Journal of Schizophrenia Research is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of a mental disorder often characterized by abnormal social behavior and failure to recognize what is real with common symptoms including false beliefs, auditory hallucinations, confused or unclear thinking, inactivity, and reduced social engagement and emotional expression. The journal focuses upon the latest research in finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and treatment of schizophrenia.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and medicine with intent to bridge the gap between academia and research access.
Journal of Schizophrenia Research accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of schizophrenia including, finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and its treatment.
Novel Approach Of Diabetes Disease Classification By Support Vector Machine W...IJARIIT
Early diagnosis of any disease with less cost is always preferable. Diabetes is one such disease. It has become the fourth leading cause of death in developed countries and is also reaching epidemic proportions in many developing and newly industrialized nations. Diabetes leads to increase in the risks of developing kidney disease, blindness, nerve damage, blood vessel damage and heart disease also. In this study, we investigate an automatic approach to diagnose Diabetes disease based on Bacterial Foraging Optimization and Artificial Neural Network .firstly, we applied Bacterial Foraging Optimization for features selection and then we implement artificial neural network for finding out the classification accuracy. The proposed SVM method obtains 87.23% accuracy on UCI diabetes dataset which is better than other models.
Secondly, we applied again Bacterial foraging optimization for features selection and then we applied support vector machine for finding out the classification accuracy .The proposed Correlation with SVM method obtains on UCI dataset.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
efficacy and safety of Sulfad tablets in the management of NASH
patients: A randomized ,prospective, open label, multi-center,
controlled, phase III clinical trial.
Novel Approach Of Diabetes Disease Classification By Support Vector Machine W...IJARIIT
Early diagnosis of any disease with less cost is always preferable. Diabetes is one such disease. It has become the fourth leading cause of death in developed countries and is also reaching epidemic proportions in many developing and newly industrialized nations. Diabetes leads to increase in the risks of developing kidney disease, blindness, nerve damage, blood vessel damage and heart disease also. In this study, we investigate an automatic approach to diagnose Diabetes disease based on Bacterial Foraging Optimization and Artificial Neural Network .firstly, we applied Bacterial Foraging Optimization for features selection and then we implement artificial neural network for finding out the classification accuracy. The proposed SVM method obtains 87.23% accuracy on UCI diabetes dataset which is better than other models.
Secondly, we applied again Bacterial foraging optimization for features selection and then we applied support vector machine for finding out the classification accuracy .The proposed Correlation with SVM method obtains on UCI dataset.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
efficacy and safety of Sulfad tablets in the management of NASH
patients: A randomized ,prospective, open label, multi-center,
controlled, phase III clinical trial.
Effect of food on pharmacokinetics of meloxicam ijsit 2.3.7IJSIT Editor
The primary objective of the study was to investigate the effect of food on the pharmacokinetics of
MELOXICAM. Cmax, Tmax and AUC of MELOXICAM were defined as the main parameters for the assessment
of bioavailability and bioequivalence of MELOXICAM administered in fasting and fed conditions. The 90% CI
for the fed/fasting MELOXICAM did not contained within the acceptance interval (80, 125) and, therefore, it
can be concluded that the rate of systemic exposure to MELOXICAM does not fit the claim of bioequivalence
between administration in fasting and fed conditions. This study has demonstrated that all the
pharmacokinetic parameters of both the treatments were statistically different from each other. In the fed
condition the values of Cmax and AUC were decreased while Tmax increases than that of fasting which
demonstrated that the extent of systemic exposure to MELOXICAM was affected by the delay in absorption of
MELOXICAM in the presence of food. None of the study volunteers reported any serious adverse effects
throughout the study. The only two AEs reported were mild and not related to the study medication. The AEs
reported were, according to the study medical expert, related to the sampling procedure and were self
limiting and did not require any treatment. There was no change in the vital signs of the volunteers
throughout the study period. The presented data are of major importance in identifying the optimal dosing
regimen for future clinical trials with oral MELOXICAM. In our study, only one type of food (a standardized
continental breakfast) was evaluated; further studies are needed to assess the effects of foods with different
compositions and contents on the bioavailability of MELOXICAM.
