Background: The study investigates the pharmaceutical care concept to optimize drug therapy, minimize drug related problems and thereby improving health related quality of life (HRQoL) of stroke patients. Since stroke is a major health problem that negatively affects the patient's quality of life, it is relevant to the current pharmaceutical care scenario in a developing country like India. HRQoL related to stroke and life satisfaction after stroke is the important healthcare measures. Methodology: Prospective interventional study conducted among inpatients of neurology department in a tertiary care referral hospital. 128 Patients with TIA/ischemic stroke were allocated to intervention group and control group (64 in each group). Pharmaceutical care was provided to the patients in the intervention group. SF-36 questionnaire was administered to both control group and interventional group to evaluate the patient's HRQoL. Adherence to entire therapy and antithrombotic therapy in both control group and intervention group were assessed using Morisky Medication Adherence Scales MMAS-8. Results: Prevalence of ischemic stroke was more compared to hemorrhagic stroke. During the study, the intervention group showed high adherence to overall therapy than the control group. With an intensified pharmaceutical care, improvement in the HRQoL was observed in intervention group and was manifested in subscales and summary measures of SF-36. Conclusion: The study enables demonstration and application of a pharmaceutical care program among stroke patients to prevent complications to improve HRQoL. This study indicates that pharmaceutical care can be performed in both hospital and community settings as it provides more benefit and positive impact on patient'HRQoL.
Plants from the genus Passiflora have been chronicled in folk medicine. The leaf extract of Passiflora edulis has established its antiglycation property in vitro. Therefore this study aims to calibrate the extend of hypoglycemic property of P. edulis leaf extract and further provides a suitable alternative for prevention and control of hyperglycemic complications. A pre-post interventional community study was conducted in 41 type 2 DM patients by monitoring the fasting blood sugar level before and after administration of Passiflora edulis leaves extract for a period of 1 month. The mean plasma glucose level before the intervention was 193.44 mg/dl and during the intervention, it was reduced to 121.71 mg/dl that indicated a reduction of 37.1%. The paired 't' test using the mean values showed a strong evidence (t = 11.775, p < 0.001) for a significantly high reduction in the sugar level. The study indicates that the intake of P. edulis leaf extract suggests a remarkable reduction in blood sugar level during a four-week period in type 2 diabetic patients.
The aim of the study was to investigate the relationship between Gastro-esophageal reflux diseases (GERD) related symptoms and psychological symptomatology, as well as clinically diagnosed generalized anxiety disorder (GAD) or panic disorder (PD) and effectiveness of Sertraline and benzodiazepines in controlling these conditions. Methodology: A 6 months prospective study was conducted in gastroenterology outpatient department of a tertiary care referral hospital. Refractory GERD was diagnosed by assessing proton pump inhibitor failure over 4 week trial of standard doses of PPIs. Therapy with Benzodiazepines and Sertraline was initiated in patients with refractory GERD having panic and anxiety symptoms associated with refractory GERD. Effectiveness of the therapy was measured using panic and agoraphobia scale and Hamilton anxiety scale. Reduction in the severity of GERD symptoms was assessed using GERD-Health related quality of life scale. Results: The occurrence of PD or GAD in patients with refractory GERD in our sample was found to be 68% and 32% respectively. There was a significant decrease in the score of GERD HRQOL after the administration of sertraline and benzodiazepines when compared to the score of GERD HRQOL before administration of interventional drugs (p = 0.001). Conclusion: Our study investigated the role of anxiety and panic in refractory GERD and their effect on quality of life. The results indicated that quality of life of patients were highly improved as indicated by severity scores after administration with sertraline and benzodiazepines. The novel therapy of sertraline and benzodiazepines are highly effective in controlling reflux like symptoms and coexisting anxiety and panic disorder in refractory GERD.
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