restored the triglyceride and cholesterol levels. Finally, our results suggest that CmNo1 possesses strong hypoglycemic, anticholesterolemic, and antihypertriglyceridemic actions and is more economical alternate for DM treatment.

  14. Hypoglycemic Activity through a Novel Combination of Fruiting Body and Mycelia of Cordyceps militaris in High-Fat Diet-Induced Type 2 Diabetes Mellitus Mice

    Science.gov (United States)

    Yu, Sung-Hsun; Chen, Szu-Yu Tina; Li, Wei-Shan; Dubey, Navneet Kumar; Chen, Wei-Hong; Chuu, Jiunn-Jye; Leu, Sy-Jye; Deng, Win-Ping

    2015-01-01

    Diabetes mellitus (DM) is currently ranked among leading causes of death worldwide in which type 2 DM is reaching an epidemic proportion. Hypoglycemic medications for type 2 DM have either proven inadequate or posed adverse effects; therefore, the Chinese herbal products are under investigation as an alternative treatment. In this study, a novel combination of fruiting body and mycelia powder of herbal Cordyceps militaris number 1 (CmNo1) was administered to evaluate their potential hypoglycemic effects in high-fat diet- (HFD-) induced type 2 DM in C57BL/6J mice. Body weight, fasting blood glucose (FBG), oral glucose tolerance test (OGTT), and blood biochemistry indexes were measured. Results indicated that CmNo1 lowered the blood glucose level by increasing insulin sensitivity, while no change in body weight was observed. Increased protein expression of IRS-1, pIRS-1, AKT, pAKT, and GLUT-4 in skeletal muscle and adipose tissue was found indicating restoration of insulin signaling. Additionally, PPAR-γ expression in adipose tissue restored the triglyceride and cholesterol levels. Finally, our results suggest that CmNo1 possesses strong hypoglycemic, anticholesterolemic, and antihypertriglyceridemic actions and is more economical alternate for DM treatment. PMID:26258146

  15. COMPARATIVE EVALUATION OF HYPOGLYCEMIC EFFECTS OF TWO DIFFERENT PARTS OF BAUHUNIA PURPUREA LINN. PLANT IN STZ-INDUCED DIABETIC ALBINO WISTAR RATS

    Directory of Open Access Journals (Sweden)

    A. K. Brahmachari

    2015-12-01

    Full Text Available The present work was undertaken to study the comparative phytochemical profiles and hypoglycemic effects of Bauhinia purpurea Linn. Barks (BPBE and leaves ethanolic extracts (BPLE in albino wistar rats to validate their ethno medical use in hyperglycemia as well as to explore the better option. Phytochemicals in ethanolic extracts were analyzed by standard natural product chemistry methods. Diabetes was developed in rats by single intraperitoneal injection of Streptozotocin @ 60mg/ Kg bw. Diabetic albino wister rats (n=3 of either sex (150-200gm bw were orally fed with the extracts once daily for 4 weeks. Glibenclamide @ 0.5mg/Kg bw was used as a positive control for comparison. Fasting blood glucose level at 0, 14th and 28th day and hemoglobin and glycosylated hemoglobin on 28th day of experiment were analyzed. Our results show that the extracts contain alkaloids, flavonoids, glycosides, terpenoids, tannins and phenolics. Rats treated with plant extracts show better glucose modulation, decreased hemoglobin glycosylation and improved hemoglobin concentration as compared to diabetic control. The hypoglycemic effect of only BPBE at 420 mgkg-1 on 14th and 28th day is comparable to that of standard drug glibenclamide (P>0.01. The bark extract has been observed to be more potent hypoglycemic agent than leave extract.

  16. Medical health care professionals' assessments of oral health needs in children with disabilities: a qualitative study.

    Science.gov (United States)

    Hallberg, Ulrika; Klingberg, Gunilla

    2005-10-01

    Good collaboration between medical and dental care is essential to provide not only good oral health care, but also more holistic care for children with disabilities. The aim was to explore and describe medical health care professionals' assessments and considerations of orofacial problems and treatment needs in children with disabilities and in their families. In-depth interviews focusing on orofacial function were carried out with 17 medical health care employees. Interviews were transcribed verbatim and analysed in open and focused (selective) coding processes according to grounded theory. A core category was identified and named focusing on basic needs, showing that oral health care assessment was not on the agenda of medical health care professionals, but was instead viewed as a responsibility of parents or dentists. This study shows that oral health issues are not fully integrated in the medical care of children with disabilities. The omission of oral health issues from the medical agenda implies a risk of oral health problems in children with disabilities. To put the oral cavity and oral health on the medical agenda, dentists need to influence the undergraduate training of medical professionals and to initiate co-operation with the medical care system.

  17. Clinical comparative study of three kinds of insulin application schemes in the treatment of patients with type 2 diabetes for poor glycemic control by oral hypoglycemic drugs%三种胰岛素应用方案治疗口服降糖药物血糖控制不佳2型糖尿病临床对比研究

    Institute of Scientific and Technical Information of China (English)

    刘咏梅

    2016-01-01

    Objective:To investigate the clinical effects and safety differences of three kinds of insulin application schemes in the treatment of pa-tients with type 2 diabetes for poor glycemic control by oral hypoglycemic drugs including neutral protamine zinc insulin ,insulin glargine and insulin detemir .Methods :150 patients with type 2 diabetes for poor glycemic control by oral hypoglycemic drugs were chosen in our hospital in the period from March 2012 to June 2015 and randomly divided into 3 groups including A group (50 patients) with neutral protamine zinc insulin ,B group (50 pa-tients) with insulin glargine and C group (50patients) with insulin detemir ;and the blood glucose index level before and after treatment ,insulin dosage and the incidence of hypoglycemia of 3 groups were compared .Results:The blood glucose index level after treatment of 3 groups was significantly lower than before treatment(P0 .05) .The insulin dosage of A group was significantly fewer than B group and C group(P0 .05);A 组患者胰岛素用量显著多于B组、C组 ,差异有统计学意义(P<0 .05);A 组患者低血糖发生率显著高于B组、C组 ,差异有统计学意义(P<0 .05).结论:三种胰岛素应用方案治疗口服降糖药物血糖控制不佳2 型糖尿病临床疗效接近 ,但甘精胰岛素和地特胰岛素应用可有效减少胰岛素用量 ,降低低血糖发生风险.

  18. Utility of oral fluid in compliance monitoring of opioid medications.

    Science.gov (United States)

    Conermann, Till; Gosalia, Ankur R; Kabazie, Abraham Jack; Moore, Christina; Miller, Kathy; Fetsch, Madalene; Irvan, Dwain

    2014-01-01

    Prescription drug abuse is the fastest growing drug problem in the United States, and the increase in unintentional drug overdose deaths has been driven by the increase in opioid analgesic use. Given the epidemic of non-medical prescription pain reliever use and the current medico-legal climate, it is increasingly important for the prescriber to monitor for medication compliance. The purpose of this IRB approved study is to compare the results of oral fluid (OF) and routine urinalysis for monitoring compliance in a single academic pain management program in an urban setting in order to evaluate the utility of OF analysis in compliance monitoring when prescribing opioid medications. Outcomes analysis of prospective, consecutive, paired comparison study with clinical implications. Single academic interventional pain management center in the United States. Paired OF and urine specimens were collected for each patient with signed informed consent, at the Institute for Pain Medicine, Western Pennsylvania Hospital, from patients who routinely donated urine on a random basis for compliance testing. A total of 153 paired specimens were analyzed. Demographic and prescription data were made available. Specimens were screened using immunoassay and presumptive positive findings were confirmed with liquid-chromatography and mass spectrometry. Although both matrices were tested for a wider range of medications, the data presented here are representative of analgesic opioids and benzodiazepine drug classes only. Following exclusion criteria, of the 132 remaining specimen pairs that were positive for opioids or benzodiazepines in at least one matrix, 101 pairs showed exact drug class matches (76.5%). In an additional 21 pairs, at least one drug class was positive in both matrices (15.9%), giving an overall agreement of 92.4%. Overall, 191 positive results were found in urine averaging 1.4 drugs per specimen; 176 positives were detected using OF for an average of 1.3 drugs per

  19. The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

    Science.gov (United States)

    McKenzie, D; Pifalo, V

    1998-07-01

    The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

  20. Therapeutic effects of insulin detemir combined with oral hypoglycemic agents on type 2 diabetic patients%口服降糖药联合地特胰岛素治疗2型糖尿病的临床疗效

    Institute of Scientific and Technical Information of China (English)

    宋晓敏; 王博; 蔡晓莺; 朱文

    2011-01-01

    Objective To investigate the clinical efficacy and safety of insulin detemir combined with oral hypoglycemic agents in treatment of type 2 diabetic patients. Methods 36 cases of type 2 diabetic patients treated with oral hypoglycemic agents were divided into NPH group(w=20) and insulin detemir group(n=16). The fasting blood glucose, glycated hemoglobin, lipids, blood pressure) body mass index were compared between pretreatment and posttreatment for 12 and 24 weeks. Hypoglycemia events were recorded. Results Fasting blood glucose and glycated hemoglobin were significantly decreased after treatment for 12, 24 weeks in both groups (p<0. 05). There were no significant differences in fasting blood glucose and glycated hemoglobin between the two groups after 12, 24 weeks of treatment. Hypoglycemic events were significanyly lower in insulin detemir group than in NPH group (P<0. 01). Weight gain was 0. 39kg in insulin detemir group and 0. 88kg in NPH group, there was no significant difference between two groups. Conclusion Insulin determir combined with oral hypoglycemic agents can effectively decrease blood glucose, with less incidence of hypoglycemia and less weight gain.%探讨在服用降糖药治疗的T2DM患者中,每天加用一次地特胰岛素治疗的临床疗效及安全性.单纯口服降糖药治疗、血糖控制不佳的T2DM患者36例,对照组在口服药基础上加用中效胰岛素,治疗组在其口服药基础上加用每日一次地特胰岛素,就寝前注射,比较治疗前、治疗后12周、24周空腹血糖、HbA1c、血脂、血压、BMI变化,记录低血糖发生率. 结果两组治疗后12、24周患者空腹血糖、HbA1c较治疗前均明显降低(P<0.05);治疗后12、24周两组间空腹血糖、HbA1c差异无统计学意义;地特胰岛素组低血糖发生率明显低于对照组(P<0.01);地特胰岛素组治疗24周后体重增加0.39kg,中效胰岛素组增加0.88kg,两组间差异无统计学意义. 结论 口服药

  1. Oral Health Education for Medical Students: Malaysian and Australian Students' Perceptions of Educational Experience and Needs.

    Science.gov (United States)

    Ahmad, Mas S; Abuzar, Menaka A; Razak, Ishak A; Rahman, Sabariah A; Borromeo, Gelsomina L

    2017-09-01

    Education in oral health is important to prepare future medical professionals for collaborative roles in maintaining patients' oral health, an important component of general health and well-being. The aims of this study were to determine the perceptions of medical students in Malaysia and Australia of the quality of their training in oral health care and their perceptions of their professional role in maintaining the oral health of their patients. A survey was administered in the classroom with final-year Malaysian (n=527; response rate=79.3%) and Australian (n=455; response rate: 60%) medical students at selected institutions in those countries. In the results, most of these medical students reported encountering patients with oral health conditions including ulcers, halitosis, and edentulism. A majority in both countries reported believing they should advise patients to obtain regular dental check-ups and eat a healthy diet, although they reported feeling less than comfortable in managing emergency dental cases. A high percentage reported they received a good education in smoking cessation but not in managing dental trauma, detecting cancerous lesions, or providing dietary advice in oral disease prevention. They expressed support for inclusion of oral health education in medical curricula. These students' experience with and perceptions of oral health care provide valuable information for medical curriculum development in these two countries as well as increasing understanding of this aspect of interprofessional education and practice now in development around the world.

  2. Hypoglycemic indices of Vernonia amygdalina on postprandial ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-12-17

    Dec 17, 2008 ... Hypoglycemic indices of Vernonia amygdalina on postprandial blood ..... amygdalina have shown that it has antihyperglycemic effect. The study by .... of Solanum xanthocarpum (solanaceae) fruits in normal and streptozotocin ...

  3. Hypoglycemic effect of aqueous extract of Ammi visnaga in normal and streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Jouad, Hassan; Maghrani, Mhamed; Eddouks, Mohammed

    2002-01-01

    The effect of the aqueous extract of Ammi visnaga (Apiaceae) on blood glucose levels was investigated in fasting normal and streptozotocin-induced diabetic rats after single and repeated oral administration. The aqueous extract of Ammi visnaga (AV) at a dose of 20 mg/kg significantly reduced blood glucose in normal rats six hours after a single oral administration (P < 0.005) and nine days after repeated oral administration (P < 0.05). This hypoglycemic effect is more pronounced in streptozotocin (STZ) diabetic rats (P < 0.001). Acute toxicity (LD50) and general behavioural effects of an aqueous extract of AV fruits was studied in mice. The LD50 of intraperitoneal (i.p.) and oral administration was 3.6 and 10.1 g/kg, respectively. These findings suggest that the aqueous extract of AV possess significant hypoglycemic effect in both normal and STZ diabetic rats and support, therefore, its claimed clinical use by the Moroccan population.

  4. Oral Care of Hospitalised Older Patients in the Acute Medical Setting

    Directory of Open Access Journals (Sweden)

    Kathryn Salamone

    2013-01-01

    Full Text Available Oral health care is an essential aspect of nursing care. There are many variances in the quality and frequency of the oral care that is delivered to patients by nursing staff, such as oral care being given a low priority when compared to other nursing care elements, oral care being neglected, and oral care delivery being dependent on the nurse’s knowledge of oral hygiene. Additionally, there are some particular patient groups known to be at risk of oral health problems or who have existing oral diseases and conditions. As people age their susceptibility increases to chronic and life-threatening diseases, and they can be at increased risk of acute infections increases compromised by ageing immune systems. The aim of this literature review was to ignite the discussion related to the oral care practices of nurses for older acute medical hospitalised patients. The review revealed that nursing staff know that good nursing includes oral health care, but this knowledge does not always mean that oral health care is administered. Oral health care seems to be separated from other nursing activities and is not discussed when nursing care plans are written, only when oral problems are obvious.

  5. Type of oral solid medication packaging and medication preparation time in nursing homes: A direct observation study.

    Science.gov (United States)

    Cready, C M; Hudson, C; Dreyer, K

    2017-06-05

    Medication administration is a substantial portion of the workday in nursing homes, with the medication preparation step being the most time-consuming. However, little is known about how medication preparation time is affected by the type of packaging used for oral solid medications (ie, tablets/capsules). We examined the effects of two types of packaging. As fewer steps are associated with strip packaging compared to bingo card packaging, we hypothesized that the increase in medication preparation seconds per resident with each additional oral solid medication would be smaller when strip packaging was used. A total of 430 medication preparations conducted by eight nurses during the regularly scheduled morning medication administration period in two nursing homes-using strip packaging and bingo card packaging, respectively-were observed. Each medication preparation observation was matched to its corresponding medication administration record and observations averaged across resident. Using the resident sample (N=149), we estimated three regression models (adjusting the standard errors for the clustering of resident by nurse). The first model regressed medication preparation seconds on the number of oral solid medications. The second model added the type of packaging used and the control variables (type of unit [long-term care, post-acute care], the number of one-half pills and the dosage form diversity in the preparation). To test our hypothesis, the third model added an interaction term between the number of oral solid medications and the type of packaging used. As hypothesized, all else equal, the number of oral solid medications tended to increase medication preparation time per resident in both nursing homes, but the increase was smaller in the strip packaging nursing home (Phome increased medication preparation by an average of 13 seconds (b=13.077), whereas each oral solid medication administered in the strip packaging nursing home increased medication

  6. Antioxidant and Hypoglycemic Activities of Leaf Extracts of Three Popular Terminalia Species

    Directory of Open Access Journals (Sweden)

    Aditya Arya

    2012-01-01

    Full Text Available This study aimed to ascertain the antioxidant and hypoglycemic activity of methanolic extracts of the leaves of Terminalia arjuna, T. bellerica, and T. chebula. Extracts were evaluated for total phenolic, flavonoid, and tannin content, and in vitro antioxidant potential with DPPH, ORAC, and FRAP assays. The extracts' hypoglycemic activities were evaluated by hypoglycemic screening and an oral glucose tolerance test (OGTT in normal rats. The methanolic extracts of T. chebula leaves exhibited the highest quantity of total phenolic and flavonoid content, followed by those of T. bellerica and T. arjuna. T. arjuna contained more tannin than T. bellerica did, but less than that of T. chebula. The scavenging capacity of T. chebula for the antioxidant DPPH was the highest of the extracts tested, as it recorded the lowest IC50 value of all 3 extracts. Likewise, the results attributed the T. chebula extract with the highest oxygen radical absorption capacity (ORAC. In the FRAP assay, the extracts' ferric reducing antioxidant abilities were T. arjuna > T. chebula > T. bellerica. This correlates the potential of polyphenolic content enriched with antioxidant capabilities and substantiates the results of the hypoglycemic screening and OGTT, which determined that the T. chebula extract had a better hypoglycemic effect in normal and glucose-induced hyperglycemic rats (p <0.001 than that of T. bellerica and T. arjuna, respectively. The use of these Terminalia species as food supplements may help in reducing oxidative stress and related diabetic complications. The phytoconstituents responsible for the hypoglycemic activity need to be isolated to elucidate the relationship between the extracts' antioxidant capacity and their hypoglycemic effects.

  7. Adherence to oral chemotherapy medications among gastroenterological cancer patients visiting an outpatient clinic.

    Science.gov (United States)

    Hirao, Chieko; Mikoshiba, Naoko; Shibuta, Tomomi; Yamahana, Reiko; Kawakami, Aki; Tateishi, Ryosuke; Yamaguchi, Hironori; Koike, Kazuhiko; Yamamoto-Mitani, Noriko

    2017-09-01

    The purpose of this study was to investigate medication adherence to oral chemotherapy medications and determinants of medication non-adherence to them among gastroenterological cancer patients. A cross-sectional study was conducted on 117 consecutive, consenting, eligible patients visiting an outpatient clinic of university hospital in Japan. Good medication adherence was defined as taking 100% of the prescribed dose. Medication adherence was measured via self-report. We hypothesized that there was a significant relationship between medication non-adherence and the five factors defined by the World Health Organization: patient-related, socioeconomic-related, condition-related, treatment-related, and healthcare-system/provider-related factors. Multiple logistic regression models were used to identify factors associated with oral chemotherapy medication non-adherence. The proportion of patients showing good medication adherence was 56.4%. The multiple logistic regression analysis revealed that the determinants of medication non-adherence to oral chemotherapy medications included having a history of patient-caused treatment interruptions due to worsening of symptoms (adjusted odds ratio [AOR] = 9.59, 95% confidence interval [CI] = 1.38-66.47), having diarrhea (AOR = 3.25, 95% CI = 1.13-9.34), experiencing pain (AOR = 0.17, 95% CI = 0.05-0.55), taking oral chemotherapy medication every 8 h (AOR = 5.52, 95% CI = 1.71-17.81), and diminished sense of priority for medication (AOR = 1.40, 95% CI = 1.21-1.63). This study suggests that many patients with gastroenterological cancer were non-adherent to oral chemotherapy medications. It might be necessary to conduct periodic screening and connect patients at a high risk of medication non-adherence to appropriate support.

  8. Determinants and associated factors influencing medication adherence and persistence to oral anticancer drugs: a systematic review.

    Science.gov (United States)

    Verbrugghe, M; Verhaeghe, S; Lauwaert, K; Beeckman, D; Van Hecke, A

    2013-10-01

    The use of oral anticancer drugs has increased in modern oncology treatment. The move from intravenous treatments towards oral anticancer drugs has increased the patients' own responsibility to take oral anticancer drugs as being prescribed. High rates of non-adherence to oral anticancer drugs have been reported. A systematic literature review was conducted to gain insight into determinants and associated factors of non-adherence and non-persistence in patients taking oral anticancer therapy. PubMed, Cochrane, Web of Science and Cinahl were systematically searched for studies focusing on determinants and associated factors of medication non-adherence and non-persistence to oral anticancer drugs. The methodological quality of the included studies was assessed by two independent reviewers. No studies were excluded based on the quality assessment. Twenty-five studies were included and systematically reviewed. The quality of the studies was moderate. Associated factors influencing medication non-adherence and non-persistence to oral anticancer drugs are multifactorial and interrelated. Older and younger age, and the influence of therapy related side effects were found to be predominant factors. Non-adherence and non-persistence to oral anticancer drug therapy are complex phenomena. More qualitative research is needed to facilitate the development of patient tailored complex interventions by exploring patients' needs and underlying processes influencing medication non-adherence and non-persistence to oral anticancer drugs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Evaluation of free radical scavenging properties and hypoglycemic activity of ethanolic extract of Tridax procumbens Linn. in Wistar rats

    Directory of Open Access Journals (Sweden)

    Subramani Parasuraman

    2014-01-01

    Full Text Available Objective: The aim was to evaluate the free radical scavenging properties and hypoglycemic effect of ethanolic extract of whole plant of Tridax procumbens in Wistar rats. Materials and Methods: The plants parts were powdered and extracted with ethanol. The ethanolic extract was used for screening of hypoglycemic activity. The free radical scavenging properties and hypoglycemic effect of ethanolic extract of T. procumbens were studied using 2,2-diphenyl-1-picrylhydrazyl methods and oral glucose tolerance test. Result: The free radical scavenging properties of the ethanolic extract of T. procumbens was comparable with ascorbic acid. The plant extract was not affecting normal animal glucose levels, whereas its affects hyperglycemia induced by glucose load. The glucose lowering effect (hypoglycemic of ethanolic extract of T. procumbens was dose dependent. Conclusion: The ethanolic extract of T. procumbens did not affect the normal animal glucose levels and preventing the hyperglycemia induced by glucose load in rodents.

  10. Comparative study of hypoglycemic and antibacterial activity of organic extracts of four Bangladeshi plants

    Institute of Scientific and Technical Information of China (English)

    Mohammad Shah Hafez Kabir; Shabbir Ahmad; Md. Sofi Mahamoud; Nishan Chakrabarty; Md.Akramul Hoque; Mohammed Munawar Hossain; Md.Nazim Uddin Chy; Mohammed Shoibe

    2016-01-01

    Objective:To examine hypoglycemic and antibacterial activity against some Gram-positive and Gram-negative bacteria of organic extracts of four Bangladeshi plants. Methods:Anin vivo hypoglycemic effect on mice model was used to check the hypoglycemic effect of four Bangladeshi herbal organic extractsviz., roots ofCurculigo recurvata W. T. Aiton (Satipata) (C. recurvata), leaf ofAmorphophallus bulbiferRoxb. (Olkachu) (A. bulbifer), whole plant ofThunbergia grandiflora Roxb. (Nillata) (T. grandiflora) and leaf ofSteudnera colocasiifolia K. Koch (Yunnan) (S. colocasiifolia) using glibenclamide as a positive control and water as a negative control. They were also tested for antibacterial activity on three Gram-positive and four Gram-negative bacteria by disk diffusion method.C. recurvata,A. bulbifer andT. grandiflora were extracted with methanol andS. colocasiifolia was extracted with ethanol. Results:Among all the plant extract, only ethanol extract ofS. colocasiifolia leaves at 800 mg/kg dose significantly (P Conclusions: Through our study, it was found thatS. colocasiifolia could be considered as very promising and beneficial hypoglycemic agent. AlthoughC. recurvata andS. colocasiifolia showed comparable high antibacterial activity, further studies should be needed to develop new antibacterial agent from them.S. colocasiifolia may be a potential source for the development of new oral hypoglycemic agent.

  11. Preparation of Oral Insulin Nano-liposomes and Its Hypogly-cemic Effect%口服胰岛素纳米脂质体的制备及其降血糖作用

    Institute of Scientific and Technical Information of China (English)

    张磊; 平其能; 郭健新; 刘哲

    2001-01-01

    AIM: The present reseach was developed to prepare lecithinnano-liposomes encapsulating insulin and evaluate the enhancing effect of these vesicles on the absorption of hydrophilic proteins in the intestine. METHODS: Insulin nano-liposomes were prepared by reverse-phase evaporation and treated further by sonication. The content and entrapment efficiency of nano-liposomes were analyzed by HPLC. When liposomes were applied to the rats at a dose of 350IU/kg through both directly into the intestine and i.g. in vivo, the hypoglycemic effect was investigated. RESULTS: The particle size of nano-liposomes was 83.3nm with polydispersity index of 0.445. The entrapment efficiencies of nano-liposomes were 78.5%. In vivo hypoglycemic study showed the level of blood glucose reduced by nano-liposomes was 37.6%±13.9% at 0.25 h, reached 89.3%±9.5% at 0.5 h and remained less than 50% within 2 h. Blank nano-liposomes, insulin solution and saline had no hypoglycemic effect. CONCLUSION: Nano-liposomes may become a promising carrier for enhancing absorption of hydrophilic proteins in intestine.%目的:改进胰岛素纳米脂质体的制备方法,考察脂质体经正常大鼠小肠给药和灌胃给药的降血糖效果。方法:通过改变油相容积及油/水相比例,采用逆相蒸发-超声法制备了胰岛素纳米脂质体;测定了纳米脂质体的包封率;通过灌胃和小肠途径,给正常大鼠以350IU/kg的剂量,用酶-苯酚法测定大鼠血糖,并与空白纳米脂质体、胰岛素溶液及生理盐水相比较。结果:胰岛素纳米脂质体的平均粒径为83.3nm,多分散系数为0.445,包封率为78.5%;大鼠灌胃给药后未能显示降血糖作用,但小肠给药后0.25h血糖下降37.6%±13.9%,0.5h血糖下降了89.3%±9.5%,维持50%左右降血糖水平2h,而同法给予的胰岛素溶液、生理盐水和空白纳米脂质体组均无降血糖作用。结论:实验初步证实制备的纳米脂质体可以保护

  12. Gender difference in oral health perception and practices among Medical House Officers

    Directory of Open Access Journals (Sweden)

    Clement C. Azodo and Barnabas Unamatokpa

    2012-09-01

    Full Text Available Background: Understanding the effect of gender on oral health would facilitate the development of successful attitude and behavior modification approach towards sustainable oral health. Aim: To assess the gender difference in the oral health perception and practices among medical house officers in Benin City, Nigeria. Materials and Methods: This questionnaire-based cross-sectional study was conducted among doctors undergoing 12-months mandatory housemanship in tertiary and secondary hospitals in Benin City, Nigeria. The questionnaire assessed information on demography, perceived oral health, oral self-care, dental visit and oral disease preventive knowledge. Results: Of the 105 questionnaires distributed, 97 questionnaires were filled and returned giving a response rate of 92.4%. Females in comparison to males significantly gave good attention to their oral health, use medium strength toothbrush, brushed teeth more than once-daily, visited dentist and chose toothpaste following dentist recommendations. There was no significant gender difference in self-reported dental problem, perceived oral health, preventive knowledge in relation to dental caries and gingival bleeding, the reasons for tooth brushing and renewal of toothbrush. Conclusion: Gender played a role in the perception of general health relative oral health, dental visit, daily tooth brushing frequency and choice of toothbrush and toothpaste for oral self-care. The development of oral health attitude and behavior modification approaches towards sustainable oral health among the studied group should reflect these differences.

  13. Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

    Science.gov (United States)

    Manrique, Yady J; Sparkes, Arron M; Cichero, Julie A Y; Stokes, Jason R; Nissen, Lisa M; Steadman, Kathryn J

    2016-09-01

    Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

  14. Analysis of drug use of hypoglycemic drugs in our hospital in 2014%我院2014年降糖药物用药分析

    Institute of Scientific and Technical Information of China (English)

    陈国新

    2015-01-01

    目的 分析和探讨我院2014年降糖药物用药情况.方法 调取我院2014年1月至2014年12月一整年降糖药物用药情况,包括药物品种、销售金额、用药频次、用药频度(DDDs)、用药限定日费用(DDC)等进行分析.结果 单用胰岛素处方占26.04%,单用口服降糖药物处方占31.98%,口服降糖药物与胰岛素联合用药的处方比例为41.98%;口服降糖药物以双胍类、磺酰脲类药物、糖苷酶抑制剂为主,胰岛素类以诺和灵30R笔芯,优泌灵30R笔芯及甘精胰岛素注射液为主;诺和灵30R笔芯、优泌灵30R笔芯、甘精胰岛素类与二甲双胍类联合用药比例最高,诺和灵30R笔芯、优泌灵30R笔芯、甘精胰岛素类与非黄酰脲类促泌剂如瑞格列奈片等联合用药所占比例较低.结论 我院在使用降糖药物时,基本遵循了安全、合理、有效、经济的用药原则.%Objective: To analyze and investigate the drug use of hypoglycemic drugs in our hospital in 2014.Methods:Transfer of our hospital in 2014 from Jan uary in December a year hypoglycemic drug medication, including drugs, sales amount, frequency of drug use, DDDs (DDDs), medication defined daily cost (DDC) were analyzed. Ling Ling Ling.Results: Single in-sulin prescriptions accounted for 26.04%, single use of oral hypoglycemic drug prescription for 31.98%, oral hypoglycemic agents and insulin combined medication prescription proportion was 41.98%, oral hypoglycemic drugs with double guanidine kind, sulfonyl ureas drugs, glycosidase inhibitors, insulin like Enoch and spirit of 30R refill, and urinary 30R refill and glargine insulin injection; Novolin 30R refill, and urinary 30R refill, glargine insulin with metformin in combination with the highest proportion, Novolin 30R refill, and urinary 30R refill, glargine insulin and non yellowing ureide secretagogue agents such as repaglinide tab-lets combination ratio is low.Conclusion:When we use hypoglycemic drugs, we basically follow

  15. Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons

    Science.gov (United States)

    Harada, Eriko; Moriya, Shingo; Murata, Ayumi; Muramatsu, Masumi; Kashiwazaki, Haruhiko; Kobayashi, Kunihiko; Notani, Kenji; Inoue, Nobuo

    2012-01-01

    Objectives The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors. PMID:21306431

  16. Implementation of STFM's "Smiles for Life" oral health curriculum in a medical school interclerkship.

    Science.gov (United States)

    Silk, Hugh; O'Grady Stille, Sheila; Baldor, Robert; Joseph, Emily

    2009-01-01

    While oral health is an important topic for medical education, it is often not covered in medical school. The Association of American Medical Colleges (AAMC) has recently set guidelines for oral health training in medical education. Our objective was to demonstrate how a mandatory interclerkship (half-day workshops taught between third-year clerkships) that covers pediatric, urgent care, examination skills, and prevention topics in oral health can lead to an increase in knowledge for medical students. Teaching methods included the use of interactive lectures, an audience response system, and small-group workshops taught by medical and dental educators. The curriculum was based on the Society of Teachers of Family Medicine (STFM) Smiles for Life National Oral Health Curriculum. Students were given pretests and posttests, including a 6-month follow-up test. Students showed a significant improvement in knowledge between pretesting and immediate posttesting across a range of topics. Long-term knowledge retention was more limited. The majority of students reported enthusiasm for this topic and found the materials essential for their training. A brief interclerkship can improve medical students' oral health knowledge and be engaging. More research is needed to evaluate means to sustaining the knowledge.

  17. The influence of hypoglycemic drugs on exercise-mediated hypoglycemic effects in elderly type 2 diabetic patients

    Science.gov (United States)

    Xu, Qin; Wang, Fengdi; Wu, Yuemei; Li, Feng

    2015-01-01

    Background: To evaluate the impact of different hypoglycemic drugs on exercise-mediated blood glucose (BG) reduction. Methods: One-hundred and five retirees who were diagnosed with type 2 diabetes mellitus (T2DM) within a two-year period were included in this study. The participants were instructed to walk for 20 to 30 minutes at a moderate-speed (4.0 to 4.5 km/h) after breakfast. Blood pressure and fingertip BG were measured before and after walking. Results: The rate of BG reduction was significantly higher in all exercise groups when compared to that of non-exercised patients. Among all groups, BG declined the most in the un-medicated group, while the lowest BG reduction was observed in the acarbose group. Surprisingly, the BG reduction in acarbose group was significantly lower when compared with non-acarbose groups (P<0.0001). Interestingly, after further correcting for sex, age, BMI, diabetes history, walking time, walking speed and walking distance, only age was found to be an influencing factor (t=-3.304, P=0.001). Pearson correlation of age and BG reduction showed that correlation coefficient of age was only 0.183 and revealed no statistical significance. Conclusions: Walking at a moderate speed for 20 to30 minutes after breakfast provided a beneficial BG reduction effect in elderly T2DM patients. Among the medicated groups, the smallest BG reduction rate was observed in patients taking acarbose. We suggest that acarbose might influence hypoglycemic effects of exercise. The results of this study will be helpful for determining the best clinical usage of hypoglycemic medications in elderly T2DM patients. PMID:26550367

  18. Oral targeted therapies: managing drug interactions, enhancing adherence and optimizing medication safety in lymphoma patients.

    Science.gov (United States)

    Liewer, Susanne; Huddleston, Ashley N

    2015-04-01

    The advent of newer, targeted oral chemotherapy medications such as small molecule kinase inhibitors, ibrutinib and idelalisib, has created additional options for the treatment of lymphoma. The targeted nature of these agents offers many patient-identified advantages over older, intravenously administered chemotherapy regimens such as ease of self-administration and an increased sense of independence. However, newer oral agents also present unique challenges not previously experienced with older therapies that may affect safety, efficacy and patient adherence. In this article, we review oral agents for the treatment of lymphoma, how to evaluate and manage drug-drug and drug-food interactions with concomitant oral medications, and issues with patient adherence as well as methods to determine adherence for oral chemotherapy.

  19. Comparison or oral versus vaginal misoprostol & continued use of misoprostol after mifepristone for early medical abortion.

    Science.gov (United States)

    Mittal, Suneeta; Agarwal, Sonika; Kumar, Sunesh; Batra, Ashima

    2005-08-01

    Medical abortion though legalized in India, is still not very popular. A disadvantage of medical abortion is the longer duration of bleeding compared with surgical abortion which may reduce acceptability. Due consideration needs to be given to the issues related to medical abortion for improving the reproductive health status of women suffering from consequences of unsafe and illegal surgical abortion. The present study compared the efficacy of oral and vaginal administration of misoprostol after a single dose of 200 mg of mifepristone and evaluated the influence of continuing misoprostol for one week on efficacy and side effects. A double-blind randomized controlled trial with 150 healthy pregnant women requesting medical abortion with misoprostol either orally or vaginally on day three. Women in the oral group and one of the two vaginal groups continued 0.4 mg of oral misoprostol twice daily for seven days. Complete abortion rate in each of the groups was 96-100 per cent. The addition of misoprostol 0.4 mg twice a day from day 4-10 did not help in increasing successful outcome or shortening of duration or amount of bleeding. Medical abortion for pregnancy up to 63 days using misoprostol 0.8 mg vaginal/oral after pretreatment with mifepristone 200 mg is a safe and successful procedure. No differences in efficacy or duration of bleeding were observed with addition of oral misoprostol for 1 wk after abortion.

  20. 降糖保健品致汞砷中毒性周围神经病3例报道%Three cases of report on the peripheral neuropathy with mercury and arsenic poisoning from an oral hypoglycemic health product

    Institute of Scientific and Technical Information of China (English)

    邓秋琼; 王蓓; 刘华; 李颖; 王玮璐; 吴慧

    2015-01-01

    Objective: To analyze the clinical feature of three cases of peripheral neuropathy occurred with mercury and arsenic poisoning and summarize the clinic experience of the diagnosis and therapy for peripheral neuropathy with heavy metal poisoning.Methods:Three cases of patients with toxic peripheral neuropathy caused by orally taking a hypoglycemic health product with excessive levels of mercury and arsenic were retrospectively analyzed. Results: Subacute onset occurred in three cases of patients after they have taken the oral hypoglycemic health product for several months and the disease was progressively aggravated, in which limb peripheral-type sensory and motor deficits were as the main performance. Neurophysiological examinations suggested the impairment of multiple motor or sensory peripheral nerve mainly with axonal damage. Among them, one case of patient with respiratory dififculty could not be recovered after immunoglobulin and glucocorticoid therapy and the others were relieved after glucocorticoid therapy.Conclusion: The efifcacy of immunoglobulin and glucocorticoid therapy on the peripheral neuropathy with heavy metals (mercury and arsenic) poisoning are varied and great attention should be paid to the history of the use of medicines and health products in patients.%目的:分析3例汞砷中毒性周围神经病的临床特点,总结重金属中毒周围神经病的诊疗经验。方法:回顾3例口服同一种降糖保健品(汞砷超标)引起中毒性周围神经病患者的临床诊疗情况。结果:3例患者发病前口服摩柯复合片数月,亚急性起病,病情进行性加重,以四肢末梢型感觉和运动障碍为主要表现,神经电生理检查均提示多发性运动和(或)感觉周围神经损害,轴索损害为主。1例呼吸困难者应用激素和丙种球蛋白后疗效差,其他2例应用激素后均有缓解。结论:激素和丙种球蛋白对重金属中毒所致周围神经病的疗效有差

  1. Dental screening of medical patients for oral infections and inflammation : Consideration of risk and benefit

    NARCIS (Netherlands)

    Maret, Delphine; Peters, Ove A.; Vigarios, Emmanuelle; Epstein, Joel B.; van der Sluis, Lucas

    The primary purpose of preoperative dental screening of medical patients is to detect acute or chronic oral conditions that may require management prior to planned medical interventions. The aim of this communication is to discuss the background of preoperative dental screening and the link between

  2. The choice of initial insulin treatment plan for type 2 diabetes mellitus patients with failure of oral hypoglycemic agents%2型糖尿病患者口服降血糖药失效后起始胰岛素治疗方案的选择

    Institute of Scientific and Technical Information of China (English)

    石立; 李德; 杜云峰; 高剑波; 薛云; 杨科春; 陈丽叶; 成金罗; 叶新华

    2016-01-01

    Objective To investigate the insulin treatment plan after the failure of oral hypoglycemic agents for type 2 diabetes in China.Methods 180 patients with type 2 diabetes who failed to oral hypoglycemic drugs were randomly divided into three groups on average:A group (insulin glargine + metformin + gliclazide sustained-release tablets),B group (insulin aspart 3 0 + metformin) and C group (insulin glargine + metformin + insulin aspart).24 weeks later,the hypoglycemic effect and security were observed.Three years later,the compliance that patients used original treatment plan were observed.Results 24 weeks later,HbA1c of the three group significantly decreased compared with that before the study [A group:(7.3 ± 0.8) % vs.(10.2 ± 1.7) %;B group:(7.0 ± 0.8) % vs.(9.9 ± 1.5)%;C group:(6.9 ±0.7)% vs.(10.4 ± 1.8)%,all P <0.05].The incidence of hypoglycemia in C group (1.66 times · year-1 · people-1) was significandy higher than that in A group (1.04 times · year-1 · people-1) and B group (1.31 times · year-1 · people-1) (x2 =11.777,4.362,all P < 0.05).However,the daily average cost of the drug in the B group [(12.9 ± 3.0) yuan] was significantly lower than that in A group [(25.6 ± 3.8) yuan] and C group [(22.7 ± 4.7) yuan] (t =18.943,13.226,all P < 0.05).Three years later,the percentage of patients who used original treatment plan in the C group(40.0%) was significantly less than that in A group(68.0%) and B group (73.0%) (x2 =8.656,12.398,all P < 0.05).Conclusion Type 2 diabetic patients who failed to oral hypoglycemic agents,according to their own economic conditions,might choose aspart 30 or glargine.The hypoglycemic treatment of aspart 30 has better long term effect,lower costs and incidence of hypoglycemia,better compliance.%目的 探讨2型糖尿病患者口服降血糖药失效后的胰岛素治疗方案.方法 选择180例口服降糖药失效的2型糖尿病患者按数字表法随机分为三组:A组(60

  3. Hypoglycemic activity of Bougainvillea spectabilis stem bark in normal and alloxan-induced diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Sunil Jawla; Y Kumar; MSY Khan

    2012-01-01

    Objective: Bougainvillea spectabilis (B. spectabilis) is one of the main constituent of various herbal formulations available for diabetes. The aim of present study was to screen hypoglycemic potential of B. spectabilis stem bark extracts in albno rats (Wistar strain). Methods: The EtOH extracts (100, 250 and 500 mg/kg/day) of the B. spectabilis were administered to both normal and alloxan induced diabetic rats at defined time intervals. Blood glucose levels were measured at 0, 0.5, 1, 2, 4, 6 h, and on 0, 1, 3, 5, 7th day after oral administration of extracts. Of the doses test, highest anti-hyperglycemic effect was observed by the extract of stem bark at 250 mg/kg after a week treatment. Results: B. spectabilis stem bark extract exhibited significant hypoglycemic activity at different doses and intervals. Stem bark extract was found to be 22.2% more potent than standard oral hypoglycemic drug, glibenclamide 0.2 mg/kg. Conclusion: Treatment of alloxan induced diabetic rats up to a week with stem bark extract reversed the permanent hyperglycemia. Hence, B. spectabilis stem bark alcoholic extract exhibited potent hypoglycemic activity.

  4. Hypoglycemic herbs and their action mechanisms

    Directory of Open Access Journals (Sweden)

    Tang George

    2009-06-01

    Full Text Available Abstract Conventional drugs treat diabetes by improving insulin sensitivity, increasing insulin production and/or decreasing the amount of glucose in blood. Several herbal preparations are used to treat diabetes, but their reported hypoglycemic effects are complex or even paradoxical in some cases. This article reviews recent findings about some of the most popular hypoglycemic herbs, such as ginseng, bitter melon and Coptis chinensis. Several popular commercially available herbal preparations are also discussed, including ADHF (anti-diabetes herbal formulation, Jiangtangkeli, YGD (Yerbe Mate-Guarana-Damiana and BN (Byakko-ka-ninjin-to. The efficacy of hypoglycemic herbs is achieved by increasing insulin secretion, enhancing glucose uptake by adipose and muscle tissues, inhibiting glucose absorption from intestine and inhibiting glucose production from heptocytes.

  5. Hypoglycemic and hypolipidemic effects of Solidago chilensis in rats

    Directory of Open Access Journals (Sweden)

    Mariane Schneider

    2015-06-01

    Full Text Available AbstractSolidago chilensis Meyen, Asteraceae, is traditionally used to treat inflammation. However, phytochemical and pharmacology investigations are lacking. This study evaluated the hypoglycemic and hypolipidemic effects of hydroalcoholic extract from S. chilensis aerial parts in rats. In oral glucose tolerance tests the rats received saline (0.5 ml/100 g in control group (C, hydroalcoholic extract (125, 250 or 500 mg/kg p.o.; n = 6 or glibenclamide (10 mg/kg p.o.; n = 6. After 30 min, glucose (4 g/kg was administered. Rats treated with hydroalcoholic extract 500 demonstrated decreased glucose levels at 180 min (-22.1%, when compared with group C, similar to glibenclamide. Moreover, treatment with hydroalcoholic extract 500 significantly increased the glycogen content in the liver and soleus muscle, and hydroalcoholic extract 250 specifically inhibited the enzyme maltase when compared with group C. Furthermore, all hyperglycemic rats treated with hydroalcoholic extract (125, 250 and 500 exhibited an accentuated decrease in total cholesterol levels (-36.8%, -36.7% and -41.3%, respectively. Our results suggest that hypoglycemic and hypolipidemic effects of hydroalcoholic extract could be associated with increased production and release of insulin as well as with insulinotropic and antioxidant effects.

  6. Hypoglycemic effects of Trichosanthes kirilowii and its protein constituent in diabetic mice: the involvement of insulin receptor pathway.

    Science.gov (United States)

    Lo, Hsin-Yi; Li, Tsai-Chung; Yang, Tse-Yen; Li, Chia-Cheng; Chiang, Jen-Huai; Hsiang, Chien-Yun; Ho, Tin-Yun

    2017-01-18

    Diabetes is a serious chronic metabolic disorder. Trichosanthes kirilowii Maxim. (TK) is traditionally used for the treatment of diabetes in traditional Chinese medicine (TCM). However, the clinical application of TK on diabetic patients and the hypoglycemic efficacies of TK are still unclear. A retrospective cohort study was conducted to analyze the usage of Chinese herbs in patients with type 2 diabetes in Taiwan. Glucose tolerance test was performed to analyze the hypoglycemic effect of TK. Proteomic approach was performed to identify the protein constituents of TK. Insulin receptor (IR) kinase activity assay and glucose tolerance tests in diabetic mice were further used to elucidate the hypoglycemic mechanisms and efficacies of TK. By a retrospective cohort study, we found that TK was the most frequently used Chinese medicinal herb in type 2 diabetic patients in Taiwan. Oral administration of aqueous extract of TK displayed hypoglycemic effects in a dose-dependent manner in mice. An abundant novel TK protein (TKP) was further identified by proteomic approach. TKP interacted with IR by docking analysis and activated the kinase activity of IR. In addition, TKP enhanced the clearance of glucose in diabetic mice in a dose-dependent manner. In conclusion, this study applied a bed-to-bench approach to elucidate the hypoglycemic efficacies and mechanisms of TK on clinical usage. In addition, we newly identified a hypoglycemic protein TKP from TK. Our findings might provide a reasonable explanation of TK on the treatment of diabetes in TCM.

  7. Fulminant Hepatitis E in a Woman Taking Oral Contraceptive Medication

    Science.gov (United States)

    Mateos Lindemann, Maria Luisa; Morales, Javier Graus; Fernández-Barredo, Salceda; Domínguez, Mario Rodríguez; García de la Hoz, Fernando; Halfon, Philippe; Pérez Gracia, Maria Teresa

    2010-01-01

    We describe a fulminant autochthonous hepatic failure caused by hepatitis E (HEV) in a patient admitted in our hospital for liver-transplant evaluation. The only risk factor recorded for this severe course was the use of oral contraceptives that are known to mimic a hormonal status similar to pregnancy. The diagnosis was based on the presence of IgG and IgM anti-HEV in the serum of the patient and confirmed by the isolation of a strain of HEV genotype 3f from a blood sample obtained the fourth day after hospital admission. HEV genotype 3 is present in human and swine populations in Spain. The patient began to recover while waiting for a liver transplant. To our knowledge, this is the first report of fulminant hepatitis E in a non-pregnant European patient on oral contraceptives. PMID:20064988

  8. The Prevalence of Pemphigus (Razi Hospital and Department of Oral Pathology, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Eshghyar N

    1999-12-01

    Full Text Available The aim of this retrospective statistical study was to determine the prevalcence and frequency of"nage and sex distributions of pemphigus disease. Pemphigus disease classified as autoimmune bullous"ndermatoses which is a chronic mucocutaneous disease."nThis study was performed in Razi Hospital and department of oral pathology of dental school, Tehran"nUniversity of Medical Sciences. The most frequently effected area was buccal moucosa of oral cavity. The"nmost rate of recurrence was found in oral cavity which being more common in middle age females (25-44"nyears.

  9. Hypoglycemic effect of oral PA extracted from momordica Charantia Seeds on alloxan-induced diabetic mice%苦瓜降糖多肽PA对四氧嘧啶糖尿病小鼠的口服降血糖作用

    Institute of Scientific and Technical Information of China (English)

    刘红雨; 付中平; 周吉燕; 王富军一; 胡之璧

    2009-01-01

    Objective: To investigate the hypoglycemic effect of oral PA and its possible mechanisms. Methods: PA, co-administration with protein-ase inhibitors (PI) also from Momordica charantia seeds, was orally administrated into alloxan-induced diabetic mice( 100mg/kg, PI 50mg/ kg). Blood glucose level, insulin level, hexokinase activity in skeletal muscle and α-glucosidase activity of intestinal mucosa were measured. The pancreas was fixed with 10% formaldehyde for histopathological examination. Results: Daily treatment with PA (co-administration with PI) for 3 weeks led to fall in blood glucose level at 14 days and at 21 days, respectively. In addition, PA also raised serum insulin concentrations. The increased a-glucosidase activity of intestinal mucosa and decreased hexokinase activity in skeletal muscle were also restored partly. Oral PA may facilitate the recovery of partially damaged islet cells in alloxan-induced diabetic mice. Conclusion: The late hypoglycemic effect of oral PA, is probably due to its insulin secretagogue effect, reparative action on damaged islet cells and restoration of glucose metabolism balance.%目的:研究添加蛋白水解酶抑制剂PI的苦瓜降糖多肽PA口服降血糖作用及其可能的作用机制.方法:小鼠尾静脉注射四氧嘧啶溶液80mg/kg造糖尿病小鼠模型,分别进行PA皮下注射降血糖实验和PA口服降血糖实验;21日实验结束时取材测定血糖、血清胰岛素水平、小肠粘膜α-葡萄糖苷酶活性、骨骼肌己糖激酶(HK)活性,固定胰腺进行病理观察.结果:皮下注射PA显著降低小鼠血糖值.口服PA组小鼠血糖值明显减低;血清胰岛素水平明显升高;小肠粘膜催化麦芽糖生成的葡萄糖量大幅降低;骨骼肌己糖激酶活性明显增强;四氧嘧啶对小鼠胰岛的选择性损伤得到缓解.结论:初步证明了添加酶抑制剂PI的苦瓜降糖多肽PA口服降血糖作用;其作用机制可能是抑制小肠粘膜α-葡萄糖苷酶活

  10. Hypoglycemic Effect Hydroacetone Extracts of Treculia africana ...

    African Journals Online (AJOL)

    Dr Olaleye

    Decne Root and Stem Bark in Alloxan-Induced Diabetic Rats. Olatunji B.P1., Suleiman M2. .... compounds from T. africana reported to have been tested for their .... types of bioactive principles of which possess effective hypoglycemic activity in ...

  11. Hypoglycemic activity of Cassia javanica Linn. in normal and streptozotocin-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Urmila C Kumavat

    2012-01-01

    Full Text Available In present work, one of the ornamentals and medicinally less known plant Cassia javanica has been explored for hypoglycemic potential. It aimed to check the hypoglycemic effect of C. javanica leaves on normal and streptozotocin (STZ-induced diabetic rats by acute and sub-acute studies. Prior to the hypoglycemic study, acute oral toxicity testing of drug was performed. Later, the effects of single and multiple doses of test drug were studied using various parameters. Dried powdered leaf material was used as an oral drug. The preliminary phytochemistry of drug was done by standard qualitative tests. Diabetes was induced in rats by single intraperitoneal injection of STZ. Single and multiple doses of test drug (0.5 g/kg body weight/day were given to normal and diabetic rats. The parameters studied were blood glucose, serum cholesterol, serum triglycerides, and serum proteins. The results of test drug were compared with standard hypoglycemic drug-glibenclamide (0.01 g/kg/day. Statistical analysis was done by ′Student′s ′t′ test′ and one way ANOVA test. In preliminary phytochemistry, antidiabetic compounds were detected. Unlike acute, subacute treatment of test drug showed highly significant reduction (37.62% in blood glucose level of diabetic rats in ten days. This effect was considerably good in comparison with standard drug (63.51%. The test drug and standard drug exhibited insignificant change in the abnormal levels of serum metabolites of diabetic rats. Preclinically, C. javanica was proved to be effective hypoglycemic agent.

  12. Hypoglycemic activity of Ailanthus excelsa leaves in normal and streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Cabrera, W; Genta, S; Said, A; Farag, A; Rashed, K; Sánchez, S

    2008-03-01

    The hypoglycemic activity of a 70% methanol extract from the leaves of Ailanthus excelsa Roxb. (Simaroubaceae) was studied in normal, transiently hyperglycemic and streptozotocin (STZ)-induced diabetic rats. Oral administration of the extract at doses of 14, 70 and 350 mg/kg body weight caused no significant changes in fasting blood glucose levels of normal rats. In an oral glucose tolerance test, the extract produced a significant decrease in glycemia 90 min after the glucose pulse. Daily administration of A. excelsa extract for 60 days produced a significant hypoglycemic effect in diabetic animals. In addition, this treatment improved the altered renal function observed in diabetic control rats. This study suggests that Ailanthus leaf extract could be potentially useful for post-prandial hyperglycemia treatment.

  13. Acute and chronic hypoglycemic activity of Sida tiagii fruits in N5-streptozotocin diabetic rats.

    Science.gov (United States)

    Datusalia, Ashok Kumar; Dora, Chander Parkash; Sharma, Sunil

    2012-01-01

    Herbal prescriptions have been recognized as potentially valid by the scientific medical establishment, and their use has been increasing. Sida tiagii Bhandari (Sida pakistanica; family-Malvaceae), a native species of the Indian and Pakistan desert area, popularly known as "Kharenti" in India; is used as a folk medicine. In the present study, various fruit extracts of Sida tiagii were investigated for it's hypoglycemic and antioxidant potential in neonatal streptozotocin-induced (type 2) diabetic rats. Grinded fruits were extracted with 90% ethanol and partitioned with n-hexane (n-hexane extract; HS) and ethyl acetate (Ethyl Acetate Extract; EAS) successively. The residual ethanol fraction (residual ethanol extract; RES) was dried on water bath separately. All three extracts were administered orally at a dose of 200 mg/kg and 500 mg/kg. Blood glucose level, cholesterol, GSH (glutathione), elevated thiobarbituric acid-reactive substances (TBARS), glycated hemoglobin and liver glycogen contents were measured after 19 days treatment. The residual ethanol extract of Sida tiagii fruits significantly improve glycemic parameter and showed antioxidant activity in diabetic rats. The results of the present study indicated that the active fraction of Sida tiagii (i.e., RES) is suitable for development of a promising phytomedicine for the treatment of diabetes mellitus.

  14. Education Status of Oral Genetics at the Fourth Military Medical University and other Chinese Dental Schools.

    Science.gov (United States)

    Zhang, Yan Li; Wang, Chang Ning; Fan, Zhi Peng; Jiao, Yang; Duan, Xiao Hong

    To investigate the current state of genetics education at the Fourth Military Medical University (FMMU) and compare it with other dental schools of China. Detailed information about the history and current education status of Oral Genetics in the FMMU were collected and questionnaires were completed to acquire the feedback of twenty-seven students on the course. In the other thirty-five dental schools including the capitals of twenty-five provinces and four municipalities in China, information about the oral genetic course were collected by a telephone survey. The contents of survey included whether or not the Oral Genetic course is offered and some basic information about the curriculum (such as the content, hours, teachers' background and teaching methods). Among a total of thirty-six dental schools investigated, six of them (16.7%) offered the Oral Genetic course or related lectures/seminars. The length and contents of the curriculum vary among these schools. The FMMU offered the oral genetic curriculum both to undergraduates and graduated students. Their teachers had a broad range of backgrounds, such as dentistry, biology, genetics, and biochemistry. The students considered the Oral Genetics course to be helpful for their future professional careers. Genetic education in dentistry in China is still at a preliminary stage. More effort must be paid to spread the knowledge of Oral Genetics in China. In addition, domestic and international communications and networks for Oral Genetics should be set up in the near future.

  15. A Comparative Study on the Sedative Effect of Oral Midazolam and Oral Promethazine Medication in Lumbar Puncture

    Directory of Open Access Journals (Sweden)

    Hojjat DERAKHSHANFAR

    2013-06-01

    Full Text Available How to Cite This Article: Derakhshanfar H, Modanlookordi M, Amini A, Shahrami A. A Comparative Study of the Sedative Effect of Oral Midazolam and Oral Promethazine Medication in Lumbar Puncture. Iran J Child Neurol. 2013 Spring;7(2:11-16. ObjectiveLumbar puncture (LP essentially is a painful and stressful procedure that indicated for diagnosis and therapeutic purposes. One way to reduce the anxiety is to administer an oral premedication. The aim of this study is to compare clinical effects of oral midazolam and oral promethazine in LP.Materials & MethodsThis prospective randomized controlled clinical trial study wasperformed on 80 children aged 2-7 years that were candidate for LP. They were divided into two randomized equal groups. First group received oral midazolam syrup 0.5 mg/kg and the other group received oral promethazine syrup 1mg/kg. Level of sedation, hemodynamic changes and any other complications were monitored every 5 minutes from 30 minutes before the start of the procedure.ResultsMidazolam group and promethazine group were similar in age, gender and weight. Midazolam had significantly shorter onset of sedation and also shorter duration to maximal sedation. The two groups were similar with respect to sedative effect at all time. The only complication that was significantly more in midazolam group was nausea and vomiting.ConclusionMidazolam syrup and promethazine syrup have same sedative effect in children. Both of these medications are easy to use in preschool children and none of them appeared to be superior to another. References1. Ellenby MS, Tegtmeyer K, Lai S, Braner DA. Lumbar Puncture. N Engl J Med 2006;28;355(13:e12.2. Crock C, Olsson C, Phillips R, Chalkiadis G, Sawyer S, Ashley D, et al. General anesthesia or conscious sedation for painful procedures in childhood cancer: The family’s perspective. Arch Dis Child 2003;88(3:253−7.3. Holdsworth MT, Raisch DW, Winter SS, Frost JD, Moro MA, Doran NH, et al. Pain and

  16. Pharmacological Evaluation of Naproxen Metal Complexes on Antinociceptive, Anxiolytic, CNS Depressant, and Hypoglycemic Properties

    Science.gov (United States)

    Das, Narhari; Abdur Rahman, S. M.

    2016-01-01

    Purpose. The present study was designed to investigate the antinociceptive, anxiolytic, CNS depressant, and hypoglycemic effects of the naproxen metal complexes. Methods. The antinociceptive activity was evaluated by acetic acid-induced writhing method and radiant heat tail-flick method while anxiolytic activity was evaluated by elevated plus maze model. The CNS depressant activity of naproxen metal complexes was assessed using phenobarbitone-induced sleeping time test and the hypoglycemic test was performed using oral glucose tolerance test. Results. Metal complexes significantly (P < 0.001) reduced the number of abdominal muscle contractions induced by 0.7% acetic acid solution in a dose dependent manner. At the dose of 25 mg/kg body weight p.o. copper, cobalt, and zinc complexes exhibited higher antinociceptive activity having 59.15%, 60.56%, and 57.75% of writhing inhibition, respectively, than the parent ligand naproxen (54.93%). In tail-flick test, at both doses of 25 and 50 mg/kg, the copper, cobalt, silver, and zinc complexes showed higher antinociceptive activity after 90 minutes than the parent drug naproxen. In elevated plus maze (EPM) model the cobalt and zinc complexes of naproxen showed significant anxiolytic effects in dose dependent manner, while the copper, cobalt, and zinc complexes showed significant CNS depressant and hypoglycemic activity. Conclusion. The present study demonstrated that copper, cobalt, and zinc complexes possess higher antinociceptive, anxiolytic, CNS depressant, and hypoglycemic properties than the parent ligand. PMID:27478435

  17. Chemo-profiling of eucalyptus and study of its hypoglycemic potential

    Institute of Scientific and Technical Information of China (English)

    Baishakhi; Dey; Analava; Mitra

    2013-01-01

    Constant escalations in the number of diabetics worldwide and the failure of conventional therapy to restore normoglycemia without adverse effects,in spite of tremendous strides in modern medicine,calls for naturopathy and alternative medicine.Because diabetes is multi-factorial and has secondary complications,prevention of hyperglycemia is the central dogma for its management.To date,no oral hypoglycemic exists which can achieve tight glycemic control without side effects.Dietary adjuncts,lifestyle interventions and a resurgence of interest in phyto-therapy have consequently gained ground.Natural hypoglycemics have attracted attention due to ease of incorporation in everyday diet,affordability,less adverse effects,and long term safety.Ethno botanical literature reports more than 800 anti-diabetic plants species.Eucalyptus is well represented in the Aboriginal Pharmacopoeias for its various pharmacological activities.Its hot aqueous decoction has been used as a hypoglycemic in various regions of world.This editorial attempts to summarize the data on the hypoglycemic potential of the different eucalyptus species,highlight the value of its natural biomolecules for the prophylaxis and treatment of type2 diabetes,describe their mechanistic actions,shed light on the posology and safety aspects of eucalyptusand assess its applicability as a reinforcement to currently used therapy.

  18. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard

    2013-01-01

    To estimate the effectiveness of oral nutritional support compared to placebo or usual care in improving clinical outcome in older (65 years+) medical and surgical patients after discharge from hospital. Outcome goals were: re-admissions, survival, nutritional and functional status, quality of life...

  19. World Workshop on Oral Medicine VI : a systematic review of medication-induced salivary gland dysfunction

    NARCIS (Netherlands)

    Villa, Alessandro; Wolff, A.; Narayana, N.; Dawes, C.; Aframian, D. J.; Pedersen, A. M. Lynge; Vissink, A.; Aliko, A.; Sia, Y. W.; Joshi, R. K.; McGowan, R.; Jensen, S. B.; Kerr, A. R.; Ekstrom, J.; Proctor, G.

    2016-01-01

    The aim of this paper was to perform a systematic review of the pathogenesis of medication-induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and t

  20. Targeting Oral and Cultural Proficiency for Medical Personnel: An Examination of Current Medical Spanish Textbooks

    Science.gov (United States)

    Hardin, Karol

    2012-01-01

    Demand for medical Spanish courses has grown with the rising needs of Spanish-speaking patients in the United States, but while there is no shortage of beginning medical Spanish textbooks, very few target the intermediate level. This article examines eighteen medical Spanish texts published in the last twenty years with respect to seven factors:…

  1. 印尼复方穿心莲发酵蜂蜜汤剂“JAMSI”对高血糖患者的即刻降糖功效临床验证%Clinical Observation on The Immediate Hypoglycemic Effect of Andrographis-Fermented Honey Formula Herbal Oral Solution“Jamsi” on Hyperglycemic Volunteers

    Institute of Scientific and Technical Information of China (English)

    Ning Harmanto; Prapti Utami; Willie Japaries(叶伟生)

    2014-01-01

    Objective:To study the immediate hypoglycemic effect of Andrographis-fermented honey oral solution formula “JAMSI”( produced by PT Mahkotadewa Indonesia;registered at Indonesian Food and Drugs Authority:TR053649111) among 34 hyperglycemic volunteers .Methods:This study was designed as a pre and post treatment ’ s effect evaluation among hyperglycemic volunteers .Volun-teers were recruited from visitors to the “JAMSI” boothe during the study , who were hyperglycemic and ready to be tested with the “Jam-si” remedy under study .Their blood sugar were tested using glucometer Accu-Chek Active ( made in Germany ) before and one hour af-ter consuming the “JAMSI” oral solution.The paired blood sugar data were analyzed using student-t test with paired samples , one si-ded, with significance cut off point α=0.05.Results:During two study days on 16th and 23rd February 2013 in Jakarta, there were 34 volunteers eligible to the study .They consisted of 20 female and 14 male, among which 20 volunteers were still consuming western hypo-glycemic medicine.Their age ranged from 22 to 74 years (52.26 ±10.10 years), with diabetes mellitus history ranging from 1 to 33 years (9.36 ±8.27 years).Their average capillary blood sugar level before consumption of the tested “jamu” remedy was (243.03 ± 97.97) mg/dl and one hour after consumption of the remedy was (197.94 ±100.01) mg/dl.The difference was highly significant ( P0.05) between those still consuming oral antidiabetic drugs and those not consuming oral antidiabetic drugs.Conclusion:The “JAMSI” remedy under study showed very significant immediate hypoglycemic effect and apparently free from serious utoward effects among the tested volunteers .More studies are required to assess the medium and long term effects of the “JAM-SI” remedy.%目的:研究印尼复方穿心莲发酵蜂蜜汤剂”JAMSI”(由印尼PT Mahkotadewa Indonesia 公司生产;印尼食品药品管理局注册号:TR053649111

  2. Improving Patient Outcomes With Oral Heart Failure Medications.

    Science.gov (United States)

    Sherrod, Melissa M; Cheek, Dennis J; Seale, Ashlie

    2016-05-01

    Hospitals are under immense pressure to reduce heart failure readmissions that occur within 30 days of discharge, and to improve the quality of care for these patients. Penalties mandated by the Affordable Care Act decrease hospital reimbursement and ultimately the overall cost of caring for these patients increases if they are not well managed. Approximately 25% of patients hospitalized for heart failure are at high risk for readmission and these rates have not changed over the past decade. As a result of an aging population, the incidence of heart failure is expected to increase to one in five Americans over the age of 65. Pharmacologic management can reduce the risk of death and help prevent unnecessary hospitalizations. Healthcare providers who have knowledge of heart failure medications and drug interactions and share this information with their patients contribute to improved long-term survival and physical functioning as well as fewer hospitalizations and a delay of progressive worsening of heart failure.