Effect of Patient Counseling in Improving Physical and Mental Health of Type-...Gangula Amareswara Reddy
The present study concluded that chronic diseases like diabetes affect the quality of life of patients.As the main goal of any medical care is the improvement of the patients’ overall quality of life, the clinical pharmacist imparted patient education through counseling has a major role in improving the physical as well as mental health outcomes.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Naturopathic Treatmentfor the Prevention ofCardiovascular Disease: A Randomized Pragmatic TrialCCNM – Journal Club Sept 30th, 2010Dugald Seely, ND, MScDirector; Research & Clinical EpidemiologyThe Canadian College of Naturopathic Medicine
Recently, several novel glucose-lowering targets have had drugs developed. This has resulted in several new drugs that have been approved for the local market to treat hyperglycaemia in patients with type 2 diabetes.
This presentation will attempt to provide:
A concise summary of these drugs for an Intensive Care Physician.
A pragmatic framework for what the non-Endocrinology Doctor should do with these drugs whilst the patient is in, and being discharged from, the Intensive Care Unit.
An outline of current trials evaluating glycaemia in the Intensive Care Unit.
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDDDr. Sutanu Patra
I had done research on "Scope of Individualistic treatment with Serially Succussed and Diluted Drugs in treating Pre-diabetic condition: an Open-label Exploratory trial – in search of Prevention of Diabetes" and this was got awarded in Short Term Studentship in Homeopathy (STSH) 2014 by Central Council for Research in Homeopathy (CCRH), Ministry of AYUSH, Govt. of India.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
Because of such a high consumption level, any risky impact of these pills on public health would be important. The present study aimed to determine the relationship between consumption of OCPs and hypertension. Method: In this retrospective, cross-sectional study, 165women below 40 years of age who used OCPs were selected by convenience sampling. Necessary information was obtained by a checklist containing demographic information, obstetric history, and OCPs use history based on the subjects’ medical records. Besides, blood pressure and weight were measured at the beginning of OCPs consumption as well as 6 months and one year after that. Results: The results showed a significant difference between the subjects’ mean systolic blood pressure one year after OCPs consumption compared to the beginning (P=0.03). Moreover, this difference was related to the type of pills, such a way that it was significant in the patients who took Low Dose (LD) OCPs compared to those who used Triphasic pills (P=0.01). Conclusion: Consuming the currently available OCPs that contain lower estrogen content had an insignificant effect on blood pressure. However, it is recommended to take care of blood pressure in order to identify the unique occasional responses.
Effect of food on pharmacokinetics of meloxicam ijsit 2.3.7IJSIT Editor
The primary objective of the study was to investigate the effect of food on the pharmacokinetics of
MELOXICAM. Cmax, Tmax and AUC of MELOXICAM were defined as the main parameters for the assessment
of bioavailability and bioequivalence of MELOXICAM administered in fasting and fed conditions. The 90% CI
for the fed/fasting MELOXICAM did not contained within the acceptance interval (80, 125) and, therefore, it
can be concluded that the rate of systemic exposure to MELOXICAM does not fit the claim of bioequivalence
between administration in fasting and fed conditions. This study has demonstrated that all the
pharmacokinetic parameters of both the treatments were statistically different from each other. In the fed
condition the values of Cmax and AUC were decreased while Tmax increases than that of fasting which
demonstrated that the extent of systemic exposure to MELOXICAM was affected by the delay in absorption of
MELOXICAM in the presence of food. None of the study volunteers reported any serious adverse effects
throughout the study. The only two AEs reported were mild and not related to the study medication. The AEs
reported were, according to the study medical expert, related to the sampling procedure and were self
limiting and did not require any treatment. There was no change in the vital signs of the volunteers
throughout the study period. The presented data are of major importance in identifying the optimal dosing
regimen for future clinical trials with oral MELOXICAM. In our study, only one type of food (a standardized
continental breakfast) was evaluated; further studies are needed to assess the effects of foods with different
compositions and contents on the bioavailability of MELOXICAM.
Effect of Patient Counseling in Improving Physical and Mental Health of Type-...Gangula Amareswara Reddy
The present study concluded that chronic diseases like diabetes affect the quality of life of patients.As the main goal of any medical care is the improvement of the patients’ overall quality of life, the clinical pharmacist imparted patient education through counseling has a major role in improving the physical as well as mental health outcomes.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Naturopathic Treatmentfor the Prevention ofCardiovascular Disease: A Randomized Pragmatic TrialCCNM – Journal Club Sept 30th, 2010Dugald Seely, ND, MScDirector; Research & Clinical EpidemiologyThe Canadian College of Naturopathic Medicine
Recently, several novel glucose-lowering targets have had drugs developed. This has resulted in several new drugs that have been approved for the local market to treat hyperglycaemia in patients with type 2 diabetes.
