Objective: To evaluate whether clinical pharmacist's interventions have any impact on medication adherence of patients having inflammatory bowel disease and to assess the awareness of patients about their disease and the significance of medications they use. Materials and Methods: A prospective, interventional follow up study was conducted in the outpatients visiting Gastroenterology and Hepatology department of Amrita Institute of Medical Sciences, Kochi. To assess the level of medication adherence and patient's awareness, MMAS-8 and CCKNOW has been utilized. Once this baseline information's were collected, counselling was given to patients and they were supplemented with pill cards and patient information leaflets as educational material. During the follow up visit, all the above parameters were reassessed and compared with the baseline visit. Result: About 110 IBD patients have participated in this study. In baseline visit, 6.36% patients had low adherence, 62.73% patients had medium adherence, 30.91% patients had high adherence. During follow up visit, after intervention by clinical pharamcist, 3.64% patients had low adherence, 18.18% patients had medium adherence and 78.18 % patients had high adherence. From this study, it was notified that the average score of CCKNOW was only 8.15 in the beginning. Later on, it was escalated to 11.65 during the revisit periods. Conclusion: Knowledge of patients about their disease and medications were insufficient during baseline visit. Adherence to medication was found to be poor among IBD patients. Counselling provided by clinical pharmacist about the importance of medication adherence and provision of information leaflets and pill cards lead to an improvement in medication adherence and knowledge of IBD patients. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
QT prolongation refers to the prolonged QT interval in electrocardiography (ECG) which can even lead to life-threatening events such as ventricular arrhythmias, torsades de pointes, etc., several drugs can cause QT prolongation which includes sotalol, quinidine, arsenic, disopyramide, procainamide, amiodarone, haloperidol, etc., Arsenic trioxide (ATO) is used as an effective treatment option in promyelocytic leukemia (PML). Acute myeloid leukemia (AML) is a cancer that affects the blood and bone marrow. Acute promyelocytic leukemia (APL) is the M3 subtype of AML that affects mainly the white blood cells. In APL, immature granulocytes accumulate abnormally to form promyelocytes. ATO helps in the apoptosis of these cancerous promyelocytic cells. In patients on arsenic therapy, ECGs must be monitored to ensure QT prolongation as it a major side effect of the drug. Here is the case of a 58-year-old female patient and was newly diagnosed with APL. She developed QT prolongation with arsenic therapy. Other confounding factors such as electrolytes and presence of other QT-prolonging drugs were also corrected.
Abstract. High Peak to Average Power Ratio (PAPR) is the major disadvantage in Orthogonal Frequency Division Multiplexing (OFDM). OFDM is extensively used in wireless communication systems due to its excellent performance. To reduce high PAPR, various techniques like clipping, companding, coding, etc. have been proposed. Companding technique effectively reduces the PAPR. In this paper, we propose new non-linear companding transforms which reduce PAPR efficaciously and are much more flexible when compared to other existing transforms. The theoretical analysis and simulation results of the proposed scheme are presented.
A geometrically asymmetric plasmonic sensor for the simultaneous and individual detection of multiple parameters with enhanced specificity and accuracy.
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