  3. Alpha-Glucosidase Inhibition and Hypoglycemic Activities of Sweitenia mahagoni Seed Extract

    Directory of Open Access Journals (Sweden)

    Tutik Wresdiyat

    2015-04-01

    Full Text Available Inhibition of α-glucosidase and hypoglycemic activity are two effects commonly used to identify bioactive compounds with potential to treat diabetes. The objectives of this study were to analyse and compare the bioactive compounds and α-glucosidase inhibitory effect of four different types of Swietenia mahagoni seed extract, and to analyse the hypoglycemic activity of the greatest inhibition of α-glucosidase-extract in rats. The extracts were obtained using two different solvents (aqueous and ethanol and two different methods: maceration and reflux methods. This resulted in four types of extract varying by solvent and extraction method. Testing of these extracts for α-glucosidase inhibitory effect was carried out in vitro using spectrophotometer. Testing for hypoglycemic activity was carried out in vivo using rats. A total of 40 male Sprague-Dawley rats were divided into eight groups: (1 the negative control group, received an oral dose of aquadest only, (2 the positive control group, was given 90% sucrose orally without S. mahagoni seed extract, and five treated groups (3-7, were given 90% sucrose followed by the best extract-ethanolic S. mahagoni seed extract in doses of 100, 200, 300, 400, and 500 mg/kgBW, and (8 the acarbose group, was given 90% sucrose orally followed by acarbose. Glucose levels in each animal were measured at 0, 30, 60, 90, and 120 min after treatment. The results showed the greatest inhibition of α-glucosidase in ethanolic extract, using maceration methods. This ethanolic-maceration S. mahagoni seed extract also showed hypoglycemic effects in hyperglycemic rats at dose from 100 to 500 mg/kgBW. Ethanolic extract of S. mahagoni seed, using maceration method, can be proposed as potential antidiabetic agent.

  4. Singly-qualified medical senior house officer in oral and maxillofacial surgery: perspectives from a unit.

    Science.gov (United States)

    Solanki, Kohmal; Bhatti, Nabeel; Bridle, Christopher

    2016-06-01

    Despite constituting a minority of senior house officers (SHO) in oral and maxillofacial surgery (OMFS), the number of singly-qualified medical trainees is growing. We describe the experience of a singly qualified medical trainee in OMFS and the unique benefits and opportunities for potential trainees and the department. Overall, the advantages of synergistic training outweigh any deficiencies in knowledge, and in our experience, having both medical and dental trainees in our unit has maximised training opportunities and provided a more holistic approach to patient care. Increased exposure to conditions in the head and neck also benefits trainees who wish to pursue careers in other specialties such as ear, nose, and throat (ENT), neurosurgery, ophthalmology, and plastic surgery. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Silent myocardial infarction during hypoglycemic coma.

    Science.gov (United States)

    Mahajan, Varun Vijay; Dogra, Vikas; Pargal, Iesha; Singh, Navtej

    2012-01-01

    Hypoglycemia is a common complication of treatment of diabetes mellitus. The potential neurological complications of hypoglycemia as seizures and coma are well-recognized entities. A hypoglycemic episode is a risk factor for a patient with diabetes to have cardiovascular complications. Myocardial ischemia and infarction are known to occur in the setting of hypoglycemia. In view of the potential association of the two, the diabetic patients should undergo a routine ECG in such circumstances.

  6. Silent myocardial infarction during hypoglycemic coma

    Directory of Open Access Journals (Sweden)

    Varun Vijay Mahajan

    2012-01-01

    Full Text Available Hypoglycemia is a common complication of treatment of diabetes mellitus. The potential neurological complications of hypoglycemia as seizures and coma are well-recognized entities. A hypoglycemic episode is a risk factor for a patient with diabetes to have cardiovascular complications. Myocardial ischemia and infarction are known to occur in the setting of hypoglycemia. In view of the potential association of the two, the diabetic patients should undergo a routine ECG in such circumstances.

  7. Novel N-(pyrimidin-4-ylthiazol-2-amine derivatives as dual-action hypoglycemic agents that activate GK and PPARγ

    Directory of Open Access Journals (Sweden)

    Hui-peng Song

    2011-10-01

    Full Text Available A series of novel N-(pyrimidin-4-ylthiazol-2-amine derivatives have been synthesized and evaluated as glucokinase (GK activators. Ethyl 2-(6-(4-(2-hydroxyethylpiperazin-1-yl-2-methylpyrimidin-4-yl-aminothiazole-5-carboxylate was found to be a potent dual-acting hypoglycemic agent activating both GK and PPARγ. When given orally to normal mice, the compound demonstrated significant efficacy in decreasing the glucose level after oral glucose loading.

  8. Evaluation of hypoglycemic activity of inorganic constituents in Nelumbo nucifera seeds on streptozotocin-induced diabetes in rats.

    Science.gov (United States)

    Mani, Sivasankari S; Subramanian, Iyyam Pillai; Pillai, Subramanian Sorimuthu; Muthusamy, Kandaswamy

    2010-12-01

    The seeds of Nelumbo nucifera (Lotus) have been used in the traditional system of medicine for various ailments including diabetes. The present study was aimed at analyzing the levels of biologically important trace elements in the lotus seeds by atomic absorption spectroscopy and evaluating the hypoglycemic properties of seed ash on streptozotocin-induced diabetes in rats. Diabetic rats treated with lotus seed ash at a concentration of 200 mg/kg body weight orally for 30 days exhibited significant hypoglycemic activity. The presence of trace elements in appreciable amounts in the seeds may play a direct or indirect role on insulin secretion or its action in a synergetic manner. The hypoglycemic activity of the ash was comparable with glyclazide. The role of trace elements in disorders related to diabetes is also discussed briefly.

  9. Oral inflammation and infection, and chronic medical diseases: implications for the elderly.

    Science.gov (United States)

    Scannapieco, Frank A; Cantos, Albert

    2016-10-01

    Oral diseases, such as caries and periodontitis, not only have local effects on the dentition and on tooth-supporting tissues but also may impact a number of systemic conditions. Emerging evidence suggests that poor oral health influences the initiation and/or progression of diseases such as atherosclerosis (with sequelae including myocardial infarction and stoke), diabetes mellitus and neurodegenerative diseases (such as Alzheimer's disease, rheumatoid arthritis and others). Aspiration of oropharyngeal (including periodontal) bacteria causes pneumonia, especially in hospitalized patients and the elderly, and may influence the course of chronic obstructive pulmonary disease. This article addresses several pertinent aspects related to the medical implications of periodontal disease in the elderly. There is moderate evidence that improved oral hygiene may help prevent aspiration pneumonia in high-risk patients. For other medical conditions, because of the absence of well-designed randomized clinical trials in elderly patients, no specific guidance can be provided regarding oral hygiene or periodontal interventions that enhance the medical management of older adults.

  10. An assessment of medical doctors′ perception of possible interrelationship between oral and general health

    Directory of Open Access Journals (Sweden)

    O I Opeodu

    2014-01-01

    Full Text Available Background: The possibility of some systemic diseases having oral manifestation is well established with the recent discovery that some oral diseases also adversely affect the general health of an individual. The question is, is the relationship casual or causal? Aim: To assess the perception of medical doctors concerning the possible link of oral diseases as causal/confounding factors of systemic diseases. Materials and Methods: A cross-sectional survey of 250 medical doctors was carried out in three tertiary health institutions in Nigeria. Questionnaires were distributed to resident doctors to assess their perception as to the possibility of any causal relationship between the general systemic diseases and oral diseases. Results: Two-hundred and seven completely filled questionnaires were returned out of the 250 distributed. Over 50% of the respondents strongly agreed to the fact that there is a link between oral diseases and conditions such as diabetes mellitus, rheumatic heart disease, valvular heart disease, and human immunodeficiency virus/acquired immune deficiency syndrome HIV/AIDS. Hypertension and premature low birth weight has the highest percentage (18.8% of respondents strongly disagreeing with the possibility of having any link with the state of the oral health. There was a statistically significant difference in the perception of the possible link between the state of oral health and myocardial infarction between male and female respondents (P < 0.04 and also when the age-groups were considered in relationship with valvular heart disease (P < 0.02. Conclusion: This study revealed that doctors′ perception of the influence of dental disease/condition on the general state of patients′ health was deficient and, therefore, require improvement through health education and awareness.

  11. [Synthesis and hypoglycemic activity of bis(L-malato)oxovanadium(IV)].

    Science.gov (United States)

    Gorodetskiĭ, V K; Tochilkin, A I; Beliaeva, N F; Kovel'man, I R; Korovkin, B F

    2011-01-01

    In order to create new oral vanadyl organic complexes-based drugs for the treatment of diabetes mellitus biligand vanadyl derivative of L-malic acid (bis(L-malato)oxovanadium(IV) was prepared and its potential as a novel hypoglycemic agent was studied in the streptozotocin-diabetic rats. We show that the oral administration of bis(L-malato)oxovanadium(IV) with drink water significantly reduced glucose concentration in blood and urine, as well as the level of glycated proteins in the streptozotocin-diabetic rats.

  12. Video-based feedback of oral clinical presentations reduces the anxiety of ICU medical students: a multicentre, prospective, randomized study

    OpenAIRE

    Schmidt, Matthieu; Freund, Yonathan; Alves, Mickael; Monsel, Antoine; Labbe, Vincent; Darnal, Elsa; Messika, Jonathan; Bokobza, Jerome; Similowski, Thomas; Duguet, Alexandre

    2014-01-01

    International audience; Background: Oral presentations of clinical cases by medical students during medical rounds in hospital wards are a source of anxiety and little is known about how this anxiety can be alleviated. The objective of this study was to investigate whether video-based feedback of public oral presentations can reduce anxiety in 4th year medical students. Methods: Multicentre randomized study conducted in six intensive care units (ICU) and emergency departments (ED) in France o...

  13. Cost-effectiveness analysis of type 2 diabetes mellitus with oral hypoglycemic drugs in Shunde district%顺德地区2型糖尿病患者口服降糖药的成本-效果分析

    Institute of Scientific and Technical Information of China (English)

    汪周艳; 张丽萍

    2011-01-01

    Objechve: To finish the pharmacoeconomics evaluation on oral hypoglycemic agents in patients with type 2 diabetes meUitus, with reasonably selecting high titer oral hypoglycemic agents to control blood glucose level, for the sake of having a safe, effective, reasonable and economic effect to relief Lhe burdens of patients and society.Methods: The study group and control groups were set up to be researched.400 patients who were diagnosed type 2 diabetes according to the diabetes diagnostic criteria made by American Diabetes Society in 2003 were selected to participate in experiment.They were separated to 1 group as study group (group A) and 3 control groups as control group B.C, D with each goup 100 persons Group A was treated by Gliciazide combined with Metformin (voglibose was used instead of Gibenclami in patients who had significant hypoglycemic reaction).Group B was treated by Rosiglitazone combined with Voglibose.Croup C was treated by Acarbose combined with Repaglinide.Group D was treated by Glimepinde combined with Voglibose.The blood glucose level of patients in each group was regulady monitored.When the experiment ended, the Pharmacoeconomics Evaluation was carried on.Results: It was found that drug cost per day of group A and.total drug cost were obviously lower than that of group B, C, D (P<0.001).But the measuring of FBG, 2hPBG and Glycosylated hemoglobin, in the 4 groups was almost the same and the Hypoglycemia average month incidence and the incidence of advrerse reaction of experiment group by diabetes education didn't have significant difference than that of observation group (P>0.05).Conclusion: The treatment method of group A is the most safe and effective.It was also superior in economy than other three groups%目的:通过对2型糖尿病患者口服降糖药物的药物经济学评价,选择成本效果比最小的给药方案,达到安全、有效、合理、经济用药的效果,减轻患者和社会的负担.方法:在根据2003

  14. Knowledge and risk perception of oral cavity and oropharyngeal cancer among non-medical university students.

    Science.gov (United States)

    Osazuwa-Peters, Nosayaba; Tutlam, Nhial T

    2016-01-28

    To assess non-medical university students' knowledge and perceived risk of developing oral cavity and oropharyngeal cancer. A cross-sectional survey was conducted among non-medical students of a private Midwestern university in the United States in May 2012. Questionnaire assessed demographic information and contained 21 previously validated questions regarding knowledge and perceived risk of developing oral cavity and oropharyngeal cancer. Knowledge scale was categorized into low and high. Risk level was estimated based on smoking, drinking, and sexual habits. Bivariate associations between continuous and categorical variables were assessed using Pearson correlation and Chi-square tests, respectively. The response rate was 87% (100 out of 115 students approached). Eighty-one percent (81%) had low oral cavity and oropharyngeal cancer knowledge; and only 2% perceived that their oral cavity and oropharyngeal cancer risk was high. Risk perception was negatively correlated with age at sexual debut, r (64) = -0.26, p = 0.037; one-way ANOVA showed a marginally significant association between risk perception and number of sexual partners, F(4, 60) = 2.48, p = 0.05. There was no significant association between knowledge and perception of risk; however, oral cavity and oropharyngeal cancer knowledge was significantly associated with frequency of prevention of STDs (p perception is low among this student population. Since oral cavity and oropharyngeal cancer incidence is increasingly shifting towards younger adults, interventions must be tailored to this group in order to improve prevention and control.

  15. Oral hygiene products, medications and drugs - hidden aetiological factors for dental erosion.

    Science.gov (United States)

    Hellwig, Elmar; Lussi, Adrian

    2014-01-01

    Acidic or EDTA-containing oral hygiene products and acidic medicines have the potential to soften dental hard tissues. The low pH of oral care products increases the chemical stability of some fluoride compounds and favours the incorporation of fluoride ions in the lattice of hydroxyapatite and the precipitation of calcium fluoride on the tooth surface. This layer has some protective effect against an erosive attack. However, when the pH is too low or when no fluoride is present these protecting effects are replaced by direct softening of the tooth surface. Oral dryness can occur as a consequence of medication such as tranquilizers, antihistamines, antiemetics and antiparkinsonian medicaments or of salivary gland dysfunction. Above all, patients should be aware of the potential demineralization effects of oral hygiene products with low pH. Acetyl salicylic acid taken regularly in the form of multiple chewable tablets or in the form of headache powder, as well as chewing hydrochloric acids tablets for the treatment of stomach disorders, can cause erosion. There is most probably no direct association between asthmatic drugs and erosion on the population level. Consumers and health professionals should be aware of the potential of tooth damage not only by oral hygiene products and salivary substitutes but also by chewable and effervescent tablets. Several paediatric medications show a direct erosive potential in vitro. Clinical proof of the occurrence of erosion after use of these medicaments is still lacking. However, regular and prolonged use of these medicaments might bear the risk of causing erosion. Additionally, it can be assumed that patients suffering from xerostomia should be aware of the potential effects of oral hygiene products with low pH and high titratable acidity.

  16. What to do when people with Parkinson's disease cannot take their usual oral medications.

    Science.gov (United States)

    Alty, Jane; Robson, Jeremy; Duggan-Carter, Philippa; Jamieson, Stuart

    2016-04-01

    People with Parkinson's disease have limited brain reserves of endogenous dopamine; thus, their medications must not be omitted or delayed as this may lead to a significant drop in brain dopamine levels. This has two main clinical consequences: first, a deterioration in disease control, with distressing symptoms such as tremor, pain, rigidity, dysphagia and immobility, and second, an increased risk of developing the life-threatening complication of neuroleptic malignant-like syndrome. Common reasons for people with Parkinson's disease being unable to take their oral medications are neurogenic dysphagia from progressive disease or concurrent illness, gastroenteritis, iatrogenic 'nil by mouth' status especially perioperatively, and impaired consciousness level. Here we outline alternative methods to give dopaminergic drugs in the acute setting to people with Parkinson's disease who cannot take their usual oral treatment, namely using dispersible preparations in thickened fluids, an enteral tube, a transdermal patch or subcutaneous injections.

  17. What to do when patients with epilepsy cannot take their usual oral medications.

    Science.gov (United States)

    Bank, Anna M; Lee, Jong Woo; Krause, Patricia; Berkowitz, Aaron L

    2017-01-01

    When people with epilepsy are hospitalised for medical or surgical conditions, they may be unable to take their home antiepileptic drugs (AEDs). Such 'nil by mouth' people with epilepsy require alternative AED regimens to prevent breakthrough seizures. Here, we describe several strategies for maintaining seizure control in patients with epilepsy who have medical or surgical contraindications to their home oral regimens. These strategies include using non-pill oral formulations, using an intravenous formulation of the patient's home AED(s), using a benzodiazepine bridge and/or using alternative intravenous AED(s) when there are no intravenous formulations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Strategies for English Oral Skill Improvement Employed by Medical College Students

    Institute of Scientific and Technical Information of China (English)

    喻蓉

    2011-01-01

    Research in language learning strategies has addressed the necessity of improving oral skills in second language acquisition.This study attempts to explore the strategies employed by 19 medical students at Qiannan Medical College for Nationalities to improve their oral skills.Semi-structured interview and open-ended questionnaire were used as the instruments for the data collection.The data was then analyzed qualitatively for the purpose of the study.The findings of the study showed that the strategies employed by the students mainly indude the strategies to improve speaking skills and the strategies to improve listening skills.The strategies to improve speaking skills include two main categories:fluency-focused strategies and accuracy-focused strategies.The strategies to improve listening skills also include two main categories:direct strategies and indirect strategies.

  19. Interactions between oral antineoplastic agents and concomitant medication: a systematic review.

    Science.gov (United States)

    Carcelero, Esther; Anglada, Helena; Tuset, Montse; Creus, Natalia

    2013-05-01

    In recent years, the number of oral antitumoral agents has considerably increased. Oral administration increases the risk of interactions, because most oral anticancer drugs are taken on a daily basis. Interactions can increase exposure to antitumoral agents or cause treatment failure. Many antitumoral drugs undergo enzymatic metabolism by cytochrome P450. As some act as inducers or inhibitors of one or more isoenzymes, they can lead to decreases or increases in plasma concentrations of concomitant drugs. Hence, cytostatic drugs can act not only as victims but also as perpetrators. P-glycoprotein, an efflux transporter, can also be involved in pharmacokinetic interactions. A Medline search was performed to summarize the available evidence of the most clinically relevant interactions between oral chemotherapy agents and other drugs. The search covered the period from 1966 until August 2012 for each antitumoral drug using the medical subject headings 'Drug Interactions' OR 'Pharmacokinetics'. While the present review is not exhaustive, it aims to increase clinicians' awareness of potential drug-drug interactions. As cancer patients are often polymedicated and treated by different physicians, the risk of drug interactions between antitumoral agents and other medications is high. More clinical interaction studies are encouraged to ensure appropriate antineoplastic pharmacokinetics in clinical practice.

  20. Randomized trial of oral versus sublingual misoprostol 24 h after mifepristone for medical abortion.

    Science.gov (United States)

    Dahiya, Krishna; Mann, Sonika; Nanda, Smiti

    2011-07-01

    To assess the efficacy, side effects, and acceptability of medical abortion using oral mifepristone (200 mg) followed 24 h later by oral or sublingual misoprostol (400 μg). A total of 93 women with pregnancies up to 56 days of gestational age were assigned to two groups according to the different misoprostol regimen (group I 400 μg orally and group II 400 μg sublingually). The principle outcome measure was complete abortion defined as a complete expulsion of intrauterine contents without a need for surgical intervention 7 days after the procedure. Successful abortion occurred in 87.5% of patients in group 1 and 95.5% patients in group 2 (p = 0.166, 95% CI -0.194, 0.033). The patient acceptability and satisfaction rates were similar in both the groups. It is concluded that 400 μg of sublingual misoprostol is as effective as oral misoprostol 24 h after mifepristone for medical abortion of ≤ 56 days.

  1. STUDY OF ORAL MIDAZOLAM AS A PREANAESTHTIC MEDICATION FOR ELECTIVE SURGERY IN PAEDIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Jaya

    2014-12-01

    Full Text Available : BACKGROUND: Pre anaesthetic medication is a real challenge specially in cases of paediatric age group. A good quality oral preanaesthetic must fulfill criteria like easily application, rapid absorption, short duration of action and have minimal side effect. Present study carried out with objective of evaluation of oral Midazolam as a pre-anaesthetic in elective surgical cases in paediatric age group. METHODS: Paediatric cases for elective surgery were included for receiving oral midazolam (0.5/kg pre anaesthetic medication in prospective observational study. Total 50 cases from age group (01-10 yrs, weight (13-23kg, ASA grading I & II, normo-tensive patients were selected. Evaluation of drug was assessed with a scale from 1-4 which includes sedation, separation from parent, and child behaviour at induction. Data analyzed with percentage and mean standard deviation of the scale score. RESULTS: Sedation score mean after pre medication was 2.76+ 0.58. Child behaviour at the time of separation from parents score mean was 2.96+ 0.44. Mean score of behaviour of child during induction was 2.80+0.49. 70% of the cases achieved sedation, 86 % of the cases achieved separation from parents while 76% of the cases had more than 2 score of child behaviour at the time of induction. CONCLUSION: Oral midazolam as a preanaesthetic medication in children allay the anxiety & facilitate separation of children from their parents when they enter surgical unit. These can be overcome by lower degree of sedation in our study.

  2. Adherence to depot versus oral antipsychotic medication in schizophrenic patients during the long-term therapy

    Directory of Open Access Journals (Sweden)

    Stanković Žana

    2013-01-01

    Full Text Available Background/Aim. There is a high rate of schizophrenic patients who do not adhere to their prescribed therapy, despite the implementation of antipsychotic long-acting injections and the introduction of atypical antipsychotics. The aim of this study was to investigate the differences in sociodemographic, clinical and medication adherence variables between the two groups of schizophrenic patients on maintenance therapy with depot antipsychotic fluphenazine decanoate and oral antipsychotics only as well as a correlation between the medication adherence and other examined variables. Methods. A total of 56 patients of both genders, aged < 60 years, with the diagnosis of schizophrenia (F20 (ICD-10, 1992 clinically stable for at least 6 months were introduced in this cross-sectional study. The patients from the depot group (n = 19 were on classical depot antipsychotic fluphenazine decanoate administering intramuscularly every 4 weeks (with or without oral antipsychotic augmentation and the patients from the oral group (n = 37 were on oral therapy alone with classical or atypical antipsychotics, either as monotherapy or combined. The Positive and Negative Syndrome Scale (PANSS was used to assess symptom severity. Item G12 of the PANSS was used to assess insight into the illness. The patients completed the Medical Adherence Rating Scale (MARS was used to assess adherence to the therapy. A higher MARS score indicates behavior [Medical Adherence Questionnaire (MAQ subscale] and attitudes toward medication [Drug Attitude Inventory (DAI subscale] that are more consistent with treatment adherence. The exclusion criteria were determined. The Pearson's χ2 test was used to compare categorical variables, Student's t-test to compare continuous variables and Pearson's correlation to test the correlation significance; p = 0.05. Results. Significant betweengroup differences in age, illness duration, chlorpromazine equivalents, PANSS score and DAI subscore were found

  3. Ulceration of the oral mucosa induced by antidepressant medication: a case report

    Directory of Open Access Journals (Sweden)

    Bertini Fernanda

    2009-11-01

    Full Text Available Abstract Introduction Ulcers are frequent lesions of the oral mucosa. Generally, they are circumscribed round or elliptical lesions surrounded by an erythematous halo and covered with an inflammatory exudate in their central portion, and are accompanied by painful symptoms. Oral ulcers affect 20% of the population, especially adolescents and young adults. The etiopathogenesis includes immunological alterations, infections, nutritional deficiency, trauma, food and contact allergies, autoimmune diseases, neoplasms, and psychosomatic, genetic and environmental factors. Case presentation A 78-year-old Caucasian woman was referred by her dentist to our outpatient clinic with a 4-week history of an oral ulceration after using an antidepressant (sertraline hydrochloride. On the basis of the clinical findings and anamnesis, the occurrence of the lesion was attributed to the use of the drug. Exfoliative cytology was performed, to reassure the patient that it was not oral cancer, which revealed the presence of a nonspecific inflammatory reaction. The drug was replaced and resolution of symptoms was observed. Conclusion Exfoliative cytology should be the complementary examination of choice in cases of oral ulcers with a suspicion of drug interaction. Although this is a rare event in dental practice, dentists should be aware of the diagnostic possibility of drug-induced ulcers and should cooperate with the clinician to adjust the prescribed medication to resolve the symptoms.

  4. Barriers to adult hemodialysis patients' self-management of oral medications.

    Science.gov (United States)

    Browne, Teri; Merighi, Joseph R

    2010-09-01

    Hemodialysis patients use a variety of oral medications on a daily basis to control their kidney disease and comorbid illnesses. Under the new paradigm of kidney disease care for dialysis units outlined in the 2008 US Centers for Medicare & Medicaid Services Conditions for Coverage, there has been a formal shift in the role of the hemodialysis patient from a passive participant in care planning to a fully collaborative member of the interdisciplinary team. In the chronic disease care field, the focus from patient compliance or patient adherence to patient self-management complements this paradigm shift in dialysis care. In this narrative review, we discuss key barriers to adult hemodialysis patient self-management of oral medications that include pill burden, demographic and socioeconomic variables, psychosocial factors, health literacy, patient satisfaction, and health beliefs. We further examine these barriers in the context of the 2008 Medicare Conditions for Coverage. To promote hemodialysis patients' self-management of oral medication regimens, additional research and behavioral interventions are needed to help hemodialysis patients overcome obstacles that impede their ability to effectively manage chronic illness and improve health outcomes.

  5. Oral cancer--current knowledge, practices and implications for training among an Irish general medical practitioner cohort.

    LENUS (Irish Health Repository)

    Ni Riordain, Richeal

    2009-11-01

    This study investigated the current knowledge and practices of general medical practitioners (GMPs) in Ireland regarding the examination of the oral cavity and the detection of oral malignancy and the training they had received at both undergraduate and postgraduate level and since commencing in practice. A questionnaire survey of GMPs in Ireland was conducted. One hundred and fifty four (65.3%) of the practitioners reported regularly examining the oral mucosa of their patients. Almost half of these (n=68) further qualified this response by stating that they only examined the oral mucosa if the patient reported pain in this area or if the patient specifically requested an oral examination for some reason. Eighty one (34.3%) practitioners surveyed felt confident in their ability to detect oral malignancies with the remaining two thirds unsure of whether they would be able to detect oral cancer. There was a significant association between the undergraduate and postgraduate teaching on examination of the oral cavity and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=4.811, p<0.05]. A statistically significant association was also found between the undergraduate and postgraduate teaching on the diagnosis of oral malignant disease and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=6.194, p<0.05]. In conclusion the level of knowledge of Irish general medical practitioners needs to be addressed with appropriate initiatives both at undergraduate level and via CME.

  6. Use of oral antihypertensive medication preceding blood pressure elevation in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Macedo Cristiano Ricardo Bastos de

    2001-01-01

    Full Text Available OBJECTIVE: To evaluate the frequency of oral antihypertensive medication preceding the increase in blood pressure in patients in a university hospital, the drug of choice, and the maintained use of antihypertensive medication. METHODS: Data from January to June 1997 from the University Hospital Professor Edgard Santos Pharmacy concerning the prescriptions of all inpatients were used. Variables included in the analysis were: antihypertensive medication prescription preceding increase in blood pressure, type of antihypertensive medication, gender, clinical or surgical wards, and the presence of maintained antihypertensive medication. RESULTS: The hospital admitted 2,532 patients, 1,468 in surgical wards and 818 in medical wards. Antihypertensive medication prescription preceding pressure increase was observed in 578 patients (22.8%. Nifedipine was used in 553 (95.7% and captopril in 25 (4.3%. In 50.7% of patients, prescription of antihypertensive medication was not associated with maintained antihypertensive medication. Prescription of antihypertensive drugs preceding elevation of blood pressure was significantly (p<0.001 more frequent on the surgical floor (27.5%; 405/1468 than on the medical floor (14.3%; 117/818. The frequency of prescription of antihypertensive drugs preceding elevation of blood pressure without maintained antihypertensive drugs and the ratio between the number of prescriptions of nifedipine and captopril were greater in surgical wards. CONCLUSION: The use of antihypertensive medication, preceding elevation of blood pressure (22.8% observed in admitted patients is not supported by scientific evidence. The high frequency of this practice may be even greater in nonuniversity hospitals.

  7. Evaluación de un programa de educación médica continua para la atención primaria en la prescripción de hipoglucémicos An evaluation of a continuing medical education program for primary care services in the hypoglycemic agent’s prescription in diabetes mellitus type 2

    Directory of Open Access Journals (Sweden)

    Angélica Castro-Ríos

    2008-01-01

    Full Text Available OBJETIVO: Evaluar el efecto en la prescripción de hipoglucémicos de un programa de educación médica continua en unidades de medicina familiar (UMF. MATERIAL Y MÉTODOS: Se realizó un estudio observacional que comparó dos grupos (con y sin programa con dos cortes transversales (antes y después. La unidad de análisis fue la consulta. El periodo de análisis comprendió seis meses anteriores y seis posteriores a la institución del programa. La principal variable de resultado fue la prescripción adecuada, evaluada mediante dos criterios: elección e indicación correctas. El análisis incluyó modelos de regresión logística, se aplicó la técnica de dobles diferencias y se ajustó por variables relativas al paciente, la consulta y la UMF; las más relevantes fueron sexo, obesidad, otras afecciones, número de consultas, número de medicamentos, tamaño de la clínica, grupo y etapa. RESULTADOS: Se obtuvo un incremento atribuible al programa de 0.6% en la probabilidad de prescripción adecuada y de 11% en la elección correcta en pacientes obesos.OBJECTIVE: To evaluate the impact of a continuing medical education program on family doctors to improve prescription of hypoglycemic drugs. MATERIAL AND METHODS: An observational study was conducted with two groups of comparison (with-without program and before-after periods. The unit of analysis was the visit. The period of evaluation comprised six months before and six after implementing the program. The outcome variable was the appropriateness of prescription that was based upon two criteria: appropriate selection and proper indication of the drug. Logistic regression models and the double differences technique were used to analyze the information. Models were adjusted by independent variables related with the patient, the visit and the PCC, the more relevant ones were: sex, obesity, conditions other than diabetes, number of visits in the analyzed period, number of drugs prescribed, size of

  8. Consensus guidelines for oral dosing of primarily renally cleared medications in older adults.

    Science.gov (United States)

    Hanlon, Joseph T; Aspinall, Sherrie L; Semla, Todd P; Weisbord, Steven D; Fried, Linda F; Good, C Bernie; Fine, Michael J; Stone, Roslyn A; Pugh, Mary Jo V; Rossi, Michelle I; Handler, Steven M

    2009-02-01

    To establish consensus oral dosing guidelines for primarily renally cleared medications prescribed for older adults. Literature search followed by a two-round modified Delphi survey. A nationally representative survey of experts in geriatric clinical pharmacy. Eleven geriatric clinical pharmacists. After a comprehensive literature search and review by an investigative group of six physicians (2 general internal medicine, 2 nephrology, 2 geriatrics), 43 dosing recommendations for 30 medications at various levels of renal function were created. The expert panel rated its agreement with each of these 43 dosing recommendations using a 5-point Likert scale (1=strongly disagree to 5=strongly agree). Recommendation-specific means and 95% confidence intervals were estimated. Consensus was defined as a lower 95% confidence limit of greater than 4.0 for the recommendation-specific mean score. The response rate was 81.8% (9/11) for the first round. All respondents who completed the first round also completed the second round. The expert panel reached consensus on 26 recommendations involving 18 (60%) medications. For 10 medications (chlorpropamide, colchicine, cotrimoxazole, glyburide, meperidine, nitrofurantoin, probenecid, propoxyphene, spironolactone, and triamterene), the consensus recommendation was not to use the medication in older adults below a specified level of renal function (e.g., creatinine clearance <30 mL/min). For the remaining eight medications (acyclovir, amantadine, ciprofloxacin, gabapentin, memantine, ranitidine, rimantadine, and valacyclovir), specific recommendations for dose reduction or interval extension were made. An expert panel of geriatric clinical pharmacists was able to reach consensus agreement on a number of oral medications that are primarily renally cleared.

  9. Surviving with lung cancer: medication-taking and oral targeted therapy.

    Science.gov (United States)

    Wickersham, Karen E; Happ, Mary Beth; Bender, Catherine M; Engberg, Sandra J; Tarhini, Ahmad; Erlen, Judith A

    2014-01-01

    Oral epidermal growth factor receptor inhibitors (EGFRIs) improve survival for non-small cell lung cancer (NSCLC) patients; however, medication-taking implications are unknown. We used grounded theory to explore the process of medication-taking for NSCLC patients receiving oral EGFRIs. Thirty-two interviews were conducted for 13 participants purposively selected for gender, race/ethnicity, age, time in therapy, dose reductions, and therapy discontinuation and theoretically sampled for age and health insurance carrier. The study produced a grounded theory, Surviving with Lung Cancer, in which participants framed EGFRI therapy within recognition of NSCLC as a life-limiting illness without cure. Medication-taking was a "window" into participants' process of surviving with metastatic cancer that included deciding and preparing to take EGFRIs and treating lung cancer as a chronic condition. Our results contribute to understanding how NSCLC patients view themselves in the context of a life-limiting illness and support development of a theoretically-based intervention to improve medication-taking with EGFRIs.

  10. Knowledge, attitude and awareness of speciality of oral and maxillofacial surgery amongst medical consultants of vadodara district in gujarat state.

    Science.gov (United States)

    Shah, Navin; Patel, Nameeta; Mahajan, Amit; Shah, Rishabh

    2015-03-01

    Aim of this study was to survey the knowledge, attitude and awareness of the subject of oral and maxillofacial surgery speciality amongst the consultants and practitioners of medicine in district of Vadodara. List of members of various specialities in medical faculty were obtained from Indian Medical Association, Baroda branch and staff members of medical colleges of Vadodara district. A questionnaire survey was made which was distributed and their options were noted. Surgical removal of third molar, oral submucous fibrosis and implants were the problems where oral surgeons were preferred. For maxillofacial trauma plastic surgeons and orthopaedic surgeons were preferred than oral surgeons. For maxillofacial pathology E.N.T surgeons were mostly preferred. There is low awareness regarding oral and maxillofacial surgery amongst the general practitioners and medical consultants in Vadodara district. Survey shows that our training needs to be upgraded and revamped so that our trainees (post graduates in oral surgery) and have a greater "hands-on" exposure during their postgraduate training. They will then be able to handle increasingly complex cases in a multispecialty setup when they graduate and earn the mutual respect of the medical and dental fraternity and also the general public. MBBS students during their dental postings should be made aware of the depth and scope of oral surgery branch.

  11. Family history of cancer, personal history of medical conditions and risk of oral cavity cancer in France: the ICARE study.

    OpenAIRE

    Radoï, Loredana; Paget-Bailly, Sophie; Guida, Florence; Cyr, Diane; Menvielle, Gwenn; Schmaus, Annie; Carton, Matthieu; Cénée, Sylvie; Sanchez, Marie; Guizard, Anne-Valérie; Trétarre, Brigitte; Stücker, Isabelle; Luce, Danièle

    2013-01-01

    International audience; BACKGROUND: The aim of this study was to evaluate the role of family history of cancer and personal history of other medical conditions in the aetiology of the oral cavity cancer in France. METHODS: We used data from 689 cases of oral cavity squamous cell carcinoma and 3481 controls included in a population-based case--control study, the ICARE study. Odds-ratios (ORs) associated with family history of cancer and personal medical conditions and their 95% confidence inte...

  12. Medication adherence to oral iron therapy in patients with iron deficiency anemia

    Science.gov (United States)

    Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Erdogan, Ferit; Kut, Altug

    2016-01-01

    Objective: This study aimed at investigating the factors affecting medication adherence in patients who use oral iron therapy due to iron deficiency anemia. Methods: A total of 96 female patients in fertile age with mean age of 30±10.1 years (range 18-53) who were admitted to Family Medicine Clinic between 01 January and 31 March 2015 and who had received iron therapy within the recent three years were enrolled in the study. Data were collected through a questionnaire form. Results: Of the patients, 39 (40,6%) were detected not to use the medication regularly or during the recommended period. A statistically significant relationship was found between non-adherence to therapy and gastrointestinal side effects and weight gain (p<0.05). Conclusion: Medication adherence is deficient in patients with iron deficiency anemia. The most important reason for this seems gastrointestinal side effects, in addition to weight gain under treatment. PMID:27375698

  13. Hypoglycemic and Hepatoprotective Activity of Fermented Fruit Juice of Morinda citrifolia (Noni in Diabetic Rats

    Directory of Open Access Journals (Sweden)

    B. Shivananda Nayak

    2011-01-01

    Full Text Available Morinda citrifolia is a medicinal plant used to treat diabetes and liver diseases. The fermented fruit juice of the M. Citrifolia (optical density = 1.25 was used to study the hypoglycemic and hepatoprotective properties in diabetes-induced rats. The rats were randomly distributed into 4 groups (control, diabetic experimental, diabetic standard, and diabetic untreated of 6 each. Diabetes was induced by administering Streptozotocin (50 mg/kg body weight. Fasting blood glucose, body mass, liver tissue glycogen content, and the extent of liver degeneration were assessed. Diabetic experimental animals were treated with M. citrifolia juice (2 ml/kg, twice a day and diabetic standard with reference hypoglycemic drug, glibenclamide orally for 20 days. Both the groups exhibited a significant reduction in blood glucose level of 150 mg/dl ±15.88 and 125 mg/dl ±3.89, respectively, as compared to diabetic untreated with FBS = 360.0 mg/dl ±15.81, (<.003. On 10th day of experiment, diabetic experimental animals exhibited a decrease in body mass (10.2 g, 5.11% which increased significantly by the 20th day (6 g, 3.0%, <.022. Histological study of liver tissue obtained from untreated diabetic animals revealed significant fatty degeneration as compared to other three groups. The data of this study proved the hypoglycemic and hepatoprotective activity of M. citrifolia.

  14. Comparison of different effects of oral hypoglycemic agents and insulin therapy on β-cell function in patients with newly diagnosed Type 2 Diabetes%口服药及胰岛素治疗对初发2型糖尿病患者β细胞功能影响的比较

    Institute of Scientific and Technical Information of China (English)

    邓敏

    2011-01-01

    目的 观察口服药及胰岛素治疗对初发2型糖尿病患者β细胞功能的不同影响.方法 68例初诊2型糖尿病患者在饮食及运动干预下,随机分为胰岛素组(Ins)33例及口服药组(OHA)35例,观察两组治疗前后FPG、2hPG、HbA1c、C-p、Ins等相关指标.用胰岛素抵抗指数(HOMA-IR)评价胰岛素敏感性,用胰岛β细胞功能指数(HOMA-β)评价β细胞功能,用胰岛素初期分泌功能指数(△I30/△G30)评价糖负荷早期β细胞的分泌功能,并计算胰岛素曲线下面积(AUGIns).结果 (1)随访至 12个月时,Ins组和OHA组的HOMA-β、△I30/△G30、AUGIns均较治疗前明显升高,但Ins组效果优于OHA组,与OHA组比较差异有统计学意义(P<0.01);(2)HOMA-β、△I30/△G30及AUGIns水平均较治疗前显著升高(P<0.01),Ins组较OHA组升高更显著,差异有统计学意义(P<0.01).结论 对初发2型糖尿病患者选择胰岛素治疗可以更好地保护胰岛β细胞功能,而且这种保护可以产生长期的影响.%Objective To observe the different effects of oral hypoglycemic agents and insulin therapy on β-cell function in patients with newly diagnosed Type 2 Diabetes (T2DM). Methods 68 newly diagnosed Type 2 diabetes patients,paralleled with the treatment of diet and physical exercise,were assigned to therapy with insulin (Ins, 33) or oral hypoglycaemic agents ( OHA, 35 ) randomly. Related parameters, including: FPG、 2hPG、 HbA1c、 C-p and Ins,were observed before and after the treatment. The insulin sensitivity was evaluated by HOMA-IR. The β-cell function was evaluated by HOMA-β. And the early phage secretion function of β-cell was evaluated with ΔI30/Δ G30 , and AUGIns was calculated. Results (1) After 12 months follow-up,the levels of HOMA-β、ΔI30/Δ G30 and AUGIns were significantly elevated in these two groups. And the insulin group group was superior to OHA group. There were significant differences of the change of these characteristics between the two

  15. Reducing oral and maxillofacial surgery resident risk exposure: lessons from graduate medical education reform.

    Science.gov (United States)

    Buhrow, Suzanne Morse; Buhrow, Jack A

    2013-12-01

    It is estimated that, in the United States, more than 40,000 patients are injured each day because of preventable medical errors. Although numerous studies examine the causes of medical trainee errors and efforts to mitigate patient injuries in this population, little research exists on adverse events experienced by oral and maxillofacial surgery (OMFS) residents or strategies to improve patient safety awareness in OMFS residency programs. The authors conducted a retrospective literature review of contemporary studies on medical trainees' reported risk exposure and the impact of integrating evidence-based patient safety training into residency curricula. A review of the literature suggests that OMFS residents face similar risks as medical trainees in medical, surgical, and anesthesia residency programs and may benefit from integrating competency-based safety training in the OMFS residency curriculum. OMFS trainees face particular challenges when transitioning from dental student to surgical resident, particularly related to their limited clinical exposure to high-reliability organizations, which may place them at higher risk than other medical trainees. OMFS educators should establish resident competence in patient safety principles and system improvement strategies throughout the training period.

  16. Hypoglycemic, antihyperglycemic, and antioxidant effects of the edible plant Anoda cristata.

    Science.gov (United States)

    Juárez-Reyes, Krutzkaya; Brindis, Fernando; Medina-Campos, Omar N; Pedraza-Chaverri, José; Bye, Robert; Linares, Edelmira; Mata, Rachel

    2015-02-23

    Some studies refer that the entire plant of Anoda cristata is consumed as food and medicine; in particular for treating diabetes, inflammation, fever, cough, and wounds. The aim of this study was to establish the preclinical efficacy of Anoda cristata as hypoglycemic and/or antihyperglycemic agent using well-known animal models. The acute toxicity was analyzed by the Lorke method. Acute hypoglycemic as well as oral glucose and sucrose tolerance tests were used to determine the hypoglycemic and antihyperglycemic action of Anoda cristata. Several preparations of the plant, including a mucilage (M), an aqueous (T-AE), a free mucilage aqueous (FM-AE), and an organic (OE) extracts, were tested in healthy and NA-STZ-hyperglycemic mice. Glibenclamide (15mg/kg), acarbose (5mg/kg ) and metformin (200mg/kg) were used as positive controls. The major compounds acacetin (1) and diosmetin (2), isolated from an infusion of the plant applying chromatographic methods, were evaluated as hypoglycemic agents using the same assays. The FM-AE was tested also in rats with metabolic syndrome induced by a high-fructose fed. Finally some assays were performed to determine the antioxidant capacity of the FM-AE in vitro. The results demonstrated that the extracts and compounds from Anoda cristata were effective for reducing blood glucose levels in healthy and NA-STZ-hyperglycemic mice when compared with vehicle groups (pAnoda cristata is effective to diminish glucose levels in vivo and to ameliorate different disorders related with the metabolic syndrome in rats. According to the results, the efficacy of Anoda cristata preparations could be due to the presence of active principles with different mode of actions at the molecular level, including α-glycosidases inhibitors, insulin secretagogues, glucose entrapment and radical trapping agents. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Prescription practices and medical knowledge on direct oral anticoagulants in a reference hospital

    Directory of Open Access Journals (Sweden)

    Correa, Manuela

    2015-04-01

    Full Text Available Introduction and objective: The experience and knowledge concerning the use of direct oral anticoagulants among specialists in Medellin, Colombia, are not known. Our goal was to describe the use of these drugs in patients treated at Hospital Pablo Tobón Uribe and to assess the level of knowledge regarding this issue in professionals from this institution. Materials and methods: Cross sectional study conducted between January 2012 and January 2013. Two strategies to collect information were used, namely: Analysis of relevant medical records and evaluation of knowledge about the appropriate use and prescription of direct oral anticoagulants in the group of medical specialists. Results: 114 records were included in the analysis; rivaroxaban was the most frequently prescribed drug (87% followed by dabigatran (13%. The main indication was prophylaxis in orthopedic surgery (69%. Average of correct answers among the different specialists evaluated was 67% with no apparent difference between them. Conclusion: rivaroxaban was prescribed more often than dabigatran; however, this fact does not appear to be associated with a clear and sufficient medical knowledge about these drugs. No reports of adverse events associated with this therapy were found.

  18. Antiketogenic and hypoglycemic effects of aminocarnitine and acylaminocarnitines

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, D.L.; Griffith, O.W.

    1986-01-01

    DL-Aminocarnitine (DL-3-amino-4-trimethyl-aminobutyrate) is a potent, noncovalent inhibitor of carnitine palmitoyltransferase (palmitoyl-CoA:L-carinite O-palmitoyltransferase, EC 2.3.1.21). Here the authors show that decanoyl-DL-aminocarnitine and palmitoyl-DL-aminocarnitine inhibit carnitine palmitoyltransferase in vitro about 7-fold and 100-fold more effectively than does aminocarnitine. Aminocarnitine and its decanoyl and palmitoyl derivatives are active in vivo following oral or parenteral administration and, at doses of 0.3 mmol/kg or less, inhibit the oxidation of (/sup 14/C)palmitate to /sup 14/CO/sup 2/ by 45-70% in mice. Larger doses do not significantly increase the extent of inhibition, a finding suggesting that substantial carnitine palmitoyltransferase-independent long-chain fatty acid oxidation may occur in vivo. Small doses of aminocarnitine and palmitoylaminocarnitine prevent the development of ketoacidemia in fasted, normal mice and reverse the ketoacidemia observed in diabetic mice. Aminocarnitine has a strong hypoglycemic effect in fasted diabetic mice; a single dose (0.3 mmol/kg) normalizes plasma glucose levels within 4-8 hr and remains effective for at least 12 hr.

  19. Oral health promotion through an online training program for medical students.

    Science.gov (United States)

    de Sousa Eskenazi, Ednalva; de Arruda Martins, Mílton; Ferreira, Mario

    2011-05-01

    The objective of this study was to compare the impact on knowledge and counseling skills of face-to-face and Internet-based oral health training programs on medical students. Participants consisted of 148 (82 percent) of the 180 invited students attending their fifth academic year at the Faculty of Medicine, University of São Paulo, Brasil, in 2007. The interventions took place during a three-month training period in the clinical Center for Health Promotion, which comprised part of a clerkship in Internal Medicine. The students were divided into four groups: 1) Control Group (Control), with basic intervention; 2) Brochure Group (Br), with basic intervention plus complete brochure with oral health themes; 3) Cybertutor Group (Cy), with basic intervention plus access to an Internet-based training program about oral health themes; and 4) Cybertutor + Contact Group (Cy+C), the same as Cy plus brief proactive contact with a tutor. The impact of these interventions on student knowledge was measured with pre- and post assessments, and student skills in asking and counseling about oral health were assessed with an objective structured clinical examination (OSCE). Multivariate logistic regression models were applied to identify the odds ratios of scoring above Control's medians on the final assessment and the OSCE. In the results, Cy+C performed significantly better than Control on both the final assessment (OR 9.4; 95% CI 2.7-32.8) and the OSCE (OR 5.6; 95% CI 1.9-16.3) and outperformed all the other groups. The Cy+C group showed the most significant increase in knowledge and the best skills in asking and counseling about oral health.

  20. Application of oral history to contemporary history of medicine in Korea: with a focus on medical scientists.

    Science.gov (United States)

    Kim, Ock-Joo

    2013-08-01

    The oral history helps researchers to fill the gap in historical documents in research on the contemporary history of medicine in Korea. More and more studies in history of contemporary medicine in Korea have come out using oral history of doctors and patients. Based upon the author's research on development of neurosurgery in late 20th century Korea, this paper discusses how to apply oral history to contemporary history of medicine, focusing on oral history of doctors in Korea. In this paper the author describes how to do and use oral history of key doctors and medical scientists in the contemporary history of medicine in Korea. The oral history can be a powerful tool to complement the written documents as following. First, from their interview, doctors and medical scientists often provide valuable information which historians cannot get from documents and written sources. As intelligent interviewees, they not only understand the purpose of research but also help actively the historianresearcher- interviewer. Second, the oral history facilitates further searches and often it leads to more findings of informants, and written and image material. More often than not, doctors and medical scientists do their own research on the topic and provide the historian with valuable historical source material from their laboratories, bedsides, family and friends. Third, interviews with medical scientists and oral material produced by doctors and medical scientists helped the researcher to understand and interpret the papers and written documents. Fourth, the subjective stories told by the medical scientists provide perspectives and historical source as narrative truth. Before a historian attempts to use the oral material as complementary historial evidence, he or she needs to cross-check the validity and of objectivity of the oral material. Oral material is produced through bidirectional intersubjective interaction between the interviewer and interviewee, and critical reflection

  1. Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland

    LENUS (Irish Health Repository)

    O’Shea, M. P.

    2014-05-01

    Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour.\\r\

  2. Cost-effectiveness of oral hypoglycemic drug treatment program in elderly patients of newly diagnosed type 2 diabetes and hypoglycemia rate%初诊2型糖尿病的老年患者口服降糖药物治疗方案的效价对比及低血糖的研究

    Institute of Scientific and Technical Information of China (English)

    莫焕娇; 杨滔; 陈国强; 李秋玲

    2016-01-01

    Objective To investigate commonly used three oral hypoglycemic drug treatment programs in elderly patients of newly diagnosed type 2 diabetes in our hospital,analyse their cost-effectiveness,and learn hypoglycemia rate,to provide a reference of antidiabetic treatment options for elderly patients.Method Retrospective survey was performed,elderly patients of newly diag-nosed type 2 diabetes in our hospital were treated with Glimepiride(Group A),Repaglinide (Group B)and Pioglitazone(Group C), respectively,besides oral metformin.Blood glucose levels and glycated hemoglobin were measurement indicators,cost-effectiveness of three treatment programs were analysed,the number of statistical hypoglycemia was calculated.Results The basic situation was no significant difference among the three groups of patients(P>0.05).Average drug costs of Group A,B and C were ¥675.15, 875.95 and 650.15,respectively,program A had a higher cost-effectiveness than program B and C,there was no significant differ-ence between program B and C.Hypoglycemia rate in group A was significantly greater than group B,C.Conclusion For the initial treatment of type 2 diabetes,Glimepiride in combination with metformin has a higher cost -effectiveness and hypoglycemia rate.Patients with age,cognitive disorders,poor self-care,liver and kidney dysfunction,expected long-term short-life may use Repaglinide treatment.%目的:调查我院初诊2型糖尿病的老年患者常用的三组口服降糖药物治疗方案,进行3个治疗方案的成本-效果分析,并了解低血糖发生比例,为老年患者选择降糖治疗方案提供参考。方法:采用回顾性调查,将我院初诊2型糖尿病的老年患者,均在口服二甲双胍的基础上,A组加用格列美脲,B组加用瑞格列奈,C组加用吡格列酮,采集监测的血糖值和糖化血红蛋白作为效果测量指标,进行成本-效果分析,并统计低血糖发生次数。结果:三组间患者的基本情

  3. Hypoglycemic effect of Ganoderma lucidum polysaccharides

    Institute of Scientific and Technical Information of China (English)

    Hui-na ZHANG; Zhi-bin LIN

    2004-01-01

    AIM: To investigate the hypoglycemic effect of Ganoderma lucidum polysaccharides (Gl-PS) in the normal fasted mice and its possible mechanism. METHODS: Normal fasted mice were given a single dose of Gl-PS 25, 50, and 100 mg/kg by ip and the serum glucose was measured at 0, 3, and 6 h after administration. Gl-PS 1 00 mg/kg were also given by ip and the serum glucose and insulin levels were measured at 0 min, 30 min, 1 h, 3 h, 6 h, and 12 h.Pancreatic islets were isolated and incubated with glucose 5.6 mmol/L and different concentration of Gl-PS, the insulin content of islets and insulin release were examined. The islets fluorescent intensity of [Ca2+]i was also studied with a confocal microscope. Verapamil and egtazic acid were used to testify whether the insulin-releasing effect of Gl-PS was mediated by its ability to raise the Ca2+ influx. RESULTS: Gl-PS dose-dependently lowered the serum glucose levels at 3 h and 6 h after administration. Gl-PS 100 mg/kg raised the circulating insulin levels at 1 h after administration. In vitro, Gl-PS had no effect on islets insulin content, but it stimulated the insulin release after incubation with glucose 5.6 mmol/L. Confocal microscope showed that Gl-PS 100 mg/L had the capacity to raise the [Ca2+] i. The insulin-releasing effect of Gl-PS was inhibited by verapamil/egtazic acid. CONCLUSION:Gl-PS possesses the hypoglycemic effect on normal mice; one mechanism is through its insulin-releasing activity due to a facilitation of Ca2+ inflow to the pancreatic β cells.

  4. Hypoglycemic and antiperglycemic effects of Semecarpus anacardium linn in normal and alloxan-induced diabetic rats.

    Science.gov (United States)

    Kothai, R; Arul, B; Kumar, K Suresh; Christina, A J M

    2005-01-01

    The effect of ethanolic extract of dried nuts of Semecarpus anacardium on blood glucose level was investigated in both normal and alloxan induced diabetic rats. The blood glucose levels were measured at 0, 1, 2 and 3 hours after the treatment. The ethanolic extract of S. anacardium (100 mg/kg) reduced the blood glucose of normal rat from 84 +/- 1.4 to 67 +/- 1.7 mg/dl, 3 hours after oral administration of the extract (P < 0.05). It also significantly lowered blood glucose level in alloxan induced diabetic rat from 325 +/- 2.2 to 144 +/- 1.4 mg/dl, 3 hours after oral administration of the extract (P < 0.05). The antihyperglycemic activity of S. anacardium was compared with tolbutamide, an oral hypoglycemic agent.

  5. A survey of reading, writing, and oral communication skills in North American veterinary medical colleges.

    Science.gov (United States)

    Hendrix, C M; Thompson, I K; Mann, C J

    2001-01-01

    In the 1989 report by the Pew National Veterinary Education Program (PNVEP), communication skills topped the list of characteristics the veterinary graduate should possess in order to function effectively in the twenty-first century. To determine the reading, writing, and oral communication requirements and opportunities in veterinary curricula in the US and Canada, and to determine the perceived communication tasks that might be commonly required of practicing veterinarians in the next century, we sent a 15-item communications skills questionnaire to the academic deans of the 31 veterinary curricula in the US and Canada. The results reinforce the importance of communication skills in veterinary medicine, as detailed by the PNVEP over 10 years ago. Based on the responses to our questionnaire and on our own experiences with veterinary medical students, we make several recommendations to enhance communication instruction in veterinary medical curricula.

  6. Ensuring medication adherence with direct oral anticoagulant drugs: lessons from adherence with vitamin K antagonists (VKAs).

    Science.gov (United States)

    Di Minno, Alessandro; Spadarella, Gaia; Tufano, Antonella; Prisco, Domenico; Di Minno, Giovanni

    2014-05-01

    Medication adherence (taking drugs properly) is uncommon among patients on warfarin. Poor adherence to warfarin leads to an increase in adverse medical events, including stroke in atrial fibrillation (AF). Factors related to patients, physicians and the health system account for poor adherence. Direct oral anticoagulants (DOACs) are easier to use than warfarin, with fewer drug and food interactions and no need for routine blood monitoring. A proper use of DOACs may reduce the risk of stroke in AF. However, in clinical settings where no laboratory monitoring is needed, a poor medication adherence is common and may impact clinical outcomes. In the management of chronic disorders, careful knowledge of the individual patient's attitudes and behaviors is a pre-requisite for a successful doctor-patient communication. To increase patient's awareness of the risks and benefits of DOACs and, in turn, increase medication adherence, at each follow-up visit physicians should screen for priorities and motivational problems; check for the lack of understanding and/or knowledge; assess any health system or personal barriers to medication adherence; identify appropriate interventions and provide tailored support to patient needs. Dissemination of guidelines to the health care chain (prescribing physician, general practitioners, caregivers, nurses, pharmacists) further encourages medication adherence. However, the long-term effect of some of these strategies is unknown; one tool may not fit all patients, and the prescribing physician should consider individualization of these aids to ensure medication adherence and persistence (continuing to take drugs properly in long-term treatments) for DOACs in every day practice.

  7. Effect of different hypoglycemic scheme ion serum inflammatory factors and blood hypercoagulability on patients with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Kun Zhang; Fei Feng

    2016-01-01

    Objective:To observe the effect of different hypoglycemic scheme on serum inflammatory factors and blood hypercoagulability in patients with type 2 diabetes mellitus (T2DM). Methods:A total of 186 cases patient with T2DM were randomly divided into 3 groups according to the different hypoglycemic scheme, such as: insulin group (69 cases), oral drug group (58 cases) and combination group (60 cases). Insulin group was given insulin aspart; oral drug group was given metformin and pioglitazone; combination group was given insulin aspart and metformin. For 6 mouths, to observe the different of serum inflammatory factorsα(TNF-α, hs-CRP, IL-6, MCP-1) and blood hypercoagulabilit indexes (PT, APTT, TT, FIB, PLT, TXB2) between the three groups.Results: After treatment, TNF-α, hs-CRP, IL-6, MCP-1 of the three groups were decreased with before (P0.05). After treatment, except PLT was no change, PT, APTT, TT of the three groups were increased and FIB, TXB2 were decreased with before (P0.05).Conclusions:All of the 3 hypoglycemic schemes are beneficial to reduce the inflammatory reaction and relieve the blood hypercoagulability, but the effect of insulin combined with oral drug is the best.

  8. Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia.

    Science.gov (United States)

    Kruger, Estie; Perera, Irosha; Tennant, Marc

    2010-01-01

    Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

  9. Oral health knowledge among pre-clinical students of International Branch of Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    2015-01-01

    Full Text Available   Background and Aims: Oral health is an important issue in public health with a great impact on individuals’ general health status. A good access to oral healthcare services and a good knowledge of it play a key role in the oral disease prevention. A better health attitude and practice require a better knowledge. The aims of this study was to evaluate the oral health knowledge among the International students branch (Kish of Shiraz University of Medical Sciences in 2011-12.   Materials and Methods: 159 pre-clinical students in medicine (54 students, dentistry (69 students and pharmacy (36 students participated in this research. A standard questionnaire was used as the main tool of research to evaluate the attitude and knowledge of students about the oral health. Data were analyzed using Chi-square test.   Results: According to the results, dental students had the best level of knowledge and pharmacy students had a better knowledge level compared to the medical students. The results also showed a significant relationship between students’ oral health knowledge and their field and duration of study and the place of their secondary school (P0.05.   Conclusion: The results showed that the students at the International Branch of Shiraz University of Medical Sciences had a relatively good knowledge of oral health. Students’ knowledge level can be improved by providing students with educational materials, organized workshops and seminars.

  10. Are excipients really inert ingredients? A review of adverse reactions to excipients in oral dermatologic medications in Canada.

    Science.gov (United States)

    Noiles, Kristin; Vender, Ronald

    2010-01-01

    Whereas several literature reviews have discussed the role of excipients in drug-related reactions, no article has focused specifically on those found in oral dermatologic medications. The Compendium of Pharmaceuticals and Specialties (CPS) was used to reference the inert ingredients found in oral dermatologic medications. An extensive literature review was subsequently conducted using PubMed and MEDLINE to document adverse reactions to these excipients. Sixty-three oral dermatologic medications were reviewed. Lactose was commonly used as a filler. Several medications indicated that they were dye, tartrazine, or gluten free. Three medications were found to contain soybean oil and one was found to contain peanut oil. Although there are documented reactions to excipients in other products in the literature, few reports outline reactions to excipients in oral dermatologic medications. Whether this low frequency is accurate or whether it is due to a lack of reporting remains unknown. If the latter reasoning is correct, dermatologists must be more aware of these possible reactions. This article serves as a reference guide for dermatologists to aid in prescribing medications to individuals with known sensitivities and to assist in working up patients with suspected reactions to inert ingredients.

  11. Medication adherence in diabetes mellitus and self management practices among type-2 diabetics in Ethiopia

    Directory of Open Access Journals (Sweden)

    Nasir T Wabe

    2011-01-01

    Full Text Available Background : Type-2 diabetes mellitus and its complication are becoming more prevalent in Ethiopia. Evidence abound that the most important predictor of reduction of morbidity and mortality due to diabetes complication is the level of glycemic control achieved. Aims : The aim is to assess adherence to anti diabetic drug therapy and self management practice among type-2 diabetic patient in Ethiopia. Patients and Method : The study consists of two phases. A cross-sectional review of randomly selected 384 case notes of type-2 diabetic patient that attend diabetes mellitus clinic over 3 month and cross-sectional interview, with pre tested adherence and self management and monitoring tool questioner of 347 consecutive patients that attend in Jimma university specialized hospital diabetic clinic. Result: Oral hypoglycemic agent were prescribed for 351(91.4 of the patient while insulin and oral hypoglycemic agent was prescribed in 33(8.6%. About 312 (88.9% patients on oral hypoglycemic agent were on mono therapy, the most frequently prescribed oral hypoglycemic agent was glibenclamide 232(74.3% and metformine 80(25.7%. Only 41.8% of the patient had adequate glycemic control. The main external factors for non adherence were lack of finance (37.1% followed by perceived side effect of drug 29.2%. Only 6.5% patient who missed their medications disclosed to physician during consultation. The knowledge and practice of critical component of diabetes self management behavior were generally low among the patient studied. Conclusion: Majority of the patient with type 2 diabetes in Ethiopia are managed by OHA monotherapy mainly glybenclamide and metformine. While the current prescribing strategy do not achieve glycemic control on majority of the patient. This is due to poor adherence with the prescribed drug regimen and poor knowledge and practice of successful self management.