This presentation will attempt to provide:
A concise summary of these drugs for an Intensive Care Physician.
A pragmatic framework for what the non-Endocrinology Doctor should do with these drugs whilst the patient is in, and being discharged from, the Intensive Care Unit.
An outline of current trials evaluating glycaemia in the Intensive Care Unit.
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDDDr. Sutanu Patra
I had done research on "Scope of Individualistic treatment with Serially Succussed and Diluted Drugs in treating Pre-diabetic condition: an Open-label Exploratory trial – in search of Prevention of Diabetes" and this was got awarded in Short Term Studentship in Homeopathy (STSH) 2014 by Central Council for Research in Homeopathy (CCRH), Ministry of AYUSH, Govt. of India.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
Because of such a high consumption level, any risky impact of these pills on public health would be important. The present study aimed to determine the relationship between consumption of OCPs and hypertension. Method: In this retrospective, cross-sectional study, 165women below 40 years of age who used OCPs were selected by convenience sampling. Necessary information was obtained by a checklist containing demographic information, obstetric history, and OCPs use history based on the subjects’ medical records. Besides, blood pressure and weight were measured at the beginning of OCPs consumption as well as 6 months and one year after that. Results: The results showed a significant difference between the subjects’ mean systolic blood pressure one year after OCPs consumption compared to the beginning (P=0.03). Moreover, this difference was related to the type of pills, such a way that it was significant in the patients who took Low Dose (LD) OCPs compared to those who used Triphasic pills (P=0.01). Conclusion: Consuming the currently available OCPs that contain lower estrogen content had an insignificant effect on blood pressure. However, it is recommended to take care of blood pressure in order to identify the unique occasional responses.
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docxssuserf9c51d
Systematic Reviews and Meta- and Pooled Analyses
Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk
Factors: A Meta-Analysis of Randomized Controlled Clinical Trials
Tian Hu, Katherine T. Mills, Lu Yao, Kathryn Demanelis, Mohamed Eloustaz, William S. Yancy, Jr,
Tanika N. Kelly, Jiang He, and Lydia A. Bazzano*
* Correspondence to Dr. Lydia A. Bazzano, Department of Epidemiology, Tulane University School of Public Health and Tropical
Medicine. 1440 Canal Street, SL-18, Suite 2000, New Orleans, LA 70112 (e-mail: [email protected]).
Initially submitted December 16, 2011; accepted for publication May 11, 2012.
The effects of low-carbohydrate diets (≤45% of energy from carbohydrates) versus low-fat diets (≤30% of
energy from fat) on metabolic risk factors were compared in a meta-analysis of randomized controlled trials.
Twenty-three trials from multiple countries with a total of 2,788 participants met the predetermined eligibility crite-
ria (from January 1, 1966 to June 20, 2011) and were included in the analyses. Data abstraction was conducted
in duplicate by independent investigators. Both low-carbohydrate and low-fat diets lowered weight and improved
metabolic risk factors. Compared with participants on low-fat diets, persons on low-carbohydrate diets experi-
enced a slightly but statistically significantly lower reduction in total cholesterol (2.7 mg/dL; 95% confidence inter-
val: 0.8, 4.6), and low density lipoprotein cholesterol (3.7 mg/dL; 95% confidence interval: 1.0, 6.4), but a greater
increase in high density lipoprotein cholesterol (3.3 mg/dL; 95% confidence interval: 1.9, 4.7) and a greater de-
crease in triglycerides (−14.0 mg/dL; 95% confidence interval: −19.4, −8.7). Reductions in body weight, waist
circumference and other metabolic risk factors were not significantly different between the 2 diets. These
findings suggest that low-carbohydrate diets are at least as effective as low-fat diets at reducing weight and
improving metabolic risk factors. Low-carbohydrate diets could be recommended to obese persons with abnor-
mal metabolic risk factors for the purpose of weight loss. Studies demonstrating long-term effects of low-
carbohydrate diets on cardiovascular events were warranted.
carbohydrate-restricted diet; fat-restricted diet; meta-analysis; metabolic syndrome; obesity
Abbreviations: CI, confidence interval; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol.
There were an estimated 937 million overweight and 396
million obese people worldwide in 2005 (1). Moreover, it
was estimated that 68.0% of American adults were either
overweight or obese in 2009 (2). Overweight and obesity
are important risk factors for diabetes, cardiovascular dis-
ease, cancer, and premature death. The high prevalence of
obesity has become a serious public health challenge. The
dietary recommendations for weight loss from the Ameri-
can Heart Association and the National Insti ...
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
ABSTRACT- Background: Several studies demonstrated relationship between dyslipidemia and various
antipsychotic drugs after treatment of psychotic disorders. Our study aimed to compare the effects of commonly
prescribed antipsychotic drugs Risperidone and Olanzapine on serum lipid profile of psychiatric patients.
Materials and Methods: This current study was conducted on 30 psychiatric patients, divided in to two groups
according to the antipsychotic drug prescribed by doctor Risperidone or Olanzapine. All the patients were assessed for
changes in serum lipid profile Total cholesterol (TC), Triglycerides (TG), High Density Lipoprotein (HDL-C), Low
Density Lipoprotein (LDL-C), Very Low Density Lipoprotein (VLDL-C) & Risk Factors for coronary artery
disease (CAD Risk Factor I &II) after 16 weeks of treatment.
Results: Patients taking Olanzapine therapy were showed significant (p<0.05) increase in all lipid parameters, whereas
Risperidone treated patients were showed significant increase in serum triglyceride and VLDL-C only.
Conclusion: Olanzapine therapy is strongly associated with dyslipidemia than Risperidone.
Key-words- Dyslipidemia, Lipid profile, Coronary artery disease, Risk factors, Schizophrenia
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
A comparative analysis of biochemical and hematological parameters in diabeti...amsjournal
This study evaluated the biochemical and the hematological parameters in diabetic and non- diabetic patients. The measured biochemical parameters were fasting blood sugar, serum alanine aminotransferase (SGPT/ALT), total cholesterol, urea, creatinine and hematological parameters were hemoglobin, total white blood cell, neutrophil, lymphocyte,monocyte, eosinophil and ESR. There were 403 diabetic and 320 non-diabetic subjects included in this study and the study was carried out in BIRDEM (Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital). It was observed that the mean values of SGPT/ALT (p<0.001),><0.001)><0.001)><0.001),><0.004),><0.001) of hematological parameters were significantly higher in diabetic patients than in the non-diabetic patients. In univariate analysis, all biochemical parameters and only four hematological parameters were found significantly associated with fasting blood sugar after adjusted with age and sex. The fasting blood sugar correlates highly with the other biochemical parameters but less or none with the hematological parameters. Our findings demonstrated that control of increased biochemical parameters and abnormal hematological levels in the early stage of diabetes mellitus may help the patients to raise quality of life.
Running head MANAGEMENT OF DIABETES IN ELDERLY HISPANIC AMERICA.docxcowinhelen
Running head: MANAGEMENT OF DIABETES IN ELDERLY HISPANIC AMERICA
MANAGEMENT OF DIABETIS IN ELDERLY HISPANIC AMERICA
8
Nidhi Sharma
NRS433VN
Linnette Nolte
03/12/2017
Abstract
The study was conducted to analyze the management of diabetes within the Hispanic America ethnic group. The research was carried out in the different hospitals in the United States to determine the best management practices for the elderly Hispanic America suffering from diabetes. The research used interviews with the patients and the nurses who offer the services to the patients. The research focused on the population of 65years and above Hispanic America. The result indicates that the patients with good care from the family respond to treatment as the proper management results in glycemic control. The research also got that most of the diabetes has a biological origin.
Management of diabetes in Hispanic America
P)-Population: Adults aged 65 years and above from the ethnic group of Hispanic origin who are the leading majority with the diabetes cases across the country. The other adults aged over 65 years and above but not Hispanic America are excluded from the exercise.
I)-Intervention: The research analysis the best management of Type 2 diabetes which is the most dominant type of the Hispanic America. The research compares the effectiveness of the Bariatric surgery in patients with body mass index, the healthy eating habit, and weight control measures. The best approach will be taught in every hospital holding the patients with diabetes in every two weeks seminar.
C)-Comparison: The procedure will take approximately three months then the result will be compared in line the previous mortality related cases. The progress in the health status of the patients will be matched with prior data before the process started.
O)-Outcome: The healthy eating habit and the weight management proved better in improving the conditions required to sustain the patients. The patients with the caretakers who help them in Glycemic control management improves even faster compared to patients without helpers.
T) – Time: The procedure will be analyzed monthly after every two weeks collection of data in the different hospitals.