  12. Breast cancer oral anti-cancer medication adherence: a systematic review of psychosocial motivators and barriers.

    Science.gov (United States)

    Lin, Cheryl; Clark, Rachel; Tu, Pikuei; Bosworth, Hayden B; Zullig, Leah L

    2017-09-01

    In the past decade, there has been an increase in the development and use of oral anti-cancer medications (OAMs), especially for breast cancer-the most prevalent cancer in women. However, adherence rates for OAMs are often suboptimal, leading to lower survival rate, increased risk of recurrence, and higher healthcare costs. Our goal was to identify potentially modifiable psychosocial facilitators and barriers that may be targeted to increase OAM adherence for breast cancer patients. We systematically searched PubMed for studies published in the U.S. by June 15, 2016 that addressed the following: (1) OAMs for breast cancer; (2) medication adherence; and (3) at least one psychosocial aspect of adherence. Of the 1752 papers screened, 21 articles were included and analyzed. The most commonly reported motivators for adherence are patient-provider relationships (n = 11 studied, 82% reported significant association) and positive views and beliefs of medication (n = 9 studied, 89% reported significant association). We also identified consistent evidence of the impact of depression and emotions, perception of illness, concern of side effects, self-efficacy in medication management and decision making, knowledge of medication, and social support on OAM adherence. Compared to traditional demographic, system, and clinical-related factors that have been well documented in the literature but are not easily changed, these cognitive, psychological, and interpersonal factors are more amendable via intervention and therefore could generate greater benefit in improving patient compliance and health outcomes. As OAMs shift treatment administration responsibility onto patients, continuous provider communication and education on illness and regimen are the keys to supporting patients' medication behavior.

  13. [Patients' preferences for nurses' nonverbal expressions of warmth during nursing rounds and administration of oral medication].

    Science.gov (United States)

    Kim, H S; Kim, M S

    1990-12-01

    Nursing involves deep human interpersonal relationships between nurses and patients. But in modern Korea, the nurse-patient relationship tends to be ritualistic and mechanestic. Patients usually express the hope that nurses be more tender and kind. Patients expect nurses to express their warmth especially through nonverbal behaviour. This study was conducted to identify patients' preferences for nurse's nonverbal expressions of warmth. Through the confirmation of these preferences, nurses may learn how to enhance their interpersonal relationships with patients. Subjects for the study were 73 patients who had been admitted to a university teaching hospital for at least three days and agreed to be interviewed by the investigator. The interactions were studied nonverbal expressions of warmth during nursing rounds and administration of oral medication. The interview schedule was especially designed by the investigator to measure the nurse's posture, the distance between the nurse and the patient, the nurse's eye contact, facial expression, hand motion and head nodding. Data analysis included frequencies, percentages and X2-test. The results of this study may be summerized as follows: 1. Patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds. Preferred nurse's posture was sitting (50.7%) or standing (49.3%) opposite the patient. Preferred distance between the nurse and the patient was close to the bed (93.2%), less than 1m. Preferred eye contact was directed to the patient's eyes or their affected part (41.1%). Preferred facial expression was a smile (97.3%). Preferred hand motions were light gestures (41.1%). Patients preferred head nodding which approved their own opinions (69.9%). 2. Patient's preferences for nurse's nonverbal expressions of warmth during administration of oral medication. Preferred nurse's posture was standing and waiting to confirm that the medication had been taken (58.9%). Preferred distance from the patient was

  14. Comparative study of hypoglycemic and antibacterial activity of organic extracts of four Bangladeshi plants

    Directory of Open Access Journals (Sweden)

    Mohammad Shah Hafez Kabir

    2016-03-01

    ]. Only methanol extract of A. bulbifer showed (8.50 ± 0.50 mm and (7.20 ± 0.76 mm zone of inhibition against Pseudomomas aeruginosa at 1 000 and 800 µg/disk dose respectively. Conclusions: Through our study, it was found that S. colocasiifolia could be considered as very promising and beneficial hypoglycemic agent. Although C. recurvata and S. colocasiifolia showed comparable high antibacterial activity, further studies should be needed to develop new antibacterial agent from them. S. colocasiifolia may be a potential source for the development of new oral hypoglycemic agent.

  15. Hypoglycemic and hypotensive effects of Psidium guajava Linn. (Myrtaceae) leaf aqueous extract.

    Science.gov (United States)

    Ojewole, J A O

    2005-12-01

    The leaf of Psidium guajava Linn. (family, Myrtaceae) is used traditionally in African folk medicine to manage, control, and/or treat a plethora of human ailments, including diabetes mellitus and hypertension. In order to scientifically appraise some of the anecdotal, folkloric, ethnomedical uses of P. guajava Linn., the present study was undertaken to investigate the hypoglycemic and hypotensive effects of P. guajava leaf aqueous extract (PGE, 50-800 mg/kg) in rat experimental paradigms. The hypoglycemic effect of the plant's extract was examined in normal and diabetic rats, using streptozotocin (STZ)-induced diabetes mellitus model. Hypertensive Dahl salt-sensitive rats were used to investigate the hypotensive (antihypertensive) effect of the plant's extract. Chlorpropamide (CPP; 250 mg/kg, p.o.) was used as the reference hypoglycemic agent for comparison. Acute oral administrations of the plant's extract (PGE; 50-800 mg/kg, p.o.) caused dose-related, significant (p < 0.05-0.001) hypoglycemia in normal (normoglycemic) and STZ-treated, diabetic rats. Moreover, acute intravenous administrations of the plant's extract (PGE, 50-800 mg/kg i.v.) produced dose-dependent, significant reductions (p < 0.05-0.001) in systemic arterial blood pressures and heart rates of hypertensive, Dahl salt-sensitive rats. Although the exact mechanisms of action of the plant's extract still remain speculative at present, it is unlikely that the extract causes hypotension in the mammalian experimental animal model used via cholinergic mechanisms, since its cardiodepressant effects are resistant to atropine pretreatment. The numerous tannins, polyphenolic compounds, flavonoids, pentacyclic triterpenoids, guiajaverin, quercetin, and other chemical compounds present in the plant are speculated to account for the observed hypoglycemic and hypotensive effects of the plant's leaf extract. However, the results of this experimental animal study indicate that the leaf aqueous extract of P. guajava

  16. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    Directory of Open Access Journals (Sweden)

    Wu P

    2016-06-01

    Full Text Available Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB, patients’ beliefs about taking oral antidiabetic drugs (OADs as prescribed, and to measure the correlations between beliefs and medication adherence.Patients and methods: We performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8. Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at P<0.05.Results: From 130 eligible Chinese patients with an average age of 60.6 years and a male proportion of 50.8%, a nonsignificant relationship between behavioral, normative, and the most facilitating control beliefs and OAD adherence was found in our study. Having the OADs on hand (P=0.037 was the only facilitating control belief associated with adherence behavior. Being away from home or eating out (P=0.000, not accepting the disease (P=0.000, ignorance of life-long drug adherence (P=0.038, being busy (P=0.001, or poor memory (P=0.008 were control belief barriers found to be correlated with poor adherence. TPB is the only important determinant influencing OAD adherence among all the factors (P=0.011.Conclusion: The results indicate that the TPB model could be used to examine adherence to OADs. One

  17. A STUDY OF DIFFERENT DOSES OF SUBLINGUAL MISOPROSTOL AFTER ORAL MIFEPRISTONE IN MEDICAL TERMINATION OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-11-01

    Full Text Available BACKGROUND: Though Mifepristone- Misoprostol combination is well established for early pregnancy termination, the optimal Misoprostol dose is still under much debate. AIMS: To compare the efficacy of sublingual 400µg Misoprostol and 800µg Misoprostol after oral 200mg Mifepristone in achieving complete abortion, to study the induction abortion interval, complications and adverse effects seen with both groups. Setting 100 antenatal women requesting for medical termination of pregnancy of upto 63 days of gestation in ESI Medical College and Postgraduate Institute of Medical Sciences and Research, Karnataka in India. Design A Prospective Observational study. METHODS AND MATERIAL: Study population was randomized into 2 groups of 50 patients each. Both groups received 200 mg Mifepristone. Twenty four hours later, Group A received 400µg sublingual Misoprostol and Group B received 800 µg sublingual Misoprostol. OUTCOME MEASURES: The primary outcome analyzed in this study is the efficacy of the two regimens in achieving complete abortion. Secondary outcome measures are Induction to Abortion interval and adverse effects like pain abdomen, nausea, vomiting, diarrhoea, fever and chills. STATISTICAL ANALYSIS USED: Averages and proportions were calculated for the study and appropriate statistical tests like Chi Square Test, Fischer Exact Test and Student T Test were done using MiniTab version 16. RESULTS: Administration of 400µg sublingual Misoprostol 24 hours after 200 mg of Mifepristone has complete medical abortion rates comparable with 800µg sublingual Misoprostol with significantly lesser side effects. CONCLUSIONS: In the present study, administration of 400µg sublingual Misoprostol after 200 mg of Mifepristone has complete medical abortion rates comparable with 800µg sublingual Misoprostol with significantly lesser side effects. However further research with different doses and routes of administration of Misoprostol in required in a larger

  18. In vitro α-amylase inhibitory activity and in vivo hypoglycemic effect of ethyl acetate extract of Mallotus repandus (Willd.) Muell. stem in rat model

    Institute of Scientific and Technical Information of China (English)

    Md. Rakib Hasan; Nizam Uddin; Md. Monir Hossain; Md. Mahadi Hasan; Md. Emtiaz Yousuf; Swagata Sarker Lopa; Tasmina Rahman

    2014-01-01

    Objective: To investigate the therapeutic effects of ethyl acetate extract of Mallotus repandus stem in α-amylase inhibitory activity (in vitro) and hypoglycemic activity in normal and glucose induced hyperglycemic rats (in vivo). Methods: Ethyl acetate extract of Mallotus repandus stem was tested for the presence of phytochemical constituents, α-amylase inhibitory activity and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats.Results:Presence of different types of phytochemicals was identified in the extract. The extract has moderate α-amylase inhibitory activity [IC50=(2.038±0.033) mg/mL] as compared to acarbose. The does 1000 mg/kg significantly reduced (P<0.0100) fasting blood glucose level in normal rats. In oral glucose tolerance test, both 1000 and 2000 mg/kg doses showed good hypoglycemic activity (P<0.0001) like glibenclamide in each specific hour after administration. Overall time effect in oral glucose tolerance test was found extremely significant (P<0.0001) with F (3, 48) value=202.4.Conclusions:These findings suggest that this plant may be a potential source for the development of new oral hypoglycemic agent.

  19. Practice and problems regarding oral hygiene: study among female medical undergraduate students of tertiary care hospital, Pune, India

    Directory of Open Access Journals (Sweden)

    Kajal Srivastava

    2016-06-01

    Conclusion: The study highlights the fact that preventive behaviour among medical students increased after they experienced some or the other oral health problem for which they were advised to follow these preventive practices so that the severity and extent of the disease does not progress. Further research is required on a larger scale so that the ways to increase the promotive and preventive oral health practices can be identified (e.g. behaviour change communication to prevent the occurrence of oral health problems. [Int J Res Med Sci 2016; 4(6.000: 2214-2217

  20. Evaluation of the toxicity and hypoglycemic effect of the aqueous extracts of Cnidoscolus quercifolius Pohl

    Directory of Open Access Journals (Sweden)

    S.M. Lira

    2017-08-01

    Full Text Available Diabetes mellitus is one of the most common chronic degenerative diseases, and it is estimated to increase worldwide to around 415 million and to impact 642 million in 2040. Research shows that some plants are sources of bioactive compounds against diabetes. Thus, the objective of this work was to evaluate the oral toxicity and the hypoglycemic effect of the aqueous extract of the leaves of Cnidoscolus quercifolius Pohl. Diabetes was induced in Swiss mice with streptozotocin and the mice were treated with an aqueous extract of C. quercifolius leaves for a period of 30 days. Phytochemical analysis showed that the extract was rich in flavonoids, catechins and triterpenoid, which did not show any mortality and behavioral alterations in mice treated with 200, 1000, and 2000 mg/kg body weight of the extract for 14 days. Histopathological analysis of organs (kidney, pancreas, liver from mice treated with the 2000 mg/kg extract revealed no architectural change. In the present study, we found a 29% reduction in glucose levels in animals receiving 200 mg/kg body weight. These results are very promising because they showed that C. quercifolius had a hypoglycemic effect and did not present oral toxicity, thus being a new source of compounds for the control of diabetes.

  1. Knowledge, opinions, and practices about oral cancer among general medical practitioners in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Olalekan Micah Gbotolorun

    2015-01-01

    Full Text Available Objectives: To evaluate the knowledge and practices of general medical practitioners (GMPs in Lagos on screening for oral cancer (OC. Materials and Methods: A 43-item self-administered questionnaires was filled by each GMPs recruited into the study. Analysis was done using the SPSS version 17.5. Descriptive analyses were used and results were presented in percentages, graphs, and tables. Results: One-hundred and twenty GMPs participated in the study, 58.7% were males and 41.3% females; their ages ranged 22-61 years (36.1 ΁ 7.97. While most participants answered correctly that smoked tobacco (96.1%, increasing age >45 years (97%, oral sex (99%, and patient with a previous OC (93.7% were risk factors for OC; there was misinformation on the nonrisk factors as only 5.5%, 7.9%, and 18.9%, respectively, answered correctly that family history of cancer, dental infections, and poor oral hygiene were not identifiable risk factors associated with OC. Furthermore, although majority of subjects (81.1% identified the floor and the tongue as the most common sites of OC and leukoplakia (75.6% as a common precursor of OC; only 29.1% identified correctly that OC had one of the worst morbidity and mortality rates of the most common cancers due to late presentation. Only 0.8% of GMPs had a consistent high score in the indexes. Conclusion: The knowledge and practices of GMPs in the Lagos environment on OC needs a lot of improvement for them to become significant in the screening for the disease entity.

  2. The effect of structured education to patients receiving oral agents for cancer treatment on medication adherence and self-efficacy

    Directory of Open Access Journals (Sweden)

    Gamze Tokdemir

    2017-01-01

    Full Text Available Objective: This study was conducted to examine the effect of structured education on medication adherence and self-efficacy through the use of the MASCC Oral Agent Teaching Tool (MOATT for patients receiving oral agents for cancer treatment. Methods: This quasi-experimental study has been conducted at two hospitals; 41 patients were included in the study. Data were obtained using a questionnaire, medication adherence self-efficacy scale (MASES, memorial symptom assessment scale, and a follow-up form (diary. Patients were educated through the use of the MOATT at a scheduled time; drug-specific information was provided along with a treatment scheme and follow-up diary. Phone interviews were completed 1 and 2 weeks after the educational session. At the next treatment cycle, the patients completed the same questionnaires. Results: Majority of the patients were receiving capecitabine (90.2%; n = 37 as an oral agent for breast (51.2%; n = 21 and stomach cancer (24.6%; n = 10 treatment. About 90.2% of patients (n = 37 stated that they did not forget to take their medication and experienced medication-related side effects (78%; n = 32. The total score of MASES was increased after the education (66.39 vs. 71.04, P < 0.05. Conclusions: It was shown that individual education with the MOATT and follow-up for patients receiving oral agents for cancer treatment increased patient medication adherence self-efficacy.

  3. HYPOGLYCEMIC ACTIVITY OF SOME INDONESIAN RICE VARIETIES AND THEIR PHYSICOCHEMICAL PROPERTIES

    Directory of Open Access Journals (Sweden)

    Sri Widowati

    2016-10-01

    Full Text Available Diabetes mellitus is a spectrum of inherited and acquired disorders characterized by elevating blood glucose levels. Diabetes is an abnormal carbohydrate metabolism, therefore, diet therapy for diabetics plays a key role in the management of the disease. Most Indonesian people consume rice as source of energy and protein. Generally, diabetics consume very limited rice because they believe that rice is the one of hyperglycemic food, even though different rice varieties have large range of glycemic index. The study aimed to evaluate hypoglycemic properties by using rat assay and chemical characteristics of 10 Indonesian rice varieties, i.e. Pandan Wangi, Rojolele, Bengawan Solo, Cenana Bali, Memberamo, Celebes, Ciherang, Batang Piaman, Cisokan, and Lusi. Taj Mahal, an herbal ponni imported rice, was used as a comparison. Male Sprague Dawley rats (150- 200 g body weight were used for hypoglycemic assay. The rats were fasted overnight before the blood glucose was measured in the morning. The rats were then feed with 4.5 g rice per kg body weight by oral administration, followed by 1 ml of 10% glucose solution in the next 30 minutes. The blood glucose was measured for the next 30, 60, 90, and 120 minutes. Changes in blood glucose concentrations (mg dl-1 before and after the oral administrations were calculated for each rice variety tested. Results showed that Cisokan and Batang Piaman were categorized as low glycemic responses and Ciherang as high glycemic response, while the other varieties (Memberamo, Cenana Bali, Lusi, Bengawan Solo, Pandan Wangi, Celebes, and Rojo Lele showed moderate glycemic responses. As the best hypoglycemic activity, Cisokan contained high amylose (27.6%, fat (0.87%, total dietary fiber (6.24%, resistant starch (2.02%, and lowest starch digestibility (52.2%, which are ideal for diabetic’s consumption. Ciherang as the worst hypoglycemic activity had low resistant starch (1.78%, low total dietary fiber (4.52%, and medium

  4. Hypoglycemic and antihyperglycemic effect of Semecarpus anacardium Linn in normal and streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Arul, B; Kothai, R; Christina, A J M

    2004-12-01

    The effect of ethanolic extract of dried nuts of Semecarpus anacardium on blood glucose was investigated in both normal (hypoglycemic) and streptozotocin-induced diabetic (antihyperglycemic) rats. The blood glucose levels were measured at 0, 1, 2 and 3 h after the treatment. The ethanolic extract of S. anacardium (100 mg/kg) reduced the blood glucose of normal rats from 85.83 +/- 1.55 to 65.83 +/- 2.20 mg/dl, 3 h after oral administration of the extract (p < 0.05). It also significantly lowered blood glucose levels in streptozotocin-induced diabetic rats from 335.33 +/- 4.90 to 132.17 +/- 4.49 mg/dl, 3 h after oral administration of the extract (p < 0.05). The antihyperglycemic activity of S. anacardium was compared with tolbutamide, a sulfonyl urea derivative used in diabetes mellitus. 2004 Prous Science

  5. Hypoglycemic Effects of Exo-biopolymers Produced by Five Different Medicinal Mushrooms in STZ-induced Diabetic Rats

    Science.gov (United States)

    Yang, Byung-Keun; Kim, Guk-Nam; Jeong, Yong-Tae; Jeong, Hun; Mehta, Pradeep

    2008-01-01

    Hypoglycemic effects of exo-biopolymers (EBP) produced by submerged mycelial cultures of Coriolus versicolor, Cordyceps sinensis, Paecilomyces japonica, Armillariella mellea, and Fomes fomentarius were investigated in streptozotocin (STZ)-induced diabetic rats. The rats from each experimental group were orally administered with EBPs (100 mg/kg BW) daily for 2 weeks. Though the hypoglycemic effect was achieved in all the cases, however, C. versicolor EBP proved as the most potent one. The administration of the C. versicolor EBP substantially reduced (29.9%) the plasma glucose level as compared to the saline administered group (control). It also reduced the plasma total cholesterol (TC), triglyceride (TG), aspartate aminotransferase (AST) and, alanine aminotransferase (ALT) levels by 9.22, 23.83, 16.93, and 27.31%, respectively. The sugar and amino acid compositions of this EBP were also analyzed in detail. PMID:23997607

  6. The Hypoglycemic and Synergistic Effect of Loganin, Morroniside, and Ursolic Acid Isolated from the Fruits of Cornus officinalis.

    Science.gov (United States)

    He, Kai; Song, Shanghua; Zou, Zongyao; Feng, Min; Wang, Dezhen; Wang, Yanzhi; Li, Xuegang; Ye, Xiaoli

    2016-02-01

    Hypoglycemic activity-guided separation of ethanol extracts from the fruits of Cornus officinalis Sieb. et Zucc (CO) led to the isolation of loganin, morroniside, and ursolic acid. The antidiabetic capacity of CO extracts and related compounds was further investigated in diabetes mellitus mice. The results suggested that both CO extracts and pure compounds could ameliorate diabetes-associated damages and complications. Oral administration of loganin and morroniside decreased fasting blood glucose levels in diabetes mellitus mice. Ursolic acid exhibited the highest reactive oxygen species scavenging activity and α-glucosidase inhibitory activity. Notably, we noticed an interesting synergistic effect between loganin and ursolic acid. Given these favorable hypoglycemic properties, C. officinalis, a food and medicinal plant in China, may be used as a valuable food supplement for the treatment of diabetes mellitus.

  7. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

    OpenAIRE

    Mehta Bharati

    2016-01-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a...

  8. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    OpenAIRE

    Wu P; Liu N

    2016-01-01

    Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between bel...

  9. Comparison of Dental Caries Experience in Children Suffering From Epilepsy with and without Administration of Long Term Liquid Oral Medication.

    Science.gov (United States)

    Goyal, Ankita; Bhadravathi, Manjunath Chaluvaiah; Kumar, Adarsh; Narang, Ridhi; Gupta, Ambika; Singh, Harneet

    2016-06-01

    Sucrose is added as sweetening agent in liquid oral medication (LOM) to mask the acrid taste of medicines which may be potentially cariogenic. Many children under long term LOM therapy for treatment of epilepsy may be susceptible to dental caries. To assess and compare dental caries experience in children under long term liquid oral medication with those not under such medication among 2-12 years old children suffering from epilepsy. A cross-sectional study was undertaken on a total of 84 children aged 2-12 years, who were suffering from epilepsy receiving liquid oral medication for more than 3 months were selected (study group) and for comparison 106 children of similar age group and disease but on other forms of medication were included as control group. Dental caries was assessed using DMFT/DMFS (Decayed, Missing, Fillled Teeth / Surfaces), dmft/dft and dmfs/dfs indices. One-way ANOVA and t-test were used with p-value fixed at 0.05. Univariate logistic regression was applied. Children on LOM were at increased risk of dental caries than those with other forms of medications (OR: 2.55, 95% CI (2.37-4.15) p=0.000, HS). Caries prevalence was high in the study group (76.1%) when compared to control group (55.6%). Long term use of liquid medicines containing sucrose is a risk factor for dental caries among children with epilepsy.

  10. Comparison of Dental Caries Experience in Children Suffering From Epilepsy with and without Administration of Long Term Liquid Oral Medication

    Science.gov (United States)

    Bhadravathi, Manjunath Chaluvaiah; Kumar, Adarsh; Narang, Ridhi; Gupta, Ambika; Singh, Harneet

    2016-01-01

    Introduction Sucrose is added as sweetening agent in liquid oral medication (LOM) to mask the acrid taste of medicines which may be potentially cariogenic. Many children under long term LOM therapy for treatment of epilepsy may be susceptible to dental caries. Aim To assess and compare dental caries experience in children under long term liquid oral medication with those not under such medication among 2-12 years old children suffering from epilepsy. Materials and Methods A cross-sectional study was undertaken on a total of 84 children aged 2–12 years, who were suffering from epilepsy receiving liquid oral medication for more than 3 months were selected (study group) and for comparison 106 children of similar age group and disease but on other forms of medication were included as control group. Dental caries was assessed using DMFT/DMFS (Decayed, Missing, Fillled Teeth / Surfaces), dmft/dft and dmfs/dfs indices. One-way ANOVA and t-test were used with p-value fixed at 0.05. Univariate logistic regression was applied. Results Children on LOM were at increased risk of dental caries than those with other forms of medications (OR: 2.55, 95% CI (2.37-4.15) p=0.000, HS). Caries prevalence was high in the study group (76.1%) when compared to control group (55.6%). Conclusion Long term use of liquid medicines containing sucrose is a risk factor for dental caries among children with epilepsy. PMID:27504416

  11. Dentists’ Knowledge, Attitude and Practice in Treating Patients Taking Oral Antithrombotic Medications – A Survey

    Science.gov (United States)

    Bagadia, Ritvi K; Mohan, Anusha; Kandaswamy, Eswar; Chandrasekaran, Deepak

    2017-01-01

    Abstract Introduction India lists high on patients suffering from diabetes, hypertension, stroke and myocardial infarction. Hence, a large proportion of the population is on long term Oral Antithrombotic Medications (OAM). Though several guidelines exist on dental management of these patients, previous surveys have shown variation among the dentists. Aim The purpose of this study was to assess the knowledge, attitude and practice of dentists in Chennai, India, towards dental management of patients taking OAM using a questionnaire survey. Materials and Methods The survey was conducted among 256 dentists in Chennai, India using a printed questionnaire containing 16 questions, at their university location. Descriptive statistical analysis was used to analyze the data. Results Of the final population of dentists who were included in the survey (n =212), majority of them were aware about drugs such as warfarin and aspirin compared to other newer drugs (dabigatran, rivaroxaban). Most participants took physician’s opinion before proceeding with any invasive dental procedure and thromboembolic events were their major concern while treating patients on OAM. Conclusion The survey revealed dentists are knowledgeable about management of patients on OAM. However, they tend to overestimate the bleeding risk, thus being cautious in their treatment approach. Based on the results of the study, the authors suggest that continuing dental education programs and further training on management of such medically complex patients will be beneficial in order to provide optimum dental care to people taking OAM. PMID:28274053

  12. Medication Use and Its Potential Impact on the Oral Health Status of Nursing Home Residents in Flanders (Belgium).

    Science.gov (United States)

    Janssens, Barbara; Petrovic, Mirko; Jacquet, Wolfgang; Schols, Jos M G A; Vanobbergen, Jacques; De Visschere, Luc

    2017-09-01

    Polypharmacy is considered the most important etiologic factor of hyposalivation, which in turn can initiate oral health problems. To describe the medication use of nursing home residents, to identify the medications related to hyposalivation and to find possible associations between the different classes of medication, the number of medications, and the oral health status of the residents. A cross-sectional study. The study population consisted of the residents of a nonrandom sample of 23 nursing homes from 2 Belgian provinces, belonging to the oral health care network Gerodent. All residents of the sample visited the Gerodent mobile dental clinic between October 2010 and April 2012. For each resident, oral health data, demographic data, and an overview of the total medication intake were collected. The study sample consisted of 1226 nursing home residents with a mean age of 83.9 years [standard deviation (SD) 8.5]. The mean number of medications per person was 9.0 (SD 3.6, range 0-23, median 9.0). Of all prescribed medication, 49.6% had a potential hyposalivatory effect with a mean number per person of 4.5 (SD 2.2, range 0-15, median 4.0). In the bivariate analyses, associations were found between medication use and oral health of residents with natural teeth: the higher the number of medications (with risk of dry mouth) and the overall risk of medication-related dry mouth, the lower the number of natural teeth (P = .022, P = .005, and P = .017, respectively). In contrast, the total treatment need tended to decrease with rising medication intake, resulting in a clear increase of the treatment index with rising medication intake (P = .003, P < .001 and P = .002). The logistic regression model analysis confirmed that the proportion of carious teeth diminished and the treatment index increased in case of rising medication intake, especially when considering the number of medications with a risk of dry mouth and the overall risk of medication

  13. Difficulties in administration of oral medication formulations to pet cats: an e-survey of cat owners.

    Science.gov (United States)

    Sivén, M; Savolainen, S; Räntilä, S; Männikkö, S; Vainionpää, M; Airaksinen, S; Raekallio, M; Vainio, O; Juppo, A M

    2017-03-11

    The purpose here was to determine the problems cat owners encounter in medicating their cats with orally administered drugs at home. The study was carried out as an open e-questionnaire survey addressed to cat owners in which the authors focused on the oral administration route. A total of 46 completed questionnaires were included in the survey. In the study, 46 cats received 67 orally administered drugs. Approximately half of the drugs were registered for use in cats by the European Medicines Agency (54 per cent), and there were also off-label drugs registered for human (36 per cent) and canine medication (7.4 per cent) and an ex tempore drug (3.0 per cent). The owners were unable to give the doses as prescribed for their cats for one-fourth of the medications (16/67). Drugs that were registered for feline medication were significantly more palatable than drugs registered for other species (odds ratio (OR) 4.9), and liquid formulations were significantly more palatable than solid formulations (OR 4.8). However, most of the owners (22/38) preferred a solid dosage form, while few (4/38) chose a liquid formulation. The results indicate that there is still a need for more palatable and easily administered oral drugs for cats.

  14. Study of Medical Interns’ Knowledge Level About Children’s Oral Health Between 2011 and 2012 in Medical Universities in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Fahimzad

    2015-07-01

    Full Text Available Background There are several oral problems in pediatrics relating to normal general health. The most common problems are tooth decay and periodontal disease. Objectives This study was conducted to evaluate medical interns’ knowledge about oral/dental problems in educational hospitals affiliated to the medical universities in Tehran. Materials and Methods In this cross-sectional descriptive study, conducted between 2011 and 2012, 391 educational hospital interns from medical universities of Tehran, Shahid Beheshti, Iran, and Islamic Azad were included. The data, collected via questionnaires, were analyzed through descriptive statistics and central index tests. Results In this study, the average age of the interns was 25.18 (standard deviation (SD = 1.25 years. Males accounted for 44.2% of the study population, and the rest were female. The average score of the interns’ knowledge level was 4.87 from a maximum of 15 (SD = 1.73. Age, sex, and duration of education did not have any effect on the level of knowledge. Conclusions According to this study, it seems that the educational hospital interns do not have enough essential information and knowledge about pediatric oral/dental health. Therefore, it is recommended to incorporate new learning programs about pediatric oral/dental health in their curricula.

  15. Adherence to oral diabetes medications and glycemic control during and following breast cancer treatment.

    Science.gov (United States)

    Calip, Gregory S; Hubbard, Rebecca A; Stergachis, Andy; Malone, Kathleen E; Gralow, Julie R; Boudreau, Denise M

    2015-01-01

    We evaluated changes in oral diabetes mellitus medication adherence and persistence, as well as glycemic control for the year prior to breast cancer (BC) diagnosis (Year -1), during BC treatment, and in subsequent years. Cohort study of 4216 women diagnosed with incident early stage (I and II) invasive BC from 1990-2008, enrolled in Group Health Cooperative. Adherence was measured in prevalent users at baseline (N = 509), during treatment, and 1-3 years post-diagnosis using medication possession ratio (MPR), % adherent (MPR ≥0.80) and discontinuation rates. Laboratory data on glycosylated hemoglobin (HbA1c ) was obtained for the corresponding periods. Compared with Year -1, mean MPR for metformin/sulfonylureas (0.86 vs 0.49, p adherent (75.3% vs 24.6%, p adherent rose slightly during Years 1-3 post-diagnosis but never returned to baseline. Discontinuation rates increased from treatment to Year +1 (59.3% vs 75.6%, p 7.0% (34.9% vs 51.1%, p adherence. Diabetes mellitus medication adherence declined following BC diagnosis, whereas discontinuation rates were relatively stable but poor overall. The proportion of adherent users increased only marginally following treatment, whereas the proportion of women meeting goals for HbA1c decreased considerably. These data support the hypothesis that adherence and subsequent glycemic control are sensitive to BC diagnosis and treatment. Confirmatory studies in other settings, on reasons for reduced adherence post-cancer diagnosis, and on subsequent indicators of glycemic control are warranted. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Patients' Perception of App-based Educational and Behavioural Interventions for Enhancing Oral Anticancer Medication Adherence.

    Science.gov (United States)

    Ali, Eskinder Eshetu; Leow, Jo Lene; Chew, Lita; Yap, Kevin Yi-Lwern

    2017-07-14

    Well-designed smartphone apps can potentially help in enhancing adherence to oral anticancer medications (OAMs). The objective of this study was to evaluate patients' perception on inclusion of various adherence-enhancing strategies as features of an app and their interest in using such app. A cross-sectional survey was conducted at the National Cancer Centre Singapore. A structured self-administered questionnaire was used to collect data from patients taking OAMs. Final analysis was based on 409 surveys and most of the respondents were female (291, 71.1%), Chinese (332, 81.2%), married (296, 72.4%) and breast cancer patients (211, 51.6%). Close to two-thirds of respondents rated medication information (65.0%), disease information (60.2%) and side effect self-management (60.2%) features as having the highest level of importance in an adherence app. Three hundred thirty-two (81.2%) of the respondents owned a smartphone, among which 92 (27.7%) reported using health-related apps. From respondents with smartphones, 219 (66.0%) were interested in using an app for OAM adherence. Age 65 and older compared to 21-54 years old (adjusted OR = 0.34; 95% CI = 0.15-0.76) and current use of a health app (adjusted OR = 1.91; 95% CI = 1.07-3.41) were significant predictors of interest to adopt an adherence app. In conclusion, patients value the inclusion of educational and behavioural interventions in adherence apps. Developers of adherence apps should consider including tools for side effect self-management and provision of information to educate patients on their medications and disease condition.

  17. Assessing the need for improved strategies and medication-related education to increase adherence for oral anticancer medications in the young adult oncology population.

    Science.gov (United States)

    Divakaruni, Anupama; Saylor, Elizabeth; Duffy, Alison P

    2017-01-01

    Rationale Oral anticancer medication adherence is a critical factor in optimizing cancer treatment outcomes and minimizing toxicity. Although potential adherence barriers exist, it is not well understood how these factors impact adherence. Methods This is a prospective, single-center, patient survey-based study conducted at the University of Maryland Greenebaum Comprehensive Cancer Center including 18- to 39-year-old patients who have been actively taking an oral anticancer medication for at least one month from 1 April 2013 to 1 April 2016. The primary objective of this study is to describe institutional practices for medication education and adherence monitoring practices as perceived by young adult patients at the University of Maryland Greenebaum Comprehensive Cancer Center and to describe practice consistency with recommendations from the American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards. The secondary objectives include patient-reported facilitators and barriers to oral anticancer medication adherence. Results Seventeen patients completed the survey; 24% ( n = 4) of patients denied receiving information about what to do in case of a missed dose. The most common facilitators of adherence include understanding of disease and treatment (88%, n = 15), perceived severity of illness (82%, n = 14), and use of oral anticancer medications (82%, n = 14). The most common barriers to adherence are side effects (59% n = 10), forgetfulness (47%, n = 8), and depressive symptoms (35%, n = 6). Conclusion Based on patient-reported guideline adherence, improvement is needed in including family, caregivers, and others in the education process as well as providing education about plan for missed doses and drug-drug and drug-food interactions. The strengths of the current medication education and adherence monitoring practices as perceived by the young adult patient population include education

  18. Double-blind comparison of oral transmucosal fentanyl citrate with oral meperidine, diazepam, and atropine as preanesthetic medication in children with congenital heart disease.

    Science.gov (United States)

    Goldstein-Dresner, M C; Davis, P J; Kretchman, E; Siewers, R D; Certo, N; Cook, D R

    1991-01-01

    The effectiveness of oral transmucosal fentanyl citrate (OTFC) as preanesthetic medication was compared with oral meperidine, diazepam, and atropine (MDA) in 40 pediatric patients scheduled to undergo repair of congenital heart defects. In a double-blinded manner, patients received a fentanyl lollipop (20-25 micrograms/kg) and a placebo oral solution (0.4 ml/kg) (n = 20) or a placebo lollipop and an oral solution (0.4 ml/kg) of meperidine (1.5 mg/kg), diazepam (0.2 mg/kg), and atropine (0.02 mg/kg) (n = 20). The patient's vital signs, systolic and diastolic blood pressures, heart rate, respiratory rate, and oxyhemoglobin saturation (SpO2), as well as activity and apprehension scores were evaluated and recorded at baseline and at 10-min intervals. The patient's emotional status at the time of parental separation and at induction of anesthesia were also assessed. Side effects and onset of action were observed. After OTFC, onset of sedation was significantly faster than with the oral solution of meperidine, diazepam, and atropine. In both groups there was no significant change in heart rate. Although systolic blood pressure, diastolic blood pressure, and respiratory rate showed statistically significant decreases, these changes were not clinically significant. The child's emotional status at the time of separation from the parents and during induction was similar in both groups. Side effects with OTFC were more frequent: nose itching occurred in 65%, body itching in 10%, and vomiting in 30%. Two patients (10%) in the OTFC-treated group became hypoxemic (SpO2 less than 90) and required supplemental oxygen. In the group receiving oral meperidine, diazepam, and atropine, 10% had mild facial pruritus and 5% complained of a dry mouth.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Structured oral examination in pharmacology for undergraduate medical students: Factors influencing its implementation.

    Science.gov (United States)

    Khilnani, Ajeet Kumar; Charan, Jaykaran; Thaddanee, Rekha; Pathak, Rakesh R; Makwana, Sohil; Khilnani, Gurudas

    2015-01-01

    The study aims to understand the process and factors influencing the implementation of structured oral examination (SOE) for undergraduate medical students; in comparison with conventional oral examination (COE) in pharmacology. In a randomized, parallel group study, 123 students of pharmacology were divided into two groups, SOE (n = 63) and COE (n = 60). Students of each group were subdivided into two, and four examiners took viva voce individually. Three sets of questionnaires from autonomic nervous system were prepared, each having 15 items with increasing difficulty levels and were validated by subject experts and pretested. Ten minutes were allotted for each student for each viva. Feedback of students and faculty about the novel method was obtained. SOE yielded significantly lower marks as compared to COE. There were significant inter-examiner variations in marks awarded in SOE and COE. Other factors influencing implementation were difficulty in structuring viva, rigid time limits, lack of flexibility in knowledge content, monotony, and fatigue. The students perceived this format not different from COE but felt that it required in-depth preparation of topic. Faculty opined that SOE led to less drift from main topic and provided uniform coverage of topics in given time. Conducting SOE is a resource-intensive exercise. Despite structuring, inter-examiner variability was not completely eliminated. The students' performance was depended on factors related to examiners such as teaching experience, vernacular language used, and lack of training. Orientation and training of examiners in assessment strategies is necessary. Standardization of questionnaire is necessary before the implementation of SOE for summative assessment.

  20. Initial choice of oral glucose-lowering medication for diabetes mellitus: a patient-centered comparative effectiveness study.

    Science.gov (United States)

    Berkowitz, Seth A; Krumme, Alexis A; Avorn, Jerry; Brennan, Troyen; Matlin, Olga S; Spettell, Claire M; Pezalla, Edmund J; Brill, Gregory; Shrank, William H; Choudhry, Niteesh K

    2014-12-01

    Although many classes of oral glucose-lowering medications have been approved for use, little comparative effectiveness evidence exists to guide initial selection of therapy for diabetes mellitus. To determine the effect of initial oral glucose-lowering agent class on subsequent need for treatment intensification and 4 short-term adverse clinical events. This study was a retrospective cohort study of patients who were fully insured members of Aetna (a large national health insurer) who had been prescribed an oral glucose-lowering medication from July 1, 2009, through June 30, 2013. Individuals newly prescribed an oral glucose-lowering agent who filled a second prescription for a medication in the same class and with a dosage at or above the World Health Organization's defined daily dose within 90 days of the end-of-day's supply of the first prescription were studied. Individuals with interim prescriptions for other oral glucose-lowering medications were excluded. Initiation of treatment with metformin, a sulfonylurea, a thiazolidinedione, or a dipeptidyl peptidase 4 inhibitor. Time to addition of a second oral agent or insulin, each component separately, hypoglycemia, other diabetes-related emergency department visits, and cardiovascular events. A total of 15 516 patients met the inclusion criteria, of whom 8964 (57.8%) started therapy with metformin. In unadjusted analyses, use of medications other than metformin was significantly associated with an increased risk of adding a second oral agent only, insulin only, and a second agent or insulin (P < .001 for all). In propensity score and multivariable-adjusted Cox proportional hazards models, initiation of therapy with sulfonylureas (hazard ratio [HR], 1.68; 95% CI, 1.57-1.79), thiazolidinediones (HR, 1.61; 95% CI, 1.43-1.80), and dipeptidyl peptidase 4 inhibitors (HR, 1.62; 95% CI, 1.47-1.79) was associated with an increased hazard of intensification. Alternatives to metformin were not associated with a

  1. Comparative hypoglycemic activity of different fractions of Thymus serpyllum L. in alloxan induced diabetic rabbits.

    Science.gov (United States)

    Alamgeer, -; Mushtaq, Muhammad Naveed; Bashir, Sajid; Ullah, Ikram; Karim, Sabeha; Rashid, Muhammad; Malik, Muhammad Nasir Hayat; Rashid, Haroonur

    2016-09-01

    The aim of present study was to evaluate and compare the hypoglycemic activity of different solvents extracts of Thymus serpyllum in rabbits. Diabetes was induced with single intravenous injection of alloxan monohydrate (150mg/kg). Glibenclamide and acarbose were used as standard drugs. The crude powder of Thymus serpyllum (500 mg/kg b.w) significantly reduced blood glucose level in both normal and diabetic rabbits. Various extracts of Thymus serpyllum were compared for their hypoglycemic activity in diabetic rabbits. Ether and aqueous extracts significantly reduced the blood glucose level with maximum effect (p<0.001) produced by aqueous extract, which was selected for further study. Aqueous extract significantly inhibited the rise in glucose level in oral glucose tolerance test. The extract showed synergistic effect with different doses of insulin; however serum insulin level of the diabetic rabbits was not significantly increased by the extract. HbA1c level was significantly (p<0.05) reduced whereas hemoglobin level was significantly increased in three months study. Phytochemical screening of the aqueous extract showed the presence of alkaloids, flavonoids, tannins, terpinoids, reducing sugar and cardiac glycosides. It is concluded that the aqueous extract might be used alone or in combination with insulin to manage diabetes and its associated complications.

  2. 甘精胰岛素联合口服药物治疗2型糖尿病的疗效及安全性分析%Analysis of Efficacy and Safety of the Treatment of Insulin Glargine Combined with Oral Hypoglycemic Drugs for Type 2 Diabetic Patients

    Institute of Scientific and Technical Information of China (English)

    李敬华; 刘丽楠; 王素莉; 关树梅; 候雯莉

    2011-01-01

    Objective Evaluation of the efficacy end safety of the treatment insulin glargine combined with OADs for type 2 diabetic patients with poor glycemic control using premixed insulin therapy. Methods 50 cases of type 2 diabetic patients were randomly divided into treatment group (convert premixed insulin into insulin glargine plus OADs) (n= 30) and control group (continue to use the premixed insulin plus OADs) (n= 20), all groups were adjusted the dosage of insulin and OADs based on the levels of blood glucose. After 12 weeks the index of FBG、2hPG、HbA1c、BMI and the incidence of hypoglycemia during the test were compared in two groups. Results Compared with those before treatment, HbA1c、FBG、2hPG of the two groups have declined (P all < 0.01); the treatment group has no significant change in BMI (P >0.05). Compared with the control group, FBG、lunch 2hPG and HbA1c of the treatment group is lower (P all<0.01); BMI of treatment group is lower (P< 0.01); the incidence of hypoglycemia during the test of the treatment group is lower(P< 0.01). Conclusion The treatment of insulin glargine combined OADs for poor glycemic control in type 2 diabetic patients using premixed insulin,can significantly improve the levels of FBG and HbA1c, do not increase body weight, be simple, and can greatly reduce the risk of hypoglycemia.%目的 评价甘精胰岛素联合口服降糖药物(oral hypoglycemic drugs,OADs)治疗方案对使用预混胰岛素血糖控制欠佳的2型糖尿病患者的疗效及安全性.方法 预混胰岛素30/70单独或联合使用OADs血糖控制不良的2型糖尿病患者50例,随机分为治疗组(停用预混胰岛素,改为皮下注射甘精胰岛素联合OADs) (n= 30)和对照组(继续使用预混胰岛素早晚餐前皮下注射联合OADs)(n=20),各组均依据血糖监测水平调整胰岛素及OADs用量.12周后对比两组患者空腹血糖(fasting blood glucose,FBG)、三餐后2h血糖(2-hour postprandial blood glucose,2hPG

  3. Lantus with glucobay vs Novomix 30 in treatment of very old patients with type 2 diabetes poorly controlled by oral hypoglycemic drugs%来得时联合拜唐苹和诺和锐30治疗口服降糖药疗效不佳的高龄2型糖尿病患者的临床观察

    Institute of Scientific and Technical Information of China (English)

    邵莉; 滕丽莉; 牛宪萍; 李明珠; 葛剑力; 江华

    2013-01-01

    Objective To investigate the changes of blood glucose, HbA1c, and incidence of hypoglycemia in the very old patients (over 80 years) with type 2 diabetes mellitus (T2DM) after the treatment of lantus with glucobay or Novomix 30, and the clinical significance. Methods A total of 120 very old T2DM patients poorly controlled with oral hypoglycemic drugs admitted in our department from July 2011 to June 2012 were subjected in this study. They were randomly divided into lantus with glucobay group and Novomix 30 group (n=60 in each group). Lantus was injected before breakfast, and glucobay was taken with meals, while Novomix 30 was injected before morning and evening meals for total 16 weeks. Fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), the decrease of HbA1c, and the incidence of hypoglycemia were compared between the two groups. Results After the treatment, blood glucose, TG, TC, LDL-C and HbA1c were decreased in the two groups though without significant difference (P>0.05). HbA1c was decreased from (8.8%±2.0%) to (7.1%±1.2%) in the glucobay group, and from (8.9%±2.4%) to (7.0%±1.2%) in Novomix 30 group, with no significant difference between them (P>0.05). The incidence of hypoglycemia was significantly lower in glucobay group than in Novomix 30 group (3.3%vs 13.3%, P<0.01). Conclusion Lantus combined with glucobay and Novomix 30 have the similar improvement in FBG, 2hPBG, TG, TC, LDL-C and HbA1c. But the combination with glucobay has significantly lower incidence of hypoglycemia.%  目的探讨来得时联合拜唐苹和诺和锐30治疗高龄(80岁以上)2型糖尿病(T2DM)患者血糖、糖化血红蛋白(HbA1c)变化,低血糖事件发生率及临床意义。方法将120例口服降糖药物疗效较差的高龄T2DM患者随机分为来得时联合拜唐苹组和诺和锐30

  4. Coleus forskohlii extract attenuates the hypoglycemic effect of tolbutamide in vivo via a hepatic cytochrome P450-mediated mechanism.

    Science.gov (United States)

    Yokotani, Kaori; Chiba, Tsuyoshi; Sato, Yoko; Umegaki, Keizo

    2014-01-01

    This in vivo study in rats evaluated whether Coleus forskohlii extract (CFE) taken orally interacted with tolbutamide, a hypoglycemic drug metabolized by CYP2C enzymes. Rats were fed 0%, 0.3%, 1% (w/w) CFE diet for 2 weeks, followed by 0% CFE diet for 1 day. They were then given 40 mg/kg tolbutamide by intragastric gavage. Blood glucose level was determined up to 6 h after tolbutamide administration. CFE treatment increased total CYP content and various CYP subtypes in the liver. In particular, increases in activity and protein expression were noted for the CYP2B, CYP2C, and CYP3A subtypes. CFE treatment dose-dependently attenuated both the hypoglycemic action of tolbutamide at 6 h and the plasma concentration of tolbutamide. The activity of (S)-warfarin 7-hydroxylase, a CYP2C enzyme was negatively correlated with plasma tolbutamide level, which also showed a negative correlation with the reduction of blood glucose level. These results indicate that CFE induced hepatic CYPs in rats and attenuated the hypoglycemic action of tolbutamide via a hepatic CYP2C-mediated mechanism.

  5. Hypoglycemic effect of Bromelia plumieri (E. Morren) L.B. Sm., leaves in STZ-NA-induced diabetic rats.

    Science.gov (United States)

    Andrade-Cetto, Adolfo; Medina-Hernández, Anamarel E

    2013-01-01

    This study confirms the hypoglycemic effects of two extracts obtained from the Bromelia plumieri (BP) plant in streptozotocin-nicotinamide-induced diabetic rats (STZ-NA). BP has been traditionally used in the municipality of Tlanchinol Hidalgo, Mexico, to treat type 2 diabetes. Two different BP extracts were prepared and tested. The first extract was a water extract (WE), similar to that traditionally used to make tea, and the second extract was an ethanol:water extract (EWE). The extracts (WE at 35 and 350 mg/kg, and EWE at 30 and 300 mg/kg) were tested in STZ-NA-induced diabetic rats to determine whether hypoglycemia occurred after oral administration of the extracts. Phytochemistry: Two different extracts were prepared, n-hexane and butanol, to determine the presence of alkaloids, terpenes and flavonoids. The extracts that were administered to the STZ-NA-induced diabetic rats produced a significant hypoglycemic effect as compared with the control group, similar to that achieved with glibenclamide. We also determined that flavonoids were the main components of BP leaves. The results presented here support the hypothesis that extracts obtained from this plant have hypoglycemic effects, which are in agreement with the traditional uses of this plant.

  6. Improving the Safety of Oral Chemotherapy at an Academic Medical Center

    Science.gov (United States)

    Casella, Erica; Capozzi, Donna; McGettigan, Suzanne; Gangadhar, Tara C.; Schuchter, Lynn; Myers, Jennifer S.

    2016-01-01

    Purpose: Over the last decade, the use of oral chemotherapy (OC) for the treatment of cancer has dramatically increased. Despite their route of administration, OCs pose many of the same risks as intravenous agents. In this quality improvement project, we sought to examine our current process for the prescription of OC at the Abramson Cancer Center of the University of Pennsylvania and to improve on its safety. Methods: A multidisciplinary team that included oncologists, advanced-practice providers, and pharmacists was formed to analyze the current state of our OC practice. Using Lean Six Sigma quality improvement tools, we identified a lack of pharmacist review of the OC prescription as an area for improvement. To address these deficiencies, we used our electronic medical system to route OC orders placed by treating providers to an oncology-specific outpatient pharmacist at the Abramson Cancer Center for review. Results: Over 7 months, 63 orders for OC were placed for 45 individual patients. Of the 63 orders, all were reviewed by pharmacists, and, as a result, 22 interventions were made (35%). Types of interventions included dosage adjustment (one of 22), identification of an interacting drug (nine of 22), and recommendations for additional drug monitoring (12 of 22). Conclusion: OC poses many of the same risks as intravenous chemotherapy and should be prescribed and reviewed with the same oversight. At our institution, involvement of an oncology-trained pharmacist in the review of OC led to meaningful interventions in one third of the orders. PMID:26733627

  7. [Withdrawal of high estrogen containing oral contraceptives and the demand for medical service].

    Science.gov (United States)

    Kamper-Jorgensen, F; Albertsen, J; Almind, G; Andersen, K; Braae, M; Dybkjaer, L; Frolund, F; Granlie, K; Hald, E; Hald, J; Hector, O; Jacobsen, K; Kaltoft, S; Kjaerulff, E; Mabeck, C D; Magnusson, B; Nielsen, A; Novella, P; Olsen, O M; Pedersen, P A; Rasmussen, I; Strunk, K; Traeden, J B; Veje, J O

    1975-03-24

    The results of a survey are presented conerning the effectiveness of mass media publicity with the public. After oral contraceptives containing high levels of estrogen were prohibited in Denmark, a telephone survey of 23 doctors was taken to determine the fluctuation in demand for medical information from patients, and the reason for the fluctuation. The reasons were divided into 3 groups: 1) resulting from mass media publicity, 2) resulting from the unavailability of a particular contraceptive, and 3) other. 3 surveys were conducted of the frequency of demand for information on the high estrogen contraceptives, 1 for each of the 2 weeks after the prohibition and withdrawal of the contraceptives took place, and 1 1 month after the prohibition. 2-3% of the inquiries received by the doctors concerned the prohibited contraceptives, and half of these could be attributed directly to the mass media publicity. The number of requests in categories 1 and 2 dropped sharply in the 2nd and 3rd surveys, indicating that the effect of the mass meida publicity and the withdrawal of the contraceptive from the market had only a very immediate effect. It is also shown that the telephone can be used successfully to ascertain the effects of a short-term social phenomenon on the public.

  8. Venue of receiving diabetes self-management education and training and its impact on oral diabetic medication adherence.

    Science.gov (United States)

    Wu, Jun; Davis-Ajami, Mary Lynn; Noxon, Virginia; Lu, Zhiqiang Kevin

    2017-04-01

    To determine predictors associated with the diabetes self-management education and training (DSME) venue and its impact on oral antidiabetic (OAD) medication adherence. The Medical Expenditure Panel Survey household component (MEPS-HC) data (2010-2012) identified adults with diabetes prescribed OAD medication(s) who completed a supplemental Diabetes Care Survey (DCS). Based on the DCS responses to questions about the number and type of DSME venue(s), two groups were created: (1) multiple venues (a physician or health professional plus internet and/or group classes) vs (2) single venue (physician or health professional only). The medication possession ratio (MPR) measured medication adherence, with 0.80 the cut-point defining adherent. Logistic regression examined factors associated with the DSME venue and its effect on OAD medication adherence. Of the 2119 respondents, 41.6% received DSME from multiple venues. Age (medication adherence was suboptimal (mean MPR 0.66 vs 0.64, p=0.245), and venue showed no influence on adherence (OR: 0.92, 95% CI, 0.73-1.16). Sociodemographic characteristics influence where adults with diabetes receive DSME. Adding different DSME venues may not address suboptimal OAD medication adherence. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  9. Health disparities among highly vulnerable populations in the United States: a call to action for medical and oral health care

    Directory of Open Access Journals (Sweden)

    Allison A. Vanderbilt

    2013-03-01

    Full Text Available Healthcare in the United States (US is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, yet oral health disparities continue to plague the US healthcare system. Interprofessional education and teamwork has been demonstrated to improve patient outcomes and provide benefits to participating health professionals. We propose the implementation of interprofessional education and teamwork as a solution to meet the increasing oral and systemic healthcare demands of highly vulnerable US populations.

  10. Health disparities among highly vulnerable populations in the United States: a call to action for medical and oral health care.

    Science.gov (United States)

    Vanderbilt, Allison A; Isringhausen, Kim T; VanderWielen, Lynn M; Wright, Marcie S; Slashcheva, Lyubov D; Madden, Molly A

    2013-01-01

    Healthcare in the United States (US) is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, yet oral health disparities continue to plague the US healthcare system. Interprofessional education and teamwork has been demonstrated to improve patient outcomes and provide benefits to participating health professionals. We propose the implementation of interprofessional education and teamwork as a solution to meet the increasing oral and systemic healthcare demands of highly vulnerable US populations.

  11. In vitro α-amylase inhibitory activity and in vivo hypoglycemic effect of methanol extract of Citrus macroptera Montr. fruit

    Institute of Scientific and Technical Information of China (English)

    Nizam Uddin; Md. Rakib Hasan; Md. Monir Hossain; Arjyabrata Sarker; A.H.M. Nazmul Hasan; A.F.M. Mahmudul Islam; Mohd. Motaher H. Chowdhury; Md. Sohel Rana

    2014-01-01

    Objective: To investigate the therapeutic effects of methanol extract of Citrus macroptera Montr. fruit in α-amylase inhibitory activity (in vitro) and hypoglycemic activity in normal and glucose induced hyperglycemic rats (in vivo). Methods: Fruits of Citrus macroptera without rind was extracted with pure methanol following cold extraction and tested for presence of phytochemical constituents, α-amylase inhibitory activity, and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats.Results:showed that fruit extract had moderate α-amylase inhibitory activity [IC50 value=(3.638±0.190) mg/mL] as compared to acarbose. Moreover at 500 mg/kg and 1 000 mg/kg doses fruit extract significantly (P<0.05 and P<0.01 respectively) reduced fasting blood glucose level in normal rats as compared to glibenclamide (5 mg/kg). In oral glucose tolerance test, 500 mg/kg dose significantly reduced blood glucose level (P<0.05) at 2 h but 1000 mg/kg dose significantly reduced blood glucose level at 2 h and 3 h (P<0.05 and P<0.01 respectively) whereas glibenclamide (5 mg/kg) significantly reduced glucose level at every hour after administration. Overall time effect is also considered extremely significant with F value=23.83 and P value=0.0001 in oral glucose tolerance test.Conclusion:These findings suggest that the plant may be a potential source for the development Presence of saponin, steroid and terpenoid were identified in the extract. The results of new oral hypoglycemic agent.

  12. Investigation of hypoglycemic, hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark in diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Subramaniam Ramachandran; Aiyalu Rajasekaran; KT Manisenthilkumar

    2012-01-01

    Objective: To investigate the hypoglycemic, hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark (AETPB) in streptozotocin (STZ)-induced diabetic rats. Methods: Acute toxicity was studied in rats after the oral administration of AETPB to determine the dose to assess hypoglycemic activity. In rats, diabetes was induced by injection of STZ (60 mg/kg, i.p.) and diabetes was confirmed 72 h after induction, and then allowed for 14 days to stabilize blood glucose level. In diabetic rats, AETPB was orally given for 28 days and its effect on blood glucose and body weight was determined on a weekly basis. At the end of the experimental day, fasting blood sample was collected to estimate the haemoglobin (Hb), glycosylated haemoglobin (HbA1c), serum creatinine, urea, serum glutamate-pyruvate transaminase (SGPT), serum glutamate-oxaloacetate transaminase (SGOT) and insulin levels. The liver and kidney were collected to determine antioxidants levels in diabetic rats. Results:Oral administration of AETPB did not exhibit toxicity and death at a dose of 2000 mg/kg. AETPB treated diabetic rats significantly (P<0.001, P<0.01 and P<0.05) reduced elevated blood glucose, HbA1c, creatinine, urea, SGPT and SGOT levels when compared with diabetic control rats. The body weight, Hb, insulin and total protein levels were significantly (P<0.001, P<0.01 and P<0.05) increased in diabetic rats treated with AETPB compared to diabetic control rats. In diabetic rats, AETPB treatment significantly reversed abnormal status of antioxidants and lipid profile levels towards near normal levels compared to diabetic control rats. Conclusions: Present study results confirm that AETPB possesses significant hypoglycemic, hypolipidemic and antioxidant activities in diabetic condition.

  13. Health disparities among highly vulnerable populations in the United States: a call to action for medical and oral health care

    OpenAIRE

    Vanderbilt, Allison A; Isringhausen, Kim T; VanderWielen, Lynn M.; Wright, Marcie S.; Slashcheva, Lyubov D.; Madden, Molly A.

    2013-01-01

    Healthcare in the United States (US) is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, ...

  14. Rising Prices of Targeted Oral Anticancer Medications and Associated Financial Burden on Medicare Beneficiaries.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Xu, Ying; Liu, Lei; Smieliauskas, Fabrice

    2017-08-01

    Purpose The high cost of oncology drugs threatens the affordability of cancer care. Previous research identified drivers of price growth of targeted oral anticancer medications (TOAMs) in private insurance plans and projected the impact of closing the coverage gap in Medicare Part D in 2020. This study examined trends in TOAM prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. Methods Using SEER linked to Medicare Part D, 2007 to 2012, we identified patients who take TOAMs via National Drug Codes in Part D claims. We calculated total drug costs (prices) and OOP payments per patient per month and compared their rates of inflation with general health care prices. Results The study cohort included 42,111 patients who received TOAMs between 2007 and 2012. Although the general prescription drug consumer price index grew at 3% per year over 2007 to 2012, mean TOAM prices increased by nearly 12% per year, reaching $7,719 per patient per month in 2012. Prices increased over time for newly and previously launched TOAMs. Mean patient OOP payments dropped by 4% per year over the study period, with a 40% drop among patients with a high financial burden in 2011, when the coverage gap began to close. Conclusion Rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D. Policymakers should explore methods of harnessing the surge of novel TOAMs to increase price competition for Medicare beneficiaries.

  15. Sentinel node biopsy for early-stage oral cavity cancer: the VU University Medical Center experience

    NARCIS (Netherlands)

    Den Toom, I.J.; Heuveling, D.A.; Flach, G.B.; van Weert, S.; Karagozoglu, K.H.; van Schie, A.; Bloemena, E.; Leemans, C.R.; de Bree, R.

    2015-01-01

    Background Sentinel node biopsy (SNB) in head and neck cancer is recently introduced as the staging technique of oral squamous cell carcinoma. We report the results of SNB in patients diagnosed with a T1-T2 oral squamous cell carcinoma and clinically negative (N0) neck in a single center. Methods A

  16. The Postprandial Hypoglycemic Activity of Fenugreek Seed and Seeds′ Extract in Type 2 Diabetics: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Hiba A Bawadi

    2009-01-01

    Full Text Available Trigonella foenum-groecum L. is directly related to the traditional use. Trigonella foenum-graecum L, have been reported to be beneficial for treating type 2 diabetes (T2D. The study was conducted to investigate the postprandial hypoglycemic effect of fenugreek seeds on patients with T2D. Pretest - posttest control group design was used to test the hypothesis that fenugreek may have a hypoglycemic effect on blood sugar. One hundred sixty--six D2T patients were assigned into three groups: FGO (control group: placebo drink, FG2.5 (2.5g of fenugreek, and FG5 (5g of fenugreek. Participants were instructed to drink the extract and chew the seeds. Postprandial plasma glucose level was measured before and 2-hours after the administration of the treatment. Accounting for gender, age, education, physical activity, body mass index, glycemic control, and medication, patients in FG5 group showed the greatest decrease in postprandial glucose with a pretest-posttest difference (D of - 41 ± 6.1 mg/dl. Two-hour plasma glucose dropped for patients in FG2.5, however, the drop was not statistically different from that noticed in the placebo group (D = - 24.8 ± 4.9 mg/dl vs. - 9.8 ± 2.2 mg/dl respectively. Fenugreek seeds appear to have a significant hypoglycemic activity in T2D patients.

  17. 口腔颌面外科住院病案质量存在的问题及思考%Problems and Reflection of Inpatient Medical Record Quality in Oral and Maxillofacial Surgery

    Institute of Scientific and Technical Information of China (English)

    喻棣; 曾大顺; 金凯; 李小新; 陈剑云

    2016-01-01

    Objective By randomly checking inpatient medical record in oral and maxillofacial surgery and analyzing the existing quality problems in medical record, put forward corresponding countermeasures for medical record quality management so as to improve inpatient medical record in oral and maxillofacial surgery.Methods 500 cases of inpatient medical records in oral and maxillofacial surgery from 2013-2014 were checked and the problems in medical record quality and their causes were analyzed before relevant suggestions were put forward.Results The main problems of inpatient medical records in oral and maxillofacial surgery included: delayed record, unrelated or undetailed content, deficiency, the lack of systematic and scientific medical history, the lack of pertinence, indistinct definition for discharge and the lack of signature.Conclusion Inpatient medical record in oral and maxillofacial surgery has certain problems, which could be improved through improving medical record writing ability, strengthening medical record quality consciousness, strengthening control, improving and implementing relevant policies.

  18. Comparing medical and dental providers of oral health services on early dental caries experience.

    Science.gov (United States)

    Kranz, Ashley M; Rozier, R Gary; Preisser, John S; Stearns, Sally C; Weinberger, Morris; Lee, Jessica Y

    2014-07-01

    Most state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children. We examined the association between who (PCP, dentist, or both) provides these services to Medicaid enrollees before age 3 years and oral health at age 5 years. We linked North Carolina Medicaid claims (1999-2006) to oral health surveillance data (2005-2006). Regression models estimated oral health status (number of decayed, missing, and filled primary teeth) and untreated disease (proportion of untreated decayed teeth), with adjustment for relevant characteristics and by using inverse-probability-of-treatment weights to address confounding. We analyzed data for 5235 children with 2 or more oral health visits from a PCP, dentist, or both. Children with multiple PCP or dentist visits had a similar number of overall mean decayed, missing, and filled primary teeth in kindergarten, whereas children with only PCP visits had a higher proportion of untreated decayed teeth. The setting and provider type did not influence the effectiveness of preventive oral health services on children's overall oral health. However, children having only PCP visits may encounter barriers to obtaining dental treatment.