Articles
Foundation, C. H. (2003). Guidelines for improving the care of the older person with diabetes mellitus. Journal of the American Geriatrics Society, , 51(5s), 265-280.
The article was written with the efforts of the California Health Foundation in collaboration with America Geriatrics Society concerned with improving the health of the elderly with diabetes on February 25, 2003. The T2D is highly increasing among the Hispanic America who is and 65 years and above. The estimates indicate that the total of approximately 20% adult aged 65 years and above are suffering from the T2D. The research is, therefore, provides the critical analysis of the guidelines required to improve the care of the elder people with T2D by giving a series of recommendatio ...
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
Austin Journal of Robotics & Automation is an international scholarly, peer review, Open Access journal, initiated with an aim to promote the research in Robotics & Automation, which deals with design, construction, operation, and application of robots.
Austin Journal of Robotics & Automation is a comprehensive Open Access peer reviewed scientific journal that covers multidisciplinary fields. We provide limitless access towards accessing our literature hub with colossal range of articles. The journal aims to publish high quality varied article types such as Research, Review, Short Communications, Case Reports, Perspectives (Editorials).
Austin Journal of Robotics & Automation supports the scientific modernization and enrichment in Robotics & Automation research community by magnifying access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed member journals under one roof thereby promoting knowledge sharing, collaborative and promotion of multidisciplinary technology.
Austin Journal of Multiple Sclerosis & Neuroimmunology is an open access, peer review Journal publishing original research & review articles on aetiology, epidemiology, and pathogenesis of inflammatory demyelinating diseases of the central nervous system. Austin Journal of Multiple Sclerosis & Neuroimmunology is aimed to provide a strong platform for challenging cases that includes but not excludes the damage of insulating covers of both central nervous system and spine. It is a grounding platform for all neurologists, neuroimmunologists, neurovirologists, researchers, medical doctors, health professionals, scientists, and scholars to publish their research work & update the latest research information.
Topics include but not limited to Clinical Neurology, Biomarkers, Glial, Myelin Chemistry, Neuroimaging, Neuropathology, Neuroepidemiology, Therapeutics, Genetics/Transcriptomics, Experimental Models, Pathobiology, Neuroimmunology, Neuropsychology, Neurorehabilitation, Pathobiology of the Brain, Psychology, Measurement Scales, Teaching, and Neuroethics.
Austin Journal of Multiple Sclerosis & Neuroimmunology supports the scientific transformation and fortification in Medical and Clinical research community by magnifying access to peer reviewed scientific literary works. Austin also brings universally peer reviewed member journals under one roof thereby promoting knowledge sharing, collaborative and promotion of multidisciplinary science.
Austin Leukemia is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Leukemia.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Leukemia. Austin Leukemia accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Leukemia.
Austin Leukemia strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Autism & Related Disabilities is a developmental disorder that affects the brain's normal development of social and communication skills. It is also known as a complex developmental disability. Austin Journal of Autism & Related Disabilities is an open access, peer reviewed scholarly journal committed to publication of unique contributions concerned with Autism & Related Disabilities.
Austin Journal of Autism & Related Disabilities accepts original research articles, review articles, case reports, clinical images and rapid communication on all the aspects of Autism & Related Disabilities.
Austin Journal of Asthma: Open Access is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Asthma.
The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, and healthcare professionals to find most recent advances in the areas of Asthma. Austin Journal of Asthma: Open Access accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Asthma.
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Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
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Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
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Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
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Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
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Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
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improvement in positive symptoms such as hallucinations and
delusions [27-31].
The aim of this work is to study the biochemical changes including
metabolic parameters after six months of continuous treatment and
to test the role of antipsychotic medications (haloperidol, clozapine,
risperidone and olanzapine) in these changes. This may help in
selection of the suitable medication and the precautions that will
cause the patient’s benefit outweigh the adverse effects.
Subjects and Methods
This prospective cohort comparative study was carried out
in Neuropsychiatry departments, Tanta University hospital from
January 2010 to November 2012 and conducted on One hundred
and sixty patients with schizophrenia and fifty healthy volunteers as
control. They were enrolled through convenience sampling. A written
informed consent from obtained from every individual (patient &
control) enrolled in the study, this consent was written by patient
or the legal sponsor - based on the degree of reality testing of the
patient - after explaining the aim of the study and the procedures in
which the patient will be involved All subjects related data were kept
confidential. Patient and /or his legal sponsor were given the right to
withdraw at any step of the research. All these ethical procedures were
reviewed, approved and monitored by the faculty of medicine Tanta
university research ethics committee.
At the end of the period, the number of patients that fulfilled
these criteria was 190 schizophrenic patients (59 on Haloperidol, 48
on Clozapine, 45 on Risperidone and 38 on Olanzapine). Patient were
compared with 50 healthy control matched with patient’s age and sex
[p>0.5] and coming from the same social and cultural background,
the biological parameters of this control sample were compared with
that of the patient at the beginning of the study.
Patients were clinically evaluated by The Mini-International
Neuropsychiatric Interview [32] Arabic version [33] and the diagnosis
was made according to DSM-IV-TR [34] diagnostic criteria. In
addition to the clinical evaluation which included duration of illness,
type of schizophrenia and detailed drug history. Measurement
of body weight & waist circumference [35] in addition to physical
examination to exclude any organic disease were also performed.
Llaboratory studies including
1. Fasting and post prandial blood glucose levels [36]
2. Total leucocytic count.
3. Liver function tests: liver enzymes
4. Lipid profile including: serum cholesterol, triglycerides, LDL
and HDL level. [37]
All patients will be submitted to these tests at the start, and
6months after start of research.
Exclusion criteria
1. Patients receiving any drugs other than antipsychotics.
2. Patients suffering from any metabolic problem such as
diabetes, obesity, renal or liver impairment before administration of
antipsychotics.
3. Family history of any metabolic problem such as diabetes,
obesity
Statistical analysis
The hypothesis beyond this study was that the morbidity”
particularly metabolic syndrome “in patients with schizophrenia is
more than general population matched with age and sex this could be
due to various factors e.g. the disease itself, the life style of the patient
and/or the effect of antipsychotic medications. In our sample we
tried to find any changes in the values of some biological parameters
that may carry increased morbidity risk in patients after 6 months of
continuous treatment with antipsychotics and any role of the type
of antipsychotics in these changes after controlling other factors that
may cause such changes. To reach these goals we use computer based
statistical package (SPSS version 13 under windows). The following
statistical analysis was done:
The difference in the mean values of the studied biological
parameters between patients and control cases was calculated using t
test for independent variables. The nonparametric version of the test
was used to deal with the difference between number patients and
Figure 1(a): Mean values of changes of fasting Blood Glucose during the
study. Significant difference between changes happened in haloperidol
treated group and both clozapine treated group (P<0.05), and olanzapine
treated group (P<0.02), and between olanzapine treated group and
Risperidone treated group (P<0.02).
Figure 1(b): Mean values of changes of post prandial Blood Glucose during
the period of the studySignificant difference between changes happened in
haloperidol treated group and clozapine treated group (P<0.05), clozapine
treated group and Risperidone treated group (P<0.05) and Risperidone
treated group and olanzapine treated group (P<0.05).
3. J Schizophr Res 5(1): id1035 (2018) - Page - 03
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number of control samples.
The difference in mean values of the studied biological parameters
after 6 months of antipsychotic treatment we used paired t test to
compare the mean values at the beginning of the study with at the
value at end of the study for each group of patients.
Analysis of variance was to calculate the effect of treatment with
antipsychotic medication on each the biological parameter. We
used general linear model to test the interaction among the variable
of possible influence on the values. The mean value of each studied
biological parameter at the end of the study as dependent variable.
Type of drug used of treatment as variable of fixed effect. Age,
gender, duration of illness and any previous history of antipsychotic
medication as variable with random effect and the mean value of
the same biological variable as a covariance. Intercept was included
in the equation. Post Hoc multiple comparison analyses of Least
Significance Difference (LSD) was used to calculate the mean
difference in the change of value between each two drugs. All the mean
values are “estimated marginal means” calculated after considering
the interaction of all variables. This model gives 2 level of significance,
the first level is the effect of the factor of treatment in the whole model
and the second level is the effect of drug on the end value of each
biological parameter.