  19. EDGE study in Russian Federation: efficacy and safety of vildagliptine in comparison with other oral antidiabetic agents in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    G R Galstyan

    2013-06-01

    Full Text Available According to international consensus, metformin is acknowledged as a first-line therapeutic agent for type 2 diabetes mellitus (T2DM. However, in most cases this treatment eventually requires intensification by supplementation with other hypoglycemic medications. The aim of the EDGE study (Effective Diabetes control with vildaGliptin and vildagliptin/mEtformin was to assess the efficacy and safety of vildagliptin in comparison with other oral agents in routine management of patients with T2DM that has been poorly controlled by metformin monotherapy.

  20. Increased risk of severe hypoglycemic events with increasing frequency of non-severe hypoglycemic events in patients with Type 1 and Type 2 diabetes.

    LENUS (Irish Health Repository)

    Sreenan, Seamus

    2014-07-15

    Severe hypoglycemic events (SHEs) are associated with significant morbidity, mortality and costs. However, the more common non-severe hypoglycemic events (NSHEs) are less well explored. We investigated the association between reported frequency of NSHEs and SHEs among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in the PREDICTIVE study.

  1. Burning sensation in oral cavity--burning mouth syndrome in everyday medical practice

    National Research Council Canada - National Science Library

    Gerlinger, Imre

    2012-01-01

    .... It is observed principally in middle-aged patients and postmenopausal women. BMS is characterized by an intense burning or stinging sensation, typically on the tongue or in other areas of the oral mucosa...

  2. Oral health knowledge, attitude and practices among health professionals in King Fahad Medical City, Riyadh

    Directory of Open Access Journals (Sweden)

    Mohammad Abdul Baseer

    2012-01-01

    Conclusion: Oral health knowledge among the health professionals working in KFMC, Riyadh was lower than what would be expected of these groups, which had higher literacy levels in health care, but they showed a positive attitude toward professional dental care.

  3. A case of hypoglycemic hemiparesis and literature review.

    Science.gov (United States)

    Yoshino, Tetsuhiro; Meguro, Shu; Soeda, Yukie; Itoh, Arata; Kawai, Toshihide; Itoh, Hiroshi

    2012-08-01

    An 89-year-old man with diabetes treated with metformin 500 mg/day and glimepiride 4 mg/day was hospitalized because of hypoglycemic right hemiparesis and dysarthria (casual glucose value 1.8 mmol/L), which resolved quickly following administration of 40 mL of 40% dextrose. Hemiparesis is a rare symptom (4.2%) of hypoglycemia. There are about 200 case reports of hypoglycemic hemiparesis. The average glucose level at which hemiparesis developed was 1.8 mmol/L. Right-sided hemiparesis predominated (R 66%; L 34%). On imaging studies, abnormal findings were frequently observed in the internal capsule or splenium of the corpus callosum. The mechanism of hemiparesis is not fully understood. The existence of cases in which hypoglycemia cannot be distinguished from stroke on imaging studies suggests the importance of measurement of the blood glucose level when the symptoms of stroke are first recognized.

  4. EVALUATION OF HYPOGLYCEMIC EFFECT OF AN INDIAN FRUIT: DILLENIA INDICA

    Directory of Open Access Journals (Sweden)

    Das Munmee

    2013-08-01

    Full Text Available The fruit of DiIlenia indica has been an integral part of the Assamese cuisine and it is claimed that this fruit can control blood sugar when consumed on a regular basis. A randomized clinical trial was carried out on 40 patients in Government Ayurvedic College and Hospital, Guwahati, Assam, India. The study revealed the hypoglycemic activity of Dillenia indica in type 2 diabetes patients, following standardized approach. The fruit powder of Dillenia indica used in this trial showed significant hypoglycemic effect (p < 0.001. The result of the clinical trial has been highly encouraging with the mean blood sugar both FBS and PPBS of the patients being reduced gradually overtime without any unwanted effect.

  5. [Hypoglycemic activity of Bouvardia terniflora, Brickellia veronicaefolia, and Parmentiera edulis].

    Science.gov (United States)

    Pérez-Gutiérrez, R M; Pérez-González, C; Zavala-Sánchez, M A; Pérez-Gutiérrez, S

    1998-01-01

    To evaluate the hypoglycemic activity of the hexane, chloroform and methanol extracts of Bouvardia terniflora, Brickelia veronicaefolia and Parmentiera edulis. Normal and alloxan-induced diabetic mice were administered these plant extracts (intraperitoneal 100, 200 and 300 mg/kg). The administration of 300 mg/kg of chloroform extracts from P. edulis and B. terniflora and hexane from B. veronicaefolia to diabetic mice decreased the blood glucose levels in 43.75, 58.56 and 72.13%, respectively. These extracts administered to normal mice reduced blood glucose levels in 29.61, 33.42 and 39.84%, respectively. The hypoglycemic effect of these plant extracts used in traditional medicine for diabetes treatment is confirmed.

  6. Sulfation of tea polysaccharides: synthesis, characterization and hypoglycemic activity.

    Science.gov (United States)

    Wang, Yuanfeng; Peng, Yonghua; Wei, Xinlin; Yang, Zhiwei; Xiao, Jianbo; Jin, Zhengyu

    2010-03-01

    Neutral polysaccharides (NTPS) and acid polysaccharides (ATPS) from tea leaves were obtained on a D315 macroporous anion-exchange resin column chromatography. NTPS and ATPS were sulfated by the pyridine-sulfonic acid method to obtain NTPS-S and ATPS-S. It was found that NTPS was easier sulfated than ATPS. There are strong characteristic absorption peaks located in 1258 cm(-1), 1146 cm(-1), 832 cm(-1) and 617 cm(-1) in the FTIR spectra of sulfated polysaccharides. Sulfation of polysaccharides also affected the endothermic and exothermic peaks via the DSC scan analysis. The appearance of exothermic peaks in both NTPS-S and ATPS-S indicated that the redox reaction might happen. The comparative study of hypoglycemic effect on mice showed that the sulfation of polysaccharides significantly improved hypoglycemic activity.

  7. A Confusing Coincidence: Neonatal Hypoglycemic Seizures and Hyperekplexia

    Directory of Open Access Journals (Sweden)

    Nihat Demir

    2014-01-01

    Full Text Available Hyperekplexia is a rare, nonepileptic, genetic, or sporadic neurologic disorder characterized by startle responses to acoustic, optic, or tactile stimuli. Genetic defects in glycine receptors as well as encephalitis, tumors, inflammation, and disgenesis are among the etiologic causes of the disease. The main problem in hyperekplexia is the incomplete development of inhibitory mechanisms or exaggerated stimulation of excitatory mediators. Hyperekplexia is often confused with epileptic seizures. Here we present a case with hypoglycemic convulsions coexisting with hyperekplexia, causing diagnostic difficulty.

  8. A case of hypoglycemic brain injuries with cortical laminar necrosis.

    Science.gov (United States)

    Lee, Byung-Wan; Jin, Eun Sun; Hwang, Hyung-Sik; Yoo, Hyung-Joon; Jeong, Je Hoon

    2010-06-01

    We report a case of 68-yr-old male who died from brain injuries following an episode of prolonged hypoglycemia. While exploring controversies surrounding magnetic resonance imaging (MRI) findings indicating the bad prognosis in patients with hypoglycemia-induced brain injuries, we here discuss interesting diffusion-MRI of hypoglycemic brain injuries and their prognostic importance focusing on laminar necrosis of the cerebral cortex.

  9. Hypoglycemic Activity of Aqueous Extracts from Catharanthus roseus

    Directory of Open Access Journals (Sweden)

    Elisa Vega-Ávila

    2012-01-01

    Full Text Available Introduction. Catharanthus roseus (L. is used in some countries to treat diabetes. The aim of this study was to evaluate the hypoglycemic activity of extracts from the flower, leaf, stem, and root in normal and alloxan-induced diabetic mice. Methods. Roots, leaves, flowers, and stems were separated to obtain organic and aqueous extracts. The blood glucose lowering activity of these extracts was determinate in healthy and alloxan-induced (75 mg/Kg diabetic mice, after intraperitoneal administration (250 mg/Kg body weight. Blood samples were obtained and blood glucose levels were analyzed employing a glucometer. The data were statistically compared by ANOVA. The most active extract was fractioned. Phytochemical screen and chromatographic studies were also done. Results. The aqueous extracts from C. roseus reduced the blood glucose of both healthy and diabetic mice. The aqueous stem extract (250 mg/Kg and its alkaloid-free fraction (300 mg/Kg significantly ( reduced blood glucose in diabetic mice by 52.90 and 51.21%. Their hypoglycemic activity was comparable to tolbutamide (58.1%, . Conclusions. The best hypoglycemic activity was presented for the aqueous extracts and by alkaloid-free stem aqueous fraction. This fraction is formed by three polyphenols compounds.

  10. Hypoglycemic Activity of Aqueous Extracts from Catharanthus roseus

    Science.gov (United States)

    Vega-Ávila, Elisa; Cano-Velasco, José Luis; Alarcón-Aguilar, Francisco J.; Fajardo Ortíz, María del Carmen; Almanza-Pérez, Julio César; Román-Ramos, Rubén

    2012-01-01

    Introduction. Catharanthus roseus (L.) is used in some countries to treat diabetes. The aim of this study was to evaluate the hypoglycemic activity of extracts from the flower, leaf, stem, and root in normal and alloxan-induced diabetic mice. Methods. Roots, leaves, flowers, and stems were separated to obtain organic and aqueous extracts. The blood glucose lowering activity of these extracts was determinate in healthy and alloxan-induced (75 mg/Kg) diabetic mice, after intraperitoneal administration (250 mg/Kg body weight). Blood samples were obtained and blood glucose levels were analyzed employing a glucometer. The data were statistically compared by ANOVA. The most active extract was fractioned. Phytochemical screen and chromatographic studies were also done. Results. The aqueous extracts from C. roseus reduced the blood glucose of both healthy and diabetic mice. The aqueous stem extract (250 mg/Kg) and its alkaloid-free fraction (300 mg/Kg) significantly (P < 0.05) reduced blood glucose in diabetic mice by 52.90 and 51.21%. Their hypoglycemic activity was comparable to tolbutamide (58.1%, P < 0.05). Conclusions. The best hypoglycemic activity was presented for the aqueous extracts and by alkaloid-free stem aqueous fraction. This fraction is formed by three polyphenols compounds. PMID:23056144

  11. Evaluation of Hypoglycemic Efficacy of Tangningtongluo Formula, a Traditional Chinese Miao Medicine, in Two Rodent Animal Models

    Directory of Open Access Journals (Sweden)

    Long Cheng

    2014-01-01

    Full Text Available Traditional Chinese medicines largely lack adequate and scientifically rigorous evidence regarding efficacy and functional mechanisms. The present study was aimed to confirm the hypoglycemic effect of Tangningtongluo (TNTL formula, a traditional Chinese Miao medicine, in two animal models: high-fat diet and streptozotocin- (STZ- induced diabetic rats and C57BL/KsJ-db/db diabetic mice. After 4 weeks, TNTL intervention in STZ-induced diabetic rats yielded in significant improvement on the glucose tolerance test. Moreover, the islet histopathology showed that oral TNTL reduced the severity of islet necrosis in pancreases tissue. Compared with diabetic controls, a 12-week TNTL treatment regimen (dosages = 0.9, 1.8, and 3.6 g/kg in db/db mice significantly decreased fasting glucose and HbA1c. Additionally, oral glucose tolerance in TNTL-treated mice improved significantly, compared with diabetic mice receiving metformin. Finally, tissue histopathology and biochemical index evaluations revealed significant improvement in TNTL-treated mice. Taken together, our results show that TNTL exerted a strong hypoglycemic effect in two diabetic rodent animal models, preserving β-cells in the pancreas islet and reducing the risk of diabetic retinopathy and nephropathy.

  12. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

    Directory of Open Access Journals (Sweden)

    Mehta Bharati

    2016-09-01

    Full Text Available Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months. Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome.

  13. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates.

    Science.gov (United States)

    Bharati, Mehta

    2016-09-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months). Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months) and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome.

  14. Anti-hyperlipidemic and hypoglycemic effects of Gynostemma pentaphyllum in the Zucker fatty rat.

    Science.gov (United States)

    Megalli, Samer; Davies, Neal M; Roufogalis, Basil D

    2006-01-01

    Gynostemma pentaphyllum is a traditional Chinese medicine used for a variety of conditions, including elevated cholesterol. We have examined the pharmacological anti-hyperlipidemic and hypoglycemic effectiveness of Gynostemma pentaphyllum in the obese Zucker fatty diabetic rat model. After treatment for 4 days Gynostemma pentaphyllum 250 mg/kg reduced triglyceride (33%), total cholesterol, (13%) and low density lipoprotein cholesterol levels (33%). These effects were dose-dependent and maintained for at least 5 weeks. Chronic treatment for 3-5 weeks also reduced post-prandial hypertriglyceridemia induced by olive oil 10 mg/kg in the Zucker fatty rats but had no significant effect in lowering sucrose-induced hyperglycemia in Sprague-Dawley rats. A novel regulation by Gynostemma of glucose levels was also observed in the Zucker fatty rat model. In a glucose tolerance test in obese and lean Zucker rats pretreatment with Gynostemma pentaphyllum 250 mg/kg demonstrated glucose levels were significantly less 2 hours post challenge (20%) in the Gynostemma pentaphyllum obese rats compared to the control group. Gynostemma pentaphyllum did not significantly reduce glucose levels at 120 min in the lean strain, in contrast to the 20% decrease seen in the obese rat. In vitro, Gynostemma pentaphyllum inhibited alpha-glucosidase activity (50% inhibition at 42.8), which compared to acarbose (50% at 53.9 microg/mL). The improvement in glucose tolerance at 120 min by Gynostemma pentaphyllum in obese Zucker fatty rats but not lean rats suggests that it may improve insulin receptor sensitivity and together with the significant reduction of hypertriglyceridemia, cholesterol and low density lipoprotein cholesterol suggests that Gynostemma should be examined further by oral hypoglycemic/anti-hyperlipidemic therapy.

  15. Improvement of dissolution and hypoglycemic efficacy of glimepiride by different carriers.

    Science.gov (United States)

    Mohamed, Elham A; Meshali, Mahasen M; Foda, Abdel Monem M; Borg, Thanaa M

    2012-09-01

    Effects of tromethamine (Tris), polyvinylpyrrolidone (PVP-K25), and low molecular weight chitosan (LM-CH) on dissolution and therapeutic efficacy of glimepiride (Gmp) were investigated using physical mixtures (PMs), coground mixtures, coprecipitates (Coppts) or kneaded mixtures (KMs), and compared with drug alone. Fourier transform infrared spectroscopy, differential scanning colorimetry, and X-ray diffractometry were performed to identify any physicochemical interaction with Gmp. Surface morphology was examined via scanning electron microscopy. The results of Gmp in vitro dissolution revealed that it was greatly enhanced by Coppt with Tris or PVP-K25 and KM with LM-CH at a drug to carrier ratio of 1:8. Gmp amorphization by PVP-K25 and LM-CH was a major factor in increasing Gmp dissolution. Being basic, Tris might increase the pH of the microdiffusion layer around Gmp particles improving its dissolution. Formation of water-soluble complexes suggested by solubility study may also explain the enhanced dissolution. Capsules were prepared from Coppts and KM 1:8 drug to carrier binary systems and also with Tris PMs. In vivo, the hypoglycemic efficacy of Gmp capsules in rabbits increased by 1.63-, 1.50-, and 1.46-fold for 1:8 Coppts with Tris or PVP-K25 and KM with LM-CH respectively, compared with Gmp alone. Surprisingly, the response to Tris PM 1:20 capsules was 1.52-fold revealing statistically insignificant difference to that of Tris Coppt 1:8 (1.63 fold). As a conclusion, dissolution enhancement and hypoglycemic potentiation by 1:20 PM of Gmp/Tris, being simple and easy to prepare, may enable development of a reduced-dose and fast-release oral dosage form of Gmp.

  16. Effect of Indian herbal hypoglycemic agents on antioxidant capacity and trace elements content in diabetic rats.

    Science.gov (United States)

    Chandra, Anu; Mahdi, Abbas Ali; Singh, Raj Kumar; Mahdi, Farzana; Chander, Ramesh

    2008-09-01

    In the present investigation we report the protective potential of some herbal hypoglycemic agents on antioxidant status and levels of metal ions in streptozotocin-induced diabetic rats. Furthermore, in vitro antioxidant activity of the herbs was also evaluated. Induction of diabetes mellitus in rats caused an increase in blood lipid peroxide levels that was associated with the reduced activity of red blood cell (RBC) antioxidant enzymes--namely, superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase--along with depletion of plasma reduced glutathione (GSH) and copper, zinc, iron, magnesium, and selenium levels. Oral treatment of diabetic rats with Allium sativum, Azadirachta indica, Momordica charantia, and Ocimum sanctum extracts (500 mg/kg of body weight) not only lowered the blood glucose level but also inhibited the formation of lipid peroxides, reactivated the antioxidant enzymes, and restored levels of GSH and metals in the above-mentioned model. The herbal extracts (50-500 microg) inhibited the generation of superoxide anions (O(2)(-.)) in both enzymatic and nonenzymatic in vitro systems. These preparations also inhibited the ferrous-sodium ascorbate-induced formation of lipid peroxides in RBCs. The in vivo and in vitro protective effects of the above-mentioned herbal drugs were also compared with that of glibenclamide. On the basis of our results, we conclude that the above-mentioned herbal plants not only possess hypoglycemic properties, but they also decrease oxidative load in diabetes mellitus. Therefore, we propose that long-term use of such agents might help in the prevention of diabetes-associated complications. However, the extrapolation of these results to humans needs further in-depth study.

  17. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea : A Systematic Review Sponsored by the World Workshop on Oral Medicine VI

    NARCIS (Netherlands)

    Wolff, Andy; Joshi, Revan Kumar; Ekström, Jörgen; Aframian, Doron; Pedersen, Anne Marie Lynge; Proctor, Gordon; Narayana, Nagamani; Villa, Alessandro; Sia, Ying Wai; Aliko, Ardita; McGowan, Richard; Kerr, Alexander Ross; Jensen, Siri Beier; Vissink, Arjan; Dawes, Colin

    2016-01-01

    BACKGROUND: Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist. OBJECTIVE: Our objective

  18. Oral Platelet Gel Supernatant Plus Supportive Medical Treatment Versus Supportive Medical Treatment in the Management of Radiation-induced Oral Mucositis: A Matched Explorative Active Control Trial by Propensity Analysis.

    Science.gov (United States)

    Bonfili, Pierluigi; Gravina, Giovanni L; Marampon, Francesco; Rughetti, Anna; Di Staso, Mario; Dell'Orso, Luigi; Vittorini, Francesca; Moro, Roberto; La Verghetta, Maria E; Parente, Silvia; Reale, Marilisa; Ruggieri, Valeria; Franzese, Pietro; Tombolini, Vincenzo; Masciocchi, Carlo; Di Cesare, Ernesto

    2017-08-01

    In this active control trial, the rate of radio-induced WHO grade 3/4 oral mucositis and the change in quality of life, assessed by OMWQ-HN, were measured in subjects with head and neck cancer treated by platelet gel supernatant (PGS) and supportive medical treatment versus subjects treated by supportive medical treatment alone. Eighty patients with nonmetastatic head and neck cancer underwent curative or adjuvant radiotherapy. All patients underwent supportive medical treatment and/or PGS at the beginning and during radiotherapy. Sixteen patients received PGS in association with supportive medical treatment. To obtain 2 groups virtually randomized for important clinical characteristics subjects were matched, by propensity analysis, with a group of subjects (64 patients) treated with supportive medical treatment alone. Subjects treated with standard supportive treatment experienced significant higher WHO grade 3/4 toxicity (55%; 35/64) than subjects treated by PGS (13%; 3/16). The reduced toxicity found in PGS group paralleled with the evidence that they developed later symptoms with respect to controls. The Cox proportional hazard model indicated that patients treated with standard supportive medical treatment experienced 2.7-fold increase (hazard ratio=2.7; 95% confidence interval, 1.3-5.7) in the occurrence of WHO grade 3/4 toxicity. PGS group significantly experienced higher quality of life than control groups as measured by OMWQ-HN. A significant decrease in the opioid analgesics usage was found in the PGS group. These preliminary data should be interpreted with caution and could serve as a framework around which to design future trials.

  19. Comparison of SGA Oral Medications and a Long-Acting Injectable SGA : The PROACTIVE Study

    NARCIS (Netherlands)

    Buckley, Peter F.; Schooler, Nina R.; Goff, Donald C.; Hsiao, John; Kopelowicz, Alexander; Lauriello, John; Manschreck, Theo; Mendelowitz, Alan J.; Miller, Del D.; Severe, Joanne B.; Wilson, Daniel R.; Ames, Donna; Bustillo, Juan; Mintz, Jim; Kane, John M.; de Jong, Corina

    2015-01-01

    Until relatively recently, long-acting injectable (LAI) formulations were only available for first-generation antipsychotics and their utilization decreased as use of oral second-generation antipsychotics (SGA) increased. Although registry-based naturalistic studies show LAIs reduce rehospitalizatio

  20. [Pre-anesthetic medication with intranasal dexmedetomidine and oral midazolam as an anxiolytic. A clinical trial].

    Science.gov (United States)

    Linares Segovia, B; García Cuevas, M A; Ramírez Casillas, I L; Guerrero Romero, J F; Botello Buenrostro, I; Monroy Torres, R; Ramírez Gómez, X S

    2014-10-01

    Dexmedetomidine is a pharmacological option for sedation in children. In this study, the efficacy of intranasal dexmedetomidine to reduce preoperative anxiety in pediatric patients is compared with that of oral midazolam. A prospective, randomized, double-blind, controlled trial was conducted on children 2-12 years of age, randomly assigned to one of the following two groups: group A received premedication with oral midazolam and intranasal placebo, group B received intranasal dexmedetomidine and oral placebo. Anxiety was assessed with the modified Yale scale, and a risk analysis and number needed to treat was performed. A total of 108 patients were included, 52 (48.1%) treated with dexmedetomidine, and 56 (51.9%) with midazolam. Anxiety was less frequent in the dexmedetomidine group at 60minutes (P=.001), induction (p=.04), and recovery (P=.0001). Risk analysis showed that dexmedetomidine reduced the risk of anxiety by 28% (RAR=0.28, 95% CI; 0.12 to 0.43) and to prevent one case of anxiety, four patients need to be treated with intranasal dexmedetomidine (NNT=4, 95% CI: 3-9).Changes in heart rate, mean arterial pressure, and oxygen saturation, were statistically significant in the dexmedetomidine group, with no clinical consequences. There were no cases of bradycardia, hypotension or oxygen desaturation. Intranasal dexmedetomidine premedication is more effective than oral midazolam to reduce preoperative anxiety in pediatric patients. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  1. Berberine Nanosuspension Enhances Hypoglycemic Efficacy on Streptozotocin Induced Diabetic C57BL/6 Mice

    Directory of Open Access Journals (Sweden)

    Zhiping Wang

    2015-01-01

    Full Text Available Berberine (Ber, an isoquinoline derivative alkaloid and active ingredient of Coptis, has been demonstrated to possess antidiabetic activities. However its low oral bioavailability restricts its clinical application. In this report, Ber nanosuspension (Ber-NS composed of Ber and D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS was prepared by high pressure homogenization technique. Antidiabetic effects of Ber-NS relative to efficacy of bulk Ber were evaluated in streptozotocin (STZ induced diabetic C57BL/6 mice. The particle size and zeta potential of Ber-NS were 73.1 ± 3.7 nm and 6.99 ± 0.17 mV, respectively. Ber-NS (50 mg/kg treatment via oral gavage for 8 weeks resulted in a superior hypoglycemic and total cholesterol (TC and body weight reduction effects compared to an equivalent dose of bulk Ber and metformin (Met, 300 mg/kg. These data indicate that a low dosage Ber-NS decreases blood glucose and improves lipid metabolism in type 2 diabetic C57BL/6 mice. These results suggest that the delivery of Ber as a nanosuspension is a promising approach for treating type 2 diabetes.

  2. Berberine nanosuspension enhances hypoglycemic efficacy on streptozotocin induced diabetic C57BL/6 mice.

    Science.gov (United States)

    Wang, Zhiping; Wu, Junbiao; Zhou, Qun; Wang, Yifei; Chen, Tongsheng

    2015-01-01

    Berberine (Ber), an isoquinoline derivative alkaloid and active ingredient of Coptis, has been demonstrated to possess antidiabetic activities. However its low oral bioavailability restricts its clinical application. In this report, Ber nanosuspension (Ber-NS) composed of Ber and D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS) was prepared by high pressure homogenization technique. Antidiabetic effects of Ber-NS relative to efficacy of bulk Ber were evaluated in streptozotocin (STZ) induced diabetic C57BL/6 mice. The particle size and zeta potential of Ber-NS were 73.1 ± 3.7 nm and 6.99 ± 0.17 mV, respectively. Ber-NS (50 mg/kg) treatment via oral gavage for 8 weeks resulted in a superior hypoglycemic and total cholesterol (TC) and body weight reduction effects compared to an equivalent dose of bulk Ber and metformin (Met, 300 mg/kg). These data indicate that a low dosage Ber-NS decreases blood glucose and improves lipid metabolism in type 2 diabetic C57BL/6 mice. These results suggest that the delivery of Ber as a nanosuspension is a promising approach for treating type 2 diabetes.

  3. Intraoral film containing insulin-phospholipid microemulsion: formulation and in vivo hypoglycemic activity study.

    Science.gov (United States)

    Rachmawati, Heni; Haryadi, Bernard Manuel; Anggadiredja, Kusnandar; Suendo, Veinardi

    2015-06-01

    Non-invasive administration of insulin is expected for better diabetes mellitus therapy. In this report, we developed intraoral preparation for insulin. Insulin was encapsulated into nanocarrier using self-assembly emulsification process. To increase lipophilicity of insulin, it was dispersed in phospholipid resulted in insulin-phospholipid solid dispersion. The microemulsion formula was established from our previous work which contained glyceryl monooleate (GMO), Tween 20, and polyethylene glycol (PEG 400) in a ratio of 1:8:1. To confirm the formation of insulin-phospholipid solid dispersion, PXRD, FTIR spectroscopy, and Raman spectroscopy were performed. Then, the microemulsion was evaluated for droplet size and distribution, zeta potential, entrapment efficiency, physical stability, and Raman spectroscopy. In addition, microemulsion with expected characteristic was evaluated for in vitro release, in vitro permeation, and in vivo activity. The droplets size of ∼100 nm with narrow distribution and positive charge of +0.56 mV were formed. The insulin encapsulated in the oil droplet was accounted of >90%. Water-soluble chitosan seems to be a promising film matrix polymer which also functioned as insulin release controller. Oral administration of insulin microemulsion to healthy Swiss-Webster mice showed hypoglycemic effect indicating the success of this protein against a harsh environment of the gastrointestinal tract. This effectiveness significantly increased by fourfold as compared to free insulin. Taken together, microemulsion seems to be a promising carrier for oral delivery of insulin.

  4. Hypoglycemic and antioxidant effects of leaf essential oil of Pelargonium graveolens L’Hér. in alloxan induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Boukhris Maher

    2012-06-01

    Full Text Available Abstract Background Rose-scented geranium (Pelargonium graveolens L’Hér., which is used in traditional Tunisian folk medicine for the treatment of hyperglycaemia, is widely known as one of the medicinal herbs with the highest antioxidant activity. The present paper is conducted to test the hypoglycemic and antioxidative activities of the leaf essential oil of P. graveolens. Methods The essential oil P. graveolens was administered daily and orally to the rats at two doses of 75 mg/kg and 150 mg/kg body weight (b.w. for 30 days. The chemical composition of P. graveolens essential oil, body weight, serum glucose, hepatic glycogen, thiobarbituric acid-reactive substances (TBARS, the components of hepatic, and renal and serum antioxidant systems were evaluated. The hypoglycemic effect of rose-scented geranium was compared to that of the known anti-diabetic drug glibenclamide (600 μg/kg b.w.. Results After the administration of two doses of essential oil of Pelargonium graveolens L’Hér. together with glibenclamide which is known by its antidiabetic activities and used as reference (600 μg/kg b.w., for four weeks, the serum glucose significantly decreased and antioxidant perturbations were restored. The hypoglycemic effect of P. graveolens at the dose of 150 mg/kg b.w. was significantly (p Conclusions It suggests that administration of essential oil of P. graveolens may be helpful in the prevention of diabetic complications associated with oxidative stress. Our results, therefore, suggest that the rose-scented geranium could be used as a safe alternative antihyperglycemic drug for diabetic patients.

  5. Evaluation of Hypoglycemic Activity of Boswellia carterii and Cissus rotundifolia in Streptozotocin/Nicotinamide-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Ali A. Al-Mehdar

    2016-12-01

    Full Text Available Objective: To evaluate the hypoglycemic activity of Boswellia carterii and Cissus rotundifolia in rats compared to that of glibenclamide and metformin as common oral hypoglycemic drugs. Methods: Thirty-six male Wistar rats, divided into six groups of six rats each, were assigned into diabetic and non-diabetic groups. Diabetes was induced in rats by single intraperitoneal administration of streptozotocin (65 mg/kg b.w. and nicotinamide (110 mg/kg b.w.. The first two groups were normal and diabetic controls, whereas the other four diabetic groups were treated with water extracts of the medicinal plants; B. carterii (100 mg/kg b.w. and C. rotundifolia (100 mg/kg b.w., glibenclamide (5 mg/kg b.w. and metformin (150 mg/kg b.w.. Body weight and serum glucose were measured on days 1, 7, 14, 21 and 28. Serum cholesterol and triglyceride levels were also measured. Results: Treatment of diabetic rats with the water extracts of B. carterii and C. rotundifolia for four weeks resulted in a significant (p<0.05 increase in their body weights and a significant decrease in the levels of serum glucose, cholesterol and triglycerides. The effects of the two plant extracts were almost similar to those of glibenclamide and metformin. Conclusion: Water extracts of B. carterii or C. rotundifolia have a hypoglycemic effect resembling those of glibenclamide and metformin, and these findings provide a pharmacological evidence for their anti-diabetic claims in folk medicine.

  6. Hypoglycemic activities of lyophilized powder of Gynura divaricata by improving antioxidant potential and insulin signaling in type 2 diabetic mice

    Directory of Open Access Journals (Sweden)

    Bing-Qing Xu

    2015-12-01

    Full Text Available Background: Diabetes mellitus is a serious disease affecting about 5% of people worldwide. Although several studies have indicated hypoglycemic activities of Gynura divaricata (GD, the mechanisms by which GD improves the symptoms of diabetes remain unclear. Objective: The aim of this study was to investigate the potential hypoglycemic effects of GD. Design: The leaves and stems of GD were prepared and lyophilized into a powder, which was added to the diet of mice with type 2 diabetes induced by a high-fat diet in combination with streptozotocin for 4 weeks. During this period, fasting blood glucose (FBG levels and body weight of mice were measured. In addition, at the end of the experiment, a series of assays was performed. Results: GD administration effectively alleviates insulin resistance and induces a decrease in FBG by 59.54% in 1.2% (L GD-treated diabetic group and 56.13% in 4.8% (H GD-treated diabetic group after 4 weeks, respectively, relative to diabetic model mice. The antioxidant capacity was improved by increasing the activities of glutathione peroxidase (GSH-Px and total superoxide dismutase (T-SOD by 64.87% and 53.42% in treatment group H, compared to diabetic model mice, while GD treatment induced a significant decrease in malondialdehyde (MDA level by 50% in treatment group L, compared to the level in diabetic model mice. Furthermore, glucose metabolism was ameliorated by the increased glycogen synthesis in the livers of diabetic mice. In addition, we also demonstrated that the messenger RNA (mRNA and protein expression levels of AKT, PI3K and PDK-1, which are involved in insulin signaling, were significantly increased. Conclusions: Oral administration of the GD-lyophilized powder has been effectively hypoglycemic, which is done by activating insulin signaling and improving antioxidant capacity in mice with type 2 diabetes.

  7. Antioxidant and anti-inflammatory effects of a hypoglycemic fraction from Cucurbita ficifolia Bouché in streptozotocin-induced diabetes mice.

    Science.gov (United States)

    Roman-Ramos, R; Almanza-Perez, J C; Fortis-Barrera, A; Angeles-Mejia, S; Banderas-Dorantes, T R; Zamilpa-Alvarez, A; Diaz-Flores, M; Jasso, I; Blancas-Flores, G; Gomez, J; Alarcon-Aguilar, F J

    2012-01-01

    Type 2 diabetes is characterized by oxidative stress and a chronic low-grade inflammatory state, which also play roles in the pathogenesis of this disease and the accompanying vascular complications by increasing the production of free radicals and pro-inflammatory cytokines. Cucurbita ficifolia Bouché (C. ficifolia) is an edible Mexican plant whose hypoglycemic activity has been demonstrated in several experimental and clinical conditions. Recently, D-chiro-inositol has been proposed as the compound responsible for the hypoglycemic effects; however, the antioxidant and anti-inflammatory potential of this plant has not yet been explored. The aim of this research is to study the influence of a hypoglycemic, D-chiro-inositol-containing fraction from the C. ficifolia fruit (AP-Fraction) on biomarkers of oxidative stress, as well as on the inflammatory cytokines in streptozotocin-induced diabetes. The AP-Fraction obtained from the mature fruit of C. ficifolia contained 3.31 mg of D-chiro-inositol/g of AP-Fraction. The AP-Fraction was administrated daily by gavage to normal mice for 15 days as a preventive treatment. Then these animals were given streptozotocin, and the treatments were continued for an additional 33 days. Pioglitazone was used as a hypoglycemic drug for comparison. Administration of the AP-Fraction significantly increased glutathione (GSH) and decreased malondialdehyde (MDA) in the liver without significantly affecting the levels in other tissues. The AP-Fraction reduced TNF-α and increased IL-6 and IFN-γ in serum. Interestingly, the AP-Fraction also increased IL-10, an anti-inflammatory cytokine. These results suggest that C. ficifolia might be used as an alternative medication for the control of diabetes mellitus and that it has antioxidant and anti-inflammatory properties in addition to its hypoglycemic activity.

  8. Oral yeast flora and its ITS sequence diversity among a large cohort of medical students in Hainan, China.

    Science.gov (United States)

    Wang, Huamin; Wang, Yin; Chen, Jinglong; Zhan, Zilong; Li, Yinglin; Xu, Jianping

    2007-08-01

    The most prevalent fungal infection of humans is candidiasis which is caused by species of Candida that are typical members of the commensal microbial flora of the oral mucosa and other body surfaces. Since species of Candida differ in virulence properties and susceptibilities to anti-fungal drugs, understanding the human commensal yeast flora will have a significant impact on designing treatment and prevention strategies against yeast infections. However, although there is a global interest in Candida species, the global distributions of Candida species remain largely unknown, especially among healthy hosts. Here we report the oral yeast flora from the surveys of over 1,000 medical students in China. Our results showed that this population had a yeast carriage rate (4.5%) much lower than other population samples reported previously from Mainland China (40-70%). In addition, C. albicans was isolated at a much higher frequency than those from other Chinese samples, with a frequency (80.9%) more similar to those in developed regions such as North America. The oral yeast carriage rates and yeast species compositions were similar between male and female students and between the hosts borne and raised on Hainan Island and those borne and raised on Mainland China. Furthermore, the sequence variation at the internal transcribed spacer (ITS) regions of the nuclear ribosomal RNA gene cluster was analyzed for strains of the dominant species, C. albicans. Our analysis identified 14 ITS types among the 41 Hainan isolates of C. albicans. However, only four of the 14 ITS types were identical to those in reference strains from Europe and North America. Taken together, our analyses suggest that the oral yeast flora among host populations in China is highly heterogeneous and that there is a high ITS sequence diversity in the Hainan population of C. albicans.

  9. Food insecurity and medication adherence in low-income older Medicare beneficiaries with type 2 diabetes.

    Science.gov (United States)

    Sattler, Elisabeth Lilian Pia; Lee, Jung Sun; Bhargava, Vibha

    2014-01-01

    Little is known about diabetes management among low-income older Americans. This study used statewide self-administered survey and Medicare claims data to examine the relationships of food insecurity and medication (re)fill adherence in a sample of Medicare Part D beneficiaries with type 2 diabetes in need of food assistance in Georgia in 2008 (n = 243, mean age 74.2 ± 7.8 years, 27.2% African American, 77.4% female). (Re)fill adherence to oral hypoglycemics was measured as Proportion of Days Covered. Food insecurity was assessed using a six-item validated standard measure. About 54% of the sample were food insecure. About 28% of the diabetic sample did not (re)fill any diabetes medication and over 80% had at least one diabetes complication. Food insecure participants showed comparable (re)fill adherence to food secure participants. However, 57% of food insecure participants were nonadherent to oral hypoglycemics. Underlying basic needs must be addressed to improve diabetes management in this population.

  10. Multinational Internet-based survey of patient preference for newer oral or injectable Type 2 diabetes medication

    Directory of Open Access Journals (Sweden)

    Marco daCosta DiBonaventura

    2010-11-01

    Full Text Available Marco daCosta DiBonaventura1, Jan-Samuel Wagner1, Cynthia J Girman2, Kimberly Brodovicz2, Qiaoyi Zhang3, Ying Qiu3, Sri-Ram Pentakota3, Larry Radican31Health Sciences Practice, Kantar Health, New York; 2Epidemiology, 3Global Health Outcomes, Merck, Whitehouse Station, New Jersey, USABackground: The prevalence of Type 2 diabetes mellitus continues to rise. Although glucagon-like peptide-1 (GLP-1 analog and dipeptidyl peptidase-4 (DPP-4 inhibitor medications are effective, there are differences between these products, including method of administration (injectable versus oral. The objective of this study was to examine patient preferences (and predictors of preferences for two different medication profiles, one similar to a GLP-1 analog (liraglutide and another similar to a DPP-4 inhibitor (sitagliptin.Methods: Internet survey data were collected in two waves (wave 1, n = 2402; wave 2, n = 1340 using patients from the US and Europe. Patients were presented with two hypothetical medication profiles (“drug A” and “drug B”, resembling sitagliptin and liraglutide, respectively and asked to report their preferences.Results: Most patients in wave 1 and wave 2 reported that overall they would prefer a drug with the sitagliptin-like profile (81.9% and 84.4%, respectively over a drug with the liraglutide-like profile (18.1% and 15.6%, respectively, and >80% of patients reported that they would be able to take a drug with the sitagliptin-like profile as directed by their physician for a longer period. The likelihood of preferring the sitagliptin-like profile significantly increased as age (odds ratio [OR] = 1.02 and importance placed on method of administration (OR = 1.32 increased (P < 0.05. Although the sitagliptin-like profile was preferred by the majority of patients in all subgroups, a lower proportion of patients with obesity, with weight gain, with A1C values above target, and who exercised preferred the sitagliptin-like profile compared with

  11. Hypoglycemic treatment of diabetic patients in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Carmen Caballero Requejo

    2016-05-01

    Full Text Available Objectives: To analyze if the hypoglycemic therapy prescribed in the Emergency Department adapts to the consensus recommendations available, as well as to assess its clinical impact. Methods: A descriptive observational study, which included patients awaiting hospital admission, who were in the Observation Ward of the Emergency Department and had been previously diagnosed with diabetes mellitus, and were receiving treatment with hypoglycemic drugs at home. The management of antidiabetic treatment and its clinical impact were assessed. Results: 78 patients were included. At admission to the Emergency Department, treatment was modified for 91% of patients, and omitted for 9%. The most prescribed treatment was sliding scale insulin (68%. The treatments prescribed coincided in a 16.7% with the recommendations by the Spanish Society of Emergency Medicine. After intervention by the Pharmacist, the omission descended to 1.3%, and the adaptation to the recommendations increased to 20.5%. Comparing patients whose treatment coincided with the recommendations and those who did not, the clinical impact was respectively: mean glycemia at 24 hours: 138.3 } 49.5 mg/dL versus 182.7 } 97.1 mg/dL (p = 0.688; mean rescues with insulin lispro: } 1.6 versus 1.5 } 1.8 (p = 0.293; mean units of insulin lispro administered: 4.6 } 12.7 IU versus 6.6 } 11.3 IU (p = 0.155. Conclusions: We found antidiabetic prescriptions to have a low adaptation to consensus recommendations. These results are in line with other studies, showing an abuse of sliding scale regimen as single hypoglycemic treatment

  12. Role of attitudes and intentions in predicting adherence to oral diabetes medications

    Directory of Open Access Journals (Sweden)

    Emmanuel K Fai

    2017-02-01

    Full Text Available The purpose of this quantitative study was to investigate the extent to which patient attitudes and intentions predict adherence to the use of oral antihyperglycemic regimens in African Americans. This cross-sectional study of 115 participants used correlation analysis to establish relationships among patient attitudes, intentions and adherence. Data analyses showed significant correlations between the variables. Multiple regression analysis was used to establish predictions between the variables. A prediction model containing attitudes, subjective norms and perceived behavioral control (PBC explained 37% of the variance to behavioral intention. Intentions accounted for 8.5% of the variance to adherence. Attitudes predicted behavioral intentions. The findings support the theory of planned behavior model and identify important correlations between attitudes, intentions and behaviors. In addition, the results underscore the need for promoting positive attitudes and positive intentions in effective adherence to the use of oral antihyperglycemic regimens. Achieving adequate adherence through behavioral counseling can effect positive social change by reducing the mortality and morbidity that are associated with inadequate adherence to the use of oral diabetic agents.

  13. Adaptation of oral medication in people institutionalized in nursing homes for whom medication is crushed: The ADECUA Study

    Directory of Open Access Journals (Sweden)

    Francisco Apolo Carvajal

    2016-12-01

    Full Text Available Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention. Moreover, health professionals received a training course. Results: Medication was being crushed for 33% (618/1875 of residents (mean: 5 drugs susceptible of crushing. 220 pharmaceutical interventions were performed, mostly in extended release or gastro-resistant drugs (48% were accepted. Switch was the type of intervention more frequent (79%, mainly to Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention. Moreover, health professionals received a training course. Results

  14. Oral Cancer Exam

    Medline Plus

    Full Text Available ... and College Students Recent College Graduates Dental and Medical Students See All Careers & Training Opportunities Job Openings ... of oral cancer, along with definitions of selected medical terms and resource information. Oral Cancer A fact ...

  15. Hypoglycemic potential of alcoholic root extract of Cassia occidentalis Linn. in streptozotocin induced diabetes in albino mice

    Directory of Open Access Journals (Sweden)

    Surbhi Sharma

    2014-12-01

    Conclusion: The results suggest that ethanolic roots extract of C. occidentalis Linn. possesses hypoglycemic potential for the NIDDM and support the traditional use of the roots of plant as hypoglycemic agent.

  16. Exercise-Induced Hypoglycemic Hemiplegia in a Child with Type 1 Diabetes: A Rare Find with Multiple Potential Causative Mechanisms

    Directory of Open Access Journals (Sweden)

    M. Constantine Samaan

    2011-01-01

    Full Text Available A 10-year-old boy known to have type 1 diabetes presented to the emergency department with history of sudden onset of right-sided hemiplegia after exercise. He did not respond to oral glucose administration, but had an almost immediate resolution of symptoms with intravenous bolus of dextrose. Hemiplegic hypoglycemia is a rare complication in diabetic children, mostly affects the right side of the body, and is rarely recurrent. Children have normal brain imaging and angiography testing, and electroencephalogram may show slow-wave activity. The recovery takes place within 24 hours, and the prognosis is excellent with no focal neurological deficits noted. Our patient responded within minutes to intravenous dextrose, which is unusual and has not been reported previously. The mechanisms leading to development of hypoglycemic hemiplegia are unclear, but may involve effects of hypoglycemia on intracellular signaling pathways or molecules on motor neurons, as recent studies have shown normal brain cell glucose uptake and metabolism in hypoglycemia. While hypoglycemic hemiplegia is rare, it is a frightening experience to caregivers, and efforts should concentrate on its prevention by preventing hypoglycemia.

  17. Hypoglycemic and hypolipidemic effects of neohesperidin derived from Citrus aurantium L. in diabetic KK-A(y) mice.

    Science.gov (United States)

    Jia, Sheng; Hu, Ying; Zhang, Wenna; Zhao, Xiaoyong; Chen, Yanhong; Sun, Chongde; Li, Xian; Chen, Kunsong

    2015-03-01

    The present study is to investigate the possible hypoglycemic and hypolipidemic effects of neohesperidin (NHP) derived from Citrus aurantium L. in vivo. KK-A(y) mice were used as the diabetic experimental model, whereas C57BL/6 mice were used as normal control for a 6-week study. Treatment of NHP significantly decreased fasting glucose, serum glucose, and glycosylated serum protein (GSP) in KK-A(y) mice. It significantly elevated oral glucose tolerance and insulin sensitivity and decreased insulin resistance in the diabetic mice. In addition, NHP significantly decreased serum triglycerides (TG), total cholesterol (TCH), leptin level, and liver index in the KK-A(y) mice. NHP also inhibited lipid accumulation in the liver and decreased the size of epididymal adipocyte in the KK-A(y) mice. Gene expression of stearoyl-CoA desaturase 1 (SCD-1) and fatty acid synthase (FAS) were significantly inhibited, whereas the expression of acyl-CoA oxidase (ACOX) was significantly induced by NHP treatment in the liver of KK-A(y) mice. In addition, elevated level of phosphorylation of hepatic AMPK was observed in NHP-treated mice. Therefore, the activation of the AMPK pathway and regulation of its target genes, including SCD-1, FAS, and ACOX, may play important roles in the hypoglycemic and hypolipidemic effects of NHP in vivo, and NHP may have great potential in the prevention of diabetes and its complications.

  18. Heart failure hospitalization risk associated with use of two classes of oral antidiabetic medications: an observational, real-world analysis.

    Science.gov (United States)

    Gautam, Santosh; Agiro, Abiy; Barron, John; Power, Thomas; Weisman, Harry; White, Jeff

    2017-07-31

    Newer oral antidiabetic drug classes are expanding treatment options for type 2 diabetes mellitus (T2DM); however, concerns remain. The objective was to assess relative risk of heart failure hospitalization of sodium-glucose co-transporter-2 (SGLT2) and dipeptidyl peptidase-4 (DPP4) inhibitors in T2DM patients. This retrospective observational study used a national commercially insured claims database. Adults (>18 years) with T2DM newly starting SGLT2 or DPP4 medication between April 2013 and December 2014 were included. Depending on their index fill, patients were grouped into either SGLT2 or DPP4 medication class cohorts. The primary outcome was hospitalization for heart failure and the risk was assessed using Cox regression models. Propensity score matching (1:2 ratio) was used to adjust for potential confounders. Analyses were also stratified by the presence of baseline diabetes complication and age (heart failure hospitalization was lower among SGLT2 users in comparison with matched DPP4 users (2.0% SGLT2 vs 3.1% DPP4; adjusted hazard ratio [aHR] 0.68; 95% confidence interval [CI] 0.54-0.86; p = .001). However, the stratified analyses revealed no risk difference among the majority of the analyzed patients, i.e., those aged heart failure was significantly lower for patients initiating an SGLT2 compared with a DPP4 medication, specifically among older patients and those with diabetes complication.

  19. Hypoglycemic effect of Opuntia streptacantha Lemaire in NIDDM.

    Science.gov (United States)

    Frati-Munari, A C; Gordillo, B E; Altamirano, P; Ariza, C R

    1988-01-01

    To assess the hypoglycemic effect of the nopal Opuntia streptacantha Lemaire (O. streptacantha Lem.), three groups of patients with non-insulin-dependent diabetes mellitus (NIDDM) were studied. Group one (16 patients) ingested 500 g of broiled nopal stems. Group 2 (10 patients) received only 400 ml of water as a control test. Three tests were performed on group 3 (6 patients): one with nopal, a second with water, and a third with ingestion of 500 g broiled squash. Serum glucose and insulin levels were measured at 0, 60, 120, and 180 min. After the intake of O. streptacantha Lem., serum glucose and serum insulin levels decreased significantly in groups 1 and 3, whereas no similar changes were noticed in group 2. The mean reduction of glucose reached 17.6 +/- 2.2% of basal values at 180 min in group 1 and 16.2 +/- 1.8% in group 3; the reduction of serum insulin at 180 min reached 50.2 +/- 8.0% in group 1 and 40.3 +/- 12.4% in group 3. This study shows that the stems of O. streptacantha Lem. cause a hypoglycemic effect in patients with NIDDM. The mechanism of this effect is unknown, but an increased insulin sensitivity is suggested.

  20. Truncation of the krebs cycle during hypoglycemic coma.

    Science.gov (United States)

    Sutherland, Garnette R; Tyson, Randy L; Auer, Roland N

    2008-07-01

    There is a misconception that hypoglycemic nerve cell death occurs easily, and can happen in the absence of coma. In fact, coma is the prerequisite for neuronal death, which occurs via metabolic excitatory amino acid release. The focus on nerve cell death does not explain how most brain neurons and all glia survive. Brain metabolism was interrogated in rats during and following recovery from 40 min of profound hypoglycemia using ex vivo (1)H MR spectroscopy to determine alterations accounting for survival of brain tissue. As previously shown, a time-dependent increase in aspartate was equaled by a reciprocal decrease in glutamate/glutamine. We here show that the kinetics of aspartate formation during the first 30 min (0.36 +/- 0.03 micromol g(-1) min(-1)) are altered such that glutamate, via aspartate aminotransferase, becomes the primary source of carbon when glucose-derived pyruvate is unavailable. Oxaloacetate is produced directly from alpha-ketoglutarate, so that reactions involving the six-carbon intermediates of the tricarboxylic acid cycle are bypassed. These fundamental observations in basic metabolic pathways in effect redraw the tricarboxylic acid cycle from a tricarboxylic to a dicarboxylic acid cycle during hypoglycemia. The basic neurochemical alterations according to the chemical equilibrium of mass action augments flux through a truncated Krebs cycle that continues to turn during hypoglycemic coma. This explains the partial preservation of energy charge and brain cell survival during periods of glucose deficiency.

  1. Characterization, pharmacokinetics, and hypoglycemic effect of berberine loaded solid lipid nanoparticles

    Directory of Open Access Journals (Sweden)

    Xue M

    2013-12-01

    Full Text Available Mei Xue, Ming-xing Yang, Wei Zhang, Xiu-min Li, De-hong Gao, Zhi-min Ou, Zhi-peng Li, Su-huan Liu, Xue-jun Li, Shu-yu Yang Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China Abstract: The high aqueous solubility, poor permeability, and absorption of berberine (BBR result in its low plasma level after oral administration, which greatly limits its clinical application. BBR solid lipid nanoparticles (SLNs were prepared to achieve improved bioavailability and prolonged effect. Developed SLNs showed homogeneous spherical shapes, small size (76.8 nm, zeta potential (7.87 mV, encapsulation efficiency (58%, and drug loading (4.2%. The power of X-ray diffraction combined with 1H nuclear magnetic resonance spectroscopy was employed to analyze chemical functional groups and the microstructure of BBR-SLNs, and indicated that the drug was wrapped in a lipid carrier. Single dose (50 mg/kg oral pharmacokinetic studies in rats showed significant improvement (P<0.05 in the peak plasma concentration, area under the curve, and variance of mean residence time of BBR-SLNs when compared to BBR alone (P<0.05, suggesting improved bioavailability. Furthermore, oral administration of both BBR and BBR-SLNs significantly suppressed body weight gain, fasting blood glucose levels, and homeostasis assessment of insulin resistance, and ameliorated impaired glucose tolerance and insulin tolerance in db/db diabetic mice. BBR-SLNs at high dose (100 mg/kg showed more potent effects when compared to an equivalent dose of BBR. Morphologic analysis demonstrated that BBR-SLNs potentially promoted islet function and protected the islet from regeneration. In conclusion, our study demonstrates that by entrapping BBR into SLNs the absorption of BBR and its anti-diabetic action were effectively enhanced. Keywords: berberine, solid lipid nanoparticles, pharmacokinetic, hypoglycemic effect

  2. The oral microflora in obesity and type-2 diabetes

    Directory of Open Access Journals (Sweden)

    Edward Shillitoe

    2012-10-01

    Full Text Available Background: Type 2 diabetes mellitus (T2DM is prevalent in people with obesity. It has been proposed that these conditions are related to specific features of the microflora of the mouth and lower gastrointestinal (GI tract. Hyperglycemia often resolves quickly after Roux-en-Y gastric bypass (RYGB but the role of the GI microflora cannot be examined easily because of reduced intestinal mobility. We propose that the study of microorganisms present in the mouth of patients undergoing RYGB will contribute to our understanding of the role of bacteria in the pathogenesis of T2DM. Objective: To conduct a feasibility study to examine differences in oral microbes in obese patients with and without T2DM and to determine whether it is feasible to measure changes after gastric bypass surgery. Methods: Individuals with morbid obesity (n=29, of whom 13 had T2DM, were studied. Oral rinses, stool samples, and blood samples were obtained before RYGB, and oral rinses and blood samples were obtained at 2 and 12 weeks postsurgery. Results: Prior to surgery, participants with T2DM had slightly higher total levels of oral bacteria than those without diabetes. Those with HbA1c > 6.5% had rather lower levels of Bifidobacteria in the mouth and stool. At 2 weeks post-RYGB, patients with T2DM were able to reduce or discontinue their hypoglycemic medications. Stool samples could not be obtained but oral rinses were readily available. The levels of oral Bifidobacteria had increased tenfold and levels of circulating endotoxin and tumor necrosis factor-alpha had decreased. Conclusions: The study of oral bacteria before and after RYGB is feasible and should be tested in larger patient populations to increase our understanding of the role of microorganisms in the pathogenesis of obesity and T2DM.

  3. World Workshop on Oral Medicine VI : clinical implications of medication-induced salivary gland dysfunction

    NARCIS (Netherlands)

    Aliko, Ardita; Wolff, Andy; Dawes, Colin; Aframian, Doron; Proctor, Gordon; Ekstrom, Jorgen; Narayana, Nagamani; Villa, Alessandro; Sia, Ying Wai; Joshi, Revan Kumar; McGowan, Richard; Jensen, Siri Beier; Kerr, A. Ross; Pedersen, Anne Marie Lynge; Vissink, Arjan

    2015-01-01

    Objective. This study aimed to systematically review the available literature on the clinical implications of medication-induced salivary gland dysfunction (MISGD). Study Design. The systematic review was performed using PubMed, Embase, and Web of Science (through June 2013). Studies were assessed f

  4. World Workshop on Oral Medicine VI : clinical implications of medication-induced salivary gland dysfunction

    NARCIS (Netherlands)

    Aliko, Ardita; Wolff, Andy; Dawes, Colin; Aframian, Doron; Proctor, Gordon; Ekstrom, Jorgen; Narayana, Nagamani; Villa, Alessandro; Sia, Ying Wai; Joshi, Revan Kumar; McGowan, Richard; Jensen, Siri Beier; Kerr, A. Ross; Pedersen, Anne Marie Lynge; Vissink, Arjan

    2015-01-01

    Objective. This study aimed to systematically review the available literature on the clinical implications of medication-induced salivary gland dysfunction (MISGD). Study Design. The systematic review was performed using PubMed, Embase, and Web of Science (through June 2013). Studies were assessed f

  5. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update.

    Science.gov (United States)

    Ruggiero, Salvatore L; Dodson, Thomas B; Fantasia, John; Goodday, Reginald; Aghaloo, Tara; Mehrotra, Bhoomi; O'Ryan, Felice

    2014-10-01

    Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaw (MRONJ) were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007 and 2009. The position papers were developed by a special committee appointed by the board and composed of clinicians with extensive experience in caring for these patients and basic science researchers. The knowledge base and experience in addressing MRONJ has expanded, necessitating modifications and refinements to the previous position paper. This special committee met in September 2013 to appraise the current literature and revise the guidelines as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis, staging, and management strategies and highlights current research status. The AAOMS considers it vitally important that this information be disseminated to other relevant health care professionals and organizations.

  6. "You have no good blood in your body". Oral communication in sixteenth-century physicians' medical practice.

    Science.gov (United States)

    Stolberg, Michael

    2015-01-01

    In his personal notebooks, the little known Bohemian physician Georg Handsch (1529-c. 1578) recorded, among other things, hundreds of vernacular phrases and expressions he and other physicians used in their oral interaction with patients and families. Based primarily on this extraordinary source, this paper traces the terms, concepts and images to which sixteenth-century physicians resorted when they explained the nature of a patient's disease and justified their treatment. At the bedside and in the consultation room, Handsch and his fellow physicians attributed most diseases to a local accumulation of impure, putrid or otherwise pathological humours. The latter were commonly said to result, in turn, from an insufficient concoction and assimilation of food and drink in the stomach and the liver or from an obstruction of the humoral flow inside the body and across its borders. By contrast, other notions and explanatory models, which had a prominent place in contemporary learned medical writing, hardly played a role at all in the physicians' oral communication. Specific disease terms were rarely used, a mere imbalance of the four natural humours in the body was almost never inculpated, and the patient's personal life-style and other non-naturals did not attract much attention either. These striking differences between the ways in which physicians explained the patients' diseases in their daily practice and the explanatory models we find in contemporary textbooks, are attributed, above all, to the physicians' precarious situation in the early modern medical marketplace. Since dissatisfied patients were quick to turn to another healer, physicians had to explain the disease and justify their treatment in a manner that was comprehensible to ordinary lay people and in line with their expectations and beliefs, which, at the time, revolved almost entirely around notions of impurity and evacuation.

  7. Report: Antioxidant and hypoglycemic activity of strawberry fruit extracts against alloxan induced diabetes in rats.

    Science.gov (United States)

    Abdulazeez, Sheriff Sheik; Ponnusamy, Ponmurugan

    2016-01-01

    The strawberries (Fragaria x ananassa) of Rosaceae family are an accomplished source of bioactive compounds such as ascorbic acid and diverse range of polyphenols including anthocyanins, phenolic acids, flavonols, ellagitannins etc. These phenolic compounds classify strawberry as an important health promoting food. Strawberries are proved to have potent antioxidant capacity in various in vitro assay systems. The in vivo beneficial effects are getting explored against various ailments including cancer, metabolic syndrome, and cardiovascular diseases. The present research study was designed to analyze the effect of strawberry fruit extracts (water and methanol) against alloxan induced hyperglycemia in albino rats of Wister strain. Upon alloxan (150mg/kg body weight) induction, the diabetic animals showed marked increase in the values of plasma glucose, urea, uric acid, creatinine and concomitant decrease in body weight and plasma insulin level. The oral administration of strawberry extracts for 45 days in diabetic animals reversed the biochemical changes significantly (P0.05) to near normal. Furthermore, the restoration of body weight loss was also observed. The results suggest that the strawberry extract has effective hypoglycemic activity against alloxan diabetes. The poly phenolic antioxidant contents of the strawberry fruit extracts are responsible for the observed biological effect.

  8. Hypoglycemic action of chicken meat extract in type-2 diabetic KKAy mice and GK rats.

    Science.gov (United States)

    Sim, Meng-Kwoon; Wong, Yong-Chiat; Xu, Xiao-Guang; Sim, Sai-Zhen; Tsi, Daniel

    2009-12-01

    This study researched the effects of chicken meat extract on blood glucose and insulin level, membrane glucose transporter-4 (GLUT4), and tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) in type 2 diabetic KKAy mice and GK rats. Eight-week-old KKAy mice and GK rats and euglycemic control animals, C57BL/6J mice and Wistar rats, were orally administered a liquid commercial chicken meat extract, BRAND'S Essence of Chicken (BEC), for up to 8 weeks. BEC (1.5 ml/kg) had no effect on blood insulin levels, but significantly lessened the hyperglycemia in the diabetic animals. In the BEC-treated diabetic animals, insulin induced a significant increase in plasma membrane GLUT4 and cytosolic tyrosine-phosphorylated IRS-1, indicating that it attenuates insulin resistance. The present findings are the first demonstration of the hypoglycemic action of a dietary protein, and they lend credence to the reported benefits of using chicken meat as a source of protein in the dietary management of diabetic individuals.

  9. Two-pill regimens of misoprostol after mifepristone medical abortion through 63 days' gestational age: a randomized controlled trial of sublingual and oral misoprostol.

    Science.gov (United States)

    Raghavan, Sheila; Comendant, Rodica; Digol, Irena; Ungureanu, Sergiu; Friptu, Valentin; Bracken, Hillary; Winikoff, Beverly

    2009-02-01

    A 400 mcg dose of sublingual misoprostol has high efficacy and few side effects when used with 200 mg mifepristone for medical abortion through 63 days' gestation. Eligible and consenting women (n=480) were randomized to 400 mcg of misoprostol sublingually or orally, 24 h after 200 mg of mifepristone. Abortion status was assessed two weeks later. Complete abortion occurred in 98.7% of the sublingual group and 94.0% of the oral group (p value=.006, RR: 1.05, 95% CI=1.01--1.09). Over 90% of women in both arms expressed high satisfaction with the method. Side effects were similar in both groups, with only fever or chills reported by significantly more women in the sublingual arm. The sublingual route appears superior to the regimen of 400 mcg misoprostol used orally and may be a good option for mifepristone medical abortion.

  10. Oral and maxillofacial malignancies: An analysis of 77 cases seen at an academic medical hospital

    Directory of Open Access Journals (Sweden)

    Adebayo Aremu Ibikunle

    2016-01-01

    Full Text Available Introduction: Oral and maxillofacial malignancies (OMMs consist of a wide range of lesions, which constitute varying proportions of the total incidence of malignancies in the human population. Available epidemiological data vary across racial, geographical, gender, and occupational divides. They are often associated with significant impairment of patients' quality of life. Materials and Methods: A review of hospital records of patients with histologically diagnosed primary OMM, who presented to the Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, over a 5-year period, was done. Data including age, gender, site, and type of tumor, and histological grade of tumor were retrieved and analyzed with the SPSS version 20.0. Results: A total of 77 cases of OMMs were identified with a male/female ratio of 1:1.03. The mean (±standard deviation age was 50.1 (17.8 years. Squamous cell carcinoma was the most frequently seen epithelial malignancy constituting 35.1% of all malignancies, with most patients in advanced stages of the disease. Osteosarcoma was the most frequently diagnosed sarcoma, constituting 11.7% of all malignancies seen. Salivary gland malignancies constituted 29 (37.7%. Other malignancies seen include, malignant peripheral nerve sheath tumor, leiomyosarcoma, and malignant melanoma. Conclusion: OMMs constitute a significant health burden in our region. Thus, adequate resources should be allocated toward improving awareness among the populace. Policy shifts and regular dental visits which may increase the likelihood of early intervention should be instituted.

  11. Study of antimicrobial property of some hypoglycemic drugs

    Directory of Open Access Journals (Sweden)

    Arun Kumar Dash

    2011-01-01

    Full Text Available In the present work, a comparative antimicrobial study of different hypoglycemic drugs (Metformin, Phenformin, and Rosiglitazone was carried out. The main objective was to ascertain the antimicrobial activity by using "non-antibiotics" as the test substances. The antimicrobial activity was carried out against different bacteria and fungi namely Bacillus liceniformis, Escherichia coli, Proteus vulgaris, Pseudomonas aeruginosa, Shigella flexneri, Bacillus subtilis, Staphylococcus aureus subspp., and Staphylococcus epidermidis by using disc diffusion method and agar dilution method. Ciprofloxacin was taken as the standard antibiotic. The entire procedure was carried out in an aseptic area under the laminar flow by inoculating the bacterial strain to the agar media in which the drug solution was added. Different concentrations (300 and 400 μg/ml of the standard antibiotic and selected drugs were subjected for minimum inhibitory concentration, and zone of inhibition tests and the antimicrobial activity of the selected drugs were determined.