Results
Although the patients are of age, sex and social background match
with the control sample albeit difference in post prandial glucose,
blood cholesterol, TG, body weight and total leukocyte count was
Mean Std. D t df P
95% Confidence Interval
Lower Upper
Blood Glucose
F.B. S
Control 88.74 11.611
-1.22 238 0.22 -7.75 1.81
Patients 91.71 16.080
PP
Control 111.04 17.157
-3.87 238 0.00 -17.06 -5.56
Patients 122.35 18.668
Serum Lipid Profile
Cholesterol
Control 158.94 31.239
-3.69 238 0.00 -25.52 -7.74
Patients 175.57 27.603
TG
Control 99.46 33.197
-4.00 238 0.00 -47.45 -16.11
Patients 131.24 53.559
LDL
Control 122.24 22.880
1.26 238 0.21 -3.12 14.30
Patients 116.65 28.961
HDL
Control 49.66 11.783
1.16 238 0.25 -1.10 4.25
Patients 48.08 7.480
Morphological Changes
BW
Control 79.84 11.229
3.18 238 0.00 2.59 11.00
Patients 73.05 13.950
WCC
Control 90.76 13.502
1.13 238 0.262 -1.70 6.26
Patients 88.51 12.374
Liver Enzymes
SGOT
Control 27.60 10.874
1.56 238 0.12 -0.79 6.68
Patients 24.65 12.178
SGPT
Control 28.36 13.155
1.71 238 0.09 -0.51 7.09
Patients 25.07 11.848
TLC
Control 8294.00 1485.22
3.89 238 0.00 542.88 1655.64
Patients 7194.74 1845.02
Table 1: Differences in mean values of biological parameter between patients and control at the beginning of the study.
Antipsychotic medication
Blood glucose Serum Lipid Profile Morphological changes Liver enzymes
WBC
FBS PP Cholesterol TG LDL HDL Body weight Waist circumference SGOT SGPT
Haloperidol 95.92 131.29 198.31 126.24 118.97 47.23 73.69 90.23 26.95 25.83 7232.17
Clozapine 101.77 141.20 197.50 156.27 142.71 47.08 75.13 90.72 26.72 28.46 6887.80
Risperidone 97.16 130.09 204.14 191.24 137.67 50.81 73.79 89.41 26.65 26.39 7596.81
Olanzapine 105.78 141.37 201.75 137.11 128.89 42.18 76.10 90.32 29.99 27.80 7673.91
ANOVA
F 2.75 3.77 0.58 21.49 18.01 7.60 37.85 63.99 18.12 113.36 5.04
df 3 3 3 3 3 3 3 3 3 3 3
p 0.10 0.048 0.640 0.000 0.000 0.006 0.000 0.000 0.000 0.000 .02
Table 2: Estimated marginal mean value at the end of the study in every drug treated group.
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found (Table 1). The changes in mean values of biological parameters
between the beginning and the end of the study in the same drug-
treated group and the difference between one group and other was
calculated as estimated marginal mean after testing the interaction
of all variables. The type of drug showed significant effect on the
biological parameters in this interaction except in the end of the study
Figure 2(a): Mean values of changes of blood Cholesterol during the period
of the study. Post-Hoc pair wise comparison showed that no significant
difference in changes of serum cholesterol among the 4 drug groups (P>0.05).
Figure 2(b): Mean values of changes of blood TG during the period of
the study. Post Hoc pair wise comparison showed significant difference in
haloperidol treated group from both Risperidone treated group and olanzapine
treated group (p<0.05) in addition Risperidone treated group is also different
from clozapine treated group (P<0.01).
Figure 2(c): Mean values of changes of blood LDL during the period of
the study. Serum LDL in haloperidol treated group is significantly different
from clozapine and Risperidone (p<0.01) and olanzapine (p<0.05) the same
between clozapine and olanzapine.
Figure 2(d ): Mean values of changes of blood HDL during the period of the
study. Olanzapine treated group showed significant decrease in HDL while
Risperidone treated group showed the height increase in HDL.
Figure 3(a): Mean values of body weight changes during the period of the
study, No significant difference in changes body weight between haloperidol
treated group and Risperidone treated group but each one of them is
significantly different from both clozapine and olanzapine (P<0.01).
Figure 3(b): Mean values of Waist circumference changes during the period
of the study. Risperidone the least significant difference in changes of waist
circumference compared to other 3 groups (p<0.001). Haloperidol treated
group is also significantly less than clozapine treated group (p<0.05). Other
comparisons are not significant.
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fasting Blood Glucose and serum cholesterol (Table 2).