  12. One-year adherence to oral antihyperglycemic medication and risk prediction of patient outcomes for adults with diabetes mellitus

    Science.gov (United States)

    Huber, Carola A.; Rapold, Roland; Brüngger, Beat; Reich, Oliver; Rosemann, Thomas

    2016-01-01

    Abstract Medication adherence is essential in preventing adverse intermediate outcomes, but little is known on hard outcomes. The aims of this study were to determine the 1-year adherence to oral antihyperglycemic drugs (OADs) and to predict the risk of subsequent health outcomes among (non)adherent patients with diabetes. Using a large Swiss healthcare claims database from 2011 to 2014, we identified all patients aged ≥18 years with diabetes and treated with at least 1 OAD prescription. Adherence to OADs was measured as the proportion of days covered (PDC) over 1 year and subdivided into 2 categories: adherent (PDC ≥ 80%), nonadherent (PDC < 80%). We estimated the relative risk of hospitalization and mortality at follow-up using multivariate Cox proportional hazard models. Based on a sample of 26,713 patients, adherence to OADs was quite low: 42% of the patients achieved a PDC of ≥80% during the 1-year observation period. A 7% reduction in the hospitalization risk and a 10% reduction in the risk of mortality could be observed in adherent patients compared to nonadherent patients (hazard ratio [HR], 0.93 [95% CI, 0.89–0.97]; HR, 0.90 [95% CI, 0.82–0.99]). Subgroup analysis showed that an intensified diabetes therapy had no significant influence on the risk of both outcomes in adherent patients. Poor medication adherence increases the risk of subsequent hospitalizations and premature mortality in patient with diabetes, regardless of disease severity and comorbidities. This emphasizes the need for an earlier identification of patients with poor medication adherence. The awareness of physicians and patients regarding the importance of adherence in diabetes treatment should be increased. PMID:27368004

  13. A comparison of the efficacy and tolerability of oxcarbazepine oral suspension between infants and children with epilepsy: a retrospective chart review at a single medical center in Taiwan.

    Science.gov (United States)

    Wei, Shu-Hao; Liu, Cheng-Chao; Fan, Pi-Chuan

    2014-02-01

    Few clinical studies have assessed the efficacy and safety of oxcarbazepine (OXC) oral suspension in Asian pediatric patients and particularly in infants. The aim of this study was to investigate and compare the efficacy, tolerability, and side effects of OXC oral suspension in Taiwanese infants and children with various types of epilepsy. A retrospective review of the efficacy, tolerability, and side effects of OXC oral suspension in a tertiary medical center in Taiwan was conducted and included children (1-9 years old) and infants (epilepsy, which was classified into idiopathic partial, symptomatic partial, or multifocal subtypes. The OXC oral suspension (Trileptal(®); Novartis) was given in a gradual dose titration, from an initial 7.5 mg/kg/day to 30 mg/kg/day within 1 month in all cases. A total of 20 infants and 38 children were identified. There were no statistically significant differences between the children and infants in efficacy (75 vs. 82 %, p = 0.734) and adverse effects (30 vs. 21 %, p = 0.525) after OXC oral suspension treatment. The efficacy was significantly correlated with the epilepsy subtype (p epilepsy responded better to OXC oral suspension than those with multifocal epilepsy. OXC oral suspension is effective and well tolerated in both infants and children with partial epilepsy in Taiwan. Treatment efficacy was related to epilepsy subtype and number of combined AEDs before OXC treatment. Monotherapy had an excellent therapeutic response in partial epilepsy but not in multifocal epilepsy.

  14. Impact of Ramadan focused education program on hypoglycemic risk and metabolic control for patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Tourkmani AM

    2016-09-01

    Full Text Available Ayla M Tourkmani,1 Mohamed Azmi Hassali,2 Turki J Alharbi,1 Hesham I Alkhashan,1 Aljoharah H Alobikan,1 Ahmed H Bakhiet,1 Hala B Alqahtani,1 Alian A Alrasheedy,3 Ahmed D Alawwad,1 Adel M Mishriky,1 Hisham Aljadhey4 1Family and Community Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 2Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 3Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim Saudi Arabia; 4Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia Background: Fasting during the month of Ramadan could lead to acute complications and increased hypoglycemic risk of patients with type 2 diabetes. Therefore, diabetes is one of the diseases that need careful observation and special considerations during Ramadan including patients’ education and counseling. Objectives: To evaluate the impact of Ramadan focused education program on acute complications and biomedical parameters. Methods: A prospective nonrandomized interventional controlled design was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n=140 received focused individualized diabetic education sessions and antidiabetic medications adjustment before and after Ramadan, while the control group (n=122 received standard diabetic care. A validated hypoglycemia questionnaire was used in both groups to assess the change of the risk. Patients were advised to adjust the dosage and timing of antidiabetic agents according to the recommendations for management of diabetes during Ramadan. Primary outcomes were postintervention change of hypoglycemia score and HbA1c over 6-month follow-up. Data were presented as mean ± standard deviation. HbA1c was expressed in percentage. Results: The hypoglycemic scores before, during, and after Ramadan were 14

  15. Hypoglycemic Potential of Aqueous Extract of Moringa oleifera Leaf and In Vivo GC-MS Metabolomics

    Directory of Open Access Journals (Sweden)

    Washim Khan

    2017-09-01

    Full Text Available Moringa oleifera Lam. (family; Moringaceae, commonly known as drumstick, have been used for centuries as a part of the Ayurvedic system for several diseases without having any scientific data. Demineralized water was used to prepare aqueous extract by maceration for 24 h and complete metabolic profiling was performed using GC-MS and HPLC. Hypoglycemic properties of extract have been tested on carbohydrate digesting enzyme activity, yeast cell uptake, muscle glucose uptake, and intestinal glucose absorption. Type 2 diabetes was induced by feeding high-fat diet (HFD for 8 weeks and a single injection of streptozotocin (STZ, 45 mg/kg body weight, intraperitoneally was used for the induction of type 1 diabetes. Aqueous extract of M. oleifera leaf was given orally at a dose of 100 mg/kg to STZ-induced rats and 200 mg/kg in HFD mice for 3 weeks after diabetes induction. Aqueous extract remarkably inhibited the activity of α-amylase and α-glucosidase and it displayed improved antioxidant capacity, glucose tolerance and rate of glucose uptake in yeast cell. In STZ-induced diabetic rats, it produces a maximum fall up to 47.86% in acute effect whereas, in chronic effect, it was 44.5% as compared to control. The fasting blood glucose, lipid profile, liver marker enzyme level were significantly (p < 0.05 restored in both HFD and STZ experimental model. Multivariate principal component analysis on polar and lipophilic metabolites revealed clear distinctions in the metabolite pattern in extract and in blood after its oral administration. Thus, the aqueous extract can be used as phytopharmaceuticals for the management of diabetes by using as adjuvants or alone.

  16. REDUCTION OF CARDIOVASCULAR COMPLICATIONS OF MODERN HYPOGLYCEMIC THERAPY OF DIABETES MELLITUS TYPE 2: "FLORENTINE HERESY"

    Directory of Open Access Journals (Sweden)

    A. A. Aleksandrov

    2010-01-01

    Full Text Available The classic hypoglycemic agents include biguanides, sulfonylurea drugs, meglitinides, glitazones and alpha-glucosidase inhibitors. Modern algorithm of hypoglycemic therapy in the first step considers lifestyle modification and metformin monotherapy, the second step — the combined therapy. However, the effect of combined hypoglycemic therapy on long-term cardiovascular prognosis in patients with type 2 diabetes mellitus is studied insufficiently. Combined therapy with glibenclamide and metformin can result in adverse cardiovascular effects, so that long term therapy should be avoided in patients with coronary heart disease. Adequate pharmacological approaches to hyperglycemia correction should be elaborated.

  17. A comparison of hypoglycemic activity of three species of basidiomycetes rich in vanadium.

    Science.gov (United States)

    Han, Chunchao; Liu, Tongjun

    2009-02-01

    The hypoglycemic activity of fermented mushroom of three fungi of basidiomycetes rich in vanadium was studied in this paper. Alloxan- and adrenalin-induced hyperglycemic mice were used in the study. The blood glucose and the sugar tolerance were determined. After the mice were administered (ig) with Coprinus comatus rich in vanadium, the blood glucose of alloxan-induced hyperglycemic mice decreased (p hypoglycemic effects of Coprinus comatus rich in vanadium on hyperglycemic animals are significant; it may be used as a hypoglycemic food or medicine for hyperglycemic people.

  18. Ability of Saudi mothers to appropriately and accurately use dosing devices to administer oral liquid medications to their children

    Directory of Open Access Journals (Sweden)

    Almazrou S

    2014-12-01

    Full Text Available Saja Almazrou, Hind Alsahly, Huda Alwattar, Lamya Alturki, Mona Alamri Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia Background: Most liquid medications are packaged with administration devices, which may be used inappropriately or inaccurately, and sometimes are not used at all. Because of the importance of their proper use for children's health, this study was designed to assess Saudi mothers' experiences with measuring cups, syringes, and droppers for oral liquid medications; to compare accuracy of dosing across these devices; and to determine the effects of mothers' education statuses and pharmacist counseling on dosing accuracy. Methods: This was a cross-sectional study in which mothers were observed as they used a set of commonly available dosing devices which are a dosing cup, syringe, and dropper. Interviews were conducted in the outpatient pharmacy waiting area in several tertiary hospitals and primary clinics in Riyadh, Saudi Arabia between March and April 2013. Saudi women who were mothers of children aged 12 years old or younger and who gave their consent were eligible. Caregivers other than mothers and subjects with vision problems or cognitive/physical disabilities were excluded. We gathered demographic information such as age, number of children, and education status. Subjects were asked if they had had counseling on how to use measuring devices and which device they preferred. Then, the mothers were required to demonstrate how to measure 5 mL of paracetamol (acetaminophen syrup using a cup and a syringe and 1 mL of paracetamol syrup using a dropper. Dosing errors were evaluated visually as overdosing, underdosing, or no error (if the dose was accurate. The data were entered into Microsoft Excel and evaluated using Stata 11.1. Logistic regression was employed to determine relationships. Results: The results revealed that 58% of participants measured an accurate dose of paracetamol

  19. [The spectral analysis as an instrument for the investigation of the functional-dynamic complexes of oral speech skills for the medical criminalistic identification of the speaker].

    Science.gov (United States)

    Kir'yanov, P A; Kaganov, A Sh

    2016-01-01

    The objective of the present work was the search for the theoretical foundations and the approaches to the assessment of the methodological basis for the application of the spectral analysis to the investigation of the functional-dynamic complexes (FDC) of oral speech skills for the medical criminalistic identification of the speaker. The study included the analysis of the relevant literature publications, methodological proposals of the authors of the present article, and the results of their medical criminalistics investigations and laboratory experiments. The results of the study give evidence that the spectral analysis provides an acceptable tool for distinguishing the stable identification signs of a given acoustic group that characterize the functional-dynamic complexes of oral speech skills skills for the medical criminalistic identification of the speaker.

  20. Oral communication skills of international medical graduates: assessing empathy in discourse.

    Science.gov (United States)

    Cordella, Marisa; Musgrave, Simon

    2009-01-01

    We examine a dataset consisting of 11 International Medical Graduates (IMGs) performing an Objective Structured Clinical Examination (OSCE). Our aim is to address questions about the linguistic realization of empathy in the clinical discourse of IMGs and the extent to which OSCE examiners are sensitive to relevant features of the discourse. We analyse three aspects of the dataset as manifestations of empathy: sequential organization to provide reassurance; responsiveness to the simulated patient's lexical choices for emotionally charged words; and the organization of turn-taking in the interaction. Our analysis suggests that in each of these areas it is possible to identify discourse strategies which realize empathy. These strategies are used by IMGs who are good communicators and not used by poor communicators. Our evidence suggests that of the features we examine, the most salient for the examiner is a greater than normal occurrence of transition pauses. We argue that it is only in the area of the organization of conversation that the problems displayed by some IMGs are due to differences in cultural background, and it is therefore significant that the feature we identify as salient comes from this area.

  1. Analysis of proliferative activity in oral gingival epithelium in immunosuppressive medication induced gingival overgrowth

    Directory of Open Access Journals (Sweden)

    Özdemir B Handan

    2006-05-01

    Full Text Available Abstract Background Drug-induced gingival overgrowth is a frequent adverse effect associated principally with administration of the immunosuppressive drug cyclosporin A and also certain antiepileptic and antihypertensive drugs. It is characterized by a marked increase in the thickness of the epithelial layer and accumulation of excessive amounts of connective tissue. The mechanism by which the drugs cause gingival overgrowth is not yet understood. The purpose of this study was to compare proliferative activity of normal human gingiva and in cyclosporine A-induced gingival overgrowth. Methods Gingival samples were collected from 12 generally healthy individuals and 22 Cyclosporin A-medicated renal transplant recipients. Expression of proliferating cell nuclear antigen was evaluated in formalin-fixed, paraffin-embedded gingival samples using an immunoperoxidase technique and a monoclonal antibody for this antigen. Results There were differences between the Cyclosporin A group and control group in regard to proliferating cell nuclear antigen and epithelial thickness. In addition, the degree of stromal inflammation was higher in the Cyclosporin A group when compared with the control group. Conclusion The results suggest that the increased epithelial thickness observed in Cyclosporin A-induced gingival overgrowth is associated with increased proliferative activity in keratinocytes.

  2. A Study of the Management of Patients Taking Novel Oral Antiplatelet or Direct Oral Anticoagulant Medication Undergoing Dental Surgery in a Rural Setting

    OpenAIRE

    Steven Johnston

    2015-01-01

    Purpose: Novel oral antiplatelet (NOAP) (prasugrel and ticagrelor) and direct oral anticoagulant drugs (DOAC) (dabigatran, rivaroxaban and apixaban) have emerged in the last decade. This study was undertaken to determine current approaches taken to the management of patients taking these agents in dental practice in a remote and rural setting. Methods: A small retrospective study was carried out in a small island population that identified patients taking one of the above drugs. All national ...

  3. Effects of postmeal exercise on postprandial glucose excursions in people with type 2 diabetes treated with add-on hypoglycemic agents.

    Science.gov (United States)

    Erickson, Melissa L; Little, Jonathan P; Gay, Jennifer L; McCully, Kevin K; Jenkins, Nathan T

    2017-04-01

    Type 2 diabetes treatment primarily focuses on reducing hyperglycemia, including postprandial glucose excursions. Hypoglycemic agents are used clinically to lower fasting and postprandial glucose. Metformin is the first-line therapy; however, if metformin is inadequate then 'add-on' hypoglycemic agents are implemented. Postmeal exercise has been shown to lower postprandial glucose. The aim of this study was to assess if postmeal exercise provides additional glucose-lowering benefit, beyond medication alone, in those on add-on hypoglycemic agents. Postprandial glucose excursions in eight participants with type 2 diabetes (Age: 60±10.7, HbA1C: 7.9±2.3) being treated with add-on hypoglycemic agents were assessed during both drug-treated sedentary and drug-treated postmeal exercise conditions. Continuous glucose monitoring was used to assess peak and area under the glucose curve (AUC) during exercise, as well as peak within a 2-h time window, 2-h total and 2-h incremental AUC after a standardized breakfast meal. Postmeal exercise consisted of 3×10-min intervals of treadmill walking at 50% maximal oxygen uptake. Glucose peak (drug only: 13.8±3.7, drug/exercise: 9.9±2.7mmol/L; p=0.02) and AUC (drug only: 500±136, drug/exercise: 357±89mmol/L×40min; p=0.03) were reduced during postmeal exercise. Breakfast 2-h incremental AUC was also reduced (drug only: 585±291, drug/exercise: 330±294; p=0.047). Post-breakfast exercise lowered glucose during the exercise bout, although this effect was not sustained on later meals. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Phytochemical screening and evaluation of cytotoxic and hypoglycemic properties of Mangifera indica peels

    Directory of Open Access Journals (Sweden)

    Sabiha Chowdhury

    2017-01-01

    Conclusions: This current research affirms prominent cytotoxic and moderate hypoglycemic potential of M. indica peel. Further bioactivity guided isolation of phytoconstituents and investigation on higher animals can lead to development of new drug molecules.

  5. Online video in clinical skills education of oral medication administration for undergraduate student nurses: a mixed methods, prospective cohort study.

    Science.gov (United States)

    Holland, Agi; Smith, Fiona; McCrossan, Gill; Adamson, Elizabeth; Watt, Susan; Penny, Kay

    2013-06-01

    Improvements in the safety of the prescribing, dispensing and administration of medicines are identified as a priority across international healthcare systems. It is therefore essential that higher education institutions play their part in helping to meet this patient safety objective. New developments in clinical skills education which are aligned to emerging educational theory are available, but evaluations and supportive evidence are limited. To evaluate the use of an online best practice exemplar as an adjunct to the clinical skills teaching of oral medication administration to undergraduate student nurses. Mixed-methods prospective cohort design. Two intakes of undergraduate nursing students (n=168, n=154) undertaking a first year clinical skills based module at a British university. The Control group received standard teaching using lectures and skills classes facilitated by experienced clinical skills lecturers. The Intervention group received the standard teaching and unlimited access to an online video clip of medication administration. Performance and satisfaction were measured using module assessment results and a satisfaction questionnaire. Qualitative data were gathered using focus groups (n=16, n=20). The Intervention group was significantly (p=0.021) more likely to pass the assessment and rate their satisfaction with the teaching significantly higher (p<0.05) on more than half of the items from the Student Satisfaction Survey. Two Categories were identified from focus group data; Classroom Learning and Transfer to Practice. Classroom Learning included four themes of Peers, Self, Teaching and Time and when Classroom Learning was positive, the Transfer to Practice of the clinical skill was enhanced. An online video of a best practice exemplar as an adjunct to taught clinical skills sessions improves student assessment results and satisfaction ratings. The video was also reported to positively influence all themes identified in Classroom Learning and

  6. Hypoglycemic encephalopathy: a case series and literature review on outcome determination.

    Science.gov (United States)

    Witsch, Jens; Neugebauer, Hermann; Flechsenhar, Julia; Jüttler, Eric

    2012-10-01

    Data on clinical long-term outcome after the acute phase of hypoglycemic encephalopathy (HE) using validated outcome scales is currently unavailable. Here we report the results of a systematic literature search for studies on HE and data on long-term outcome in patients with HE admitted to three Charité hospitals between January 2005 and July 2010. HE was defined as coma/stupor and blood glucose levels GOS), and Barthel index (BI). Fifteen patients were included, with a mean age of 60 years (range 29-79). Two were lost to follow-up. Of the remaining 13 patients, six had died (46 %). In the seven survivors, the median mRS score was 0 (range 0-5), median GOS score was 5 (range 2-5), and median BI was 100 (range 0-100). MRIs made in the acute phase were available for three patients and revealed no obvious relation between lesion size or pattern and clinical outcome. To our knowledge, this is the first case series using validated clinical scoring systems to determine clinical long-term outcome after HE. The results suggest that mortality is high, but long-term survival with little or no disability is possible and can be observed in the majority of survivors. Risk of death or poor outcome does not seem to be related to MRI features in the acute phase but rather to other presumably medical factors.

  7. The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus and the Management of Hypoglycemic Events

    Science.gov (United States)

    Kassem, Mahmoud Attia Mohamed; Durda, Michael Andrew; Stoicea, Nicoleta; Cavus, Omer; Sahin, Levent; Rogers, Barbara

    2017-01-01

    Recent studies discussed the benefit of bariatric surgery on obese patients diagnosed with type 2 diabetes mellitus (T2DM). Several factors play an essential role in predicting the impact of bariatric surgery on T2DM, such as ABCD score (age, BMI, C-peptide, and duration of the disease), HbA1c, and fasting blood glucose, incretins [glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP)]. DiaRem score known to include factors such as age, HbA1c, medication, and insulin usage used to predict the remission of T2DM, but it has some limitations. An extensive literature search was conducted on PubMed and Google Scholar using keywords such as gastric bypass, T2DM, bariatric surgery, GLP-1, GIP, and post bariatric hypoglycemia. Restrictive-malabsorptive procedures are most effective in treating T2DM patients based on changes induced in appetite through regulation of gastrointestinal hormones, with decreased hunger and increased satiation. We provide a review of bariatric surgery influence on T2DM and management of post-intervention hypoglycemic events. Post-bariatric surgery hypoglycemia is a serious complication especially when patients develop life-threatening neuroglycopenia with loss of consciousness and seizure. The avoidance of this adverse event may be achieved by strict dietary modification including a restriction on carbohydrates as well as foods with high glycemic index. Further research will provide more information on post-bariatric surgery hyperinsulinemic hypoglycemia pathophysiology and management. PMID:28298900

  8. Improving the Medical Curriculum in Predoctoral Dental Education: Recommendations From the American Association of Oral and Maxillofacial Surgeons Committee on Predoctoral Education and Training.

    Science.gov (United States)

    Dennis, Matthew J; Bennett, Jeffrey D; DeLuke, Dean M; Evans, Erik W; Hudson, John W; Nattestad, Anders; Ness, Gregory M; Yeung, Allison

    2017-02-01

    Dental procedures are often performed on patients who present with some level of medical fragility. In many dental schools, the exercise of taking a medical history is all too often a transcription of information to the dental chart, with little emphasis on the presurgical risk assessment and the development of a treatment plan appropriate to the medical status of the dental patient. Changes in dentistry, driven by an increasingly medically complex population of dental patients, combined with treatment advances rooted in the biomedical sciences necessitate the adaptation of our dental education to include a stronger background in systemic health. Many predoctoral educators in the American Association of Oral and Maxillofacial Surgeons (AAOMS) have expressed concern about the medical preparedness of our dental students; therefore, the AAOMS and its Committee on Predoctoral Education and Training have provided recommendations for improving the medical curriculum in predoctoral dental education, including a strengthening of training in clinical medicine and biomedical sciences, with specific recommendations for improved training of our dental students and dental faculty. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Isolation, purification, and structural features of a polysaccharide from Phellinus linteus and its hypoglycemic effect in alloxan-induced diabetic mice.

    Science.gov (United States)

    Zhao, Chao; Liao, Zunsheng; Wu, Xiaoqi; Liu, Yanling; Liu, Xiaoyan; Lin, Zhanxi; Huang, Yifan; Liu, Bin

    2014-05-01

    Phellinus linteus is a medicinal mushroom that has been used in Oriental countries for centuries for its antitumor, antioxidant, immunomodulatory, and biological activity on hyperglycemia. A water-soluble crude polysaccharide was extracted using hot water from P. linteus mycelia grown under submerged culture. An orthogonal experiment was used to optimize the extraction conditions of P. linteus mycelia polysaccharides (PLP). The crude polysaccharide was purified using DEAE Sephadex A-50 and Sephadex G-200 chromatography. Fourier transform infrared (FT-IR) spectroscopy and nuclear magnetic resonance ((1) H NMR) spectroscopy were used to investigate the structure of the purified P. linteus polysaccharide (PLP-I), revealing that it was mainly a branched-type glycan with both α- and β-linkages and a pyranoid sugar ring conformation. PLP orally administered at 100 mg/kg body weight/d could significantly reduce the blood glucose level by 35.60% in alloxan-induced diabetic mice. The results of an oral glucose tolerance test (OGTT) revealed that PLP had an effect on glucose disposal after 28 d of treatment. The result revealed that PLP from a submerged culture of P. linteus mycelia possessed potent hypoglycemic properties. The polysaccharide may be useful as a functional food additive and a hypoglycemic agent.

  10. Impact of Ramadan focused education program on hypoglycemic risk and metabolic control for patients with type 2 diabetes

    Science.gov (United States)

    Tourkmani, Ayla M; Hassali, Mohamed Azmi; Alharbi, Turki J; Alkhashan, Hesham I; Alobikan, Aljoharah H; Bakhiet, Ahmed H; Alqahtani, Hala B; Alrasheedy, Alian A; Alawwad, Ahmed D; Mishriky, Adel M; Aljadhey, Hisham

    2016-01-01

    Background Fasting during the month of Ramadan could lead to acute complications and increased hypoglycemic risk of patients with type 2 diabetes. Therefore, diabetes is one of the diseases that need careful observation and special considerations during Ramadan including patients’ education and counseling. Objectives To evaluate the impact of Ramadan focused education program on acute complications and biomedical parameters. Methods A prospective nonrandomized interventional controlled design was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n=140) received focused individualized diabetic education sessions and antidiabetic medications adjustment before and after Ramadan, while the control group (n=122) received standard diabetic care. A validated hypoglycemia questionnaire was used in both groups to assess the change of the risk. Patients were advised to adjust the dosage and timing of antidiabetic agents according to the recommendations for management of diabetes during Ramadan. Primary outcomes were postintervention change of hypoglycemia score and HbA1c over 6-month follow-up. Data were presented as mean ± standard deviation. HbA1c was expressed in percentage. Results The hypoglycemic scores before, during, and after Ramadan were 14.21±8.50, 6.36±6.17, and 5.44±5.55 in the intervention group, respectively (P<0.001) and 14.01±5.10, 13.46±5.30, and 9.27±4.65 in the control group, respectively (P<0.001). HbA1c levels were 9.79±1.89, 8.26±1.54, and 8.52±1.61 before, during, and after Ramadan in the intervention group, respectively (P<0.001), and 10.04±1.47, 9.54±1.38, and 9.59±1.79 in the control group, respectively (P<0.001). Post-Ramadan reductions of HbA1c and hypoglycemic scores were significantly higher in the intervention group (−13.0% vs −4.5%, P=0.004 for HbA1c and −61.7% vs −33.8%, P<0.001 for hypoglycemic score). Low-density lipoprotein cholesterol improved in the

  11. Use of oral anti-diabetic agents in pregnancy: A pragmatic approach

    Directory of Open Access Journals (Sweden)

    Bharti Kalra

    2015-01-01

    Full Text Available Insulin is the gold standard for treatment of hyperglycemia during pregnancy, when lifestyle measures do not maintain glycemic control during pregnancy. However, recent studies have suggested that certain oral hypoglycemic agents (metformin and glyburide may be safe and be acceptable alternatives. There are no serious safety concerns with metformin, despite it crossing the placenta. Neonatal outcomes are also comparable, with benefit of reductions in neonatal hypoglycemia, maternal hypoglycemia and weight gain, and improved treatment satisfaction. Glibenclamide is more effective in lowering blood glucose in women with gestational diabetes, and with a lower treatment failure rate than metformin. Although generally well-tolerated, some studies have reported higher rates of pre-eclampsia, neonatal jaundice, longer stay in the neonatal care unit, macrosomia, and neonatal hypoglycaemia. There is also paucity of long-term follow-up data on children exposed to oral agents in utero. This review aims to provide an evidence-based approach, concordant with basic and clinical pharmacological knowledge, which will help medical practitioners use oral anti-diabetic agents in a rational and pragmatic manner. Pubmed search was made using Medical Subject Headings (MESH terms "Diabetes" and "Pregnancy" and "Glyburide"; "Diabetes" and "Pregnancy" and "Metformin". Limits were randomized controlled trials (RCTs and meta-analysis. The expert reviews on the topic were also used for discussion. Additional information (studies/review pertaining to discussion under sub-headings like safety during breastfeeding; placental transport; long-term safety data were searched (pubmed/cross-references/expert reviews.

  12. Nephroprotection by Hypoglycemic Agents: Do We Have Supporting Data?

    Directory of Open Access Journals (Sweden)

    Jose Luis Górriz

    2015-10-01

    Full Text Available Current therapy directed at delaying the progression of diabetic nephropathy includes intensive glycemic and optimal blood pressure control, renin angiotensin-aldosterone system blockade and multifactorial intervention. However, the renal protection provided by these therapeutic modalities is incomplete. There is a scarcity of studies analysing the nephroprotective effect of antihyperglycaemic drugs beyond their glucose lowering effect and improved glycaemic control on the prevention and progression of diabetic nephropathy. This article analyzes the exisiting data about older and newer drugs as well as the mechanisms associated with hypoglycemic drugs, apart from their well known blood glucose lowering effect, in the prevention and progression of diabetic nephropathy. Most of them have been tested in humans, but with varying degrees of success. Although experimental data about most of antihyperglycemic drugs has shown a beneficial effect in kidney parameters, there is a lack of clinical trials that clearly prove these beneficial effects. The key question, however, is whether antihyperglycemic drugs are able to improve renal end-points beyond their antihyperglycemic effect. Existing experimental data are post hoc studies from clinical trials, and supportive of the potential renal-protective role of some of them, especially in the cases of dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors. Dedicated and adequately powered renal trials with renal outcomes are neccessary to assess the nephrotection of antihyperglycaemic drugs beyond the control of hyperglycaemia.

  13. Evaluation of the Hypoglycemic Properties of Anacardium humile Aqueous Extract

    Directory of Open Access Journals (Sweden)

    Márcio A. Urzêda

    2013-01-01

    Full Text Available The antihyperglycemic effects of several plant extracts and herbal formulations which are used as antidiabetic formulations have been described and confirmed to date. The main objective of this work was to evaluate the hypoglycemic activity of the aqueous extract of Anacardium humile. Although the treatment of diabetic animals with A. humile did not alter body weight significantly, a reduction of the other evaluated parameters was observed. Animals treated with A. humile did not show variation of insulin levels, possibly triggered by a mechanism of blood glucose reduction. Levels of ALT (alanine aminotransferase decreased in treated animals, suggesting a protective effect on liver. Levels of cholesterol were also reduced, indicating the efficacy of the extract in reestablishing the balance of nutrients. Moreover, a kidney protection may have been achieved due to the partial reestablishment of blood glucose homeostasis, while no nephrotoxicity could be detected for A. humile. The obtained results demonstrate the effectiveness of A. humile extracts in the treatment of alloxan-induced diabetic rats. Therefore, A. humile aqueous extract, popularly known and used by diabetic patients, induced an improvement in the biochemical parameters evaluated during and following treatment of diabetic rats. Thus, a better characterization of the medicinal potential of this plant will be able to provide a better understanding of its mechanisms of action in these pathological processes.

  14. The mechanism of the acute hypoglycemic action of phenformin (DBI).

    Science.gov (United States)

    Searle, G L; Gulli, R

    1980-07-01

    The mechanisms by which biguanide (phenformin) acutely brings about a reduction in blood glucose in diabetic subjects has been studied with the aid of C-6 14C glucose. Six diabetic subjects were studied, each at three separate dose levels of phenformin. Two of these same subjects were studied with placebo. Consistent and increasingly pronounced effects of drug versus placebo were noted as the level of biguanide was increased. Biguanide consistently lowered hepatic glucose output while not significantly affecting the removal of glucose from the circulation. It was noted that glucogenesis from lactate was not significantly curtailed. However, a lack of stimulation in Cori Cycle activity in the presence of significant elevations of circulating lactate were taken as an indication of inhibition of glucogenesis from this substrate. On balance, it is concluded that the acute hypoglycemic action of this biguanide is mediated primarily through a restriction in the supply of glucose from the liver to the circulation. The data support the contention that these drugs inhibit hepatic glucogenesis even though Cori Cycle activity may be increased and also suggest that a portion of the decrease in hepatic glucose supply may be the result of impaired glycogenolysis.

  15. Probable hypoglycemic adverse drug reaction associated with prickly pear cactus, glipizide, and metformin in a patient with type 2 diabetes mellitus.

    Science.gov (United States)

    Sobieraj, Diana M; Freyer, Craig W

    2010-01-01

    To report a case of an adverse drug reaction (ADR) in a patient with type 2 diabetes mellitus taking prickly pear cactus (PPC), glipizide, and metformin. A 58-year-old Mexican male with type 2 diabetes mellitus being treated with metformin 1000 mg twice daily and extended-release glipizide 10 mg daily was referred to the pharmacist for medication education. He denied taking herbal supplements or experiencing hypoglycemia. Two hemoglobin A(1c) values (6.8% and 6.7%) obtained over the past year demonstrated glycemic control, which was supported by his reported fasting blood glucose readings of 113-132 mg/dL. One month later, the patient reported 4 hypoglycemic events with blood glucose readings of 49-68 mg/dL, which resulted in discontinuation of glipizide. One month later, the patient denied any further hypoglycemia. During medication reconciliation he reported consuming crude PPC pads daily for 2 months for glucose control. Literature suggests that PPC has an effect on lowering blood glucose levels in patients with type 2 diabetes mellitus, although few identified data describe ADRs from combining PPC with other agents used in treating type 2 diabetes mellitus. A literature search of MEDLINE (through December 2009) using the search terms diabetes mellitus, prickly pear cactus, nopal, opuntia, metformin, glipizide, glyburide, glimepiride, and sulfonylurea revealed no case reports of the described ADR. One case report describing the blood glucose-lowering effect of PPC in a patient concurrently taking oral antihyperglycemics documented an episode of hypoglycemia, although the Naranjo probability scale was not applied. One patient survey discovered the most common drug-herbal interaction in the given population to be between PPC and antihyperglycemic agents, resulting in hypoglycemia. In our case, use of the Naranjo probability scale suggests the ADR to be probable. The mechanism may be due to the additive glucose lowering of the 3 agents consumed concurrently by the

  16. Exploration and practice of oral corner: specialized oral English training activities of medical students%医学生“口语角”医学英语口语训练活动的实践

    Institute of Scientific and Technical Information of China (English)

    黄蕾; 高源; 梅妮; 杨文卓

    2013-01-01

    Objective This paper is to investigate the specialized oral English ability and external communication demand of medical students in the stage of clinical study,and to analyze the relevant factors that influence medical students' oral expression when they study abroad.According to the result,a platform of medical oral English training is built in order to improve the specialized oral English of medical students.Methods A questionnaire is designed to survey the medical oral English ability,the demands and difficulties of external exchange study among medical students in clinical stages.Based on this result and used the theory of constructivism learning as well as PBL teaching method,the "Oral Corner" activities are designed and carried out.At the end of the activities,all participants are required to fill in the questionnaires and to take a medical English vocabulary examination so as to evaluate the effect of this trial.Results Medical oral English are to improved among the medical students.Although most students are will to go abroad for study,however,poor specialized oral English may hinder the communication with foreigners by their self-assessment.The main factors are poor public English,inferior medical English and lacking of language environment.Most participants evaluate this corner is helpful for enlarging their vocabulary and promoting the history-taking skills in English.Besides,the average score of their medical English vocabulary test are higher than other students of the same stage and this difference is statistically significant.Conclusions The "Oral Corner" activities can improve medical students' professional English and oral English effectively,which demonstrates its meaning in teaching and value in promotion.%目的 了解临床学习阶段医学生的医学英语口语水平和对外交流需求,分析在对外交流过程中影响其医学英语口语表达的相关因素.通过搭建“口语角”活动平台并开展医学英语口

  17. Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 3: oral therapies.

    Science.gov (United States)

    Del Rosso, James Q; Harper, Julie C; Graber, Emmy M; Thiboutot, Diane; Silverberg, Nanette B; Eichenfield, Lawrence F

    2015-12-01

    Parts 1 and 2 of this 3-part series provided an overview of the epidemiology, visible patterns, and important considerations for clinical and laboratory evaluation of acne vulgaris (AV) in adult women and reviewed the role of proper skin care and topical therapies in this patient population. In Part 3, oral therapies including combination oral contraceptives, spironolactone, antibiotics, and isotretinoin are discussed along with important considerations that clinicians should keep in mind when selecting oral agents for management of AV in adult women.

  18. 甘精胰岛素联合口服降糖药物对血糖控制不佳的2型糖尿病患者的疗效观察%Efficacy of insulin glargine combined with oral hypoglycemic agent in type 2 diabetic patients with poor glycemic control

    Institute of Scientific and Technical Information of China (English)

    徐迎侠; 刘洪英

    2011-01-01

    Objective To investigate the efficacy and safety of insulin glargine(lantus(R))combined with metformin and pioglitazone in type 2 diabetic patients whose blood glucose levels Were inadequately controlled by oral antidiabetic drugs(OAD).Methods 78 type 2 diabetic patients with poor glycemic control of OAD were randomly divided into group A and B.Patients in group A and B received insulin glargine and NPH insulin respectively in addition to OAD of metformin and pioglitazone.Fasting blood glucose(FBG),2-bour postprandial blood glucose(2 hVG),glycosylated hemoglobin(Hb)A1c and the increase of weight,as well as hypoglycemia rate were abserved after therapy.Results Levels of FBG,2 hPG and HbA1c were lower in group A than those in group B(P0.05).Conclusion The treatment of insulin glargine with metformin and piglitazone in type 2 diabetic patients with poor glycemic control is more efficient.As the basic insulin treatment,glarglne Was more efficient than NPH insulin.%目的 评价甘精胰岛素(来得时(R))与盐酸吡格列酮和二甲双胍联合应用治疗口服降糖药物控制不佳的2型糖尿病患者的有效性和安全性.方法 采用随机法将78例口服降糖药物控制不佳的2型糖尿病患者分为A、B两组.A组为甘精胰岛素(来得时(R))组,B组为精蛋白锌胰岛素(诺和灵N)组,两组均口服吡格列酮和二甲双胍,观察治疗后空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(Hb)A1c水平,以及体重增加值和低血糖发生率.结果 A组FBG、2 hPG及HbA1c水平均低于B组(P均0.05).结论 口服降糖药物疗效差的2型糖尿病患者应用甘精胰岛素联合吡咯列酮和二甲双胍治疗,有更显著的降糖效果;作为基础胰岛素治疗,甘精胰岛素优于精蛋白锌胰岛素.

  19. Oral Cancer Exam

    Medline Plus

    Full Text Available ... diagnosis, and treatment of oral cancer, along with definitions of selected medical terms and resource information. Oral ... of Dental and Craniofacial Research National Institutes of Health Bethesda, MD 20892-2190 301-496-4261 NIH… ...

  20. Medications not intended for treatment of dyslipidemias and with a variable effect on lipids.

    Science.gov (United States)

    Whayne, Thomas F; Mukherjee, Debabrata

    2014-01-01

    Many therapeutically active medications have significant side effects, some of which can compromise the intended therapeutic goal. The development of plasma lipid abnormalities or a dyslipidemia as the result of a medication intended for an unrelated effect has been reported. Human immunodeficiency virus (HIV) infection can cause dyslipidemia as can the medications used to treat this infection. Such dyslipidemia can be a significant problem made more relevant by the already increased risk of cardiovascular (CV) disease faced by these patients. Some hypoglycemic medications used to treat diabetes can also be associated with dyslipidemia, most notably rosiglitazone. Antihypertensive medications are intended to decrease CV risk but are not free of dyslipidemia problems with thiazides able to cause hypertriglyceridemia and older beta-blockers without an alpha-blocking effect associated with moderate plasma lipid abnormalities and altered glucose metabolism. Estrogen administered orally can be associated with a severe hypertriglyceridemia. Currently-used antipsychotic medications have a significant association with hypertriglyceridemia. Clinicians must be aware of the dyslipidemias caused by these medications and know how to manage them, even treating a secondary dyslipidemia with another medication as in the case of HIV infection rather than trying to switch treatment of the infection in many cases. Mention is also made of lipid lowering effects of medications intended for other purposes (e.g. angiotensin receptor blockers and orlistat).

  1. Associations between oral and ocular dryness, labial and whole salivary flow rates, systemic diseases and medications in a sample of older people

    DEFF Research Database (Denmark)

    Smidt, Dorte; Torpet, Lis Andersen; Nauntofte, Birgitte

    2011-01-01

    to the Anatomical therapeutic chemical (ATC) classification system), tobacco and alcohol consumption were registered, and unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 668 randomly selected community-dwelling elderly aged 65–95. Results...... number of diseases and medications, but neither with age and gender per se nor with tobacco and alcohol consumption. New detailed information concerning associations between medications and oral and ocular dryness has been obtained using the ATC classification system....

  2. Urine drug testing results and paired oral fluid comparison from patients enrolled in long-term medication-assisted treatment in Tennessee.

    Science.gov (United States)

    Miller, Katie L; Puet, Brandi L; Roberts, Ali; Hild, Cheryl; Carter, Jason; Black, David L

    2017-05-01

    Urine drug testing is recommended for individuals receiving medication-assisted treatment. It provides objective information for practitioners to consider and may serve as a protective factor against drug-related mortality. The primary objective of our study was to describe urine drug testing results for patients undergoing long-term medication-assisted treatment (≥6months). The secondary objective was to provide further evidence to establish oral fluid as a reliable alternative to urine. All subjects (n=639) included in the study were enrolled in one of five treatment centers in the state of Tennessee, and all urine specimens were positive for either methadone or buprenorphine. Nicotine (87%), caffeine (70%), marijuana (15%), alcohol (14%) and gabapentin (10%) were the most prevalent substances identified through urine drug testing. The presence of non-maintenance opioids (prescription and/or heroin) may represent relapse; these drugs were present in 10% of specimens tested. Evidence of illicit drug use (cocaine, heroin, marijuana and/or methamphetamine) was detected in 19% specimens. For 126 of the 639 subjects included in the study, paired oral fluid and urine test results were compared for agreement. Of the total paired urine and oral fluid tests, approximately 7% were positive for a drug in both specimen types and 91% were negative in both, resulting in an overall agreement of 98%. The study demonstrates continued use of illicit and commercially available medications in a medication-assisted treatment population undergoing long-term treatment. The results affirm the reliability of oral fluid as an alternative specimen type for compliance testing in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. 1946例口腔颌面外科医保患者住院病案质量分析%Analysis on 1946 cases of oral and maxillofacial surgery patients with medical insurance in hospital medical record quality

    Institute of Scientific and Technical Information of China (English)

    王春辉; 沈曙铭

    2013-01-01

      目的:通过对口腔颌面外科住院医保病案质量检查,分析其发生特点与规律,为规范医保住院病案质量管理提供参考.方法:调取2009年至2011年3年间口腔颌面外科住院医保病案1946例,按照医保相关政策,设专职人员检查,归纳整理有效数据进行统计分析.结果:医保病案缺陷发生率总体呈逐年下降趋势,但仍有反复强调的问题执行不到位.2009年缺陷发生率44.04%,2010年缺陷发生率36.81%,2011年缺陷发生率28.96%.结论:医院还需进一步改进医保工作,制订医保病案质量控制标准和完善质量监控体系,加强医保病案管理,促进医保病案质量的提高.%Objectives:Through medical insurance patient's medical record quality test in oral and maxillofacial surgery analysis, to analyze the occurrence characteristics and regularity, and to give reference on regulating medical insurance patient's medical record quality management. Methods:1946 medical insurance patient's medical records in oral and maxillofacial surgery from 2009 to 2011 were selected. According to medical insurance policy, medical record data were analyzed by professional staff. Results:Adverse rate of medical insurance patient's medical record has been decreased but problems which have been repeatedly stressed still existed. The adverse rate in 2009, 2010 and 2011 is 44.04%, 36.81% and 28.96%, respectively. Conclusions: Hospital should further improve medical insurance management, build medical insurance patient's medical record quality control standard and complete quality monitoring system to strengthen medical record management and improve medical record quality.

  4. Induction of Biologically Active Flavonoids in Cell Cultures of Morus nigra and Testing their Hypoglycemic Efficacy.

    Science.gov (United States)

    Abd El-Mawla, Ahmed M A; Mohamed, Khaled M; Mostafa, Ashraf M

    2011-01-01

    The antidiabetic activity of both leaves and MJ-treated cell cultures of Morus nigra was evaluated after their oral administration to streptozotocin-induced diabetic rats. The antidiabetic activity of extracts from leaves given to streptozotocin (STZ)-diabetic rats for 10 days increased with increasing doses of leaves extract up to 500 mg/kg/day. The administration of 500 mg/kg/day of leaves extract reduced the concentration of glucose from 370 ± 7.31 mg/dl (control) to 154 ± 6.27 mg/dl, and a significant increase in the insulin level from 11.3 ± 0.31 μU/ml (control) to 14.6 ± 0.43 μU/ml was recorded. Cell suspension cultures were established from the young leaves of Morus nigra cultivated on modified MS medium supplemented with 2.0 mg/l 1-naphthaleneacetic acid (NAA), 0.2 mg/l 6-(furfurylamino)purine (kinetin). The changes in cell weight and flavonoid content were monitored between day zero and 12. The linear increase in fresh weight was found to be parallel to flavonoids production. Cell cultures treated with 100 μM methyl jasmonate for 24 hours showed a noticeable increase in level of flavonoids and significant and more effective hypoglycemic activity than that for extract from leaves. The major flavonoids were isolated by TLC and HPLC and identified as rutin, quercetin, Morusin and cyclomorusin by co-chromatography and mass spectrometry in comparison to samples of authentic reference compounds.

  5. Synthesis, Antimicrobial and Hypoglycemic Activities of Novel N-(1-Adamantylcarbothioamide Derivatives

    Directory of Open Access Journals (Sweden)

    Ebtehal S. Al-Abdullah

    2015-05-01

    Full Text Available The reaction of 1-adamantyl isothiocyanate 4 with the various cyclic secondary amines yielded the corresponding N-(1-adamantylcarbothioamides 5a–e, 6, 7, 8a–c and 9. Similarly, the reaction of 4 with piperazine and trans-2,5-dimethylpiperazine in 2:1 molar ratio yielded the corresponding N,N'-bis(1-adamantylpiperazine-1,4-dicarbothioamides 10a and 10b, respectively. The reaction of N-(1-adamantyl-4-ethoxycarbonylpiperidine-1-carbothioamide 8c with excess hydrazine hydrate yielded the target carbohydrazide 11, in addition to 4-(1-adamantylthiosemicarbazide 12 as a minor product. The reaction of the carbohydrazide 11 with methyl or phenyl isothiocyanate followed by heating in aqueous sodium hydroxide yielded the 1,2,4-triazole analogues 14a and 14b. The reaction of the carbohydrazide 11 with various aromatic aldehydes yielded the corresponding N'-arylideneamino derivatives 15a–g. The compounds 5a–e, 6, 7, 8a–c, 9, 10a, 10b, 14a, 14b and 15a–g were tested for in vitro antimicrobial activity against certain strains of pathogenic Gram-positive and Gram-negative bacteria and the yeast-like fungus Candida albicans. The compounds 5c, 5d, 5e, 6, 7, 10a, 10b, 15a, 15f and 15g showed potent antibacterial activity against one or more of the tested microorganisms. The oral hypoglycemic activity of compounds 5c, 6, 8b, 9, 14a and 15b was determined in streptozotocin (STZ-induced diabetic rats. Compound 5c produced significant reduction of serum glucose levels, compared to gliclazide.

  6. Caracterização do fármaco hipoglicemiante glibenclamida Characterization of the hypoglycemic drug glibenclamide

    Directory of Open Access Journals (Sweden)

    Christiane Gino Colu Nery

    2008-03-01

    Full Text Available A glibenclamida (GLIB é um fármaco de segunda geração, administrado por via oral na forma de comprimidos, utilizado para o tratamento de Diabetes mellitus. GLIB possui baixa solubilidade aquosa, o que pode levar a uma baixa liberação a partir de formas farmacêuticas sólidas no teste de dissolução e, portanto, a variabilidades no tratamento. Neste estudo, avaliam-se as características da matéria-prima GLIB, que podem influenciar o perfil de dissolução, e conseqüentemente, a biodisponibilidade, por meio de técnicas tais como, adsorção de nitrogênio, difração de raio laser, análise térmica, espectroscopia por IV/UV e difração de raios X.Glibenclamide (GLIB or glyburide, a second-generation hypoglycemic agent is orally used in the form of tablets for the treatment of diabetes mellitus. Bulk GLIB has a low aqueous solubility and it may yield low drug release in the dissolution test, causing variabilility in the treatment. This work evaluates the bulk GLIB features, which may influence drug release profile, hence, bioavailability, by means of techniques such as nitrogen sorption analysis, laser diffraction, thermal analysis, IV/UV spectroscopy and X-ray analysis.

  7. Hypoglycemic effects of Zanthoxylum alkylamides by enhancing glucose metabolism and ameliorating pancreatic dysfunction in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    You, Yuming; Ren, Ting; Zhang, Shiqi; Shirima, Gerald Gasper; Cheng, YaJiao; Liu, Xiong

    2015-09-01

    This study aimed to evaluate the hypoglycemic effect of Zanthoxylum alkylamides and explore the potential mechanism in streptozotocin (STZ)-induced diabetic rats. Diabetic rats were orally treated with 3, 6, and 9 mg per kg bw alkylamides daily for 28 days. As the alkylamide dose increased, the relative weights of the liver and kidney, fasting blood glucose, and fructosamine levels were significantly decreased. The alkylamides also significantly increased the body weight and improved the oral glucose tolerance of the rats. Likewise, the alkylamides significantly increased the levels of liver and muscle glycogen and plasma insulin. These substances further alleviated the histopathological changes in the pancreas of the diabetic rats. The beneficial effects of high-dose alkylamides showed a comparable activity to the anti-diabetic drug glibenclamide. Western blot and real-time PCR results revealed that the alkylamide treatment significantly decreased the expression levels of the key enzymes (phosphoenolpyruvate caboxykinase and glucose-6-phosphatase) involved in gluconeogenesis and increased the glycolysis enzyme (glucokinase) in the liver, and enhanced the expression levels of pancreatic duodenal homeobox-1, glucokinase, and glucose transporter 2 in the pancreas. In addition, it was also observed that the alkylamides, unlike glibenclamide, increased the transient receptor potential cation channel subfamily V member 1 and decreased cannabinoid receptor 1 expressions in the liver and pancreas. Therefore, alkylamides can prevent STZ-induced hyperglycemia by altering the expression levels of the genes related to glucose metabolism and by ameliorating pancreatic dysfunction.

  8. Self-assembled lecithin/chitosan nanoparticles for oral insulin delivery: preparation and functional evaluation

    Directory of Open Access Journals (Sweden)

    Liu LY

    2016-02-01

    Full Text Available Liyao Liu, Cuiping Zhou, Xuejun Xia, Yuling Liu State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Beijing Key Laboratory of Drug Delivery Technology and Novel Formulations, Department of Pharmaceutics, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China Purpose: Here, we investigated the formation and functional properties of self-assembled lecithin/chitosan nanoparticles (L/C NPs loaded with insulin following insulin–phospholipid complex preparation, with the aim of developing a method for oral insulin delivery.Methods: Using a modified solvent-injection method, insulin-loaded L/C NPs were obtained by combining insulin–phospholipid complexes with L/C NPs. The nanoparticle size distribution was determined by dynamic light scattering, and morphologies were analyzed by cryogenic transmission electron microscopy. Fourier transform infrared spectroscopy analysis was used to disclose the molecular mechanism of prepared insulin-loaded L/C NPs. Fast ultrafiltration and a reversed-phase high-performance liquid chromatography assay were used to separate free insulin from insulin entrapped in the L/C NPs, as well as to measure the insulin-entrapment and drug-loading efficiencies. The in vitro release profile was obtained, and in vivo hypoglycemic effects were evaluated in streptozotocin-induced diabetic rats.Results: Our results indicated that insulin-containing L/C NPs had a mean size of 180 nm, an insulin-entrapment efficiency of 94%, and an insulin-loading efficiency of 4.5%. Cryogenic transmission electron microscopy observations of insulin-loaded L/C NPs revealed multilamellar structures with a hollow core, encircled by several bilayers. In vitro analysis revealed that insulin release from L/C NPs depended on the L/C ratio. Insulin-loaded L/C NPs orally administered to streptozotocin-induced diabetic rats exerted a significant

  9. The Hypoglycemic Properties of BAE Maca Max Preparation

    Directory of Open Access Journals (Sweden)

    Lim K. Choong

    2009-01-01

    Full Text Available Problem statement: Considering an urgency of a question of diabetes treatment and decrease the side effects of hypoglycemic therapies, there is a necessity to elaborate a new approaches to this problem. This study was directed on estimation of possibilities of a preparation of naturally modified BAE maca max product for improvement of semeiology of diabetes and reduce the glucose level in the blood. Approach: Experiment was carried out on not purebred rats, received from Rappolovo (Russia nursery, with use of alloksan preparation for creation of models of type 1 and type 2 forms of diabetes. During the basic experiment animals have been divided into three groups: First group was made with control animals; second group, represented type 2 form of diabetes and third group represented animals with type 1 form of diabetes. Animals received BAE Maca Max preparation, which consists of two major active ingredients which are Maca and Tribulus Terresteris plants, in the form of drink, dissolved in 200 mL potable water from standard drinking bowls (after development of hyperglycemia. Glucose level defined before consumption of preparation, for 3rd day, 7th day and 10th day of consumption. Results: Result of experiences established that: Glucose level in blood of healthy animals for 10 day of experiment was in 1,26 times below than initial level (remaining in the range of norm; in group of animals with type 2 form of diabetes glucose level has reduced in 1,2 times; in the second group of animals with type 1 form of diabetes glucose level reduced in a range from 9,8±0,8-8,3±0,8 mmol L?1. Conclusion: Results of experiments showed that BAE maca max preparation possesses ability to statistical significant reduce the level of glucose in both type 1 and 2 forms of diabetes.

  10. Hypoglycemic agents and potential anti-inflammatory activity

    Directory of Open Access Journals (Sweden)

    Kothari V

    2016-04-01

    Full Text Available Vishal Kothari,1 John A Galdo,2 Suresh T Mathews3 1Department of Nutrition and Dietetics, Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, 2Department of Pharmacy Practice, 3Department of Nutrition and Dietetics, Samford University, Birmingham, AL, USA Abstract: Current literature shows an association of diabetes and secondary complications with chronic inflammation. Evidence of these immunological changes include altered levels of cytokines and chemokines, changes in the numbers and activation states of various leukocyte populations, apoptosis, and fibrosis during diabetes. Therefore, treatment of diabetes and its complications may include pharmacological strategies to reduce inflammation. Apart from anti-inflammatory drugs, various hypoglycemic agents have also been found to reduce inflammation that could contribute to improved outcomes. Extensive studies have been carried out with thiazolidinediones (peroxisome proliferator-activated receptor- agonist, dipeptidyl peptidase-4 inhibitors, and metformin (AMP-activated protein kinase activator with each of these classes of compounds showing moderate-to-strong anti-inflammatory action. Sulfonylureas and alpha glucosidase inhibitors appeared to exert modest effects, while the injectable agents, insulin and glucagon-like peptide-1 receptor agonists, may improve secondary complications due to their anti-inflammatory potential. Currently, there is a lack of clinical data on anti-inflammatory effects of sodium–glucose cotransporter type 2 inhibitors. Nevertheless, for all these glucose-lowering agents, it is essential to distinguish between anti-inflammatory effects resulting from better glucose control and effects related to intrinsic anti-inflammatory actions of the pharmacological class of compounds. Keywords: diabetes, inflammation, insulin, metformin, thiazolidinedione, gliptin

  11. Hypoglycemic Effects of Three Medicinal Plants in Experimental Diabetes: Inhibition of Rat Intestinal α-glucosidase and Enhanced Pancreatic Insulin and Cardiac Glut-4 mRNAs Expression.

    Science.gov (United States)

    Moradabadi, Leila; Montasser Kouhsari, Shideh; Fehresti Sani, Mohammad

    2013-01-01

    Garlic (Allium sativum L., Alliaceae), Persian shallot (Allium ascalonicum L., Alliaceae ) and Sage (Salvia officinalis L., Lamiaceae) are believed to have hypoglycemic properties and have been used traditionally as antidiabetic herbal medicines in Iran. In this study, diabetes was induced by subcutaneous injection of alloxan monohydrate (100 mg kg(-1)) to male Wistar rats. Antidiabetic effects of methanolic extracts of the above mentioned three plants on alloxan-diabetic rats was investigated in comparison with the effects of antidiabetic drugs such as acarbose, glibenclamide and metformin by measuring postprandial blood glucose (PBG), oral glucose tolerance test (OGTT), inhibition of rat intestinal α-glucosidase enzymes activities and pancreatic Insulin and cardiac Glut-4 mRNAs expression. In short term period, hypoglycemic effects of A. sativum and A. ascalonicum showed significant reduction of PBG similar to glibenclamide (5 mg kg(-1) bw) while S. officinalis significantly reduced PBG similar to acarbose (20 mg kg(-1) bw). After 3 weeks of treatment by methanolic plant extracts, significant chronic decrease in the PBG was observed similar to metformin (100 mg kg(-1) bw). For OGTT, S. officinalis reduced PBG in a similar way as acarbose (20 mg kg(-1) bw). Intestinal sucrase and maltase activities were inhibited significantly by A. sativum, A. ascalonicum and S. officinalis. In addition, we observed increased expression of Insulin and Glut-4 genes in diabetic rats treated with these plants extracts. Up regulation of Insulin and Glut-4 genes expression and inhibition of α-glucosidaseactivities are the two mechanisms that play a considerable role in hypoglycemic action of garlic, shallot and sage.

  12. The application effect of bedside oral medication dispensing in hospitalized patients%床旁摆发口服药在住院患者中的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    赵波(通讯作者); 刘红梅

    2013-01-01

    Objective:To discuss the application effect of bedside oral medication dispensing in hospitalized patients.Methods:250 patients were divided into two groups:observation group and control group and there were 250 cases in each group.Bedside oral medication dispensing was performed in observation group and centralized oral medication dispensing in control group. The incidence of nursing errors、mastery condition of health knowledge and patients satisfaction were compared between the two groups.Results:The mastery condition of health knowledge and patients satisfaction in observation group were superior to those in control group.However,the incidence of nursing errors in observation group was lower than that of control group. There were statisticaly significant differences between the two groups(p  Conclusions:Bedside oral medication dispensing is helpful to improve   the mastery condition of health knowledge and patients satisfaction and   decrease the incidence of nursing errors.

  13. The Effect of the Theoretical Course of Community Oral Health on the Oral Health Prevention Knowledge, Attitude and Self-Reported Practice in Dental School Students at Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Mehri Esfandiyar

    2012-09-01

    Full Text Available Background and Aims: Evaluation of the training is a principle for successful education. This study evaluated the effect of the theoretical course of community oral health on knowledge, attitude and self-reported practice of preventive dentistry in dental students at Tehran University of Medical Sciences and assessed the students' satisfaction from the course.Materials and Methods: The intervention group comprised the forth-year students of Tehran University of Medical Sciences, Dental School and the controls were the forth year students of Shahid Beheshti Medical University. The questionnaire included questions on backgrounds, knowledge, attitude and practice of students towards preventive dentistry, and students' satisfaction from the course. The intervention was 17 weekly sessions (hours of the community oral health course. The sum of scores for questions on backgrounds, knowledge, attitude and practice were calculated and changes were analyzed by General Linear Model.Results: The mean baseline knowledge score in the intervention group was 16.9 (SD=4.0 and for the control group 16.3 (SD=3.5. Corresponding figures were 23.7 (SD=3.4 and 17 (SD=3.3 after intervention. General linear model showed the intervention to be successful in increasing the students' knowledge scores on preventive dentistry (P<0.0001. Most students (92% were satisfied with learning several new items during the course.Conclusion: The students' knowledge was successfully increased by passing the theoretical course of community oral health delivered by teacher-centered method of lecture. Student-centered methods may help in changing the students' attitude and practice of preventive dentistry.

  14. Influence of glucosamine on the bioactivity of insulin delivered subcutaneously and in an oral nanodelivery system

    Directory of Open Access Journals (Sweden)

    Al-Kurdi ZI

    2015-11-01

    Full Text Available Zakieh I Al-Kurdi,1,2 Babur Z Chowdhry,2 Stephen A Leharne,2 Nidal A Qinna,3 Mahmoud MH Al Omari,1 Adnan A Badwan1 1The Jordanian Pharmaceutical Manufacturing Company (PLC, Naor, Jordan; 2Faculty of Engineering and Science, University of Greenwich, Medway Campus, Kent, UK; 3Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan Abstract: The aim of the work reported herein was to study the effect of glucosamine HCl (GlcN·HCl on the bioactivity (BA of insulin, administered via subcutaneous (SC and oral routes, in adult male Sprague Dawley rats. The oral insulin delivery system (insulin–chitosan reverse micelle [IC-RM] was prepared by solubilizing insulin–chitosan (13 kDa polyelectrolyte complex in a RM system consisting of oleic acid, PEG-8 caprylic/capric glycerides, and polyglycerol-6-dioleate. The BA of insulin in vivo was evaluated by measuring blood glucose level using a blood glucose meter; the results revealed that the extent of hypoglycemic activity of SC insulin was GlcN·HCl dose dependent when they were administered simultaneously. A significant reduction in blood glucose levels (P<0.05 was found for the insulin:GlcN·HCl at mass ratios of 1:10 and 1:20, whereas lower ratios (eg, 1:1 and 1:4 showed no significant reduction. Furthermore, enhancement of the action of SC insulin was achieved by oral administration of GlcN·HCl for 5 consecutive days prior to insulin injection (P<0.05. For oral insulin administration via the IC-RM system, the presence of GlcN·HCl increased the hypoglycemic activity of insulin (P<0.05. The relative BA were 6.7% and 5.4% in the presence and absence of GlcN·HCl (ie, the increase in the relative BA was approximately 23% due to incorporating GlcN·HCl in the IC-RM system, respectively. The aforementioned findings offer an opportunity to incorporate GlcN·HCl in oral insulin delivery systems in order to enhance a reduction in blood

  15. Polypharmacy in elderly patients with type 2 diabetes receiving oral antidiabetic treatment.

    Science.gov (United States)

    Noale, Marianna; Veronese, Nicola; Cavallo Perin, Paolo; Pilotto, Alberto; Tiengo, Antonio; Crepaldi, Gaetano; Maggi, Stefania

    2016-04-01

    Polypharmacy in older diabetics can have detrimental effects linked to poor adherence and the risk of drug interaction or more serious/frequent side effects. The aim of this study was to identify the characteristics associated with polypharmacy in a cohort of elderly diabetic patients being treated with oral hypoglycemic agents. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers in Italy participating in the METABOLIC Study. Patients meeting the following inclusion criteria were enrolled: diagnosis of type 2 diabetes mellitus, age ≥65 years, and receiving oral antidiabetic treatment. Data concerning diabetes duration and complications, the medications the patients were taking, and the number of hypoglycemic events were registered. Multidimensional impairment was assessed using the Multidimensional Prognostic Index. The mean age of the participants was 73.3 ± 5.5 years. Polypharmacy, defined as being prescribed contemporaneously at least five drugs, was found in 57.1 % of the study population. According to a multivariable logistic model, the female gender was significantly associated with polypharmacy, as were living in Northern Italian regions, diabetes duration longer than 4 years, and having a body mass index ≥30 kg/m(2). Comorbidities, diabetes complications, a better cognitive performance on the Short Portable Mental Status Questionnaire, and being malnourished/at risk of malnourishment according to the mini nutritional assessment were associated with polypharmacy. Polypharmacy, a condition that may lead to many potential detrimental outcomes in older diabetic subjects, was significantly associated with some risk factors that may be useful to identify subjects at risk.

  16. The Final Oral/Practical State Examination at Freiburg Medical Faculty in 2012 – Analysis of grading to test quality assurance

    Directory of Open Access Journals (Sweden)

    Schickler, Angela

    2015-10-01

    Full Text Available Aim: The aim of this study is to analyze the grades given for the oral/practical part of the German State Examination at the Medical Faculty of Freiburg. We examined whether or not the grades given for the written and the oral/practical examinations correlated and if differences in grading between the Freiburg University Medical Center (UMC and the other teaching hospitals could be found.In order to improve the quality of the state examination, the medical school has been offering standardized training for examiners for several years. We evaluated whether or not trained and untrained examiners differed in their grading of the exam and how these differences have changed over time.Methods: The results of the 2012 spring and fall exams were analyzed (N=315. The relevant data set was made available to us by the Baden-Württemberg Examination Office (. The data were analyzed by means of descriptive and inferential statistics.Results: We observed a correlation of ρ=0.460** between the grades for the written and the oral/practical exams. The UMC and the teaching hospitals did not differ significantly in their grade distributions. Compared to untrained examiners, trained ones assigned the grade of “very good” less often. Furthermore, they displayed a significantly higher variance in the grades given (p=0.007, phi=0.165. This effect is stronger when concentrating specifically on those examiners who took part in the training less than a year before.Conclusion: The results of this study suggest that the standardized training for examiners at the Medical Faculty of Freiburg is effective for quality assurance. As a consequence, more examiners should be motivated to take part in the training.

  17. Understanding the economic burden of nonsevere nocturnal hypoglycemic events: impact on work productivity, disease management, and resource utilization.

    Science.gov (United States)

    Brod, Meryl; Wolden, Michael; Christensen, Torsten; Bushnell, Donald M

    2013-12-01

    Nonsevere hypoglycemic events are common and may occur in one-third of persons with diabetes as often as several times a week. This study's objective was to examine the economic burden of nonsevere nocturnal hypoglycemic events (NSNHEs). A 20-minute Web-based survey, with items derived from the literature, expert input, and patient interviews, assessing the impact of NSNHEs was administered in nine countries to 18 years and older patients with self-reported diabetes having an NSNHE in the past month. A total of 20,212 persons were screened, with 2,108 respondents meeting criteria and included in the analysis sample. The cost of lost work productivity per NSNHE was estimated to be between $10.21 (Germany) and $28.13 (the United Kingdom), representing 3.3 to 7.5 hours of lost work time per event. A reduction in work productivity (presenteeism) was also reported. Compared with respondents' usual blood sugar monitoring practice, on average, 3.6 ± 6.6 extra tests were conducted in the week following the event at a cost of approximately $87.1 per year. Additional costs were also incurred for doctor visits as well as medical care required because of falls or injuries incurred during the NSNHE for an annual cost of $2,111.3 per person per year. When taking into consideration the multiple impacts of NSNHEs for the total sample and the frequency that these events occur, the resulting total annual economic burden was $288,000 or $127 per person per event. NSNHEs have serious consequences for patients. Greater attention to treatments that reduce NSNHEs can have a major impact on reducing the economic burden of diabetes. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. The hypoglycemic effect of the aqueous extract of the fruits of Balanites aegypticea in Alloxan-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Abdella Emam Abdella Baragob

    2014-01-01

    Full Text Available Background: Balanites aegypticea is used medically for many purposes e.g. anti-spasmodic, stomach pain, malaria, and yellow fever. The extract of the fruit is also used to reduce the blood glucose levels. Objectives: The objective of this study was to investigate the hypoglycemic effects of the aqueous extract of the fruits of the Balanites aegypticea in alloxan-induced diabetic rats. Materials and Methods: Twenty-five adult male Vistar rats were used in this study. The rats were randomly collected and divided into 5 groups (5 rats in each group. The untreated rats (negative control group received basal diet and tap water only for 15 days. The experimental rats became diabetic by intraperitoneal injection of alloxan (150 mg/kg body weight. The fruit of Balanites aegypticea was powdered, extracted, and dried using organic solvents. The diabetic rats received aqueous extract 200 mg/kg, 400 mg/kg, and 800 mg/kg, respectively, for 2 weeks. Plasma glucose levels were measured by using Glucose GOD-PAP method through spectrophotometer. Results: The results showed that 800 mg/kg aqueous extract decrease significantly the plasma glucose level (P ≤ 0.05 in diabetic rats, and there is a considerable gain in body weight (P ≤ 0.05 compared to the diabetic control group. Four-hundred mg/kg aqueous extract has a mild effect on body weights and plasma glucose levels, while 200 mg/kg aqueous extract has no significant effect on plasma glucose level and a little effect on body weight. Conclusions: The results of the presented study revealed that the aqueous extract of Balanites aegypticea has hypoglycemic properties. It can decrease the plasma glucose level and can improve weight in diabetic experimental animals.

  19. Hypoglycemic effect of Brassica juncea (seeds) on streptozotocin induced diabetic male albino rat

    Institute of Scientific and Technical Information of China (English)

    T Thirumalai; S Viviyan Therasa; EK Elumalai; E David

    2011-01-01

    Objective: To evaluate the hypoglycemic effect of Brassica juncea (seeds) on streptozotocin induced diabetic male albino rats. Methods: Hypoglycemic activity of Brassica juncea (seeds) aqueous extract at a dose of 250, 350 and 450 mg/kg body weight was evaluated. Adult male Swiss albino rats of six numbers in each group was undertaken for study and evaluated. Results: The serum insulin levels were recorded a significant depletion in all groups, short term as well as long term diabetic animals, when compared to that of normal animals. A significant dosage dependent augmenting effect of the seed extract on the serum insulin was recorded in both short term as well as long term groups. Conclusions: The aqueous seed extract of Brassica juncea has potent hypoglycemic activity in male albino rat.

  20. Hypoglycemic effects and biochemical mechanisms of oat products on streptozotocin-induced diabetic mice.

    Science.gov (United States)

    Shen, Rui-Ling; Cai, Feng-Li; Dong, Ji-Lin; Hu, Xin-Zhong

    2011-08-24

    Oat products are abundant in β-glucan, which could lower the glycemic index of products or foods. A low glycemic index is beneficial in the control of postprandial glycemia. The study examined the hypoglycemic effects of oat products that had the same percentage of oat β-glucan and were added into the diet fed to streptozotocin-induced diabetic mice for 6 weeks, and potential mechanisms are discussed here. Oat products significantly decreased fasting blood glucose and glycosylated serum protein (p 0.05). Oat products increased glycogen, hormone, and nuclear receptor levels (p oat products had hypoglycemic effects. Hypoglycemic effects of oat products might be regulating glucose and fat metabolisms, stimulating hormone secretion, activating the nuclear receptor, and protecting organ function.

  1. A Study of the Management of Patients Taking Novel Oral Antiplatelet or Direct Oral Anticoagulant Medication Undergoing Dental Surgery in a Rural Setting

    Directory of Open Access Journals (Sweden)

    Steven Johnston

    2015-10-01

    Full Text Available Purpose: Novel oral antiplatelet (NOAP (prasugrel and ticagrelor and direct oral anticoagulant drugs (DOAC (dabigatran, rivaroxaban and apixaban have emerged in the last decade. This study was undertaken to determine current approaches taken to the management of patients taking these agents in dental practice in a remote and rural setting. Methods: A small retrospective study was carried out in a small island population that identified patients taking one of the above drugs. All national health service and private dental records were examined to determine the type of treatment carried out and whether drug therapy, treatment plans or actual treatment were modified as a result of NOAP or DOAC therapy. In addition other outcomes such as referral to another service for advice or treatment and any adverse bleeding events were noted. Results: 156 dental encounters for 95 patients taking one of the drugs were identified. Significant events were identified in sixteen encounters and the management of patients taking each drug type differed significantly between cases but no patients returned with troublesome post-operative bleeding. Conclusions: The approaches taken by dental surgeons in Orkney in the management of the NOAPs and DOACs varied and this is likely to be a reflection of the limited literature available.

  2. Effect of topical cromoglycate solution on atopic dermatitis: combined treatment of sodium cromoglycate solution with the oral anti-allergic medication, oxatomide.

    Science.gov (United States)

    Kimata, H; Hiratsuka, S

    1994-02-01

    The effect of topically applied sodium cromoglycate solution in moderate to severe atopic dermatitis (AD) in children aged 4-14 years was studied in a double-blind, placebo-controlled, randomized group-comparative trial. One group of patients was treated with topical sodium cromoglycate solution and oral oxatomide whereas the other group was treated with topical placebo solution and oral oxatomide. After 4 weeks, AD improved significantly in the group treated with the sodium cromoglycate solution and oxatomide combination while marginal improvement was noted in the placebo. In addition, spontaneous IgE production from peripheral blood mononuclear cells decreased significantly in the sodium cromoglycate group but not in the placebo group. These results suggest that sodium cromoglycate solution may be very effective in combination with anti-allergic medication in the treatment of moderate to severe AD in children.

  3. Association of hypoglycemic treatment regimens with cardiovascular outcomes in overweight and obese subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Køber, Lars; Finer, Nick;

    2013-01-01

    To assess the association of hypoglycemic treatment regimens with cardiovascular adverse events and mortality in a large population of type 2 diabetic patients at increased cardiovascular risk.......To assess the association of hypoglycemic treatment regimens with cardiovascular adverse events and mortality in a large population of type 2 diabetic patients at increased cardiovascular risk....

  4. Anti-Obesity and Hypoglycemic Effects of Poncirus trifoliata L. Extracts in High-Fat Diet C57BL/6 Mice

    Directory of Open Access Journals (Sweden)

    Sheng Jia

    2016-04-01

    Full Text Available The present study investigated the possible anti-obesity and hypoglycemic effects of Poncirus trifoliata L. extracts. Mature fruit were divided into flavedo (PF and juice sacs (PJ, and extracts from them were tested on C57BL/6 mice fed a high-fat diet (HFD for thirteen weeks. Both fruit extracts (40 mg/kg body weight, respectively showed anti-obesity and hypoglycemic effects. Consumption of PF and PJ extracts reduced body weight by 9.21% and 20.27%, respectively. Liver and adipose weights, fasting glucose, serum triglyceride (TG, and low density lipoprotein cholesterol (LDL-c levels decreased significantly, while serum high density lipoprotein cholesterol (HDL-c and oral glucose tolerance levels increased significantly in response to two fruit extracts. These effects were due in part to the modulation of serum insulin, leptin, and adiponectin. Furthermore, transcript levels of fatty acid synthase (FAS and stearoyl-CoA desaturase 1 (SCD1 were reduced while those of carnitine palmitoyltransferase 1α (CPT1α and insulin receptor substrate 2 (IRS2 were increased in the liver of C57BL/6 mice, which might be an important mechanism affecting lipid and glucose metabolism. Taken together, P. trifoliata fruit can be potentially used to prevent or treat obesity and associated metabolic disorders.

  5. Can You Teach a Teen New Tricks? Problem Solving Skills Training Improves Oral Medication Adherence in Pediatric Patients with Inflammatory Bowel Disease Participating in a Randomized Trial.

    Science.gov (United States)

    Greenley, Rachel N; Gumidyala, Amitha P; Nguyen, Eve; Plevinsky, Jill M; Poulopoulos, Natasha; Thomason, Molly M; Walter, Jennifer G; Wojtowicz, Andrea A; Blank, Ellen; Gokhale, Ranjana; Kirschner, Barbara S; Miranda, Adrian; Noe, Joshua D; Stephens, Michael C; Werlin, Steven; Kahn, Stacy A

    2015-11-01

    Medication nonadherence is associated with higher disease activity, greater health care utilization, and lower health-related quality of life in pediatric inflammatory bowel diseases (IBD). Problem solving skills training (PSST) is a useful tool to improve adherence in patients with chronic diseases but has not been fully investigated in IBD. This study assessed feasibility, acceptability, and preliminary efficacy of PSST in pediatric IBD. Recruitment occurred during outpatient clinic appointments. After completion of baseline questionnaires, families were randomized to a treatment group or wait-list comparison group. The treatment group received either 2 or 4 PSST sessions. Youth health-related quality of life was assessed at 3 time points, and electronic monitoring of oral medication adherence occurred for the study duration. Seventy-six youth (ages 11-18 years) on an oral IBD maintenance medication participated. High retention (86%) and treatment fidelity rates (95%) supported feasibility. High satisfaction ratings (mean values ≥4.2 on 1-5 scale) supported intervention acceptability. Modest increases in adherence occurred after 2 PSST sessions among those with imperfect baseline adherence (d = 0.41, P 0.05). Phone-delivered PSST was feasible and acceptable. Efficacy estimates were similar to those of lengthier interventions conducted in other chronic illness populations. Older adolescents benefited more from the intervention than their younger counterparts.

  6. [Monitoring of a protocol for the adequacy of the pharmaceutical form of the oral medication to the degree of dysphagia in patients hospitalized in an internal medicine service].

    Science.gov (United States)

    García Aparicio, J; Herrero Herrero, J I; Moreno Gómez, A Ma; Martínez Sotelo, J; González del Valle, E; Fernández de la Fuente, Ma A

    2011-01-01

    The oral route is the most convenient way of administering medication, although it may not be safe. Dysphagia is one of the factors rendering difficult a proper feeding and administration of medication. to improve the administration of oral medication in patients with dysphagia by changing the pharmaceutical formulation of the principles prescribed to tolerable textures. Pilot project for the application of a dysphagia protocol that included the patients admitted to the Internal Medicine Unit at Los Montalvos Center for 4 months. After detecting the suspicion of dysphagia, a dysphagia-viscosity test was applied to know the tolerated textures. Then, the pharmaceutical formulations were adapted and the manipulation instructions for the drugs were indicated for their proper administration. 23 out of 627 admitted patients were included, with a mean age of 85 years (σ±7.4). The pathologies implicated in dysphagia were: dementia (65.2%); cerebrovascular disease (30.4%), and Parkinson's disease (4.4%). The best texture for drug intake was a "pudding" in 48.0%. 43 active ingredients were reviewed and 134 interventions were performed: in 41% of the cases, swallowing was made easier by mixing the drug with the food and in 59% water and a thickener were used. 94% of the recommendations were considered to be appropriate. the adaptation of the pharmaceutical formulations to the degree of dysphagia impacts on the improvement of healthcare quality by implementing safety in drug prescription and administration processes.

  7. Analysis on Use of Hypoglycemic Drugs in Our Hospital during 2008-2010%2008-2010年我院降血糖药物用药分析

    Institute of Scientific and Technical Information of China (English)

    林国强; 沈斌

    2012-01-01

    Objective To investigate the current situation and the development trend of the hypoglycemic drugs used in our hospital to provide reference for the clinical application of antidiabetic drugs and its management. Methods The data of hypoglycemic drugs in the medical supply store were collected based on the used amount, defined daily dosages (DDDs) and the sums of money for statistical analysis during 2008 - 2010. Results The average annual increasing rate of the consumption amount of antidiabetic drugs was 40% during these three years. Acarbose occupied the first place in the list of the sum of consumption money and DDDs. Sulfonylureas and biguanides were most commonly used hypoglycemic drugs in clinic during successive 3 years, accounting for 32% of the total value of DDDs in whole antidiabetic drugs. The first line of antidiabetic drugs included metformin, gliclazide, acarbose, glipizide and insulin. Conclusion The used amounts of hypoglycemic drugs are gradually increased with the increase of diabetic patients year by year. Therefore, more attention should be paid to the curative effects and safety in medication.%目的 为降血糖药物的临床应用和管理提供参考.方法 对2008年至2010年医院药库出库的降血糖药物使用金额、用药频度(DDDs)、用药金额、各年度DDDs前10位药物等进行统计分析.结果 3年间降血糖药物销售金额年平均增长率为40%.销售金额及DDDs居首位的是阿卡渡糖,磺酰脲类和双胍类连续3年为临床主要使用的降血糖药物,占所有降血糖药物DDDs总值的32%;二甲双胍、格列齐特、阿卡波糖、格列美脲、胰岛素等为临床一线用药.结论 降血糖药物的用量随着糖尿病患者的增加逐年增长,因此临床用药应注意药物疗效及安全性.

  8. Evaluating the impact of a mobile oral telemedicine system on medical management and clinical outcomes of patients with complicated oral lesions in Botswana.

    Science.gov (United States)

    Tesfalul, Martha; Littman-Quinn, Ryan; Antwi, Cynthia; Ndlovu, Siphiwo; Motsepe, Didintle; Phuthego, Motsholathebe; Tau, Boitumelo; Mohutsiwa-Dibe, Neo; Kovarik, Carrie

    2013-01-01

    Mobile telemedicine, which involves the use of cellular phone telecommunications to facilitate exchange of information between parties in different locations to assist in the management of patients, has become increasingly popular, particularly in resource-limited settings. In Botswana, small studies of mobile telemedicine programs suggest access to these services positively affect patients, but these programs' impact is difficult to capture given limitations of baseline and comparative data. Our observational study uses each patient receiving mobile oral telemedicine services in Botswana as his/her own control to assess the impact of these services on his/her diagnosis and management plan. At month 5 of 12 total, preliminary analysis of eligible cases (n = 27) reveals management plan discordance between clinicians submitting cases and the specialist was 68.0% (17/25), suggesting that telemedicine can result in significant changes in management of patients.

  9. Transmission of human papillomavirus DNA from patient to surgical masks, gloves and oral mucosa of medical personnel during treatment of laryngeal papillomas and genital warts.

    Science.gov (United States)

    Ilmarinen, Taru; Auvinen, Eeva; Hiltunen-Back, Eija; Ranki, Annamari; Aaltonen, Leena-Maija; Pitkäranta, Anne

    2012-11-01

    The risk of occupational human papillomavirus (HPV) transmission from patient to medical personnel during laser vaporization procedures remains controversial. The purpose of this study was to determine the risk of HPV transmission from the patient to the protective surgical masks, gloves and oral mucosa of medical personnel during the treatment of laryngeal papillomas and genital warts. The study involved five male patients scheduled for the surgical treatment of laryngeal papillomas, and five male patients undergoing carbon dioxide (CO(2)) laser treatment for urethral warts. Oral mucosa specimens were obtained from the study patients and the employees pre- and postoperatively. Samples were collected from the HPV-infected patient tissue, and from the surgical masks and gloves used by the employees. A total of 120 samples were analyzed for the presence of HPV DNA by PCR, using the degenerated MY09/11/HMB01 primers. After the papilloma procedures, the surgeons' gloves tested HPV positive in one of the five cases and those of the surgical nurse in three of the five cases. After the treatment of genital warts, HPV DNA corresponding to the patient tissue specimens was present in all the samples obtained from the surgical gloves of the operators. All oral mucosa samples obtained from 18 different employees tested HPV negative, as did the surgical mask specimens. According to our study, HPV may contaminate protective equipment, most of all surgical gloves, but transmission of HPV DNA to medical personnel is unlikely to occur provided that protective surgical gloves and masks are applied and disposed of properly.

  10. Low-health literacy flashcards & mobile video reinforcement to improve medication adherence in patients on oral diabetes, heart failure, and hypertension medications.

    Science.gov (United States)

    Yeung, Denise L; Alvarez, Kristin S; Quinones, Marissa E; Clark, Christopher A; Oliver, George H; Alvarez, Carlos A; Jaiyeola, Adeola O

    To design and investigate a pharmacist-run intervention using low health literacy flashcards and a smartphone-activated quick response (QR) barcoded educational flashcard video to increase medication adherence and disease state understanding. Prospective, matched, quasi-experimental design. County health system in Dallas, Texas. Sixty-eight primary care patients prescribed targeted heart failure, hypertension, and diabetes medications INTERVENTION: Low health literacy medication and disease specific flashcards, which were also available as QR-coded online videos, were designed for the intervention patients. The following validated health literacy tools were conducted: Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy Medicine-Short Form, and Short Assessment of Health Literacy-50. The primary outcome was the difference in medication adherence at 180 days after pharmacist intervention compared with the control group, who were matched on the basis of comorbid conditions, targeted medications, and medication class. Medication adherence was measured using a modified Pharmacy Quality Alliance proportion of days covered (PDC) calculation. Secondary outcomes included 90-day PDC, improvement of greater than 25% in baseline PDC, and final PDC greater than 80%. Linear regression was performed to evaluate the effect of potential confounders on the primary outcome. Of the 34 patients receiving the intervention, a majority of patients scored a high possibility of limited health literacy on the NVS tool (91.2%). The medication with the least adherence at baseline was metformin, followed by angiotensin-converting enzyme inhibitors and beta blockers. At 180 days after intervention, patients in the intervention group had higher PDCs compared with their matched controls (71% vs. 44%; P = 0.0069). The use of flashcards and QR-coded prescription bottles for medication and disease state education is an innovative way of improving adherence to diabetes, hypertension, and heart

  11. Quality assurance review of training in oral and maxillofacial surgery by the General Medical Council: areas of good practice, requirements, and recommendations.

    Science.gov (United States)

    Sandhu, Davinder P S; Dover, Michael Stephen; Lay, Sarah

    2016-04-01

    The purpose of this paper is to disseminate the outcome of the 2012/13 UK-wide quality assurance review of postgraduate training in oral and maxillofacial surgery (OMFS) by the General Medical Council (GMC), as part of its review of small specialties. OMF surgeons need to be aware of the evidence on which the conclusions are based, and to know about the strengths of the specialty and the areas for future development so that postgraduate training, and ultimately the outcomes for patients, can be improved. This paper, by the authors involved in the review, summarises the salient points and is not a verbatim report. Copyright © 2016. Published by Elsevier Ltd.

  12. Oral toxicity of isotretinoin, misoprostol, methotrexate, mifepristone and levonorgestrel as pregnancy category X medications in female mice

    OpenAIRE

    KIM, SEONG-KWAN; Shin, Soo-Jeong; YOO, YOHAN; KIM, NA-HYUN; KIM, DONG-SOON; Zhang, Dan; PARK, JIN-A; Yi, Hee; Kim, Jin-Suk; Shin, Ho-Chul

    2015-01-01

    An oral toxicity study of several pregnancy category X drugs was performed in female ICR mice. The drugs were administered orally once daily for 3 days at doses of 1, 10 and 100 ?g/kg for isotretinoin; 6.7, 67 and 670 ?g/kg for misoprostol; 83, 830 and 8,300 ?g/kg for methotrexate; 3.3, 33 and 330 ?g/kg for mifepristone; and 25, 250 and 2,500 ?g/kg for levonorgestrel. During the test period, clinical signs, mortality, body weight, hematology, serum biochemistry and necropsy findings were exam...

  13. Hypoglycemic effect and mechanism of honokiol on type 2 diabetic mice

    Directory of Open Access Journals (Sweden)

    Sun J

    2015-12-01

    Full Text Available Jing Sun,1 Xueqi Fu,1–3 Ye Liu,1 Yongsen Wang,1 Bo Huo,1 Yidi Guo,1 Xuefeng Gao,1 Wannan Li,1–3,* Xin Hu1–3,* 1School of Life Sciences, 2Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, 3National Engineering Laboratory of AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, People’s Republic of China *These authors contributed equally to this work Background: Honokiol is one of the main bioactive constituents of the traditional Chinese herbal drug Magnolia bark (Cortex Magnoliae officinalis, Hou Po. The aim of this study was to probe its anti-type 2 diabetes mellitus effects and the underlying mechanism.Methods: Type 2 diabetic mouse model was established by intraperitoneally injecting with streptozotocin. Fasting blood glucose, body weight, and lipid profile were measured. The subcutaneous adipose tissue, skeletal muscle, and liver were isolated as well as homogenized. The phospho-insulin receptor β-subunit (IRβ, IRβ, phospho-AKT, AKT, phospho-ERK1/2, ERK1/2, phosphotyrosine, and actin were examined by Western blot assay. Cell viability or cytotoxicity was analyzed by using MTT method. The inhibitory potencies of honokiol on the protein tyrosine phosphatase 1B (PTP1B activity were performed in reaction buffer. Molecular docking and dynamic simulation were also analyzed.Results: In in vivo studies, oral treatment with 200 mg/kg honokiol for 8 weeks significantly decreases the fasting blood glucose in type 2 diabetes mellitus mice. The phosphorylations of the IRβ and the downstream insulin signaling factors including AKT and ERK1/2 significantly increase in adipose, skeletal muscle, and liver tissue of the honokiol-treated mice. Moreover, honokiol enhanced the insulin-stimulated phosphorylations of IRβ, AKT, and ERK1/2 in a dose-dependent manner in C2C12 myotube cells. Meanwhile, honokiol enhanced insulin-stimulated GLUT4 translocation. Importantly, honokiol exhibited reversible

  14. EVALUATION OF NUTRITION AND GLYCEMIC INDEX OF SWEET POTATOES AND ITS APPROPRIATE PROCESSING TO HYPOGLYCEMIC FOODS

    Directory of Open Access Journals (Sweden)

    Made Astawana

    2011-04-01

    Full Text Available Indonesia placed the fourth biggest diabetics in the world after India, China, and the USA with prevalence amounting to 8.6% of the population. Diabetes is an abnormal carbohydrate metabolism. Therefore, nutrition plays a key role in the management of the disease. This study aimed to find hypoglycemic sweet potatoes and appropriate processing to create low glycemic foods. Eight Indonesian sweet potato varieties/clones were used in this experiment, i.e. Kidal, Sukuh, Sari, Ungu, Jago, BB00105.10, B0464, and BB00106.18. Samples were firstly analyzed for their physicochemical and nutritional properties, which then followed by evaluation of their hypoglycemic responses. The selected variety was processed into three different basic processing methods, i.e. boiling, baking, and frying, and then their glycemic indexes (GI were evaluated. Result showed that among eight sweet potato varieties/clones studied, BB00105.10 clone indicated the best hypoglycemic response. The highest hypoglycemic activity was supported with the highest resistant starch content (3.8%, protein content (5.47%, and low starch digestibility (51.4%. The sweet potato tubers contained medium to high amylose (24.94%. Processing methods influenced the GI value of foods. Fried sweet potatoes had the lowest GI (47, followed by the boiled one (GI = 62 and the baked one (GI = 80.

  15. Genetic-algorithm-based multiple regression with fuzzy inference system for detection of nocturnal hypoglycemic episodes.

    Science.gov (United States)

    Ling, Steve S H; Nguyen, Hung T

    2011-03-01

    Hypoglycemia or low blood glucose is dangerous and can result in unconsciousness, seizures, and even death. It is a common and serious side effect of insulin therapy in patients with diabetes. Hypoglycemic monitor is a noninvasive monitor that measures some physiological parameters continuously to provide detection of hypoglycemic episodes in type 1 diabetes mellitus patients (T1DM). Based on heart rate (HR), corrected QT interval of the ECG signal, change of HR, and the change of corrected QT interval, we develop a genetic algorithm (GA)-based multiple regression with fuzzy inference system (FIS) to classify the presence of hypoglycemic episodes. GA is used to find the optimal fuzzy rules and membership functions of FIS and the model parameters of regression method. From a clinical study of 16 children with T1DM, natural occurrence of nocturnal hypoglycemic episodes is associated with HRs and corrected QT intervals. The overall data were organized into a training set (eight patients) and a testing set (another eight patients) randomly selected. The results show that the proposed algorithm performs a good sensitivity with an acceptable specificity.

  16. The rs1142345 in TPMT Affects the Therapeutic Effect of Traditional Hypoglycemic Herbs in Prediabetes

    Directory of Open Access Journals (Sweden)

    Xi Li

    2013-01-01

    Full Text Available Therapeutic interventions in prediabetes are important in the primary prevention of type 2 diabetes (T2D and its chronic complications. However, little is known about the pharmacogenetic effect of traditional herbs on prediabetes treatment. A total of 194 impaired glucose tolerance (IGT subjects were treated with traditional hypoglycemic herbs (Tianqi Jiangtang for 12 months in this study. DNA samples were genotyped for 184 mutations in 34 genes involved in drug metabolism or transportation. Multinomial logistic regression analysis indicated that rs1142345 (A>G in the thiopurine S-methyltransferase (TPMT gene was significantly associated with the hypoglycemic effect of the drug (P=0.001, FDR P=0.043. The “G” allele frequencies of rs1142345 in the healthy (subjects reverted from IGT to normal glucose tolerance, maintenance (subjects still had IGT, and deterioration (subjects progressed from IGT to T2D groups were 0.094, 0.214, and 0.542, respectively. Binary logistic regression analysis indicated that rs1142345 was also significantly associated with the hypoglycemic effect of the drug between the healthy and maintenance groups (P=0.027, OR=4.828 and between the healthy and deterioration groups (P=0.001, OR=7.811. Therefore, rs1142345 was associated with the clinical effect of traditional hypoglycemic herbs. Results also suggested that TPMT was probably involved in the pharmacological mechanisms of T2D.

  17. Hypoglycemic and anti-hyperglycemic activity of Triphalādi granules in mice

    Directory of Open Access Journals (Sweden)

    Ankush Gunjal

    2016-01-01

    Conclusion: Triphalādi granules have significant hypoglycemic and anti-hyperglycemic activity in mice with minimal effect on BSL below normal range. The studies suggest the potential role of Triphalādi granules as an alternative adjuvant therapy in diabetic individuals for the control of the blood glucose level.

  18. HYPOGLYCEMIC, ANTI-INFLAMMATORY AND ANALGESIC ACTIVITY OF PEPEROMEA PELLUCIDA (L. HBK (PIPERACEAE

    Directory of Open Access Journals (Sweden)

    H. Sheikh*, S. Sikder, S. Kumar Paul , A.M. Rashedul Hasan , Md. M. Rahaman and S. Paul Kundu

    2013-01-01

    Full Text Available The aspire of the present research was to explore the hypoglycemic, analgesic and anti-inflammatory activity of ethyl acetate extract of Peporemia pellucida in alloxan-induced diabetic mice, Acquired immune deficiency syndrome (AIDS, and hypercholesterolemia and against pain. In the present study hypoglycemic effect of the ethyl acetate extract of Peperomea pellucida was significant from (25.35 to 8.1 mM ±SEM i.e., 68.44% in 300mg/kg ethyl acetate extract as a 7 days hypoglycemic treatment. On 120 minutes OGTT test, reduction of blood glucose level was also significant. In 300mg/kg extract blood glucose level reduced from (20.53mM to 7.69 ±SEM 62.64% was observed. Analgesic treatment was observed carefully and mentionable activities were evaluated. Percentage of inhibition was 58.16 with the number of writhing 11.8±SEM in 300mg/kg inhibition was observed with 6.8 ±SEM writhing. P. pellucida has significant anti-inflammatory effect after 4 hr with 3.47± SEM. The present study indicates significant hypoglycemic, analgesic and anti-inflammatory effects of P. pellucida. The present investigation established the pharmacological evidence to support the folklore claim and that of the plant has antidiabetic, analgesic and anti-inflammatory activity.

  19. Evaluation of Hypoglycemic and Genotoxic Effect of Polyphenolic Bark Extract from Quercus sideroxyla

    Directory of Open Access Journals (Sweden)

    Marcela Soto-García

    2016-01-01

    Full Text Available Quercus sideroxyla is a wood species whose bark has phenolic compound and should be considered to be bioactive; the hypoglycemic and genotoxic properties of Q. sideroxyla bark were evaluated in this study. Total phenolic compound was determined in crude extract (CE and organic extract (OE. The OE has the highest amount of phenols (724.1±12.0 GAE/g. Besides, both CE and OE demonstrated effect over the inhibition of α-amylase in vitro. Hypoglycemic activity was assessed by glucose tolerance curve and the area under curve (UAC; OE showed the highest hypoglycemic activity. In addition, diabetes was induced by streptozotocin (65 mg/kg and the extracts (50 mg/kg were administered for 10 days; OE showed hypoglycemic effect compared with diabetic control and decreased hepatic lipid peroxidation. Acute toxicity and genotoxicity were evaluated in CE; results of acute toxicity did not show any mortality. Besides, the comet assay showed that CE at a dose of 100 mg/kg did not show any genotoxic effect when evaluated at 24 h, whereas it induced slight damage at 200 mg/kg, with the formation of type 1 comets.

  20. Hypoglycemic effects of lactucin-8-O-methylacrylate of Parmentiera edulis fruit.

    Science.gov (United States)

    Perez, R M; Perez, C; Zavala, M A; Perez, S; Hernandez, H; Lagunes, F

    2000-08-01

    Hypoglycemic activity-guided fractionation together with chemical analysis led to the isolation of one guaianolide (lactucin-8-O-methylacrylate) from the chloroform extract of the dried fruits of Parmentiera edulis. Identification was based on spectroscopic methods. The compounds lowers blood sugar levels after administration to alloxan-diabetic mice.

  1. Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma.

    Science.gov (United States)

    Rana, M; Kanatas, A; Herzberg, P Y; Khoschdell, M; Kokemueller, H; Gellrich, N-C; Rana, M

    2015-04-01

    About 400,000 people worldwide are diagnosed with oral squamous cell carcinoma (SCC) annually, and the incidence is increasing. Many advanced carcinomas of the oral cavity require radical surgical treatment that can impair patient's quality of life (QoL) and severity of symptoms. We therefore aimed to identify coping strategies and disease-specific medical factors that affect QoL and severity of symptoms. Patients with oral SCC were asked to complete the Freiburg Questionnaire on Coping with Illness (FQCI), the University of Washington Quality of life Questionnaire (UW-QOL version 4), and the Brief Symptom Inventory (BSI) to measure psychological stress. We also assessed the impact of various factors on QoL and severity of symptoms, including stage and site of tumour, method of reconstruction, time of diagnosis, and social structure (age, sex, marital status, living arrangements, level of education, and employment). We enrolled a consecutive sample of 104 patients over a period of one year. Stepwise linear regression analyses indicated that both depressive coping and size of tumour had an adverse effect on QoL and severity of symptoms. Patients with high educational attainment and those who lived alone reported impaired QoL, and women experienced increased severity of symptoms. Impaired QoL and increased severity of symptoms were associated with a depressive style of coping, size of tumour, educational attainment, and living arrangements. It is important to identify these patients during treatment as they could benefit from psycho-oncological counselling.

  2. Oral candidiasis.

    Science.gov (United States)

    Millsop, Jillian W; Fazel, Nasim

    2016-01-01

    Oral candidiasis (OC) is a common fungal disease encountered in dermatology, most commonly caused by an overgrowth of Candida albicans in the mouth. Although thrush is a well-recognized presentation of OC, it behooves clinicians to be aware of the many other presentations of this disease and how to accurately diagnose and manage these cases. The clinical presentations of OC can be broadly classified as white or erythematous candidiasis, with various subtypes in each category. The treatments include appropriate oral hygiene, topical agents, and systemic medications. This review focuses on the various clinical presentations of OC and treatment options.

  3. Acute and chronic toxicity studies on partially purified hypoglycemic preparation from water extract of bark ofFicus bengalensis.

    Science.gov (United States)

    Gupta, S; Shukla, R; Prabhu, K M; Aggrawal, S; Rusia, U; Murthy, P S

    2002-01-01

    Acute and chronic toxicity studies were conducted to assess toxicity of a partially purified preparation from the water extract of the bark ofFicus bengalensis, which was demonstrated in our earlier studies to have significant hypoglycemic and hypocholesteroiemic effect on alloxan induced, mild and severe diabetes in rabbits. LD(50) of this preparation was found to be ∼1 gm/kg in rats when given orally. For chronic toxicity studies 3 doses of aqueous preparation were given to 3 groups of rats. First group received 5 times ED(50) (50 mg/kg), second group 10 times ED(50) (100 mg/kg) and the third group 15 times ED(50) (150 mg/kg) for 3 months. Fourth group which served as control was given water. After three months, blood was collected for studying biochemical and hematological parameters. Blood glucose, serum cholesterol, liver and kidney function tests, haemoglobin, total and differential leukocyte count were determined. Animals were sacrificed and histopathological examination of liver, heart and kidneys was carried out. Results of the study showed that partially purified preparation fromFicus bengalensis is not toxic by all the above mentioned parameters.

  4. Hypoglycemic and Hypocholesterolemic Effects of Botryosphaeran from Botryosphaeria rhodina MAMB-05 in Diabetes-Induced and Hyperlipidemia Conditions in Rats

    Science.gov (United States)

    Miranda-Nantes, Carolina C. B. O.; Fonseca, Eveline A. I.; Zaia, Cassia T. B. V.; Dekker, Robert F. H.; Khaper, Neelam; Castro, Inar A.

    2011-01-01

    Botryosphaeran, a water-soluble exopolysaccharide of the β-(1 → 3;1 → 6)-D-glucan type that has been isolated from the culture medium of Botryosphaeria rhodina MAMB-05 grown in submerged fermentation using glucose as the sole carbon source, was previously demonstrated to be non-genotoxic in peripheral blood and bone marrow, and exhibited strong anticlastogenic activity. In the present study, the effects of botryosphaeran were investigated in streptozotocin-induced diabetic rats as well as in high-fat diet-fed hyperlipidemic Wistar rats. The plasma glucose level was reduced by 52% in the diabetic group of rats after administration of 12 mg botryosphaeran/kg body weight of the rats (b.w.)/day by gavage over 15 days. A reduction in the median ration intake was accompanied by an increase in the median body weight gain, as well as the efficiency of food conversion. These results demonstrate that botryosphaeran has protective effects by reducing the symptoms of cachexia in Diabetes mellitus. Botryosphaeran administered by gavage at a concentration of 12 mg botryosphaeran/kg b.w./day over 15 days also reduced the plasma levels of total cholesterol and low density lipoprotein-cholesterol by 18% and 27%, respectively, in hyperlipidemic rats. Based on these findings, we conclude that botryosphaeran possesses hypoglycemic and hypocholesterolemic properties in conditions of diabetes mellitus and hyperlipidemia, respectively, and may be used as an oral anti-diabetic agent. PMID:22783102

  5. Antiketogenic and hypoglycemic effects of aminocarnitine and acylaminocarnitines.

    OpenAIRE

    Jenkins, D L; Griffith, O W

    1986-01-01

    DL-Aminocarnitine (DL-3-amino-4-trimethylaminobutyrate) is a potent, noncovalent inhibitor of carnitine palmitoyltransferase (palmitoyl-CoA:L-carnitine O-palmitoyltransferase, EC 2.3.1.21). Here we show that decanoyl-DL-aminocarnitine and palmitoyl-DL-aminocarnitine inhibit carnitine palmitoyltransferase in vitro about 7-fold and 100-fold more effectively than does aminocarnitine. Aminocarnitine and its decanoyl and palmitoyl derivatives are active in vivo following oral or parenteral adminis...

  6. Oral sex, oral health and orogenital infections

    Directory of Open Access Journals (Sweden)

    Saini Rajiv

    2010-01-01

    Full Text Available Oral sex is commonly practiced by sexually active male-female and same-gender couples of various ages, including adolescents. The various type of oral sex practices are fellatio, cunnilingus and analingus. Oral sex is infrequently examined in research on adolescents; oral sex can transmit oral, respiratory, and genital pathogens. Oral health has a direct impact on the transmission of infection; a cut in your mouth, bleeding gums, lip sores or broken skin increases chances of infection. Although oral sex is considered a low risk activity, it is important to use protection and safer sex precautions. There are various methods of preventing infection during oral sex such as physical barriers, health and medical issues, ethical issues and oral hygiene and dental issues. The lesions or unhealthy periodontal status of oral cavity accelerates the phenomenon of transmission of infections into the circulation. Thus consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.

  7. Infant acceptance of a bitter-tasting liquid medication: a randomized controlled trial comparing the Rx Medibottle with an oral syringe.

    Science.gov (United States)

    Purswani, Murli U; Radhakrishnan, Jolly; Irfan, Khudsia R; Walter-Glickman, Cynthia; Hagmann, Stefan; Neugebauer, Richard

    2009-02-01

    The calibrated oral syringe is considered the standard system for administering liquid formulations of medications to infants. Medication acceptance using the syringe may not always be favorable, particularly with unpleasant-tasting liquids. The Rx Medibottle (The Medicine Bottle Co, Hinsdale, Illinois), an alternate drug-delivery device, is an infant-feeding bottle that contains a central sleeve within its body into which a syringe is inserted. Depressing the syringe's plunger in quick, short squirts synchronized with an infant's sucking allows drug ingestion, preventing dilution of the drug in the formula within the bottle's nipple. The Rx Medibottle costs $14.95 retail. Kraus et al demonstrated that it was more efficacious, with a higher level of infant acceptance compared with the syringe, when used to administer a 1-time dose of a pleasant-tasting liquid (acetaminophen, Tempra Syrup; Mead Johnson Nutritionals, Evansville, Indiana). Our study tests the efficacy of this bottle in administering a single dose of generic prednisolone liquid, a bitter-tasting drug, with an oral syringe serving as the control method of delivery.

  8. Improving doctor-patient relationship, enhancing the oral cavity medical service effect%改善医患关系,提高口腔医疗效果

    Institute of Scientific and Technical Information of China (English)

    杨明聪; 范小平; 向学熔

    2011-01-01

    随着生物医学模式逐渐向生物-心理-社会医学模式的转变,医患沟通越来越成为医疗服务中必不可少的重要工作环节。良好的医患沟通能力是一名医生需具备的必要条件。而作为一名口腔临床医生,只有掌握了沟通交流的原则,才能恰如其分地运用一些沟通交流的技巧,才能与患者建立起良好的医患关系,最终达到良好的治疗效果。%While the medicine pattern of biomedicine turn to biological-psychology-society, the medical trouble communication becomes more and more important in the medical service. Good medical trouble communication ability is the essential condition of doctor. As oral cavity clinicians, only by gasping the principle of communication can we appropriately utilize some skills of communication exchange,establish the good medical trouble relations with the patient and achieve the good treatment result finally.

  9. Giant cell granuloma: a cross- sectional study in oral and maxillofacial pathology department of dental faculty of Tehran University of Medical Sciences (1986-2000

    Directory of Open Access Journals (Sweden)

    Jalayer Naderi N.

    2005-05-01

    Full Text Available Statement of Problem: Giant cell granuloma (G.C.G is a reactive lesion which affects the jaws and oral mucosa of gingiva.This lesion is classified to central and peripheral ones. The histopathologic aspects of central and peripheral G.C.G is the same. The central lesions are aggressive and cause osseous destruction. The peripheral G.C.G produces ulcerative swellings similar to pyogenic granuloma or peripheral ossifying fibroma. Since the peripheral and central G.C.G are common lesions, the awareness of dentists of different aspect of G.C.G is very important. Purpose: The aim of this study was a statistical evaluation of variables such as age, gender and location of peripheral and central G.C.G in oral and maxillofacial pathology department of Dental Faculty of Tehran University of Medical Sciences. Materials and Methods: This study was a cross-sectional, case series one. The medical records of oral and maxillofacial pathology department of Dental Faculty of Tehran University of Medical Sciences was assessed in two steps: In the first stage, the medical records of patients with pathologic report of peripheral and central G.C.G were selected and reviewed. In the next step, the informations such as age, gender and location of peripheral and central G.C.G were registered in data forms. The obtained data were analyzed by SPSS statistical software. Results: The results showed that the age range in peripheral and central G.C.G were 2- 90 and 4-70 years, respectively. The peak incidence of peripheral and central G.C.G was in the third and second decades, respectively. The peripheral G.C.G was more common in men (52.70% than women (47.30%. This finding in central G.C.G was 37.19% for men and 62.88% for women. 57.06% of peripheral G.C.G cases were in mandible and 42.94% in maxilla. The occurrence of central G.C.G was 67.07% in mandible and 32.93 % in maxilla. Conclusion: Based on this study, the peripheral lesions were more frequent in men, third decade

  10. A comprehensive study of the association between drug hepatotoxicity and daily dose, liver metabolism, and lipophilicity using 975 oral medications.

    Science.gov (United States)

    Weng, Zuquan; Wang, Kejian; Li, Haibo; Shi, Qiang

    2015-07-10

    It was recently suggested that daily dose, liver metabolism and lipophilicity were associated with an oral drug's potential to cause hepatotoxicity, but this has not been widely accepted. A likely reason is that published data lack comprehensiveness, as they were based on only about one third of all FDA approved single-active-ingredient oral prescription drugs. Here the 975 oral drugs used worldwide which have a Defined Daily Dose (DDD) designated in the World Health Organization's Anatomical Therapeutic Chemical classification system and whose hADRs potential and metabolism data are available in the Micromedex Drugdex® compendium were studied, with their lipophilicity calculated by the partition coefficient LogP. Of the 975 drugs examined, 49% (478) have the potential to induce at least one type of hepatic adverse drug reactions (hADRs) such as fatal hepatotoxicity, acute liver failure, significant ALT/AST elevation, hepatitis, and jaundice. By single factor analysis, a higher DDD (≥100 mg) was found to be associated with all types of hADRs, and extensive liver metabolism (≥50%) was associated with a subset of hADRs including fatal hADRs, hepatitis and jaundice, while LogP showed no relation to any types of hADRs. Contrary to previous reports, none of the combination, neither DDD and liver metabolism, nor DDD and LogP, was found to be more predictive of hADRs than using DDD or liver metabolism alone. These data provide convincing evidence that a higher daily dose and extensive liver metabolism, but not lipophilicity, are independent but not synergistic risk factors for oral drugs to induce hepatotoxicity.

  11. Patterns and obstacles to oral antidiabetic medications adherence among type 2 diabetics in Ismailia, Egypt: a cross section study

    OpenAIRE

    Heissam, Khaled; Abuamer, Zeinab; El-Dahshan, Nahed

    2015-01-01

    Introduction Diabetes is a costly and increasingly common chronic disease. Effective management of diabetes to achieve glycemic control improves patient quality of life. Adherence rates to drug regimens in patients with type 2 diabetes are relatively low and vary widely between populations. There are many factors that could affect patient adherence to drug therapy. The aim of the present study was assessing patterns and obstacles to adherence of type 2 diabetic patients to their oral hypoglyc...

  12. Hypoglycemic Activity of Methanolic Fruit Pulp Extract of Adansonia digitata on Blood Glucose Levels of Alloxan Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Mohammad Yalwa Gwarzo

    2013-06-01

    Full Text Available This study was carried out to evaluate the hypoglycemic properties of the methanolic extract of Adansonia digitata fruit pulp on blood glucose. Forty eight of the rats were randomly distributed into six. Group one served as the normal control and Group two rats were administered with alloxan (150 mg/kg intraperitoneally and served as the diabetic control. Groups 3, 4 and 5 were intraperitoneally administered with alloxan (150 mg/kg and orally administered with methanolic extract of Adansonia digitata fruit pulp (100, 200 and 300 mg/kg once daily for 4weeks. Group six rats were intraperitoneally administered with alloxan (150 mg/kg and orally administered with chlorpropamide (84 mg/kg once daily for 4 weeks. The serum concentration of glucose of all the rats in each group was determined after the 14th and 28th dose of treatment. There was significant (p<0.001 reduction of serum glucose in the three groups of rats administered with methanolic extract of fruit pulp at second and fourth week of the treatment. The group of animal treated with chlorpropamide (84 mg/kg also showed significant (p<0.001 reduction of serum glucose compared to most effective dose of the methanolic extract (300 mg/kg during the second and fourth week of the treatment. The result of qualitative phytochemical analysis of methanolic extract of Adansonia digitata fruit pulp indicated the presence of glycosides, flavonoids, tannins, saponins, terpenoids and steroids. This result suggests that the methanolic fruit pulp extract of Adansonia digitata possess antidiabetic effect on alloxan induced diabetic rats.

  13. Perspectives on Medical Students’ Reflections on Ethical Dilemmas during their Clinical Stay. Oral Presentation, COMET Conference in Aalborg, Denmark

    DEFF Research Database (Denmark)

    Gormsen, Lise Kirstine; Søndergaard, Sara; Hoffmann, Tine

    Work-in- progress Roundtable: Title: What ethical problems are out there? – a study of medical students’ reflexive writing about ethical dilemmas in the clinic. Authors: Lise Gormsen, MD, MHH, PhD., Institute of Clinical Medicine, Aarhus University, Denmark Jane Ege Møller, MA, PhD., Center.......gormsen@ki.au.dk Conference themes: Ethics and Communication Medical Education Research Ethics Values and Responsibilities in Professional Practice Background: As many other countries, Denmark has implemented the seven physician roles as the basis for medical education. Pre-graduate medical education in ethics contribute.......Schön) We have collected reflexive texts (45 texts, 199 pages in total) produced by 4th-year students (n=316). The texts were analyzed and characteristic patterns were characterized. Results: The students observe 3 types of ethical problem 1) everyday problems e.g. confidentiality in a busy ward 2...

  14. Investigation and analysis on the oral health of Hainan Medical Students%海南医学生口腔卫生保健调查

    Institute of Scientific and Technical Information of China (English)

    符方满

    2012-01-01

    OBJECTIVE To investigate medical college students in Hainan province oral health and health behaviors, and provide scientific basis for oral health education. METHODS A self-made questionnaire on 762 medical students in Hainan province was cross sectional survey. RESULTS The prevalence of dental caries in 44.88%, and there was no significant difference between men and women (χ2 = 2.689, P = 0.101); 25.85% of the students often showed bleeding gums, and no statistical difference (χ2 = 0.027, P = 0.870). The 29.13% students selected head a soft-bristled toothbrush, and the difference was significant (χ2 = 18.843, P = 0.003); 3 months for 1 toothbrush students accounted for 78.61%, and the difference was significant (χ2= 7.731, P = 0.005); 37.79% of students used the vertical brushing mode. The year should be oral examination time knowing rate was 49.87%, and the difference was significant (χ2 = 7.593, P = 0.006); Knowledge of dental technology students accounted for 87.66%, significant different grades was found on orthodontic technology awareness rates (χ2= 26.861, P< 0.001). CONCLUSION Oral health status is not optimistic, oral health behavior in medical colleges need to be improved, oral health education course is very necessary.%目的 了解海南省医学生口腔健康和健康行为现状,为进行口腔健康教育提供科学依据.方法 采用自制的调查表对762名海南省医学生进行横断面调查.结果 ①龋齿患病率44.88%,男女间差异无统计学意义(x2=2.689,P=0.101);25.85%的学生牙龈经常出血,男女间差异无统计学意义(x2=0.027,P=0.870).②29.13%的学生选用小头软毛牙刷,男女间差异有统计学意义(x2=18.843,P=0.003);3个月内换1次牙刷学生占78.61%,男女间差异有统计学意义(x2=7.731,P=0.005);37.79%的学生使用竖刷方式.③每年应进行口腔检查1次的知晓率为49.87%,男女间差异有统计学意义(x2=7.593,P=0.006);知晓

  15. An outpatient regimen of combined oral mifepristone 400 mg and misoprostol 400 microg for first-trimester legal medical abortion

    DEFF Research Database (Denmark)

    Ravn, Pernille; Rasmussen, Ase; Knudsen, Ulla Breth;

    2005-01-01

    the procedure over a 3-year period and 606 (92%) experienced successful medical abortion. The remaining 8% had vacuum aspiration performed mainly due to uterine retention (70%). Other reasons were vaginal bleeding (25%), vomiting (2%), or pelvic infection (4%). Most women reported no days with severe pain (67......%), 0--1 days with moderate pain (82%), and 0--1 days with light pain (62%). In terms of gastrointestinal side effects, 68% reported nausea, 33% vomiting, and 27% diarrhea. Most women (90%) felt that the information given at the hospital prior to the abortion was sufficient, 74% would prefer medical...

  16. To evaluate and compare the hypoglycemic, antioxidant and hypolipidemic effect of lycopene with atorvastatin in hyperlipidemic New Zealand white rabbits

    Directory of Open Access Journals (Sweden)

    Sarita Mulkalwar

    2015-02-01

    Conclusion: Findings suggest that lycopene may have considerable therapeutic benefit as an antioxidant and hypolipidemic agent, but may not be effective as a hypoglycemic agent. [Int J Basic Clin Pharmacol 2015; 4(1.000: 148-152

  17. Influence of Ginkgo Biloba extract on beta-secretase in rat hippocampal neuronal cultures following chronic hypoxic and hypoglycemic conditions

    Institute of Scientific and Technical Information of China (English)

    Xueneng Guan; Fuling Yan

    2008-01-01

    BACKGROUND: Preparation of Ginkgo leaf has been widely used to improve cognitive deficits and dementia, in particular in Alzheimer's disease patients. However, the precise mechanism of action of Ginkgo leaf remains unclear.OBJECTIVE: To explore the effect of Ginkgo Biloba extract (Egb761), Ginaton, on β-secretase expression in rat hippocampal neuronal cultures following chronic hypoxic and hypoglycemic conditions.DESIGN, TIME AND SETTNG: Completely by randomized, grouping study. The experiment was performed at the Laboratory of Molecular Imaging, Southeast University between August 2006 and August 2007.MATERIALS: A total of 128 Wistar rats aged 24 hours were selected, and hippocampal neurons were harvested for primary cultures.METHODS: On day 7, primary hippocampal neuronal cultures were treated with Egb761 (0, 25, 50, 100, 150, and 200 μ g/mL) under hypoxic/hypoglycemic or hypoglycemic culture conditions for 12, 24, and 36 hours, respectively. Hippocampal neurons cultured in primary culture medium served as control.MAIN OUTCOME MEASURES: Cell viability was assayed using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT); fluorescence detection of β-secretase activity was performed; Western Blot was used to measure β -secretase expression.RESULTS: Cell viability under hypoxic/hypoglycemic or hypoglycemic culture conditions was significantly less than control cells (P 25 μ g/mL Egb761 induced greater cell viability (P 0.05). Α -secretase activity was increased after 12 hours in hypoxic/hypoglycemic culture (P 0.05). Β -secretase activity was greater after 12, 24, and 36 hours in hypoxic/hypoglycemic culture conditions, compared with control conditions (P < 0.05). Β-secretase activity was significantly decreased in neurons treated with Egb761 for 12, 24, or 36 hours, compared with the hypoxic/hypoglycemic group (P < 0.05).β-secretase protein expression was significantly up-regulated in neurons cultured in hypoxic/hypoglycemic conditions for

  18. The Study of Hypoglycemic Effect of Pu′er Tea Extract Combined with Pioglitazone%普洱茶水提物与吡格列酮联合应用降糖功效研究

    Institute of Scientific and Technical Information of China (English)

    胡金芳; 王根辈; 徐阎; 马晓慧; 李长文; 申秀萍

    2015-01-01

    选取链脲佐菌素(Streptozotocin,STZ)致糖尿病大鼠模型,研究普洱茶水提物与吡格列酮联合应用对糖尿病大鼠的降糖作用,以明确普洱茶水提物是否对降糖药物具有协同作用,在控制血糖前提下能否减少降糖药用量。根据血糖水平按照普洱茶水提物与吡格列酮联合用药和单独用药的方式将动物分成不同的组别,包括对照、模型、吡高、吡低、吡高+PTE 低、吡高+PTE 高、吡低+PTE 低、吡低+PTE 高各实验组,每天灌胃给药2次,连续给药4周。在试验期间观察动物状态,每周大鼠尾部静脉针刺取血,测定动物的空腹血糖值;于给药第4周测定大鼠葡萄糖耐量并检测血清中糖化血清蛋白(Glucosylated serum proteins,GSP)和胰岛素(Insulin,INS)含量并计算胰岛素敏感指数。结果发现普洱茶水提物与吡格列酮混合用药能显著抑制空腹血糖的升高,下调灌胃葡萄糖后30、60、120 min 血糖的升高,显著抑制葡萄糖负荷血糖曲线下面积(Area under concentration-time curve,AUC);给药各组能显著降低大鼠血清 GSP 含量。在服用吡格列酮的同时辅助饮用普洱茶水提物,可以减少服用吡格列酮的用药量而不减弱吡格列酮的降糖效果。%The aim of this study was to investigate the hypoglycemic effect of Pu′er tea extract combined with pioglitazone on diabetic model rat induced by STZ and clarify the synergistic effect of Pu′er tea extract with hypoglycemic drugs and the amount of hypoglycemic drugs could be reduced under the premise to control blood glucose. According to the blood glucose levels and the different ways of Pu′er tea extract combined with pioglitazone, all animals were divided into different groups including control, model, high P, low P, HP+LPTE, HP+HPTE, LP+LPTE, LP+HPTE, orally administered twice a day for consecutive 4 weeks. Animals’ status was observed during the test

  19. Insulin versus oral agents in the management of Cystic Fibrosis Related Diabetes: a case based study

    Directory of Open Access Journals (Sweden)

    Langdon Leora J

    2006-06-01

    Full Text Available Abstract Background Insulin is the recommend therapeutic agent of choice for the management of Cystic Fibrosis Related Diabetes (CFRD, despite only sub-optimal reductions in glycemic control and increased morbidity and mortality reported by centers using this agent. The newer insulin sensitizing agents demonstrated to have anti-inflammatory mechanisms may provide an alternative management option for CFRD. Methods A prospective case based therapeutic comparison between insulin, sulfonylurea, metformin and thiazolidinedione was observed over one decade with 20 CFRD patients diagnosed using American Diabetes Association guideline standards. Patients entering the study elected treatment based on risk and benefit information provided for treatment options. Patients receiving organ transplant or requiring combination diabetic medications were excluded from the study. Results No statistical advantage was achieved regarding overall glycemic control for oral agents over insulin. Additional outcome measures including changes in weight, liver function testing and FEV1 were not statistically significant. Conclusion Insulin alone may not be the only therapeutic option in managing CFRD. Oral hypoglycemic agents were equally effective in treating CFRD and may provide an alternative class of agents for patients reluctant in using insulin.

  20. Hypoglycemic effect of poly-herbal combination in streptozotocin-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Gino A. Kurian

    2016-06-01

    Full Text Available The present study evaluates the combinatorial effect of a poly-herbal combination with multiple therapeutic effects as a hypoglycemic and hypolipidemic agent. Herbal combination of Salacia oblonga, Tinospora cordifolia, Emblica officinalis, Curcuma longa and Gymnema sylvestre was prepared and administered to streptozotocin (55 mg/kg, i.p.-induced diabetic rats, at a dose of 100 mg/kg, for four weeks. The poly-herbal combination significantly elevated the plasma insulin (90% and reduced serum glucose (42%, cholesterol (49%, triglycerides (43%, LDL cholesterol (62.5% and plasma apo B/apo A in the diabetic rats. The liver lipogenic enzymes like HMG CoA reductase and glucose-6-phosphatase significantly declined (p<0.05 in their activity while glucose-6-phosphate dehydrogenase and malic enzymes showed higher activity compared to the diabetic control. The results suggest a significant hypoglycemic and hypolipidemic property for the poly-herbal combination.

  1. Hypoglycemic Syndrome in a Patient with Proinsulin-Only Secreting Pancreatic Adenoma (Proinsulinoma

    Directory of Open Access Journals (Sweden)

    Gian Paolo Fadini

    2011-01-01

    Full Text Available We describe an unusual case of hypoglycemic syndrome in a 69-year old woman with a proinsulin-only secreting pancreatic endocrine adenoma. The clinical history was highly suggestive of an organic hypoglycemia, with normal or relatively low insulin concentrations and elevated proinsulin levels. Magnetic resonance and computed tomography of the abdomen showed a 1 cm pancreatic nodule and multiple accessory spleens. The diagnosis was confirmed by selective angiography, showing location and vascularization of the nodule, despite no response to intra-arterial calcium. After resection, the hypoglycemic syndrome resolved. The surgical specimen was comprised of a neuroendocrine adenomatous tissue with high proinsulin immunoreactivity. Study of this unusual case of proinsulinoma underlines (i the need to assay proinsulin in patients with hypoglycemia and normal immunoreactive insulin, (ii the differential diagnosis in the presence of accessory spleens, (iii the unresponsiveness to intra-arterial calcium stimulation, and (iv the extensive evaluation needed to reach a final diagnosis.

  2. Prescription factors associated with medication non-adherence in Japan assessed from leftover drugs in the SETSUYAKU-BAG campaign: Focus on oral antidiabetic drugs

    Directory of Open Access Journals (Sweden)

    Kaori Koyanagi

    2016-07-01

    Full Text Available Background: Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence. Objective: The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs.Methods: A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs. We evaluated the amount of drugs originally prescribed and the reduced amount after use of leftover drugs, and then calculated prescription reduction ratio (PRR. We analyzed prescription factors contributing to non-adherence based on the PRR.Results: Prescription information for 1,207 patients was reviewed, revealing that patients were non-adherent to 58% of prescriptions. Lack of a drug copayment, fewer concurrent drugs, and drugs not in single-dose packaging were associated with non-adherence. Among the 1,207 patients, 234 prescriptions for diabetes and 452 OAD formulations were included. Forty-seven percent of prescriptions and 29% of the formulations were non-adherent. A higher dosing frequency and preprandial administration were associated with non-adherence. Among the OADs, adherence was lower for α-glucosidase inhibitors and biguanides than for sulfonylureas. Conclusions: Several factors related to patient characteristics, general drug prescriptions, and OAD prescriptions were associated with non-adherence. Further consideration will be needed to improve adherence to medication in Japan. Health care providers should perform more careful monitoring of adherence in patients with the factors identified by this study.

  3. Traffic exposure in a population with high prevalence type 2 diabetes - Do medications influence concentrations of C-reactive protein?

    Energy Technology Data Exchange (ETDEWEB)

    Rioux, Christine L., E-mail: christine.rioux@tufts.edu [Department of Public Health and Community Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111 (United States); Tucker, Katherine L. [Department of Health Science, Northeastern University, Boston, MA (United States); Brugge, Doug [Department of Public Health and Community Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111 (United States); Gute, David M. [Department of Civil and Environmental Engineering, Tufts University, Medford, MA (United States); Mwamburi, Mkaya [Department of Public Health and Community Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111 (United States)

    2011-08-15

    Type 2 Diabetes (T2D) and particulate air pollution are associated with inflammatory dysregulation. We assessed the modifying effects of diabetes medications on the association of C-reactive protein (CRP), a marker of inflammation, and traffic exposure in adults with T2D (n = 379). CRP concentrations were significantly positively associated with residence {<=}100 m of a roadway, >100 m and {<=}200 m of a roadway and increased traffic density for individuals using insulin. For individuals using oral hypoglycemic medications (OHAs), CRP was significantly negatively associated with residence >100 m - {<=}200 m of a roadway and multiple roadway exposure in an interaction model. Among people with diabetes, individuals on insulin appear to be most vulnerable to the effects of traffic exposure. Disease severity among insulin users may promote the pro-inflammatory response to traffic exposure, though diabetes medications may also modify the response. Possible anti-inflammatory effects of OHAs with traffic exposure merit further evaluation. - Highlights: >We examine traffic exposure in a population with high rates of Type 2 Diabetes. >Differences in CRP were evaluated by traffic levels, medication use and type. >Those on insulin had significantly higher CRP with traffic exposure. >Interaction models demonstrated lower CRP with traffic exposure and OHA use. >Diabetes medications may modify the response to traffic exposure. - Among people with diabetes, individuals on insulin appear to be most vulnerable to the effects of traffic exposure. Diabetes medications may modify the response to traffic.

  4. Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease

    DEFF Research Database (Denmark)

    Odin, P; Ray Chaudhuri, K; Slevin, J T

    2015-01-01

    Navigate PD was an educational program established to supplement existing guidelines and provide recommendations on the management of Parkinson's disease (PD) refractory to oral/transdermal therapies. It involved 103 experts from 13 countries overseen by an International Steering Committee (ISC......) of 13 movement disorder specialists. The ISC identified 71 clinical questions important for device-aided management of PD. Fifty-six experts responded to a web-based survey, rating 15 questions as 'critically important;' these were refined to 10 questions by the ISC to be addressed through available......-levodopa-based therapies should be referred for specialist assessment even if disease duration is indication for device-aided therapies. If cognitive impairment is mild, use deep brain stimulation (DBS) with caution. For patients who have cognitive...

  5. Effects of Alda-1, an Aldehyde Dehydrogenase-2 Agonist, on Hypoglycemic Neuronal Death.

    Directory of Open Access Journals (Sweden)

    Tetsuhiko Ikeda

    Full Text Available Hypoglycemic encephalopathy (HE is caused by a lack of glucose availability to neuronal cells, and no neuroprotective drugs have been developed as yet. Studies on the pathogenesis of HE and the development of new neuroprotective drugs have been conducted using animal models such as the hypoglycemic coma model and non-coma hypoglycemia model. However, both models have inherent problems, and establishment of animal models that mimic clinical situations is desirable. In this study, we first developed a short-term hypoglycemic coma model in which rats could be maintained in an isoelectric electroencephalogram (EEG state for 2 min and subsequent hyperglycemia without requiring anti-seizure drugs and an artificial ventilation. This condition caused the production of 4-hydroxy-2-nonenal (4-HNE, a cytotoxic aldehyde, in neurons of the hippocampus and cerebral cortex, and a marked increase in neuronal death as evaluated by Fluoro-Jade B (FJB staining. We also investigated whether N-(1,3-benzodioxole-5-ylmethyl-2,6-dichlorobenzamide (Alda-1, a small-molecule agonist of aldehyde dehydrogenase-2, could attenuate 4-HNE levels and reduce hypoglycemic neuronal death. After confirming that EEG recordings remained isoelectric for 2 min, Alda-1 (8.5 mg/kg or vehicle (dimethyl sulfoxide; DMSO was administered intravenously with glucose to maintain a blood glucose level of 250 to 270 mg/dL. Fewer 4-HNE and FJB-positive cells were observed in the cerebral cortex of Alda-1-treated rats than in DMSO-treated rats 24 h after glucose administration (P = 0.002 and P = 0.020. Thus, activation of the ALDH2 pathway could be a molecular target for HE treatment, and Alda-1 is a potentially neuroprotective agent that exerts a beneficial effect on neurons when intravenously administered simultaneously with glucose.

  6. Hypoglycemic episodes in a case of Prementrual Dysphoric Disorder on sertraline.

    Science.gov (United States)

    Santra Dhali, Ranjita; Banerjee, Prithwijit; Munshi, Santanu; Chaudhuri, Patralekha Ray

    2015-01-01

    Sertraline is a selective serotonin reuptake inhibitor. It has been shown to blunt postprandial hyperglycemia in rats and to potentiate the hypoglycemic effects of sulfonylurea agents in humans. Here, we report a case of a 33-year-old nondiabetic patient with no history of glucose intolerance, who experienced multiple episodes of hypoglycemia that resolved after discontinuation of the drug. Healthcare professionals should consider sertraline among the possible causes of hypoglycemia occurring in patients receiving antidepressants.

  7. Hypoglycemic episodes in a case of Prementrual Dysphoric Disorder on sertraline

    Directory of Open Access Journals (Sweden)

    Ranjita Santra (Dhali

    2015-01-01

    Full Text Available Sertraline is a selective serotonin reuptake inhibitor. It has been shown to blunt postprandial hyperglycemia in rats and to potentiate the hypoglycemic effects of sulfonylurea agents in humans. Here, we report a case of a 33-year-old nondiabetic patient with no history of glucose intolerance, who experienced multiple episodes of hypoglycemia that resolved after discontinuation of the drug. Healthcare professionals should consider sertraline among the possible causes of hypoglycemia occurring in patients receiving antidepressants.

  8. Hypoglycemic effect of Geranium ruizii Hieron. (pasuchaca) ethanolic extract on alloxan-induced hyperglycemia in rats.

    OpenAIRE

    Herrera Calderón, Oscar; Laboratorio de Fisiología y Fisiopatología, Facultad de Farmacia y Bioquímica, Universidad Nacional San Luis Gonzaga, Ica, Perú; Unidad de Posgrado, Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Perú; Chinchay Salazar, Rosa; Laboratorio de Fisiología y Fisiopatología, Facultad de Farmacia y Bioquímica, Universidad Nacional San Luis Gonzaga, Ica, Perú;; Palomino Ormeño, Estela; Laboratorio de Fisiología y Fisiopatología, Facultad de Farmacia y Bioquímica, Universidad Nacional San Luis Gonzaga, Ica, Perú;; Arango Valencia, Evelyn; Laboratorio de Fisiología y Fisiopatología, Facultad de Farmacia y Bioquímica, Universidad Nacional San Luis Gonzaga, Ica, Perú;; Arroyo, Jorge; Laboratorio de Farmacología Experimental, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú; Instituto de Investigaciones Clínicas, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2015-01-01

    Introduction: Geranium ruizii Hieron. (pasuchaca) is a medicinal plant used by traditional medicine to lower glycemia, in Ancash, Peru. Objective: To determine the hypoglycemic effect of Geranium ruizii ethanolic extract on alloxan-induced hyperglycemia in rats. Design: Experimental. Setting: Laboratorio de Farmacología Experimental, Facultad de Medicina Humana, Universidad San Marcos, Lima, Peru. Biological material: Geranium ruizii, eight weeks female Holtzman rats 200 ± 20 g of body weight...

  9. Oral toxicity of isotretinoin, misoprostol, methotrexate, mifepristone and levonorgestrel as pregnancy category X medications in female mice.

    Science.gov (United States)

    Kim, Seong-Kwan; Shin, Soo-Jeong; Yoo, Yohan; Kim, Na-Hyun; Kim, Dong-Soon; Zhang, Dan; Park, Jin-A; Yi, Hee; Kim, Jin-Suk; Shin, Ho-Chul

    2015-03-01

    An oral toxicity study of several pregnancy category X drugs was performed in female ICR mice. The drugs were administered orally once daily for 3 days at doses of 1, 10 and 100 μg/kg for isotretinoin; 6.7, 67 and 670 μg/kg for misoprostol; 83, 830 and 8,300 μg/kg for methotrexate; 3.3, 33 and 330 μg/kg for mifepristone; and 25, 250 and 2,500 μg/kg for levonorgestrel. During the test period, clinical signs, mortality, body weight, hematology, serum biochemistry and necropsy findings were examined. Following administration of methotrexate at 8,300 μg/kg, a number of animals exhibited decreased spontaneous activity, and one animal died. In the hematological analysis, compared with those treated with the control, the animals treated with the drugs exhibited similar significant decreases in the number of granulocytes and granulocyte differentiation, and increases in lymphocyte differentiation. In the serum biochemical analysis, animals receiving high doses of the five drugs demonstrated significant changes in uric acid, glucose, alkaline phosphatase, total bilirubin, lipase, total cholesterol and calcium. At necropsy, intestinal redness was frequently observed in animals that received the high dose of methotrexate. Uterus enlargement and ovary dropsy were also detected in the groups receiving mifepristone and levonorgestrel. Despite the short-term exposure, these drugs exhibited significant side effects, including white blood cell toxicity, in the mouse model. Category X drugs can be traded illegally via the internet for the purpose of early pregnancy termination. Thus, illegal abuse of the drugs should be further discouraged to protect mothers.

  10. Hypoglycemic effect of Carica papaya leaves in streptozotocin-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Juárez-Rojop Isela Esther

    2012-11-01

    Full Text Available Abstract Background Traditional plant treatment for diabetes has shown a surging interest in the last few decades. Therefore, the purpose of this study was to assess the hypoglycemic effect of the aqueous extract of C. papaya leaves in diabetic rats. Several studies have reported that some parts of the C. papaya plant exert hypoglycemic effects in both animals and humans. Methods Diabetes was induced in rats by intraperitoneal administration of 60 mg/kg of streptozotocin (STZ. The aqueous extract of C. papaya was administered in three different doses (0.75, 1.5 and 3 g/100 mL as drinking water to both diabetic and non-diabetic animals during 4 weeks. Results The aqueous extract of Carica papaya (0.75 g and 1.5 g/100 mL significantly decreased blood glucose levels (pC. papaya could help islet regeneration manifested as preservation of cell size. In the liver of diabetic treated rats, C. papaya prevented hepatocyte disruption, as well as accumulation of glycogen and lipids. Finally, an antioxidant effect of C. papaya extract was also detected in diabetic rats. Conclusions This study showed that the aqueous extract of C. papaya exerted a hypoglycemic and antioxidant effect; it also improved the lipid profile in diabetic rats. In addition, the leaf extract positively affected integrity and function of both liver and pancreas.

  11. MR imaging of hypoglycemic encephalopathy: lesion distribution and prognosis prediction by diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Jeong-Hyun; Kim, Young-Joo; Yoo, Won-Jong; Ihn, Yon-Kwon; Kim, Jee-Young; Kim, Bum-Soo [The Catholic University of Korea, Department of Radiology, College of Medicine, Uijongbu, Kyunggi-do (Korea); Song, Ha-Hun [Cheju Halla General Hospital, Department of Radiology, Jeju (Korea)

    2009-10-15

    The aim of this study was to evaluate the patterns of hypoglycemic encephalopathy on diffusion-weighted imaging (DWI) and the relationship between the imaging patterns and clinical outcomes. This retrospective study included 17 consecutive patients that had hypoglycemic encephalopathy with DWI abnormalities. The topographic distributions of the DWI abnormalities of the cortex, deep gray matter, and white matter structures were assessed. In addition, possible correlation between the patterns of brain injury on DWI and clinical outcomes was investigated. There were three patterns of DWI abnormalities: involvement of both gray and white matter (n=8), selective involvement of gray matter (n=4), and selective involvement of white matter (n=5). There was no significant difference in the initial blood glucose levels among patients for each of the imaging patterns. Most patients (16/17) had bilateral symmetrical abnormalities. Among patients with bilateral symmetrical gray and/or white matter injuries, one had moderate to severe disability and 14 remained in a persistent vegetative state. The two patients with a focal unilateral white matter abnormality and a localized splenial abnormality recovered without neurological deficits. The results of this study showed that white matter was more sensitive to hypoglycemia than previously thought and there was no specific association between the patterns of injury and clinical outcomes whether the cerebral cortex, deep gray matter, and/or white matter were affected. Diffuse and extensive injury observed on the DWI predicts a poor neurologic outcome in patients with hypoglycemic injuries. (orig.)

  12. Protective effect of hypoglycemic therapy by liraglutide on renal function in early diabetic nephropathy

    Institute of Scientific and Technical Information of China (English)

    Rui Liu

    2016-01-01

    Objective:To study the effect of liraglutide combined with routine hypoglycemic therapy on renal function in patients with early diabetic nephropathy.Methods:A total of 134 diabetic nephropathy patients with 1-2-stage of kidney disease staging were selected as the research subjects and divided into two groups, observation group accepted liraglutide combined with routine hypoglycemic treatment and control group received routine hypoglycemic treatment. 8 weeks after treatment, the levels of blood glucose metabolism indexes as well as renal function indexes and adipocytokines in serum and urine of two groups were determined.Results:Eight weeks after treatment, FBG, PBG and FINS levels as well as HOMA-IR index of observation group were significantly lower than those of control group while HOMA-β index was significantly higher than that of control group; serum SFRP5, Nesfatin-1 and Omentin-1 levels of observation group were significantly higher than those of control group while serum IGF-1, RBP, Hcy, BNP, Chemerin, Leptin and Visfatin levels were significantly lower than those of control group; urine UAER, ACR and L-FABP of observation group were significantly lower than those of control group.Conclusions: Liraglutide treatment of early diabetic nephropathy can effectively control blood glucose, increase insulin sensitivity, improve renal function and regulate the secretion of adipocytokines, and it has a positive prospect of clinical application.

  13. Differential production of reactive oxygen species in distinct brain regions of hypoglycemic mice.

    Science.gov (United States)

    Amador-Alvarado, Leticia; Montiel, Teresa; Massieu, Lourdes

    2014-09-01

    Hypoglycemia is a serious complication of insulin therapy in patients suffering from type 1 Diabetes Mellitus. Severe hypoglycemia leading to coma (isoelectricity) induces massive neuronal death in vulnerable brain regions such as the hippocampus, the striatum and the cerebral cortex. It has been suggested that the production of reactive oxygen species (ROS) and oxidative stress is involved in hypoglycemic brain damage, and that ROS generation is stimulated by glucose reintroduction (GR) after the hypoglycemic coma. However, the distribution of ROS in discrete brain regions has not been studied in detail. Using the oxidation sensitive marker dihydroethidium (DHE) we have investigated the distribution of ROS in different regions of the mouse brain during prolonged severe hypoglycemia without isoelectricity, as well as the effect of GR on ROS levels. Results show that ROS generation increases in the hippocampus, the cerebral cortex and the striatum after prolonged severe hypoglycemia before the coma. The hippocampus showed the largest increases in ROS levels. GR further stimulated ROS production in the hippocampus and the striatum while in the cerebral cortex, only the somatosensory and parietal areas were significantly affected by GR. Results suggest that ROS are differentially produced during the hypoglycemic insult and that a different response to GR is present among distinct brain regions.

  14. Serum 25 hydroxyvitamin D profile after single large oral doses of cholecalciferol (vitamin D3 in medical staff in North India: A pilot study

    Directory of Open Access Journals (Sweden)

    L Priyambada

    2014-01-01

    Full Text Available Background: Vitamin D deficiency is widely prevalent in India and subjects who have almost no exposure to sunlight are severely deficient. Daily oral doses of cholecalciferol (vitamin D3 are costly as compared to stoss doses and further, take a long time for the serum levels to reach a plateau. Compliance to supplementation may also be better if a regimen involves single oral doses of vitamin D at specified intervals rather than daily doses. Evidence-based guidelines regarding the dosing and the frequency of dosing for prophylactic intermittent supplementation (stoss doses in severely-deficient subjects are few. Materials and Methods: In a prospective intervention study, we serially assessed 30 asymptomatic healthy medical staff for serum 25-hydroxyvitamin D [25(OHD] and parathyroid hormone (PTH; (a at baseline; (b monthly for 3 months after single oral 60,000 units (U cholecalciferol; (c monthly for 3 months after 120,000 (or 180,000 for those with elevated alkaline phosphatase U cholecalciferol; and, (d subsequently, at 3 months after a repeat dose of 60,000 U cholecalciferol by repeated measures analysis of variance. Results: The baseline serum 25(OHD was 7.1 ± 5.4 ng/mL (< 10 ng/mL in 85% subjects which increased to 18.7 ± 8.9 ng/mL at 1 month after 60,000 U of cholecalciferol (P < 0.001 and decreased to 11.1 ± 5.3 ng/mL by the 3 rd month. The higher dose of 120,000 (or 180,000 U increased mean 25(OHD to 28.9 ± 9.9 ng/mL at the end of 1 st month, declining to 17.9 ± 4.9 ng/mL (P < 0.001 at 3 months. With the subsequent 60,000 U the serum 25(OHD was 18.4 ± 3.9 ng/mL at 3 months. PTH showed a corresponding negative trend. No hypercalcemia was observed. Conclusions: Vitamin D deficiency is highly prevalent amongst medical staff in Northern India. An initial dose of 120,000-180,000 U of cholecalciferol is required to elevate 25(OHD out of the deficiency range. Maintenance dose is needed at 2 months.

  15. Causes of oral medication error of inpatients and nursing measure%内科住院患者口服药疗错误的原因分析与护理对策

    Institute of Scientific and Technical Information of China (English)

    杨桂华; 文学琴

    2012-01-01

    目的 分析发生口服药疗错误的原因,探讨预防药疗错误的对策.方法 从护理人员因素,患者因素回顾性分析发生药疗错误30例的原因,探讨相应的护理对策.结果 在发生口服药疗错误的30例患者中,20倒(67%)漏服药;8例(26%)未正确服药;2例(7%)擅自停药或减药.结论 预防药疗错误不仅需要护士严谨的工作态度,医护良好的沟通,还需要患者的积极配合.%Objective To analyze the occurrence of oral medication error and prevention strategies. Methods 30 oral medication errors were retrospectively analyzed. Results Of the 30 oral medication errors. there were 20 cases (67%) missed medication. 8 cases (26%) with incorrect medication, and 2 cases (7%) without stopping or reducing drug. Conclusion Prevention of medication errors requires not only rigorous work attitude of nurses, health care good communication, but also need the active cooperation of patients.

  16. Association between patients’ beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population [Corrigendum

    Directory of Open Access Journals (Sweden)

    Wu P

    2016-09-01

    Full Text Available Wu P, Liu N. Patient Prefer Adherence. 2016;10:1161–1167. On page 1163, Table 1, the copyright statement “Use of the MMAS-8 is protected by US copyright laws. A license agreement to use the scale is available from: Donald E. Morisky, ScD, ScM, MSPH, Professor, Department of Community Health Sciences, UCLA School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, dmorisky@gmail.com” was not included in the Note section. On page 1166, Acknowledgment section, the acknowledgment was “The authors thank the staff at the Department of Endocrinology, the First People’s Hospital of Changzhou, for their assistance and cooperation with the studies. We thank Doctor Honghong Yao, Department of Pharmacology, Medical School of Southeast University, Nanjing, Jiangsu, People’s Republic of China, for her assistance.” however it should have been “The authors thank the staff at the Department of Endocrinology, the First People’s Hospital of Changzhou, for their assistance and cooperation with the studies. We thank Doctor Honghong Yao, Department of Pharmacology, Medical School of Southeast University, Nanjing, Jiangsu, People’s Republic of China, for her assistance. The authors thank Professor Donald E. Morisky, Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, United States, for granting them to use the copyrighted MMAS-8. Professor Donald E. Morisky has worked his entire career in developing the very important instrument for medication-taking behavior measure. Permission to use the MMAS scales is required.33–35 Reproduction and distribution of the MMAS is protected by US copyright laws. A license agreement to use the scale is available from: Donald E. Morisky, ScD, ScM, MSPH, Professor, Department of Community Health Sciences, UCLA School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, dmorisky@gmail.com.” On page 1167, References

  17. Trends in racial/ethnic disparities in medical and oral health, access to care, and use of services in US children: has anything changed over the years?

    Directory of Open Access Journals (Sweden)

    Flores Glenn

    2013-01-01

    Full Text Available Abstract Introduction The 2010 Census revealed the population of Latino and Asian children grew by 5.5 million, while the population of white children declined by 4.3 million from 2000-2010, and minority children will outnumber white children by 2020. No prior analyses, however, have examined time trends in racial/ethnic disparities in children’s health and healthcare. The study objectives were to identify racial/ethnic disparities in medical and oral health, access to care, and use of services in US children, and determine whether these disparities have changed over time. Methods The 2003 and 2007 National Surveys of Children’s Health were nationally representative telephone surveys of parents of 193,995 children 0-17 years old (N = 102,353 in 2003 and N = 91,642 in 2007. Thirty-four disparities indicators were examined for white, African-American, Latino, Asian/Pacific-Islander, American Indian/Alaskan Native, and multiracial children. Multivariable analyses were performed to adjust for nine relevant covariates, and Z-scores to examine time trends. Results Eighteen disparities occurred in 2007 for ≥1 minority group. The number of indicators for which at least one racial/ethnic group experienced disparities did not significantly change between 2003-2007, nor did the total number of specific disparities (46 in 2007. The disparities for one subcategory (use of services, however, did decrease (by 82%. Although 15 disparities decreased over time, two worsened, and 10 new disparities arose. Conclusions Minority children continue to experience multiple disparities in medical and oral health and healthcare. Most disparities persisted over time. Although disparities in use of services decreased, 10 new disparities arose in 2007. Study findings suggest that urgent policy solutions are needed to eliminate these disparities, including collecting racial/ethnic and language data on all patients, monitoring and publicly disclosing disparities

  18. Anti-anxiety self-medication in rats: oral consumption of chlordiazepoxide and ethanol after reward devaluation.

    Science.gov (United States)

    Manzo, Lidia; Donaire, Rocío; Sabariego, Marta; Papini, Mauricio R; Torres, Carmen

    2015-02-01

    Rats increased preference for ethanol after sessions of appetitive extinction, but not after acquisition (reinforced) sessions (Manzo et al., 2014). Drinking was not influenced by appetitive extinction in control groups with postsession access to water, rather than ethanol. Because ethanol has anxiolytic properties in tasks involving reward loss, these results were interpreted as anti-anxiety self-medication. The present experiment tested the potential for self-medication with the prescription anxiolytic chlordiazepoxide, a benzodiazepine with an addictive profile used in the treatment of anxiety disorders. To test this hypothesis, Wistar rats exposed to a 32-to-4% sucrose devaluation received a two-bottle, 2-h preference test immediately after consummatory training. One bottle contained 1 mg/kg of chlordiazepoxide, 2% ethanol, or water for different groups (the second bottle contained water for all groups). Three additional groups received the same postsession preference tests, but were exposed to 4% sucrose during consummatory training. Rats showed suppression of consummatory behavior after reward devaluation relative to unshifted controls. This effect was accompanied by a selective increase in preference for chlordiazepoxide and ethanol. Downshifted animals with access to water or unshifted controls with access to the anxiolytics failed to exhibit postsession changes in preference. Similar results were observed in terms of absolute consumption and consumption relative to body weight. This study shows for the first time that a prescription anxiolytic supports enhanced voluntary consumption during periods of emotional distress triggered by reward loss. Such anti-anxiety self-medication provides insights into the early stages of addictive behavior.

  19. Comparison of improving newborn oral medication compliance%提高新生儿口服给药依从性的比较

    Institute of Scientific and Technical Information of China (English)

    何苑谷; 黄芳泳; 甘翠莲; 江文

    2014-01-01

    Objective:To improve newborn oral medication compliance for maximum effect and reduce adverse reaction.Methods:100 newborns with needing oral cefuroxime axetil tablets were randomly divided into two groups.The observation group and the control group were given early contact and sucking in 30 minutes after birth.After the doctors maked out doctor's advice,the observation group were given medical health education for puerpera and oral medication when sucking 5 minutes.The control group administrated a drug at conventional unified time.The neonatal reflex of two group was compared,and the differences of no sucking,blow bubbles,nausea and vomiting, spill medicine and other resisting action impacted on the next time sucking.Results:Neonatal mouth blowing bubbles,neonatal nausea and vomiting and spill medicine were significantly lower than those of the control group(P<0.05).Conclusion:The newborn medication compliance of using the temperature 37 ℃ 12.5%~15% glucose water in meal feeding has good effect.Neonatal mouth blowing bubbles,neonatal nausea and vomiting and spill medicine occur less, and the newborn is quiet sleep.There is no significant difference between distance time needed for active suck next time.%目的:提高新生儿口服给药依从性,发挥最大的疗效、减少不良反应。方法:将100例需要口服头孢呋辛酯片的新生儿随机分成两组,观察组和对照组均出生30 min内行早接触早吸吮,观察组医师开出医嘱后对产妇进行用药健康教育和吸吮5 min时口服给药,对照组常规统一时间给药。比较两组新生儿反应:不吸吮、口吹泡泡,恶心、呕吐、溢药等抗拒动作,对下次吸吮的影响等方面的差异。结果:观察组新生儿口吹泡泡、新生儿恶心呕吐、溢药等发生率明显低于对照组(P<0.05)。结论:采用温度37℃12.5%~15%葡萄糖水在餐时喂药新生儿服药依从性效果好,新生儿口吹泡泡、恶心、呕吐

  20. Hypoglycemic and hypolipidemic effects of ethanolic and aqueous extracts from Ziziphus oenoplia (L Mill on alloxan-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Pramod Mourya

    2017-03-01

    Full Text Available The objective of present study was to investigate hypoglycemic and hypolipidemic effect of ethanolic and aqueous extracts of Ziziphus oenoplia (L stem bark against Alloxan induce hyperglycemia in rats. Hyperglycemia was induced by an injection of alloxan monohydrate 150 mg/kg (i.p.. After 72 hr, the rats having Blood Glucose Level (BGL above 150 mg/dL were selected for the investigation. At two different doses (200 mg/kg and 400 mg/kg b.w. of aqueous and ethanolic extracts were observed antidiabetic effect for 12 consecutive days. BGL was monitored after 1, 3, 6 and 12 days and compared with Metformin (250 mg/kg. Alpha amylase and alpha glucosidase activity of both extracts were also determined. Phytochemical study revealed the presence of glycosides, flavonoids, alkaloids and terpenoids in ethanol extract and flavonoids, carbohydrates and proteins found in aqueous extract of Z. oenoplia bark. Oral administration of both extracts showed significant (P < 0.05 antihyperglycemic activity in dose dependent manner in alloxan induced diabetic rats. The diabetic rats had significant (P < 0.01 reduction in blood glucose; serum liver enzyme level (AST, ALT, and ALP and lipid profile were compared with normal rats. Significant effects of aqueous and alcoholic extract in alpha amylase and alpha glucosidase activity were observed in rats. The ethanolic and aqueous extract reveals the reduction in the blood glucose level, inhibition of alpha amylase and alpha glucosidase enzymes which support antidiabetic effect (reduce postprandial glucose levels of Z. oenoplia and this may be due to presence of flavonoids constituents.

  1. Hypoglycemic and hypolipidemic effects of Bersama engleriana leaves in nicotinamide/streptozotocin-induced type 2 diabetic rats

    Directory of Open Access Journals (Sweden)

    Pierre Watcho

    2012-12-01

    Full Text Available Abstract Background The present investigation was aimed at evaluating the hypoglycemic and hypolipidemic properties of the aqueous and methanolic extracts from Bersama engleriana leaves in streptozotocin/nicotinamide (STZ-NA-induced type 2 diabetic rats. Methods Animals were orally treated for 4 consecutive weeks with Bersama engleriana extracts at doses of 300 or 600 mg/kg. The anti-diabetic effect was examined by measuring blood glucose (BG at 0, 1, 14 and 28 days after STZ-NA treatment and, total cholesterol (TC, high density lipoprotein cholesterol (HDL-C, low density lipoprotein cholesterol (LDL-C and triglycerides (TG levels at sacrifice (day 29. Glibenclamide (0.25 mg/kg was used for comparison. Results STZ-NA-induced diabetic rats showed moderate to significant increases in the levels of BG, TG, TC, LDL-C while body weight, HDL-C levels and relative weights of liver and pancreas were decreased compared to controls (non diabetic rats. Administration of the plant extracts to STZ-NA diabetic rats resulted in a significant decrease in BG, TG, TC and LDL-C and the dose 600 mg/kg of the methanolic extract was the most effective; HDL-C level was markedly increased after four weeks compared to untreated diabetic rats. A dose-dependent increase in the relative weights of the diabetogenic organs was observed in the Bersama engleriana groups. It can be also noticed that the methanolic extract, especially the dose 600 mg/kg (p Conclusion Results of the present study showed that Bersama engleriana extracts and especially its methanolic extract possess antidiabetogenic properties and beneficial effects on diabetic hyperlipidemia. All these effects could be due to the bioactive components revealed in the Bersama engleriana extracts such as triterpenes and phenols and which could justify its ethnomedical use.

  2. Analysis on hypoglycemic agents and glycemic control in type 2 diabetes mellitus%2型糖尿病患者抗糖尿病药物治疗与血糖控制状况分析

    Institute of Scientific and Technical Information of China (English)

    丁雷; 石国斌; 吴吉平; 方朝晖

    2012-01-01

    目的了解2型糖尿病患者降糖药物用药现状,分析选择药物对血糖控制的影响,为合理治疗提供依据.方法调查入院时2型糖尿病患者群降糖药物使用状况、血糖控制水平及低血糖情况,根据用药情况分为胰岛素组和口服药组,比较胰岛素组和口服药组的血糖控制水平及低血糖的发生率.结果入选288例2型糖尿病患者,平均HbA1c 8.0%,血糖达标率36.8%.胰岛素组和口服药组的空腹血糖、餐后2 h血糖、体质量指数、HbA1c的控制水平相似.胰岛素组的病程明显长于口服药组[(11.5±7.0)年 vs(8.1±6.0)年],P=0.000).口服药组的达标率明显优于胰岛素组(43.4% vs 27.0%,P=0.005).胰岛素组的低血糖发生率高于口服药组(5.2% vs 1.2%,P=0.041).结论 2型糖尿病患者群血糖达标率低,启动胰岛素治疗迟、超重和低血糖是影响血糖达标重要原因.%Objective To find out the current state of medical treatment of type 2 diabetes mellitus, and to analyze the effect of different types of medicine on glycemic control, in order to contribute to a proper therapy. MethodsThe utility of hypoglycemic agents, levels of blood glucose and hypoglycemia among patients admitted by hospital were investigated by categorizing them into two groups, the insulin group and the oral hypoglycemic agents(OHA) group.Results Completed study was obtained in 288 patients, among whom the average HbA1C was 8.0% and total success rate of glycemic control was 36.8%. There were similarities in ages, levels of fasting plasma glucose(FPG), 2 h plasma glucose after meal (2 hPG), body mass index (BMI) and HbA1c. We could see a longer disease course in insulin group (11.5±7.0 vs. 8.1± 6.0,P=0.000) and a higher success rate of glycemic control in OHA group(43.4% vs. 27.0%,P=0.005), followed by a higher proportion of hypo- glycemia in insulin group(5.2% vs. 1.2%,P=0.041). ConclusionThere is a low success rate of glycemic control in type 2 diabetes

  3. Oral Cancer Exam

    Medline Plus

    Full Text Available ... In Skip to Main Content National Institute of Dental and Craniofacial Research (NIDCR) Improving the Nation's Oral ... High School and College Students Recent College Graduates Dental and Medical Students See All Careers & Training Opportunities ...

  4. Oral Cancer Exam

    Medline Plus

    Full Text Available ... and Medical Students See All Careers & Training Opportunities Job Openings Loan Repayment Programs Careers in Dental Research See All Continuing Education Practical Oral Care for People With Developmental Disabilities – ...

  5. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See ... this brochure includes information on symptoms, diagnosis, and treatment of oral cancer, along with definitions of selected medical terms and ...

  6. Epilepsy and oral care.

    Science.gov (United States)

    Fiske, Janice; Boyle, Carole

    2002-05-01

    Epilepsy is a common symptom of an underlying neurological disorder. The seizures can take a variety of forms. Both the condition and its medical management can affect oral health. Prevention of oral disease and carefully planned dental treatment are essential to the well-being of people with epilepsy.

  7. Hypoglycemic activity of withanolides and elicitated Withania somnifera.

    Science.gov (United States)

    Gorelick, Jonathan; Rosenberg, Rivka; Smotrich, Avinoam; Hanuš, Lumír; Bernstein, Nirit

    2015-08-01

    Withania somnifera, known in India as Asghawhanda, is used traditionally to treat many medical problems including diabetes and has demonstrated therapeutic activity in various animal models as well as in diabetic patients. While much of W. somnifera's therapeutic activity is attributed to withanolides, their role in the anti-diabetic activity of W. somnifera has not been adequately studied. In the present study, we evaluated the anti-diabetic activity of W. somnifera extract and purified withanolides, as well as the effect of various elicitors on this activity. W. somnifera leaf and root extracts increased glucose uptake in myotubes and adipocytes in a dose dependent manner, with the leaf extract more active than the root extract. Leaf but not root extract increased insulin secretion in basal pancreatic beta cells but not in stimulated cells. Six withanolides isolated from W. somnifera were tested for anti-diabetic activity based on glucose uptake in skeletal myotubes. Withaferin A was found to increase glucose uptake, with 10μM producing a 54% increase compared with control, suggesting that withaferin A is at least partially responsible for W. somnifera's anti-diabetic activity. Elicitors applied to the root growing solutions affected the physiological state of the plants, altering membrane leakage or osmotic potential. Methyl salicylate and chitosan increased withaferin A content by 75% and 69% respectively, and extracts from elicited plants increased glucose uptake to a higher extent than non-elicited plants, demonstrating a correlation between increased content of withaferin A and anti-diabetic activity.

  8. Oral sex and oral health: An enigma in itself

    Directory of Open Access Journals (Sweden)

    Tarun Kumar

    2015-01-01

    Full Text Available Oral sex is commonly practiced by sexually active couples of various age groups, including male-female and same-gender adolescents. The various type of oral sex practices are fellatio, cunnilingus, and analingus. Oral sex can transmit oral, respiratory, and genital infections from one site in body to the other. Oral health has a direct correlation on the transmission of infection; a cut in the mouth, bleeding gums, lip sores or broken skin increases chances of life-threatening infections. Although oral sex is considered a low risk activity, it is important to use protection such as physical barriers, health and medical issues, ethical issues, and oral hygiene and dental issues. The ulcerations or unhealthy periodontium in mouth accelerates the phenomenon of transmission of infections into the circulation. Thus, consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.

  9. Oral calcitonin

    Directory of Open Access Journals (Sweden)

    Hamdy RC

    2012-09-01

    Full Text Available Ronald C Hamdy,1,2 Dane N Daley11Osteoporosis Center, College of Medicine, East Tennessee State University, 2Veterans Affairs Medical Center, Johnson City, TN, USAAbstract: Calcitonin is a hormone secreted by the C-cells of the thyroid gland in response to elevations of the plasma calcium level. It reduces bone resorption by inhibiting mature active osteoclasts and increases renal calcium excretion. It is used in the management of postmenopausal osteoporosis, Paget's disease of bone, and malignancy-associated hypercalcemia. Synthetic and recombinant calcitonin preparations are available; both have similar pharmacokinetic and pharmacodynamic profiles. As calcitonin is a peptide, the traditional method of administration has been parenteral or intranasal. This hinders its clinical use: adherence with therapy is notoriously low, and withdrawal from clinical trials has been problematic. An oral formulation would be more attractive, practical, and convenient to patients. In addition to its effect on active osteoclasts and renal tubules, calcitonin has an analgesic action, possibly mediated through β-endorphins and the central modulation of pain perception. It also exerts a protective action on cartilage and may be useful in the management of osteoarthritis and possibly rheumatoid arthritis. Oral formulations of calcitonin have been developed using different techniques. The most studied involves drug-delivery carriers such as Eligen® 8-(N-2hydroxy-5-chloro-benzoyl-amino-caprylic acid (5-CNAC (Emisphere Technologies, Cedar Knolls, NJ. Several factors affect the bioavailability and efficacy of orally administered calcitonin, including amount of water used to take the tablet, time of day the tablet is taken, and proximity to intake of a meal. Preliminary results looked promising. Unfortunately, in two Phase III studies, oral calcitonin (0.8 mg with 200 mg 5-CNAC, once a day for postmenopausal osteoporosis and twice a day for osteoarthritis failed to

  10. Variation in lung function as a marker of adherence to oral and inhaled medication in cystic fibrosis.

    Science.gov (United States)

    White, Helen; Shaw, Nicola; Denman, Sarah; Pollard, Kim; Wynne, Sarah; Peckham, Daniel Gavin

    2017-03-01

    The aim of this study was to characterise adherence in an adult population with cystic fibrosis (CF) and to investigate if variation in lung function was a predictor of adherence to treatment.The adherence of patients aged ≥16 years from an adult CF centre was measured by medication possession ratio (MPR) and self-report. Patients were assigned to one of three adherence categories (coefficient variation measures for forced expiratory volume in 1 s (FEV1), weight and C-reactive protein concentration, measured from 6 months and 12 months before baseline.MPR data for 106 of 249 patients (mean age 29.8±9.2 years) was retrieved, indicating a mean adherence of 63%. The coefficient of variation for FEV1 was inversely related to adherence and was a univariate predictor of adherence (6 months: OR 0.92, 95% CI 0.87-0.98, p=0.005; 12 months: OR 0.94, 95% CI 0.93-0.99, p=0.03) and remained significant in the final models. The coefficient of variation of weight and C-reactive protein were not predictive of adherence.The coefficient of variation of FEV1 was identified as an objective predictor of adherence. Further evaluation of this potential marker of adherence is now required. Copyright ©ERS 2017.

  11. Hypoglycemic effect of Octomeles sumatrana aqueous extract in streptozotocin-induced diabetic rats and its molecular mechanisms

    Institute of Scientific and Technical Information of China (English)

    Mohd Aidil Azahar; Ghanya Al-Naqeb; Mizaton Hasan; Aishah Adam

    2012-01-01

    Objective:To investigate the hypoglycemic effect of the aqueous extract of Octomeles sumatrana (O. sumatrana) (OS) in streptozotocin-induced diabetic rats (STZ) and its molecular mechanisms. Methods: Diabetes was induced by intraperitoneal (i.p.) injection of streptozotocin (55 mg/kg) in to male Sprague-Dawley rats. Rats were divided into six different groups;normal control rats were not induced with STZ and served as reference, STZ diabetic control rats were given normal saline. Three groups were treated with OS aqueous extract at 0.2, 0.3 and 0.5 g/kg, orally twice daily continuously for 21 d. The fifth group was treated with glibenclamide (6 mg/kg) in aqueous solution orally continuously for 21 d. After completion of the treatment period, biochemical parameters and expression levels of glucose transporter 2 (Slc2a2), glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase (PCK1) were determined in liver by quantitative real time PCR. Results: Administration of OS at different doses to STZ induced diabetic rats, resulted in significant decrease (P<0.05) in blood glucose level in a dose dependent manner by 36%, 48%, and 64%at doses of 0.2, 0.3 and 0.5 g/kg, respectively, in comparison to the STZ control values. Treatment with OS elicited an increase in the expression level of Slc2a2 gene but reduced the expression of G6Pase and PCK1 genes. Morefore, OS treated rats, showed significantly lower levels of serum alanine transaminase (ALT), aspartate aminotransferase (AST) and urea levels compared to STZ untreated rats. The extract at different doses elicited signs of recovery in body weight gain when compared to STZ diabetic controls although food and water consumption were significantly lower in treated groups compared to STZ diabetic control group. Conclusions:O. sumatrana aqueous extract is beneficial for improvement of hyperglycemia by increasing gene expression of liver Slc2a2 and reducing expression of G6Pase and PCK1 genes in streptozotocin

  12. PROSPECTS FOR DEVELOPMENT OF ANTIDIABETIC POLYPHENOL-BASED DRUGS: MECHANISMS OF HYPOGLYCEMIC ACTION AND PHARMACOKINETICS

    Directory of Open Access Journals (Sweden)

    Ruban E. A.

    2015-12-01

    Full Text Available Introduction. Diabetes mellitus is one of the most serious chronic diseases and considered to be non-infectious epidemic worldwide. Persistent hyperglycemia is a major hallmark of diabetes and risk factor for the development of its complications. Therefore, the main therapeutic goal in the treatment of diabetes is to reduce the elevated blood glucose level. Unfortunately, management of diabetes without any side effects is still a challenge to the modern medicine and pharmacy. Among potential alternatives to synthetic antidiabetic drugs plant polyphenols are very promising. However, polyphenol efficiency in diabetes is determined by their chemical structure and hence the affinity to a certain molecular targets in body tissues. Moreover, the bioavailability and other pharmacokinetic parameters of different individual substances may also vary significantly. In this context the present paper is devoted to the analysis of the available data on the hypoglycemic mechanisms and pharmacokinetics of various individual polyphenolic compounds in order to provide the necessary biopharmaceutical requirements in the development of a new blood glucose-lowering drug. Materials and methods. A systematic literature search of Pubmed, EMBASE and other databases with no language restrictions was performed until to the end of August 2015. The following terms were used: polyphenols, diabetes mellitus, hypoglycemic action, pharmacokinetics and bioavailability of polyphenols. Results and discussion. According to available experimental data various polyphenols may influence carbohydrate metabolism at many levels. The mechanisms by which plant polyphenols exert their hypoglycemic action are mediated primarily by their ability to directly bind to target proteins (or peptides and include inhibition of carbohydrate digestion and glucose absorption in the intestine, stimulation of insulin secretion from the pancreatic β-cells, modulation of glucose release from the liver

  13. Infant oral health and oral habits.

    Science.gov (United States)

    Nowak, A J; Warren, J J

    2000-10-01

    Many oral diseases and conditions, including dental caries (cavities) and malocclusions, have their origins early in life. Prudent anticipatory guidance by the medical and dental professions can help prevent many of the more common oral health problems. This article provides information on the rationale for early dental examination and instructions for pediatric and family practitioners in scheduling and conducting an early oral intervention appointment. In addition, feeding practices, non-nutritive sucking, mouth breathing, and bruxing are discussed, including their effects on orofacial growth and development.

  14. Oral syringe use survey.

    Science.gov (United States)

    Baldwin, J N; Wedemeyer, H F

    1980-09-01

    Use of oral syringes at children's and ASHP-accredited residency hospitals in the United States was surveyed. Questionnaires were mailed to 131 hospitals; 117 (89.3%) were returned. Of the responding hospitals, 54.5% of children's hospitals and 67.1% of residency hospitals used oral syringes. There was no definite preference for a particular brand or type (glass vs. plastic) of syringe. Patients who often required liquid dosage forms, including pediatric and geriatric patients and patients with nasogastric tubes, were most frequently included in oral syringe distribution systems. Twenty-six of the 73 hospitals utilizing oral syringes used them for most unit dose liquids in all drug distribution systems. The remainder reported use for specific medications or circumstances. Expiration dating policies varied from 24 hours to one year to the manufacturer's expiration dating. The survey indicates widespread use of oral syringes and identifies a need for evaluation of medication stability in these devices.

  15. Comparison on hypoglycemic effect of Oyster (Pleurotusosteratus and Reishi (Ganodermalucidum mushroom in alloxan induced diabetic mice

    Directory of Open Access Journals (Sweden)

    Debendra Nath Roy

    2015-06-01

    Full Text Available Pleurotusosteratus (family: Pleurotaceae and Ganodermalucidum (family: ganodermataceae are common edible mushrooms in Bangladesh. Ethyl acetate extract of Pleurotusosteratus and Ganodermalucidum were used to find out their hypoglycaemicactivity in alloxan induced diabetic mice. Ethyl acetate extract of Pleurotusosteratus and Ganodermalucidum reduced blood glucose level of 39.56% and 43.27% respectively at 24 hours after intrapertitoneal administration (P<0.005 inalloxan induced diabeticmice.The possible mechanism of hypoglycemic action is due to the increased glucose uptake in liver cells because it markedly lowers the blood glucose levels in alloxan induced diabeticmice.

  16.  Evaluation of the reasons for the extraction among patients referred to the Oral Surgery Department,Faculty of Dentistry, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Ramezanian M.

    2004-06-01

    Full Text Available Statement of Problem: Tooth extraction is always considered as the final treatment option in dentistry."nConsidering the numerous advances in dentistry, nowadays the preservation of the permanent teeth until old"nage is common. However, in most economically poor countries or those without security service insurance,"nthe high rate of extraction, particularly among restorable teeth, is regrettable."nPurpose: The aim of the present study was to determine the reasons for tooth extraction among patients"nreferred to the faculty of Dentistry, Tehran University of Medical Sciences in 2002."nMaterials and Methods: This descriptive and cross-sectional study was conducted on 320 patients. The"ninformation about patient's general knowledge, oral health status, tooth location and causes of extraction were"ncollected and recorded in a questionnaire. The data were submitted to statistical Chi-Square test."nResults: No statistically significant difference was found between two genders in their mentioned causes for"nextraction. The most prevalent reasons were as follows: Caries (50%, Periodontal diseases (16.6%. Absence"nof an acceptable occlusion, prosthetic problems, patient's request, etc... make up the remaining 33.4% of the"nreasons."nConclusion: According to this study, it is suggested to investigate extraction etiology at the society level and"nif similar results are obtained, necessary steps should be taken to prevent caries and periodontal problems as"nthe major mentioned causes for tooth extraction.

  17. The Prospective Oral Mucositis Audit: relationship of severe oral mucositis with clinical and medical resource use outcomes in patients receiving high-dose melphalan or BEAM-conditioning chemotherapy and autologous SCT.

    NARCIS (Netherlands)

    McCann, S.; Schwenkglenks, M.; Bacon, P.; Einsele, H.; D'Addio, A.; Maertens, J.; Niederwieser, D.; Rabitsch, W.; Roosaar, A.; Ruutu, T.; Schouten, H.; Stone, R.; Vorkurka, S.; Quinn, B.; Blijlevens, N.M.A.

    2009-01-01

    The Prospective Oral Mucositis Audit was an observational study in 197 patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL) undergoing, respectively, high-dose melphalan or BEAM chemotherapy and autologous SCT at 25 European centres. We evaluated the relationship between severe oral m

  18. A review of the hypoglycemic effects of five commonly used herbal food supplements.

    Science.gov (United States)

    Deng, Ruitang

    2012-04-01

    Hyperglycemia is a pathological condition associated with prediabetes and diabetes. The incidence of prediabetes and diabetes is increasing and imposes great burden on healthcare worldwide. Patients with prediabetes and diabetes have significantly increased risk for cardiovascular diseases and other complications. Currently, management of hyperglycemia includes pharmacological interventions, physical exercise, and change of life style and diet. Food supplements have increasingly become attractive alternatives to prevent or treat hyperglycemia, especially for subjects with mild hyperglycemia. This review summarized current patents and patent applications with relevant literature on five commonly used food supplements with claims of hypoglycemic effects, including emblica officinalis (gooseberry), fenugreek, green tea, momordica charantia (bitter melon) and cinnamon. The data from human clinical studies did not support a recommendation for all five supplements to manage hyperglycemia. Fenugreek and composite supplements containing emblica officinalis showed the most consistency in lowering fasting blood sugar (FBS) or glycated hemoglobin (HbA1c) levels in diabetic patients. The hypoglycemic effects of cinnamon and momordica charantia were demonstrated in most of the trials with some exceptions. However, green tea exhibited limited benefits in reducing FBS or HbA1c levels and should not be recommended for managing hyperglycemia. Certain limitations are noticed in a considerable number of clinical studies including small sample size, poor experimental design and considerable variations in participant population, preparation format, daily dose, and treatment duration. Future studies with more defined participants, standardized preparation and dose, and improved trial design and size are warranted.

  19. Hypoglycemic effects of a standardized extract of salvia miltiorrhiza roots in rats

    Directory of Open Access Journals (Sweden)

    Mauro A. M. Carai

    2015-01-01

    Full Text Available Background and Aims: Salvia miltiorrhiza Bunge (Labiatae is a Chinese medicinal plant, the dried roots of which (known as Dan-Shen have been used for hundreds of years in the treatment of a series of ailments, including hyperglycemia. This study was designed to evaluate the hypoglycemic effect of a new, standardized extract of S. miltiorrhiza. Materials and Methods: S. miltiorrhiza extract (containing 21% total tanshinones and 3.7% tanshinone IIA was administered acutely and intragastrically at the doses of 0, 50, 100, and 200 mg/kg to male, healthy, fasted Wistar rats 60 min before the intragastric infusion of a bolus of starch (3 g/kg; a semi-naturalistic experimental condition (Experiment 1 or glucose (2 g/kg (Experiment 2. Results: In both experiments, treatment with S. miltiorrhiza extract produced a dose-related decrease in glycemia, evidenced in terms of reduction of peak value and/or area under the curve of the time-course of glycemia. The effect of S. miltiorrhiza extract occurred at doses devoid of any behavioral toxicity in rats. Conclusion: The results of this study suggest that the hypoglycemic effect of S. miltiorrhiza extract was likely secondary to an action on carbohydrate metabolism. These results are consistent with several preclinical and clinical data and add further support to the hypothesis that S. miltiorrhiza extracts may act as effective anti-hyperglycemic remedies.

  20. Is the hypoglycemic action of vanadium compounds related to the suppression of feeding?

    Science.gov (United States)

    Huang, Meiling; Wu, Yaling; Wang, Na; Wang, Ziwei; Zhao, Pan; Yang, Xiaoda

    2014-03-01

    Vanadium compounds exhibit effective hypoglycemic activity in both type I and type II diabetes mellitus. However, there was one argument that the hypoglycemic action of vanadium compounds could be attributable to the suppression of feeding-one common toxic aspect of vanadium compounds. To clarify this question, we investigated in this work the effect of a vanadyl complex, BSOV (bis((5-hydroxy-4-oxo-4H-pyran-2-yl)methyl-2-hydroxy-benzoatato) oxovanadium (IV)), on diabetic obese (db/db) mice at a low dose (0.05 mmol/kg/day) when BSOV did not inhibit feeding. The experimental results showed that this dose of BSOV effectively normalized the blood glucose level in diabetic mice without affecting the body weight growth. Western blotting assays on the white adipose tissue of db/db mice further indicated that BSOV treatment significantly improved expression of peroxisome proliferator-activated receptor γ (PPARγ) and activated AMP-activated protein kinase (AMPK). In addition, vanadium treatment caused a significant suppression of phosphorylation of c-Jun N-terminal protein kinase (JNK), which plays a key role in insulin-resistance in type II diabetes. This is the first evidence that the mechanism of insulin enhancement action involves interaction of vanadium compounds with JNK. Overall, the present work indicated that vanadium compounds exhibit antidiabetic effects irrelevant to food intake suppression but by modulating the signal transductions of diabetes and other metabolic disorders.

  1. Hypoglycemic Effect of Ginger (Zingiber officinale in Alloxan Induced Diabetic Rats (Rattus norvagicus

    Directory of Open Access Journals (Sweden)

    Saghir Ahmad Jafri*, Sohail Abass and Muhammad Qasim

    2011-04-01

    Full Text Available A study was conducted to evaluate the hypoglycemic effect of Zingiber officinale (Ginger aqueous extract at a dose of 500mg/kg body weight (BW once a day for six weeks. The rats were made diabetic by intraperitoneal injection of alloxan (65mg/kg BW once which induced diabetes in albino rats after 8 days. Albino rats (n=24 each weighing 150-180g were divided in 3 equal groups. Group A served as control, group B was diabetic and was not given ginger whereas group C rats were diabetic and given ginger extract (500mg/kg BW. Serum of each rat was analyzed by enzymatic kits to estimate serum glucose on 1st day (after making them diabetic, 21st and 42nd day. Blood glucose level remained unaltered in group A and B over time. However, group C, given ginger extract, showed significant (P<0.05 reduction in serum glucose level after day 21 and 42 post treatment. It may be concluded that ginger extract has hypoglycemic effect on diabetic rats.

  2. HYPOGLYCEMIC EFFECT OF 2-HYDROXYCHALCONE ON HIGH FRUCTOSE FED DIABETIC RAT

    Directory of Open Access Journals (Sweden)

    K. Jegatheesan et al.

    2012-02-01

    Full Text Available The objective of the project work was to study the effect of Hypoglycemic and Hypolipidemic activity of 2- hydroxychalcone on high fructose diet induced insulin resistance in male Wister Albino rats. Rats were rendered insulin resistant by feeding 66% (w/w fructose and 1.1% (v/w coconut oil mixed with normal pellet diet (NPD for 3 weeks. Insulin resistance high fructose diabetic rats receiving hydroxychalcone intraperitoneally (i.p. at the dose of 25mg/kg body weight daily for 7 consecutive days. At the end of the study blood glucose, serum insulin, glycosylated haemoglobin was estimated. The tissue was used for the assay of enzyme activity of Hexokinase, Glycogen, Glu-6-phosphatase and fru-1, 6 bis phosphatase were also estimated. Fructose diet with 2-hydroxychalcone significantly reduced the blood glucose, insulin, glu-6-phosphatase, fru-1, 6 bis phosphatase and significantly increase the hexokinase and glycogen activity. The flavonoid present in the cinnamon 2-hydroxychalcone were found to exhibit a significant Hypoglycemic activity in fructose fed insulin resistant rats.

  3. In vitro antioxidant and hypoglycemic activities of Ethiopian spice blend Berbere.

    Science.gov (United States)

    Loizzo, Monica R; Di Lecce, Giuseppe; Boselli, Emanuele; Bonesi, Marco; Menichini, Federica; Menichini, Francesco; Frega, Natale Giuseppe

    2011-11-01

    The metal chelating activity, antioxidant properties, and the effect on carbohydrate-hydrolyzing enzymes of Ethiopian spice blend Berbere have been investigated. Berbere contains a total amount of phenols corresponding to 71.3 mg chlorogenic acid equivalent per gram of extract and a total flavonoid content of 32.5 mg quercetin equivalent per gram of extract. An increase of the resistance towards forced oxidation was obtained when Berbere was added to sunflower oil. In order to evaluate the bioactivity of the non-polar constituents, an n-hexane extract was obtained from Berbere. The gas chromatography-mass spectrometry analysis revealed the presence of 19 fatty acids constituents (98.1% of the total oil content). Among them, linoleic acid was the major component (72.0% of the total lipids). The ethanolic extract had the highest ferric-reducing ability power (35.4 μM Fe(II)/g) and DPPH scavenging activity with a concentration giving 50% inhibition (IC(50)) value of 34.8 μg/ml. Moreover, this extract exhibited good hypoglycemic activity against α-amylase (IC(50) = 78.3 μg/ml). In conclusion, Ethiopian spice blend Berbere showed promising antioxidant and hypoglycemic activity via the inhibition of carbohydrate digestive enzymes. These activities may be of interest from functional point of view and for the revalorization of the spice blend in gastronomy also outside the African country.

  4. Acute Hypoglycemic and Antidiabetic Effect of Teuhetenone A Isolated from Turnera diffusa

    Directory of Open Access Journals (Sweden)

    Aída Parra-Naranjo

    2017-04-01

    Full Text Available Diabetes mellitus is a chronic degenerative disease that causes long-term complications and represents a serious public health problem. Turnera diffusa (damiana is a shrub that grows throughout Mexico and is traditionally used for many illnesses including diabetes. Although a large number of plant metabolites are known, there are no reports indicating which of these are responsible for this activity, and this identification was the objective of the present work. Through bioassay-guided fractionation of a methanolic extract obtained from the aerial part of T. diffusa, teuhetenone A was isolated and identified as the main metabolite responsible for the plant’s hypoglycemic activity. Alpha-glucosidase inhibitory activity and cytotoxicity of this metabolite were determined. Hypoglycemic and antidiabetic activities were evaluated in a murine model of diabetes in vivo, by monitoring glucose levels for six hours and comparing them with levels after administering various controls. Teuhetenone A was not cytotoxic at the tested concentrations, and did not show inhibitory activity in the glucosidase test, and the in vivo assays showed a gradual reduction in glucose levels in normoglycemic and diabetic mice. Considering these results, we suggest that teuhetenone A has potential as an antidiabetic compound, which could be further submitted to preclinical assays.

  5. 医学专科新生口腔健康知识与行为调查分析%Investigation into oral health knowledge and behaviors among freshmen in Anhui Medical College

    Institute of Scientific and Technical Information of China (English)

    倪成励; 柴梅; 唐旭炎

    2013-01-01

    目的 了解医学专科院校新生口腔健康知识及口腔保健行为,分析大学生口腔健康认知与行为差异,为有针对性地采取何种方式进行口腔健康教育提供基准.方法 随机抽取安徽医学高等专科学校1 100名新生作为研究对象,自行设计问卷,采用问卷调查的方法对学生口腔卫生知识与行为进行调查与分析.结果 大学生口腔健康行为总体较好,但健康知识与健康行为存在不均衡现象,对口腔保健知识存在盲区及误区.结论 不同特质大学生口腔健康认知和行为存在差异,需有针对性地制定口腔健康教育计划,加强对大学生的口腔健康教育,规范口腔健康行为,促进大学生口腔健康状况的改善.%Objective To know and investigate oral health knowledge and behaviors among freshmen of Anhui Medical college,and to provide basis for how to make oral health education among college students.Methods A survey with a self-designed questionnaire about oral health knowledge and behavior was conducted among 1100 freshmen in Anhui Medical College.Results College students' oral health behavior was good as a whole.However,the health knowledge and health behavior were imbalanced,and there was a blind area of oral health knowledge and misunderstanding.Conclusion There are differences in oral health knowledge and behavior among students of different backgrounds.Oral health education programs need to be established for the undergraduates of different backgrounds to promote the students' education about oral health and improve their oral health condition.

  6. THE ANALYSES OF QUALIFICATION EXAMINATION DATA of REGISTERED ORAL PHYSI-CIANS IN A MEDICAL COLLEGE%某医学院口腔执业医师考试数据分析

    Institute of Scientific and Technical Information of China (English)

    林鸿程; 梁馨云; 韩小玲; 王树文

    2015-01-01

    通过对某医学院2007~2011年口腔执业医师考试数据分析评估该校口腔执业医师考试通过率的变化趋势以及存在的问题,探讨口腔医学教学与执业医师资格考试接轨改革实施措施的状况,以期为新形势下口腔医学教学改革起到指导作用.%The passing rates were analyzed to know the trend and the problems by analyzing and comparing the data of registered oral physician qualification examination from 2007 to 2011 in a medical college.The implemen-tation in oral medical teaching and oral physician qualification examination standard was explored to provide guidance for the reform of oral medicine teaching under the new situations.

  7. Amerlcan Diabetic Association Standards in an Air Force Medical Clinic

    Science.gov (United States)

    1996-05-01

    were overweight ; 30% were obese ; half of the patients were treated solely with oral hypoglycemics, 19% with diet alone, and almost one-third were...of Birth : Minot, North Dakota. Secondary Education: Des Lacs High School , Des Lacs, North Dakota, May 1969. Collegiate Institutions Attended: Minol...Slale College 1969 - 1973 BS Communication Arts 1973 Minol State College 1973 - 1974 BS Elementary Education 1974 Minol Slate College 1980 - 1984

  8. Comparison effect of acupoint injection by mixture of methyl prednisolone acetate and lidocain with oral medication in acute low back pain

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Hadianfard

    2009-01-01

    Full Text Available (Received 30 December, 2009 ; Accepted 10 August, 2009AbstractBackground and purpose: Acupuncture is a treatment useful in reducing and eliminating pain. This study was undertaken to present a simple and fast method of treatment in acute radicular low back pain by injection of acupoints.Materials and methods: Fifty patients with acute low back pain with positive Straight Leg Raising (SLR test were enrolled in the study. The patients were randomly divided into two equal groups. Physical examination in the pilot study showed that patients have five tender acupoints including BL-57, BL-40, BL-36 or 37, BL-23 and GB-30. The subjects in the first group were injected in at least 3 acupoints of these 5 points. Injection was done only once by mixing 2cc of lidocaine 2% and 1ml of methylprednisolone acetate (40 mg. The subjects of the second group took medication such as piroxicam 20 mg orally, methocarbamol 1500 mg and diazepam 10 mg daily for one week. Dependent variables were measured including; pain intensity was measured by Numerical Pain Rating Scale (NPRS, balance and weight bearing ability was measured by Standard Hopping Scale (SHS, sciatic nerve stretch was measured by SLR, patients’ function was measured by Back Pain Functional Scale (BPFS questioner.Results: Both groups were equal statistically before starting treatment, but there was a significant difference between them in variables BPFS and SHS 10 days after treatment. The mean of decreased pain intensity in NPRS and SLR were equal but effective in both group on the 10th day. Conclusion: It seems that effect of injection with acupuncture points in acute low back pain not only is as good as medical treatment but it is also better than that. In this treatment, there was no report of secondary complication to treatment. So, in patients with acute radicular LBP, injection of tender acupoints is an effective, safe, economical, and time saving method of treatment. J Mazand Univ Med Sci 2009

  9. 自动摆药机差错风险防控%Risk Control of Medication Errors of Automatic Oral Drug Dispensing System in Hospital Pharmacy

    Institute of Scientific and Technical Information of China (English)

    陈莹; 蔡爽

    2014-01-01

    Objective To investigate effective management mode of the automatic oral drug dispensing sys-tem in hospital pharmacy .Methods The application of automatic drug dispensing system were analyzed in our hospital pharmacy and the problems and solving methods were summarized .Results Using effective management mode can reduce the risk of medication errors .Conclusions Automation is the inevitable trend of hospital phar-macy management .Automatic drug dispensing system is suitable for hospital pharmacy development and applica -tion, the use of which is helpful to improve the hospital pharmacy service level .The effective management can de-crease the risk of errors .%目的:分析自动口服药品摆药机在医院使用时存在的问题,探讨通过加强管理降低发生差错的方法。方法对本院自动摆药机的使用情况、遇到的问题及解决方法进行总结分析。结果通过建立有效的管理模式可以降低自动摆药机发生差错的风险。结论自动化操作是医院药局发展的必然趋势,自动摆药机适合医院药局发展应用,通过有效管理可降低发生差错的风险,有助于提高医院的药学服务水平。

  10. Pharmacokinetics of the main compounds absorbed into blood after oral administration of Liu Wei Di Huang Wan, a typical combinatorial intervention of Chinese medical formula.

    Science.gov (United States)

    Zhang, Ning; Li, Lijing; Wang, Ping; Sun, Hui; Wu, Zeming; Piao, Chengyu; Wang, Xijun

    2013-01-01

    Liu Wei Di Huang Wan (LW) has been used as an active Chinese patent formula for "Five Late Syndrome" of Children for thousands of years. Due to the complexity in its chemical constituents, the pharmacokinetics of this formula have not been elucidated clearly, and the understanding of its pharmacological properties has been delayed. Previous studies have identified the constituents absorbed into blood after the oral administration of LW; moreover, 5-hydroxymethyl-2-furoic acid (HMFA), loganin and paeonol have been proved as surrogate markers. In this study, a rapid validated high-performance liquid chromatography method was developed for determining three marker compounds in plasma. The analysis was performed on a Waters Symmetry Shield™ RP(18) column with acetonitrile and 0.15% phosphoric acid as the mobile phase, which showed acceptable linearity, intra- and inter-day precision, and accuracy. By using the established method, the pharmacokinetic analysis of LW was carried out. The t (1/2)α and t (1/2)β were 2.62/32.66, 0.46/4.71 and 1.30/23.51 h and the climax times and concentrations were 0.56/683.75, 0.70/2826.11 and 0.62 h/4030.48 ng ml(-1) for HMFA, loganin and paeonol, respectively. Especially, both the absorption and disposition of HMFA were swift (t (1/2) kα 0.1 h, t (1/2)α 2.62 h), but the elimination was quite slow (t (1/2)β 32.66 h); this phenomenon reflected the synergetic effect of LW combinatorial intervention and the value of compatibility can be more clearly understood. The pharmacokinetic characters of HMFA, loganin and paeonol not only elucidated the steady and long-lasting pharmacological properties, but they also revealed the practical value of the compatibility of Chinese medical formula.

  11. Oral health knowledge attitude and practice among freshmen in Anhui Medical University%安徽医科大学新生口腔知识态度行为分析

    Institute of Scientific and Technical Information of China (English)

    王海林; 杨玲; 陶芳标

    2011-01-01

    Objective The study aims to assess the actual oral health knowledge, attitude and behavior of freshmen, and to provide scientific basis for oral health treatment and oral health education. Methods By cluster sampling method, a questionnaire survey was conducted among 5 280 freshmen in a medical university in 2004 and 2008. Results The oral health behavior and correct rate of oral health knowledge of freshmen were not ideal. The knowledge and attitude about oral hygiene in female students were better than those in male students. Those who brushed their teeth twice or more times per day accounted for 67.1% , the condition of periodic oral health examination was poor, and the conditions did not improve significantly among students in 2008. Conclusion The oral health status of freshmen is still far from being satisfactory. So propaganda on oral health prevention for freshmen should be enhanced so as to improve their oral health conditions.%目的 了解安徽医科大学新生口腔卫生状况和口腔健康知识、态度及行为,为制订口腔保健治疗方案及口腔健康教育计划提供科学依据.方法 分别在2004,2008年选取某医科大学2557名和2723名新生进行口腔保健知识、态度和行为问卷调查.结果 医学院校大学新生的口腔保健意识欠缺,女生口腔卫生保健意识和行为优于男生;67.1%的学生每天早晚刷牙,但定期进行口腔检查行为不容乐观.与2004年相比,2008年大学新生口腔卫生知识和行为没有明显提高.结论 大学新生口腔健康状况不佳.应加强对大学生口腔疾病“早预防、早发现、早治疗”的宣传,提高大学生口腔健康水平.

  12. Oral biopsy: Oral pathologist′s perspective

    Directory of Open Access Journals (Sweden)

    K L Kumaraswamy

    2012-01-01

    Full Text Available Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

  13. Oral myiasis

    OpenAIRE

    Thalaimalai Saravanan; Mathan A Mohan; Meera Thinakaran; Saneem Ahammed

    2015-01-01

    Myiasis is a pathologic condition in humans occurring because of parasitic infestation. Parasites causing myiasis belong to the order Diptera. Oral myiasis is seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficit. In such cases, neglected oral hygiene and halitosis attracts the flies to lay eggs in oral wounds resulting in oral myiasis. We present a case of oral myiasis in 40-year-old male patient with mental disability ...

  14. Hypotriglyceridemic and hypoglycemic effects of vescalagin from Pink wax apple [Syzygium samarangense (Blume) Merrill and Perry cv. Pink] in high-fructose diet-induced diabetic rats.

    Science.gov (United States)

    Shen, Szu-Chuan; Chang, Wen-Chang

    2013-01-15

    Vescalagin, an active component from Pink wax apple [Syzygium samarangense (Blume) Merrill and Perry cv. Pink] fruit, with glucose uptake enhancing ability in insulin-resistant FL83B mouse hepatocytes, as shown in our previous study, was further evaluated for its hypotriglyceridemic and hypoglycemic effects in high-fructose diet (HFD)-induced diabetic rats. Wistar rats were fed HFD for 16 weeks and orally administered with vescalagin from Pink wax apple daily during the last 4 weeks. The results of biochemical parameters showed that fasting blood glucose, C-peptide, fructosamine, triglyceride and free fatty acid contents decreased by 44.7%, 46.2%, 4.0%, 42.5%, and 10.8%, respectively, in the HFD-induced diabetic rats administered with vescalagin at 30 mg/kg body weight in comparison with those of control HFD-induced diabetic rats. However, high-density-lipoprotein-cholesterol content increased by 14.4% in the HFD rats treated with vescalagin. The present study reveals that vescalagin could have therapeutic value against diabetic progression via its anti-hypertriglyceridemic and anti-hyperglycemic effects.

  15. Clinical approach in the management of oral chronic graft-versus-host disease (cGVHD) in a series of specialized medical centers

    DEFF Research Database (Denmark)

    Elad, Sharon; Jensen, Siri Beier; Raber-Durlacher, Judith E;

    2015-01-01

    approaches used in the diagnosis and treatment of cGVHD in a group of health-care providers specialized in the oral care of oncology patients. The secondary objective was to assess the level of implementation of the National Institutes of Health (NIH) guidelines for cGVHD patients. METHODS: One hundred...... twenty questionnaires were sent to the members of the Oral Care Study Group (OCSG) of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The questionnaire included 50 questions about the responder's demographics, level of exposure to c......BACKGROUND: The oral cavity is frequently affected in chronic graft-versus-host disease (cGVHD), with variable clinical presentations. The literature on the effective management of patients suffering from oral cGVHD is limited. OBJECTIVE: The objective of this study was to assess the clinical...

  16. Fear of driving license withdrawal in patients with insulin-treated diabetes mellitus negatively influences their decision to report severe hypoglycemic events to physicians

    Science.gov (United States)

    Brož, Jan; Brabec, Marek; Janíčková Žďárská, Denisa; Fedáková, Zuzana; Hoskovcová, Lucie; You, Jee Young; Doničová, Viera; Hlaďo, Petr; Rahelić, Dario; Kvapil, Milan; Polák, Jan

    2015-01-01

    Background Under current European Union legislation, two severe hypoglycemic events within 12 months is grounds for driving license withdrawal. The aim of the study reported here was to determine whether fear of such a withdrawal could lead to patients concealing severe hypoglycemia from physicians, which could negatively impact further treatment decisions. Methods A total of 663 patients with insulin-treated diabetes were anonymously surveyed about whether they would conceal severe hypoglycemic events from their physicians, if revealing them could result in driving license withdrawal. This investigation utilized an adapted and expanded questionnaire by Graveling et al. Results Of all diabetic patients surveyed, 26.17% would most likely not report hypoglycemia, and 25.86% were undecided. In a group of patients with type 1 diabetes, 31.83% would likely not report hypoglycemic events, and 25.06% were undecided. The patients least likely to report severe hypoglycemic events were those who indicated that vehicles were partly essential for work, and who also had more than two hypoglycemic events monthly. Conclusion A considerable percentage of diabetic patients would likely conceal severe hypoglycemic events from their physicians due to fear of driving license withdrawal. Patient failure to report severe hypoglycemic events can potentially lead to physicians being misinformed regarding the patient’s condition, which could lead to inadequate monitoring and treatment. PMID:26491264

  17. Documentation of hypoglycemic and wound healing plants in Kodiyampalayam coastal village (southeast coast of India

    Directory of Open Access Journals (Sweden)

    Satyavani Kaliamurthi

    2014-08-01

    Full Text Available Objective: To document the hypoglycemic and wound healing plant species especially halophytes and associates were carried out in the coastal village of Kodiyampalayam (Southeast coast of India. Methods: The data were collected during the month of December 2011 to November 2012 with personal interviews and group discussion of local coastal fisher women community and traditional practitioner. Results: The results indicated the traditional knowledge of 33 medicinal plant species, photographs, vernacular name, habit, active part and their mode of action. Among these, Citrullus colocynthis, Coccinia grandis, Rhizophora apiculata, Rhizophora mucronata, Bruguiera cylindrica, Excoecaria agallocha and Andrographis paniculata were discovered in huge number. Conclusions: This study concludes medicinal uses of halophytes and associates in the coastal area. It will be needed scientific validation for development of novel therapeutic agents.

  18. Documentation of hypoglycemic and wound healing plants in Kodiyampalayam coastal village (southeast coast of India)

    Institute of Scientific and Technical Information of China (English)

    Satyavani Kaliamurthi; Gurudeeban Selvaraj; Ramanathan Thirugnanasambandam

    2014-01-01

    Objective: To document the hypoglycemic and wound healing plant species especially halophytes and associates were carried out in the coastal village of Kodiyampalayam (Southeast coast of India). Methods: The data were collected during the month of December 2011 to November 2012 with personal interviews and group discussion of local coastal fisher women community and traditional practitioner. Results: The results indicated the traditional knowledge of 33 medicinal plant species, photographs, vernacular name, habit, active part and their mode of action. Among these, Citrullus colocynthis, Coccinia grandis, Rhizophora apiculata, Rhizophora mucronata, Bruguiera cylindrica, Excoecaria agallocha and Andrographis paniculata were discovered in huge number. Conclusions: This study concludes medicinal uses of halophytes and associates in the coastal area. It will be needed scientific validation for development of novel therapeutic agents.

  19. Partial blockade of nicotinic acetylcholine receptors improves the counterregulatory response to hypoglycemia in recurrently hypoglycemic rats.

    Science.gov (United States)

    LaGamma, Edmund F; Kirtok, Necla; Chan, Owen; Nankova, Bistra B

    2014-10-01

    Recurrent exposure to hypoglycemia can impair the normal counterregulatory hormonal responses that guard against hypoglycemia, leading to hypoglycemia unawareness. This pathological condition known as hypoglycemia-associated autonomic failure (HAAF) is the main adverse consequence that prevents individuals with type 1 diabetes mellitus from attaining the long-term health benefits of tight glycemic control. The underlying molecular mechanisms responsible for the progressive loss of the epinephrine response to subsequent bouts of hypoglycemia, a hallmark sign of HAAF, are largely unknown. Normally, hypoglycemia triggers both the release and biosynthesis of epinephrine through activation of nicotinic acetylcholine receptors (nAChR) on the adrenal glands. We hypothesize that excessive cholinergic stimulation may contribute to impaired counterregulation. Here, we tested whether administration of the nAChR partial agonist cytisine to reduce postganglionic synaptic activity can preserve the counterregulatory hormone responses in an animal model of HAAF. Compared with nicotine, cytisine has limited efficacy to activate nAChRs and stimulate epinephrine release and synthesis. We evaluated adrenal catecholamine production and secretion in nondiabetic rats subjected to two daily episodes of hypoglycemia for 3 days, followed by a hyperinsulinemic hypoglycemic clamp on day 4. Recurrent hypoglycemia decreased epinephrine responses, and this was associated with suppressed TH mRNA induction (a measure of adrenal catecholamine synthetic capacity). Treatment with cytisine improved glucagon responses as well as epinephrine release and production in recurrently hypoglycemic animals. These data suggest that pharmacological manipulation of ganglionic nAChRs may be promising as a translational adjunctive therapy to avoid HAAF in type 1 diabetes mellitus.

  20. Prolonged hypoglycemic effect in diabetic dogs due to subcutaneous administration of insulin in liposomes

    Energy Technology Data Exchange (ETDEWEB)

    Stevenson, R.W.; Patel, H.M.; Parsons, J.A.; Ryman, B.E.

    1982-06-01

    The biologic action of insulin entrapped in liposomes (phospholipid vesicles) has been investigated following subcutaneous injection to dogs made diabetic with a combination of alloxan and streptozotocin. The fate of the liposomally entrapped material was determined by injecting rats subcutaneously with either /sup 125/I-insulin or the labeled polysaccharide /sup 14/C-inulin, incorporated in liposomes labeled with /sup 3/H-cholesterol. Injection of liposome insulin (0.75 U/kg) to five diabetic dogs resulted in a mean (+/- SEM) blood glucose fall from 16.4 +/- 0.8 to 2.9 +/- 0.4 mmol/L. The glucose level had still not returned to baseline after 24 h and, correspondingly, immunoreactive insulin (IRI) could still be detected in frozen and thawed plasma 24 h after injection. In contrast, the hypoglycemic effect of the same dose of free insulin with or without empty liposomes virtually ended within 8 h and IRI levels returned to baseline by 3 h after injection. In experiments on rats with liposomally entrapped /sup 125/I-insulin or /sup 14/C-inulin the proportion of the injected dose of tracer recoverable by excision of the injection site remained constant after about 1 h and 70% of the dose was still fixed in subcutaneous tissue for at least 5 h thereafter. When the plasma collected 3 h after subcutaneous injection of labeled liposomes containing /sup 125/I-insulin was passed through a column of Sepharose 6B, 50-75% of the /sup 125/I-activity was found in the fractions associated with intact liposomes. One possibility for the persistence of the hypoglycemic effect and of measurable IRI following injection of liposome insulin could be the presence of intact liposomes in the circulation for many hours after adsorption had ceased.

  1. Chronic effects of methylmercury on the urinary excretion of catecholamines and their responses to hypoglycemic stress

    Energy Technology Data Exchange (ETDEWEB)

    Kabuto, M. (Japan National Inst. of Environmental Studies (NIES), Tsukuba, Ibaraki (Japan). Dept. of Environmental Health)

    1991-02-01

    Five male Wistar rats were treated with methylmecury chloride (MMC) and compared with five agematched control rats. A dose of 10 mg/kg was given three times. The chronic effects of the MMC administration on the urinary output of catecholamines (norepinephrine (NE), epinephrine (E) and dopamine (DA)) were measured for 50 days. On the 69th day after MMC administration, the rats were examined for insulin-induced hypoglycemic stress. On the 90th day, the animals were decapitated and various organs were weighted and serum thyroid hormones (thyroid stimulating hormone (TSH) and total and free thyroxine (T4)) were measured. Decreases in DA excretion and DA response to stress were observed in the MMC-treated group. Inflammation of the kidney was also found, suggesting MMC-induced damage to the renal tubular region, the apparent site of renal DA synthesis. The MMC group and the control group showed differential NE and E response patterns. The lowered baseline excretion of NE appeared to continue even 70 days after MMC administration, while the difference in E excretion between the two groups disappeared 1 month after MMC administration. Both NE and E showed normal responsiveness to hypoglycemic stress induced by insulin. All serum TSH and total and free T4 baseline levels showed slight increases, and the thyroid gland weights in the MMC group were slightly heavier. These findings suggest a rather hyperthyroid state after the initial acute phase suppression, as suggested by the previous examinations. Thus, these findings suggest long-lasting effects of methylmercury administration, especially on renal DA synthesis. Baseline urinary excretion of NE and thyroid function could also be affected for a long time. (orig.).

  2. Clinical Study on Hydrochloride Ambroxol Oral Medication Treatment of Bronchitis%盐酸氨溴索口服液治疗支气管炎的临床探析

    Institute of Scientific and Technical Information of China (English)

    巩哜萍

    2015-01-01

    Objective Clinical effect of hydrochloride ambroxol oral medication treatment of bronchitis is to be investigated. Methods Choose 108 bronchitis patients who are treated in hospital from October 2013 to June 2014 and separate them into control group and study group according to random number table; patients in control group are given bromhexine medication treatment,while patients in study group are given hydrochloride ambroxol oral medication treatment and then compare treatment effects between two groups. Results Treatment effect in study group is much more favorable than that in control group; there is a treatment differential between two groups,and such a differential has statistic value(P<0.05). Conclusion Hydrochloride ambroxol oral medication is of efficacy in treatment of bronchitis; such a treatment approach is quite worthwhile to be promoted and applied clinical y.%目的:对盐酸氨溴索口服液治疗支气管炎的临床效果进行探究。方法选取于2013年10月~2014年6月收治的108例支气管炎患者,采用随机数字表法分为对照组和观察组,对照组患者给予溴己新治疗,观察组患者给予盐酸氨溴索口服液治疗,对两组患者治疗效果进行对比分析。结果观察组的治疗效果明显优于对照组,差异有统计学意义(P<0.05)。结论使用盐酸氨溴索口服液治疗支气管炎效果较为显著,值得在临床实践中推广使用。

  3. Does the presence of a pharmacist in primary care clinics improve diabetes medication adherence?

    Directory of Open Access Journals (Sweden)

    Kocarnik Beverly Mielke

    2012-11-01

    Full Text Available Abstract Background Although oral hypoglycemic agents (OHAs are an essential element of therapy for the management of type 2 diabetes, OHA adherence is often suboptimal. Pharmacists are increasingly being integrated into primary care as part of the move towards a patient-centered medical home and may have a positive influence on medication use. We examined whether the presence of pharmacists in primary care clinics was associated with higher OHA adherence. Methods This retrospective cohort study analyzed 280,603 diabetes patients in 196 primary care clinics within the Veterans Affairs healthcare system. Pharmacists presence, number of pharmacist full-time equivalents (FTEs, and the degree to which pharmacy services are perceived as a bottleneck in each clinic were obtained from the 2007 VA Clinical Practice Organizational Survey—Primary Care Director Module. Patient-level adherence to OHAs using medication possession ratios (MPRs were constructed using refill data from administrative pharmacy databases after adjusting for patient characteristics. Clinic-level OHA adherence was measured as the proportion of patients with MPR >= 80%. We analyzed associations between pharmacy measures and clinic-level adherence using linear regression. Results We found no significant association between pharmacist presence and clinic-level OHA adherence. However, adherence was lower in clinics where pharmacy services were perceived as a bottleneck. Conclusions Pharmacist presence, regardless of the amount of FTE, was not associated with OHA medication adherence in primary care clinics. The exact role of pharmacists in clinics needs closer examination in order to determine how to most effectively use these resources to improve patient-centered outcomes including medication adherence.

  4. Pharmacokinetics of 2',3'-dideoxyinosine in patients with severe human immunodeficiency infection. II. The effects of different oral formulations and the presence of other medications.

    Science.gov (United States)

    Hartman, N R; Yarchoan, R; Pluda, J M; Thomas, R V; Wyvill, K M; Flora, K P; Broder, S; Johns, D G

    1991-09-01

    2',3'-Dideoxyinosine (ddI) has shown activity against human immunodeficiency virus in phase I clinical trials. The drug is rapidly degraded by acid, however, thus raising questions as to the efficiency and reproducibility of its absorption after oral administration. This investigation studies the bioavailability of several oral dosage forms of ddI. When ddI was given to fasting patients as an oral solution with antacid, the bioavailability was 41% +/- 7% (mean +/- SEM). However, when given as buffered tablets, the bioavailability was considerably less (25% +/- 5%). The bioavailability increased slightly when the tablets were given with supplemental antacid (36% +/- 6%). Two enteric-coated preparations had reasonable bioavailability (36% +/- 5% and 26% +/- 5%), but the peak plasma level was much lower and occurred at a much later time than with the oral solution. When ddI was given as a premeasured powder containing sucrose and buffer to be reconstituted by the patient (the "sachet" preparation), the bioavailability was 29% +/- 6%. This was similar to that of the oral solution for this particular group of patients (30% +/- 7%). However, the bioavailability of the sachet was only 17% +/- 4% when administered with food. When the sachet was given to patients receiving ranitidine, no consistent change in bioavailability was noted. Also, no change in ddI pharmacokinetics was noted in patients receiving ganciclovir.

  5. Oral myiasis

    Directory of Open Access Journals (Sweden)

    Thalaimalai Saravanan

    2015-01-01

    Full Text Available Myiasis is a pathologic condition in humans occurring because of parasitic infestation. Parasites causing myiasis belong to the order Diptera. Oral myiasis is seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficit. In such cases, neglected oral hygiene and halitosis attracts the flies to lay eggs in oral wounds resulting in oral myiasis. We present a case of oral myiasis in 40-year-old male patient with mental disability and history of epilepsy.

  6. Does switching from oral extended-release methylphenidate to the methylphenidate transdermal system affect health-related quality-of-life and medication satisfaction for children with attention-deficit/hyperactivity disorder?

    Directory of Open Access Journals (Sweden)

    Landgraf Jeanne M

    2009-12-01

    Full Text Available Abstract Background To evaluate health-related quality of life (HRQL and medication satisfaction after switching from a stable dose of oral extended-release methylphenidate (ER-MPH to methylphenidate transdermal system (MTS via a dose-transition schedule in children with attention-deficit/hyperactivity disorder (ADHD. Methods In a 4-week, multisite, open-label study, 171 children (164 in the intent-to-treat [ITT] population aged 6-12 years diagnosed with ADHD abruptly switched from a stable dose of oral ER-MPH to MTS nominal dosages of 10, 15, 20, and 30 mg using a predefined dose-transition schedule. Subjects remained on the scheduled dose for the first week, after which the dose was then titrated to an optimal effect. The ADHD Impact Module-Children (AIM-C, a disease-specific validated HRQL survey instrument measuring child and family impact, was used to assess the impact of ADHD symptoms on the lives of children and their families at baseline and study endpoint. Satisfaction with MTS use was assessed via a Medication Satisfaction Survey (MSS at study endpoint. Both the AIM-C and MSS were completed by a caregiver (parent/legally authorized representative. Tolerability was monitored by spontaneous adverse event (AE reporting. Results AIM-C child and family HRQL mean scores were above the median possible score at baseline and were further improved at endpoint across all MTS doses. Similar improvements were noted for behavior, missed doses, worry, and economic impact AIM-C item scores. Overall, 93.8% of caregivers indicated a high level of satisfaction with their child's use of the study medication. The majority of treatment-emergent AEs (> 98% were mild to moderate in intensity, and the most commonly reported AEs included headache, decreased appetite, insomnia, and abdominal pain. Seven subjects discontinued the study due to intolerable AEs (n = 3 and application site reactions (n = 4. Conclusion This study demonstrates that MTS, when carefully

  7. Determinants for inadequate glycaemic control in Chinese patients with mild-to-moderate type 2 diabetes on oral antidiabetic drugs alone

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shao-ling; CHEN Zong-cun; YAN Li; CHEN Li-hong; CHENG Hua; JI Li-nong

    2011-01-01

    Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus (T2DM)remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs (OAD) alone and to determine factors associated with inadequate giycaemic control in this population.Methods An observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers.People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were ≥30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin A1c (HbA1c) ≥6.5% detected on the index visit.Results In this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean (SD) HbA1c was 6.7% (1.3). Multivariate Logistic regression showed that physical inactivity, disease duration >10 years, body mass index (BMI) ≥24 kg/m2, low homeostasis model assessment of β-cell function (HOMA-β) index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience (47.1% vs. 34.8%, P=0.008) and more fear of hypoglycemia quantified by Worry subscaie of the Hypoglycaemia Fear Survey (HFS) Ⅱ were happened in subjects with good glycemic control.Conclusion Approximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and

  8. [Hypoglycemic action of different doses of nopal (Opuntia streptacantha Lemaire) in patients with type II diabetes mellitus].

    Science.gov (United States)

    Frati-Munari, A C; Del Valle-Martínez, L M; Ariza-Andraca, C R; Islas-Andrade, S; Chávez-Negrete, A

    1989-01-01

    To assess the relationship between the doses of O. streptacantha Lem. and its acute hypoglycemic action in diabetics, eight patients with type II diabetes mellitus were studied. Four test were performed to each patient with the intake of: (a) 400 ml of water, (b) 100 g (c) 300 g and (d) 500 g of broiled stems of O. streptacantha Lem. Serum glucose was measured at 0, 60, 120 and 180 minutes. Maximal decrease of serum glucose was noticed at 180 minutes, with a mean of 2.3, 10, 30.1 and 46.7 mg/dl less than basal value with 0, 100, 300 and 500 g respectively (P = NS, less than 0.05, less than 0.001 and less than 0.001 respectively). A significant direct correlation (r = 0.690, P less than 0.001) was noticed between the doses and the hypoglycemic effect.

  9. Hypoglycemic activity of Lagerstroemia speciosa L. extract on streptozotocin-induced diabetic rat: Underlying mechanism of action

    Directory of Open Access Journals (Sweden)

    Barun Kanti Saha, Md. Nurul Huda Bhuiyan, Kishor Mazumder and K.M. Formuzul Haque

    2009-12-01

    Full Text Available The hypoglycemic effect of Lagerstroemia speciosa L. leaves hot water extract on chemically induced diabetes in rat was investigated. Experimental result showed that, streptozotocin significantly (p<0.001 elevated the normal blood sugar level whereas treatment with hot water extract depressed the streptozotocin-induced high blood sugar level about 43.20% as compare to diabetic controls. Treatment with hot water extract increased the activity of shunt enzyme glucose–6-phosphate dehydrogenase (33.81% and glutathione level (31.25% and depression of the activity of hepatic gluconeogenic enzymes glucose-6-phasphatase (31.63% and fructose–1,6-bisphosphatase (27.40%. These studies thus strongly suggest that the hot water extract of L. speciosa leave attributed its prominent hypoglycemic activity on experimental diabetic rats through suppression of gluconeogenesis and stimulation of glucose oxidation using the pentose phosphate pathway.

  10. Oral Thrush

    Science.gov (United States)

    ... feeding mothers In addition to the distinctive white mouth lesions, infants may have trouble feeding or be fussy ... candidiasis (yeast infection) patient information. American Academy of Oral & Maxillofacial Pathology. http://www.aaomp.org/public/oral-candidiasis.php. ...

  11. The Efficacy and Safety of Chinese Herbal Medicine Jinlida as Add-On Medication in Type 2 Diabetes Patients Ineffectively Managed by Metformin Monotherapy: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial.

    Science.gov (United States)

    Lian, Fengmei; Tian, Jiaxing; Chen, Xinyan; Li, Zhibin; Piao, Chunli; Guo, Junjie; Ma, Licheng; Zhao, Lijuan; Xia, Chengdong; Wang, Chong-Zhi; Yuan, Chun-Su; Tong, Xiaolin

    2015-01-01

    Metformin plays an important role in diabetes treatment. Studies have shown that the combined use of oral hypoglycemic medications is more effective than metformin monotherapy. In this double-blind, randomized, placebo-controlled, multicenter trial, we evaluated whether Jinlida, a Chinese herbal medicine, enhances the glycemic control of metformin in type 2 diabetes patients whose HbA1c was ineffectively controlled with metformin alone. A total of 186 diabetes patients were enrolled in this double-Blind, randomized, placebo-controlled, multicenter trial. Subjects were randomly allocated to receive either Jinlida (9 g) or the placebo TID for 12 consecutive weeks. All subjects in both groups also continuously received their metformin without any dose change. During this 12-week period, the HbA1c, FPG, 2 h PG, body weight, BMI were assessed. HOMA insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were also evaluated. At week 12, compared to the HbA1c level from week 0, the level of the Jinlida group was reduced by 0.92 ± 1.09% and that of the placebo group was reduced by 0.53 ± 0.94%. The 95% CI was 0.69-1.14 for the Jinlida group vs. 0.34-0.72 for the placebo group. There was a very significant HbA1c reduction between the two groups after 12 weeks (p changes. No serious adverse events were reported. Jinlida significantly enhanced the hypoglycemic action of metformin when the drug was used alone. This Chinese herbal medicine may have a clinical value as an add-on medication to metformin monotherapy. Chinese Clinical Trial Register ChiCTR-TRC-13003159.

  12. Oral Dysfunction

    OpenAIRE

    鈴木, 規子; スズキ, ノリコ; Noriko, SUZUKI

    2004-01-01

    The major oral functions can be categorized as mastication, swallowing, speech and respiratory functions. Dysfunction of these results in dysphagia, speech disorders and abnormal respiration (such as Sleep Apnea). These functions relate to dentistry in the occurrence of : (1) oral preparatory and oral phases, (2) articulation disorders and velopharyngeal incompetence (VPI), and (3) mouth breathing, respiratory and blowing disorders. These disorders are related to oral and maxillofacial diseas...

  13. Hypoglycemic neuronal death and cognitive impairment are prevented by poly(ADP-ribose) polymerase inhibitors administered after hypoglycemia.

    Science.gov (United States)

    Suh, Sang Won; Aoyama, Koji; Chen, Yongmei; Garnier, Philippe; Matsumori, Yasuhiko; Gum, Elizabeth; Liu, Jialing; Swanson, Raymond A

    2003-11-19

    Severe hypoglycemia causes neuronal death and cognitive impairment. Evidence suggests that hypoglycemic neuronal death involves excitotoxicity and DNA damage. Poly(ADP-ribose) polymerase-1 (PARP-1) normally functions in DNA repair, but promotes cell death when extensively activated by DNA damage. Cortical neuron cultures were subjected to glucose deprivation to assess the role of PARP-1 in hypoglycemic neuronal death. PARP-1-/- neurons and wild-type, PARP-1+/+ neurons treated with the PARP inhibitor 3,4-dihydro-5-[4-(1-piperidinyl)butoxy]-1(2H)-isoquinolinone both showed increased resistance to glucose deprivation. A rat model of insulin-induced hypoglycemia was used to assess the therapeutic potential of PARP inhibitors after hypoglycemia. Rats subjected to severe hypoglycemia (30 min EEG isoelectricity) accumulated both nitrotyrosine and the PARP-1 product, poly(ADP-ribose), in vulnerable neurons. Treatment with PARP inhibitors immediately after hypoglycemia blocked production of poly(ADP-ribose) and reduced neuronal death by >80% in most brain regions examined. Increased neuronal survival was also achieved when PARP inhibitors were administered up to 2 hr after blood glucose correction. Behavioral and histological assessments performed 6 weeks after hypoglycemia confirmed a sustained salutary effect of PARP inhibition. These results suggest that PARP-1 activation is a major factor mediating hypoglycemic neuronal death and that PARP-1 inhibitors can rescue neurons that would otherwise die after severe hypoglycemia.

  14. Effervescent Granules Prepared Using Eucommia ulmoides Oliv. and Moso Bamboo Leaves: Hypoglycemic Activity in HepG2 Cells

    Directory of Open Access Journals (Sweden)

    Xiang-Zhou Li

    2016-01-01

    Full Text Available Eucommia ulmoides Oliv. (E. ulmoides Oliv. and moso bamboo (Phyllostachys pubescens leaves are used as folk medicines in central-western China to treat diabetes. To investigate the hypoglycemic activity of the effervescent granules prepared using E. ulmoides Oliv. and moso bamboo leaves (EBEG in HepG2 cells, EBEG were prepared with 5% of each of polysaccharides and chlorogenic acids from moso bamboo and E. ulmoides Oliv. leaves, respectively. HepG2 cells cultured in a high-glucose medium were classified into different groups. The results displayed EBEG-treated cells showed better glucose utilization than the negative controls; thus, the hypoglycemic effect of EBEG was much greater than that of granules prepared using either component alone, thereby indicating that this effect was due to a synergistic action of the components. Further, glucose consumption levels in the cells treated with EBEG (156.35% at 200 μg/mL and the positive controls (metformin, 162.29%; insulin, 161.52% were similar. Thus, EBEG exhibited good potential for use as a natural antidiabetic agent. The hypoglycemic effect of EBEG could be due to the synergistic action of polysaccharides from the moso bamboo leaves and chlorogenic acids from E. ulmoides Oliv. leaves via the inhibition of alpha-glucosidase and glucose-6-phosphate displacement enzyme.

  15. Hypoglycemic effect of Bromelia plumieri (E. Morren L.B. Sm., leaves in STZ-NA-induced diabetic rats.

    Directory of Open Access Journals (Sweden)

    Adolfo eAndrade-Cetto

    2013-04-01

    Full Text Available This study confirms the hypoglycemic effects of two extracts obtained from the Bromelia plumieri (BP plant in streptozotocin-nicotinamide induced diabetic rats (STZ-NA. BP has been traditionally used in the municipality of Hidalgo, Mexico, to treat type 2 diabetes (T2D. Two different BP extracts were prepared and tested. The first extract was a water extract (WE, similar to that traditionally used to make tea, and the second extract was an ethanol:water extract (EWE. The extracts (WE at 35 and 350 mg/kg, and EWE at 30 and 300 mg/kg were tested in STZ-NA induced diabetic rats to determine whether hypoglycemia occurred after administration of the extracts. Phytochemistry: Two different extracts were prepared, n-hexane and butanol, to determine the presence of alkaloids, terpenes and flavonoids.The extracts that were administered to the STZ-NA induced diabetic rats produced a significant hypoglycemic effect as compared with the control group, similar to that achieved with glibenclamide. We also determined that flavonoids were the main components of BP leaves.The results presented here support the hypothesis that extracts obtained from this plant have hypoglycemic effects, which are in agreement with the traditional uses of this plant.

  16. 江西贫困地区口腔健康行为及医疗状况调查%Survey of oral health behavior and medical status in the poverty-stricken areas in Jiangxi province

    Institute of Scientific and Technical Information of China (English)

    王迪侃; 曲靖; 朱嘉; 欧晓艳

    2015-01-01

    Objective To investigate the oral health behavior and medical status in the poverty-stricken areas in Jiangxi province,and to make suggestions for keeping oral health in the country,township,and village. Methods 198 residents were ran-domly investigated by questionnaire and examined by the free clinic in Ganfang town Jiangxi Province. Results Only less than half of the surveyed brush teeth both in the morning and in the evening every day,27.33% brush teeth with lasting 3-5 minutes,and less than 10% residents could take oral health examination on time. Conclusion Residents are lacking of oral health knowl-edge and the awareness of dental clinical treatment,and the oral medical is in bad condition in poverty-stricken areas in Jiangxi province.%目的:调查江西省贫困地区居民口腔健康行为及口腔卫生医疗状况,为贫困地区居民口腔健康维护提出指导。方法随机发放调查问卷、现场义诊检查的方式,对甘坊镇198名居民进行调查,了解其口腔健康行为及该地区医疗现状。结果仅45.67%的居民每天至少早晚各刷一次牙,27.33%的居民每次刷牙持续3-5min,不足10%的居民能定期进行口腔检查。结论江西省贫困地区居民口腔健康知识了解不足,就诊意识较差,县乡村口腔医疗状况不容乐观。

  17. Edible Flowers: A Rich Source of Phytochemicals with Antioxidant and Hypoglycemic Properties.

    Science.gov (United States)

    Loizzo, Monica Rosa; Pugliese, Alessandro; Bonesi, Marco; Tenuta, Maria Concetta; Menichini, Francesco; Xiao, Jianbo; Tundis, Rosa

    2016-03-30

    Edible flowers are receiving renewed interest as rich sources of bioactive compounds. Ethanol extracts of eight edible flowers were phytochemically characterized and investigated for their bioactivity. Rutin, quercetin, luteolin, kaempferol, and myricetin were selected as standards and quantified by HPLC. The fatty acid profile was analyzed by GC and GC-MS. Antioxidant properties were evaluated by using different in vitro tests. The hypoglycemic effects were investigated via the inhibition of α-amylase and α-glucosidase. Sambucus nigra exhibited the highest radical-scavenging activity (IC50 of 1.4 μg/mL), followed by Hedysarum coronarium (IC50 of 1.6 μg/mL). Both species contained high quercetin and rutin contents. S. nigra extract exerted the highest activity in preventing lipid oxidation. Malva sylvestris extract inhibited both α-amylase and α-glucosidase with IC50 values of 7.8 and 11.3 μg/mL, respectively. These findings support the consumption of edible flowers as functional foods and their use as sources of natural antioxidants by the food industry.

  18. Unraveling the active hypoglycemic agent trigonelline in Balanites aegyptiaca date fruit using metabolite fingerprinting by NMR.

    Science.gov (United States)

    Farag, Mohamed A; Porzel, Andrea; Wessjohann, Ludger A

    2015-11-10

    Trigonelline (3-carboxy-1-methyl pyridinium) was identified as a relevant bioactivity and taste imparting component in Balanites aegyptiaca fruit, using (1)H NMR of crude extracts without any fractionation or isolation step. The structural integrity of trigonelline was established within the extract matrix via(1)H NMR, (1)H-(1)H COSY, HMQC and HMBC and by comparison with authentic standard. A quantitative (1)H NMR method (qHNMR) was used to determine trigonelline concentrations in the peel and pulp of B. aegyptiaca fruit of 8 and 13mgg(-1), respectively. Trigonelline so far has not been reported from B. aegyptiaca or its genus as it easily escapes LC-MS based detection. Its discovery provides novel insight into the balanite fruits antidiabetic properties as the compound is known for a pronounced hypoglycemic effect. In addition, it is likely to impart the perceptible bitter taste portion to balanites sweet bitter taste. UPLC-MS of the crude extract additionally revealed the fruit flavonoid pattern showing quercetin/isorhamnetin flavonol conjugates in addition to epicatechin, the latter being present at much lower levels.

  19. Dual-action hypoglycemic and hypocholesterolemic agents that inhibit glycogen phosphorylase and lanosterol demethylase.

    Science.gov (United States)

    Harwood, H James; Petras, Stephen F; Hoover, Dennis J; Mankowski, Dayna C; Soliman, Victor F; Sugarman, Eliot D; Hulin, Bernard; Kwon, Younggil; Gibbs, E Michael; Mayne, James T; Treadway, Judith L

    2005-03-01

    Diabetic dyslipidemia requires simultaneous treatment with hypoglycemic agents and lipid-modulating drugs. We recently described glycogen phosphorylase inhibitors that reduce glycogenolysis in cells and lower plasma glucose in ob/ob mice (J. Med. Chem., 41: 2934, 1998). In evaluating the series prototype, CP-320626, in dogs, up to 90% reduction in plasma cholesterol was noted after 2 week treatment. Cholesterol reductions were also noted in ob/ob mice and in rats. In HepG2 cells, CP-320626 acutely and dose-dependently inhibited cholesterolgenesis without affecting fatty acid synthesis. Inhibition occurred together with a dose-dependent increase in the cholesterol precursor, lanosterol, suggesting that cholesterolgenesis inhibition was due to lanosterol 14alpha-demethylase (CYP51) inhibition. In ob/ob mice, acute treatment with CP-320626 resulted in a decrease in hepatic cholesterolgenesis with concomitant lanosterol accumulation, further implicating CYP51 inhibition as the mechanism of cholesterol lowering in these animals. CP-320626 and analogs directly inhibited rhCYP51, and this inhibition was highly correlated with HepG2 cell cholesterolgenesis inhibition (R2 = 0.77). These observations indicate that CP-320626 inhibits cholesterolgenesis via direct inhibition of CYP51, and that this is the mechanism whereby CP-320626 lowers plasma cholesterol in experimental animals. Dual-action glycogenolysis and cholesterolgenesis inhibitors therefore have the potential to favorably affect both the hyperglycemia and the dyslipidemia of type 2 diabetes.

  20. Hypoglycemic and Hypolipidemic Effects of Aloe vera Extract Preparations: A Review.

    Science.gov (United States)

    Pothuraju, Ramesh; Sharma, Raj Kumar; Onteru, Suneel Kumar; Singh, Satvinder; Hussain, Shaik Abdul

    2016-02-01

    Obesity is considered to be an epidemic disease, and it is associated with several metabolic disorders. Pharmacological treatments currently available are not effective for prolonged treatment duration. So, people are looking toward new therapeutic approach such as herbal ingredients. Since ancient periods, different herbs have been used for remedy purposes such as anti-obesity, antidiabetes, and antiinflammatory. Among the several herbal ingredients, Aloe vera (Aloe barbadensis Miller) is widely used to curb the metabolic complications. Till date, reports are not available for the side effects of A. vera. Several researchers are used to different solvents such as aqueous solution, alcohol, ethanol, and chloroform for the A. vera extract preparations and studied their hypoglycemic and hypolipidemic effects in animal and human studies. Furthermore, little information was recorded with the active compounds extracted from the A. vera and their anti-obesity and antidiabetic effects in clinical studies. In this review, we made an attempt to compile all the available literature by using different search engines (PubMed, Scopus, and Google Scholar) on the A. vera extract preparations and the possible mechanism of action involved in carbohydrate and lipid metabolism.

  1. Postponing the Hypoglycemic Response to Partial Hepatectomy Delays Mouse Liver Regeneration.

    Science.gov (United States)

    Huang, Jiansheng; Schriefer, Andrew E; Cliften, Paul F; Dietzen, Dennis; Kulkarni, Sakil; Sing, Sucha; Monga, Satdarshan P S; Rudnick, David A

    2016-03-01

    All serious liver injuries alter metabolism and initiate hepatic regeneration. Recent studies using partial hepatectomy (PH) and other experimental models of liver regeneration implicate the metabolic response to hepatic insufficiency as an important source of signals that promote regeneration. Based on these considerations, the analyses reported here were undertaken to assess the impact of interrupting the hypoglycemic response to PH on liver regeneration in mice. A regimen of parenteral dextrose infusion that delays PH-induced hypoglycemia for 14 hours after surgery was identified, and the hepatic regenerative response to PH was compared between dextrose-treated and control mice. The results showed that regenerative recovery of the liver was postponed in dextrose-infused mice (versus vehicle control) by an interval of time comparable to the delay in onset of PH-induced hypoglycemia. The regulation of specific liver regeneration-promoting signals, including hepatic induction of cyclin D1 and S-phase kinase-associated protein 2 expression and suppression of peroxisome proliferator-activated receptor γ and p27 expression, was also disrupted by dextrose infusion. These data support the hypothesis that alterations in metabolism that occur in response to hepatic insufficiency promote liver regeneration, and they define specific pro- and antiregenerative molecular targets whose regenerative regulation is postponed when PH-induced hypoglycemia is delayed.

  2. 网络环境下PBL教学法在医学英语视听说教学中的应用%Application of PBL in Audio-visual-oral Medical English under Multimedia Environment

    Institute of Scientific and Technical Information of China (English)

    杨琳; 李广伟; 朱莉莉

    2014-01-01

    网络环境下将PBL教学法应用于医学英语视听说教学中,能够克服这门课程教学中存在的问题。在教学实践中,这种教学模式可以弥补医学英语视听说课程学时的不足、创设真实的学习情境、促进动态的形成性评估体系发展。培养出的医学人才不仅掌握扎实的英语语言基础,而且还具有较强的沟通能力和团队意识,能够真正满足社会需要。%Through the application of PBL in Audio-visual-oral medical English under Multimedia Environment, it was found that the existent problems in the Audio-visual-oral medical English teaching can be overcome. In teaching practice,the new teaching methods could make up the lack of class hours, create real learning situation and develop formative evaluation.So the students not only master English fundamental knowledge, but also have good communication capability and team spirit. They can meet the requirements of the society.

  3. Comparison Of Oral Premedication With Combination Of Midazolam With Ketamine Vs Midazolam Ketamine Alone In Children Children Medical Center (year 2000

    Directory of Open Access Journals (Sweden)

    Hasani M

    2002-09-01

    Full Text Available Anxiolysis and sedation with oral midazolam are common practice in pediatric anesthesia. Good or excellent results are seen in only 50% to 80% of cases, so we decided to investigate if addition of a low dose of oral ketamine to midazolam (ketamine2.5 mg /kg ^midazolam 0.25 mg/kg resulted in better premedication compared with oral midazolam 0.5 mg/kg or ketamine 6 mg/kg alone."nMethods and Materials: in a prospective, randomized ,double -blind study we study 105 children (mean age 6 ,range 2-10 yr. undergoing non thoracic and non cardiac surgery of more than 30 min duration. The patients were in ASA 1, 2. After oral premedication the child's condition was evaluated by assigning 1-4 point to the quality of anxiolysis, sedation, and separation from parents in the induction room .The groups were similar in sex, age, weight, intervention and duration of anaesthesia."nResults: The score of sedation before transfer to the operation room was significantly better in the ketamine, midazolam combination group than in the ketamine or midazolam group. Success rates for anxiolysis and behavior at separation were grater than 90%with the combination, approximately 80% with midazolam and 70% with ketamine alone .The incidence of salivation, excitation, nausea and vomiting was grater in the ketamine group but were very low in other groups. During recovery there were no difference in sedation or time of possible discharge."nConclusion: In summery, significantly better anxiolysis and separation were observed with a combination of ketamine and midazolam, even in awake children than with midazolam or ketamine alone. Duration of action and side effects of the combination was similar to those of midazolam.

  4. Oral histoplasmosis

    Directory of Open Access Journals (Sweden)

    Patil Karthikeya

    2009-01-01

    Full Text Available Histoplasmosis is a systemic fungal disease that takes various clinical forms, among which oral lesions are rare. The disseminated form of the disease that usually occurs in association with Human Immunodeficiency Virus (HIV is one of the AIDS-defining diseases. Isolated oral histoplasmosis, without systemic involvement, with underlying immunosuppression due to AIDS is very rare. We report one such case of isolated oral histoplasmosis in a HIV-infected patient.

  5. Rheum turkestanicum rhizomes possess anti-hypertriglyceridemic, but not hypoglycemic or hepatoprotective effect in experimental diabetes

    Directory of Open Access Journals (Sweden)

    Mousa-Al-Reza Hadjzadeh

    2017-01-01

    Full Text Available Objective: Rheum turkestanicum (R. turkestanicum rhizomes have been used in Iranain traditional medicine as an anti-diabetic agent. The purpose of the present investigation was to evaluate the anti-diabetic and antioxidant activities of R. turkestanicum rhizome extract in streptozotocin-induced diabetic rats.Materials and Methods: Diabetes was induced by a single intraperitoneal injection of 55 mg/kg streptozotocin in male Wistar rats. Diabetic rats received the decoction extract of R. turkestanicum rhizomes at the doses of 200, 400 and 600 mg/kg daily by gavage for 3 weeks. Serum glucose and lipid levels were measured in all groups before diabetes induction and at the end of week 3. Oxidative stress was evaluated in the liver by measurement of malondialdehyde levels and total thiol concentration at the end of the experiment.Results: A significant increase in serum glucose and triglyceride levels was observed in diabetic rats, which was accompanied by increased malondialdehyde levels and decreased total thiol concentration in the liver after 3 weeks. Treatment of diabetic rats with R. turkestanicum rhizome extract at the doses of 200, 400 and 600 mg/kg over a 3-week period did not change serum glucose, hepatic malondialdehyde and total thiol levels in diabetic rats. However, treatment with R. turkestanicum extract significantly decreased serum triglyceride levels in a dose-dependent manner at the end of the experiment.Conclusion: R. turkestanicum rhizome extract possess anti-hypertriglyceridemic, but not hypoglycemic or hepatoprotective effect in diabetic rats. Therefore, R. turkestanicum rhizome should be consumed with more caution by diabetic patients.

  6. Hypoglycemic Activity of Fumaria parviflora in Streptozotocin-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Arash Khaki

    2013-02-01

    Full Text Available Purpose: Fumaria parviflora Lam (Fumariaceae has been used in traditional medicine in the treatment of several diseases such as diabetes. The present work was designed to evaluate the hypoglycaemic effects of methanolic extract (ME of F. parviflora in normal and streptozotocin-induced diabetic rats. Methods: The rats used were allocated in six (I, II, III, IV, V and VI experimental groups (n=5. Group I rats served as ‘normal control’ animals received distilled water and group II rats served as ‘diabetic control’ animals. Diabetes mellitus was induced in groups II, V and VI rats by intraperitoneal single injection of streptozotocin (STZ, 55 mg kg-1. Group V and VI rats were addi-tionally treated with ME (150 mg kg-1 day-1 and 250 mg kg-1 day-1, i.p. respectively 24 hour post STZ injection, for seven consecutive days. Groups III and IV rats received only ME 150 mg kg-1 day-1 and 250 mg kg-1 day-1, i.p. respectively for seven days. The levels of blood glucose were determined using a Glucometer. Results: Administra-tion of F. parviflora extract showed a potent glucose lowering effect only on streptozo-tocin (STZ induced diabetic rats below 100 mg/dl (P<0.001. However, no significant differences in the blood glucose levels were recorded between diabetic rats received 125 or 250 mg/kg of plant extracts. Conclusion: The findings of the study indicated that F. parviflora has significant hypoglycemic effect on STZ-induced diabetic rats with no effects on blood glucose levels of normal rats.

  7. Hypoglycemic Effects of Achillea Wilhelmsii in Normal and Streptozotocin Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    H Sadeghi

    2009-04-01

    Full Text Available ABSTRACT Introduction & Objective: Diabetes mellitus is a syndrome, initially characterized by a loss of glucose homeostasis resulting from defects in Insulin secretion, insulin action both is resulting in impaired metabolism of glucose and other energy yielding fuels as lipids and protein. Several medicinal herbs have been described with hypoglycemic effects. These include: Allium Sativum, Trigonella Foenum, Marus nigra, Ocimum Sanctum, and Astragalus Ovinus. The main purpose of the present study was to determine the effect of Achillea Wilhelmsii C. Koch on blood glucose levels of diabetic rats induced by stereptozotocine (STZ. Materials & Methods: In this experimental research, forty-eight male Wistar rats were divided into two groups: non-diabetic (normal and STZ-induced diabetic mice. Each group was further divided into four groups: control (induced by normal saline and treatment received 100, 200.and 300 mg/kg aqueous- alcoholic extract of Achillea Wilhelmsii C. Koch daily for one month. The blood glucose level was measured and Data were analyzed by t-test and ANOVA. Results: At the end of first month, significant decrease was observed in blood glucose level in diabetic rats which received 100 mg/kg (p<0/001, 200mg/kg(p<0/01, 300mg/kg (p<0/001 of aqueous alcoholic extract of Achillea Wilhelmsii C. Koch in comparison with control groups. The extract had not have any significant effects on the blood glucose level of normal groups except in those which received 300mg/kg of the extract. Conclusion: The results of this study showed that aqueous- alcoholic extract of Achillea Wilhelmsii C. Koch have a significant effect on reducing the blood glucose level of diabetic rats.

  8. Inhibition of α-Amylases by Condensed and Hydrolysable Tannins: Focus on Kinetics and Hypoglycemic Actions

    Science.gov (United States)

    Kato, Camila Gabriel; Gonçalves, Geferson de Almeida; Peralta, Rosely Aparecida; Seixas, Flavio Augusto Vicente; de Sá-Nakanishi, Anacharis Babeto; Bracht, Lívia; Comar, Jurandir Fernando

    2017-01-01

    The aim of the present study was to compare the in vitro inhibitory effects on the salivary and pancreatic α-amylases and the in vivo hypoglycemic actions of the hydrolysable tannin from Chinese natural gall and the condensed tannin from Acacia mearnsii. The human salivary α-amylase was more strongly inhibited by the hydrolysable than by the condensed tannin, with the concentrations for 50% inhibition (IC50) being 47.0 and 285.4 μM, respectively. The inhibitory capacities of both tannins on the pancreatic α-amylase were also different, with IC50 values being 141.1 μM for the hydrolysable tannin and 248.1 μM for the condensed tannin. The kinetics of the inhibition presented complex patterns in that for both inhibitors more than one molecule can bind simultaneously to either the free enzyme of the substrate-complexed enzyme (parabolic mixed inhibition). Both tannins were able to inhibit the intestinal starch absorption. Inhibition by the hydrolysable tannin was concentration-dependent, with 53% inhibition at the dose of 58.8 μmol/kg and 88% inhibition at the dose of 294 μmol/kg. For the condensed tannin, inhibition was not substantially different for doses between 124.4 μmol/kg (49%) and 620 μmol/kg (57%). It can be concluded that both tannins, but especially the hydrolysable one, could be useful in controlling the postprandial glycemic levels in diabetes. PMID:28589038

  9. Hypoglycemic effect of Astragalus polysaccharide and its effect on PTP1B

    Institute of Scientific and Technical Information of China (English)

    Yong WU; Jing-ping OU-YANG; Ke WU; Ya WANG; Yun-feng ZHOU; Chong-yuan WEN

    2005-01-01

    Aim: To examine the effects ofAstragalus polysaccharide (APS), a component of an aqueous extract of Astragalus membranaceus roots, on protein tyrosine phosphatase 1B (PTP1B), a negative regulator of insulin-receptor (IR) signal transduction, and its potential role in the amelioration of insulin resistance.Methods: Ten-week-old fat-fed streptozotocin (STZ)-treated rats, an animal model of type Ⅱ diabetes mellitus (TIIDM), were treated with APS (400 mg/kg po) for 5 weeks. Insulin sensitivity was identified by the insulin-tolerance test. Further analyses on the possible changes in insulin signaling occurring in skeletal muscle and liver were performed by immunoprecipitation or Western blotting. PTP1B activity was measured by an assay kit. Results: The diabetic rats responded to APS with a significant decrease in body weight, plasma glucose, and improved insulin sensitivity. The activity and expression of PTP1B were elevated in the skeletal muscle and liver of TIIDM rats. Thus the insulin signaling in target tissues was diminished. APS reduced both PTP1B protein level and activity in the muscle,but not in the liver of TIIDM rats. Insulin-induced tyrosine phosphorylation of the IR β-subunit and insulin receptor substrate-1 (IRS-1) were increased in the muscle,but not in the liver of APS-treated TIIDM rats. There was no change in the activity or expression of PTP1B in APS-treated normal rats, and blood insulin levels did not change in TIIDM rats after treatment with APS. Conclusion: APS enables insulin-sensitizing and hypoglycemic activity at least in part by decreasing the elevated expression and activity of PTP1B in the skeletal muscles of TIIDM rats.

  10. A stewardship intervention program for safe medication management and use of antidiabetic drugs

    Directory of Open Access Journals (Sweden)

    Zhao RY

    2015-07-01

    Full Text Available Rui-yi Zhao,1 Xiao-wen He,1 Yan-min Shan,1 Ling-ling Zhu,2 Quan Zhou3 1Clinical Nurse Specialist Section, Division of Nursing, 2Geriatric VIP Care Ward, Division of Nursing, 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Diabetes patients are complex due to considerations of polypharmacy, multimorbidities, medication adherence, dietary habits, health literacy, socioeconomic status, and cultural factors. Meanwhile, insulin and oral hypoglycemic agents are high-alert medications. Therefore it is necessary to require a multidisciplinary team’s integrated endeavors to enhance safe medication management and use of antidiabetic drugs.Methods: A 5-year stewardship intervention program, including organizational measures and quality improvement activities in storage, prescription, dispensing, administration, and monitoring, was performed in the Second Affiliated Hospital of Zhejiang University, People’s Republic of China, a 3,200-bed hospital with 3.5 million outpatient visits annually.Results: The Second Affiliated Hospital of Zhejiang University has obtained a 100% implementation rate of standard storage of antidiabetic drugs in the Pharmacy and wards since August 2012. A zero occurrence of dispensing errors related to highly “look-alike” and “sound-alike” NovoMix 30® (biphasic insulin aspart and NovoRapid® (insulin aspart has been achieved since October 2011. Insulin injection accuracy among ward nurses significantly increased from 82% (first quarter 2011 to 96% (fourth quarter 2011 (P<0.05. The number of medication administration errors related to insulin continuously decreased from 20 (2011 to six (2014. The occurrence rate of hypoglycemia in non–endocrinology ward diabetes inpatients during 2011–2013 was significantly less than that in 2010 (5.03%–5.53% versus 8.27% (P<0.01. Percentage of correct management of

  11. Hypoglycemic and hypolipidemic effect of leaves from Syzygium cumini (L. Skeels, Myrtaceae. in diabetic rats Efeito hipoglicêmico e hipolipidêmico das folhas de Syzygium cumini (L. em ratos diabeticos

    Directory of Open Access Journals (Sweden)

    Tatiana Schoenfelder

    2010-05-01

    Full Text Available Ethanolic crude extract (ECE of leaves from Syzygium cumini (L. Skeels, Myrtaceae was screened for its hypoglycemic and hypolipidemic activity (125, 250 and 500 mg/kg v.o.. Rats were divided into three groups for the evaluation of the hypoglycemic effect: normal rats, rats with alloxan-induced diabetes and hyperglycemic normal rats. Hypolipidemia was evaluated in rats with alloxan-induced diabetes. The antihyperglycemic activity was compared to treatment with glibenclamide, an oral hypoglycemic agent. The acute treatment with S. cumini ECE caused a significant decrease in the blood glucose in hyperglycemic normal rats (250 mg/kg, and in glucose (125 and 250 mg/kg, triglyceride (125 and 500 mg/kg and cholesterol (125 mg/kg levels of diabetic rats, but no effect was observed in the normal treated rats. Syzygium cumini leaves are a good candidate for alternative and/or complementary medicine in the management of diabetes mellitus, since they showed hypoglycemic activity in addition to a hypolipidemic action in diabetic animals.Na região de Criciúma-SC, as folhas de Syzygium cumini (L. Skeels, Myrtaceae, conhecida popularmente como jambolão, são utilizadas para diminuir níveis de glicose plasmática em pessoas diabéticas. Dentro deste contexto o presente trabalho teve o interesse de avaliar o efeito hipoglicêmico e hipolipidêmico do extrato bruto hidroalcoólico (EBH das folhas de S. cumini (125, 250 e 500 mg/kg. Para tal os animais foram divididos em três grupos para o efeito hipoglicêmico: ratos normais, ratos normais submetidos a curva de glicose (hiperglicêmicos e ratos diabéticos induzidos com aloxana. O efeito hipolipidêmico foi avaliado em animais diabéticos induzidos por aloxana. O efeito hipoglicêmico foi comparado com glibenclamida. O tratamento agudo com EBH de S. cumini causou uma diminuição estatisticamente significativa na glicose sanguínea em animais normais que foram submetidos à cura de glicose (250 mg/kg, e sobre

  12. Why Does My Dentist Prescribe Medication?

    Science.gov (United States)

    ... your desktop! more... Why Does My Dentist Prescribe Medication? Article Chapters Why Does My Dentist Prescribe Medication? ... dentist or pharmacist. Reviewed: January 2012 Related Articles: Medication Epilepsy, Seizure Meds Have Oral Health Implications How ...

  13. Complementary and comparative study on hypoglycemic and antihyperglycemic activity of various extracts of Eugenia jambolana seed, Momordica charantia fruits, Gymnema sylvestre, and Trigonella foenum graecum seeds in rats.

    Science.gov (United States)

    Yadav, Mukesh; Lavania, Amita; Tomar, Radha; Prasad, G B K S; Jain, Shalini; Yadav, Hariom

    2010-04-01

    In present study, we investigated hypoglycemic and antihyperglycemic potential of five extracts (water, ethanol, methanol, hexane, and chloroform) of four plants (i.e., seeds of Eugenia jambolana, fruits of Momordica charantia, leaves of Gymnema sylvestre, and seeds of Trigonella foenum graecum) alone and/or in combination with glimepiride in rats. Ethanol extract of E. jambolana, water extract of M. charantia, ethanol extract of G. sylvestre, and water extract of T. graecum exhibited highest hypoglycemic and antihyperglycemic activity (most active) in rats among all the extracts, while hexane extracts exhibited least activities. Most active extracts were further studied to dose-dependent (200, 100, and 50 mg/kg body weight (bw)) hypoglycemic and antihyperglycemic effects alone and in combination with glimepiride (20, 10, and 5 mg/kg bw). The combination of most active extracts (200 mg/kg bw) and lower dose of glimepiride (5 mg/kg bw) showed safer and potent hypoglycemic as well as antihyperglycemic activities without creating severe hypoglycemia in normal rats, while higher doses (200 mg/kg bw of most active extracts, and 10 and 20 mg/kg bw of glimepiride) were generated lethal hypoglycemia in normal rats. From this study, it may be concluded that the ethanol extract of E. jambolana seeds, water extract of M. charantia fruits, ethanol extract of G. sylvestre leaves, and water extract of T. graecum seeds have higher hypoglycemic and antihyperglycemic potential and may use as complementary medicine to treat the diabetic population by significantly reducing dose of standard drugs.

  14. Combination of HPLC chromatogram and hypoglycemic effect identifies isoflavones as the principal active fraction of Belamcanda chinensis leaf extract in diabetes treatment.

    Science.gov (United States)

    Chen, Yan; Wu, Chong-Ming; Dai, Rong-Ji; Li, Liang; Yu, Yu-Hong; Li, Yan; Meng, Wei-Wei; Zhang, Liang; Zhang, Yongqian; Deng, Yu-Lin

    2011-02-15

    In previous study, we demonstrated the hypoglycemic effect of aqueous extract of Belamcanda chinensis leaves in rats. Here, we separated the aqueous extract of B. chinensis leaves and investigated the spectrum-effect relationships between HPLC chromatograms and hypoglycemic activities of different isolates from B. chinensis leaf extract. Sequential solvent extraction with petroleum ether, chloroform, acetic ester and n-butanol provided several isolates showing similar hypoglycemic activities, making it difficult to discriminate the active fractions. Stepwise elution through HP20 macroporous resin by water, 40% and 95% ethanol provided isolates with distinct hypoglycemic activities, representing a simple, rapid and efficient preparative separation method. Combination of HPLC chromatogram and pharmacological effect targeted a hypoglycemic activity-related region in HPLC chromatogram. Each peak in this region was analyzed by UV spectrum scan. Most of them were flavonoids in which tectoridin and swertisin were known flavonoids with anti-diabetic activities. In together, this work provides a general model of combination of HPLC chromatography and pharmacological effect to study the spectrum-effect relationships of aqueous extract from B. chinensis leaves, which can be used to find principle components of B. chinensis on pharmacological activity.

  15. In-depth Medical Nutrition Therapy for a Woman with Diabetes: From Pregnancy to Delivery

    Science.gov (United States)

    2016-01-01

    Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process. PMID:27812519

  16. The Importance of Medical Students' Humanities in Oral Professional Students' Pre-service Training%医学生人文修养在口腔专业学生岗前培训中的重要性

    Institute of Scientific and Technical Information of China (English)

    徐梅; 蔡成功; 郑君

    2014-01-01

    Objective To improve students' oral communication between doctors and patients to establish a correct concept of doctor-patient communication skills necessary to master for future careers do active preparations. Methods comprehensive training before pre-job training in the consolidation of the oral professional knowledge and skills, while focusing on medical students training courses of study and training, from the build good professional image, etiquette manners, laws and regula-tions of the doctor-patient communication skills and other aspects of student intensive training. Results oral interns out of school before the transition from student to realize that the role of the doctor, in order to shorten the adaptation period to enter clinical work to improve the overall quality of the internship.%目的:提高口腔学生树立正确的医患沟通理念,掌握必要的医患沟通技巧,为今后的职业生涯做好积极的准备。方法:实习前进行岗前综合训练,在巩固口腔专业知识和技能的同时,侧重医学生人文修养课程的学习和训练,从打造良好职业形象、礼仪举止、医患沟通技巧及法律法规等方面对学生进行强化训练。结果:口腔实习生在走出校门前即实现从学生到医生角色上的转变,以缩短进入临床工作的适应期,提高实习的整体质量。①

  17. Hypoglycemic effect of Gymnema sylvestre (retz.,) R.Br leaf in normal and alloxan induced diabetic rats.

    Science.gov (United States)

    Sathya, S; Kokilavani, R; Gurusamy, K

    2008-10-01

    The water extract of Gymnema sylvestre R.Br leaf was tested for hypoglycemic activity in normal and alloxan induced diabetic rats. Grated amount (2ml/kg) of the water extract of Gymnema sylvestre leaf was given to both normal and alloxan induced diabetic rats. A significant reduction of glucose concentration was noticed in normal rats, blood glucose level was significantly reduced in diabetic rats. Protein level is also decreased in diabetic rats. Urea, uric acid and creatinine levels were increased in diabetic condition. After the herbal treatment the levels were altered near to normal level.

  18. Using prior information from the medical literature in GWAS of oral cancer identifies novel susceptibility variant on chromosome 4--the AdAPT method.

    LENUS (Irish Health Repository)

    Johansson, Mattias

    2012-01-01

    Genome-wide association studies (GWAS) require large sample sizes to obtain adequate statistical power, but it may be possible to increase the power by incorporating complementary data. In this study we investigated the feasibility of automatically retrieving information from the medical literature and leveraging this information in GWAS.

  19. Oral chemotherapy in tinnitus.

    Science.gov (United States)

    Kay, N J

    1981-05-01

    A double-blind triple cross-over trial was designed for 21 patients suffering from tinnitus; mexiletine, diazapam, betahistine and placebo were taken each for a month sequentially during which time the patients recorded their tinnitus loudness subjectively on a visual analogue scale. The results showed that these medications did not influence the tinnitus loudness. Since mexiletine is an oral analogue of lignocaine and a cardiovascular drug, any untoward cardiovascular history and clinical finding disqualified such patients from the trial. Twenty-one such patients were rejected from an original group of 42 patients. In a volunteer trial mexiletine unrelated to this, it was reported that a vasovagal attack was suffered by someone who had just consumed 400 mg mexiletine orally. After ethical considerations the tinnitus trial was stopped. Eleven patients completed the cycle of medications, 10 did not. The dangers of using a cardiovascular drug for a non-cardiovascular condition is thus exposed.

  20. Strategies to cultivate critical thinking in medical postgraduates via oral English teaching%英语教学与医学研究生思辨能力的培养

    Institute of Scientific and Technical Information of China (English)

    贾凌玉; 章国英; 李平; 张燕; 方卫; 胡继岳

    2013-01-01

    在介绍思辨能力内涵的基础上,结合医学研究生思辨口语课程教学实践,探讨如何在建构主义教学理论指导下,使用问题质疑、争议话题会话、主题辩论和课后调查四种策略来培养医学研究生思辨能力。%Oral English teaching for Chinese postgraduates has always been focused on the drill of language skills,thus little attention was paid to the cultivation of students' thinking ability. This pa-per explored into the definition and theoretical basis of critical thinking and gave a case analysis of how to integrate the cultivation of critical thinking skills into the oral English classrooms in an effec-tive way. The questionnaire and interview among students showed that questioning,controversial dia-logue,debate and survey can help students to form the habit of critical thinking in an effective way and are also proved to be popular among medical postgraduates.