Blood Glucose
The model of interaction showed that antipsychotic treatment
contribution in the changes of Blood Glucose was significant for
fasting Blood Glucose [mg/dl] [F=4.87, df=179, p=0.004] and not
significant for post prandial Blood Glucose [F=1.64, df=179, p=0.20],
this means that the factor of treatment with antipsychotic is not a
contributing factor in the changes in post prandial Blood Glucose
in such model of interaction. The type of drug is not of significance
in fasting Blood Glucose [F=2.75, df=3, p=0.10 ns] and weakly
significant in post prandial [F=3.77, df= 3, P=0.05]. Olanzapine and
clozapine treated groups showed the highest mean changes in fasting
and PP Blood Glucose while haloperidol and Risperidone treated
groups showed the lowest changes (Figure 1(a,b)).
Serum lipid profile
The antipsychotic treatment contribution in these changes after
interaction with other factors within the model showed that the
contribution to cholesterol changes was not significant [F=1.24, df
=179, P=0.38]. This means that the change in serum cholesterol is due
to other factors than the drugs. The role of antipsychotic treatment
within the model was significant for other 3 lipid components
[F=17.81, df= 179, P=0.00 for triglycerides, F= 4.74, df= 179, P=0.01
for LDL & F=3.16, df=179, P=0.02 for HDL]. The significance of
the type of medication used for treatment was not significant for
serum cholesterol [F=0.58, df= 3, P=0.6], and significant for another
component [F=21.49, df=3, P=0.00 for TG, F18.01, df=3, P=0.00 for
LDL & F= 7.60, df=3, P=0.01]. Risperidone treated group showed
the highest increase in serum cholesterol (Figure 2a), TG (Figure 2c)
and HDL and clozapine treated group showed the highest increase in
LDL (Figure 2c). The interesting finding is the statistically significant
reduction of the mean value of HDL in olanzapine treated group
(Figure 2d).
Morphological changes
The antipsychotic treatment contribution in these changes is
statistically significant within the model [F=167.44, df=179, P=00
for body weight & F=846.23, df=179, P=00 for waist circumference].
The type of medication used showed significant difference within
the 4 groups [F=37.85, df=3, p=0.00 for body weight & F=63.986,
df=3, p=0.00]. Patient showed increase in the body weight and waist
circumference during the period of the study particularly in clozapine
and olanzapine treated groups. Risperidone treated group showed the
least morphological changes among other three groups but even in
this group the changes were statistically significant (Figure 3a,b).
Liver enzymes
Role of the factor of antipsychotic treatment in liver enzyme
changes in our model was statistically significant for both SGOT
[F=38.47, df=179, P=0.000] and SGPT [F=392.48, df=179, P=0.000].
The type of drug used for treatment was also significant [F=18.12,
df=3, P=0.000 for SGOT and F=113.36, df= 3, P= 0.000 for SGPT].
Olanzapine treated group showed the highest changes then followed
by clozapine treated group, haloperidol and Risperidone treated
groups are the lowest (Figure 4a,b).
Total leukocyte count
Role of the factor of antipsychotic treatment in liver enzyme
changes in our ANOVA model was statistically significant [F=3.49,
df= 179, p=0.02]. The type of drug used for treatment was also
significant [F=5.04, df=3, p=0.02]. Haloperidol treated group
Figure (4a): Mean values of SGOT changes during the period of the study. The
mean value of change in olanzapine treated group is statistically significant
compared to changes in other 3 groups (P<0.001). Other comparisons were
not significant.
Figure 4(b): Mean values of SGPT changes during the period of the study.
The mean value of change in both olanzapine and clozapine treated groups
are statistically significant compared with either haloperidol or risperidone
treated group (p<0.01). Still changes in olanzapine treated group is more
than clozapine treated group.
Figure 5: Mean values of changes in Total leukocyte count during the
period of the study. Clozapine treated group showed the highest statistically
significant changes among other groups.
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showed significant rise in the total leukocyte count, Risperidone and
olanzapine showed no significant rise also but clozapine showed no
significant decrease in the total leukocyte count (Figure 5).
Discussion
Our study revealed significant elevation of biological parameters
in patients of schizophrenia than control cases. This elevation is
becoming more significant by the end of the study than at the start
(Table 2). These finding confirm the notion that the mentally ill in
general [38] and schizophrenics [39] are at risk of high morbidity and
mortality than general population. Life style, disease and medications
are the incriminated causes of this risk [18,40-42]. The abnormalities
of glucose regulation were reported long time ago in mentally ill
patients in general and in schizophrenics [43-46] even in drug naïve
patients [47].
Our study demonstrated that antipsychotic treatment as a factor
of effect on the model of interaction has an impact on biological
changes more over the type of drug used is also has differential effect.
Olanzapine and clozapine treated groups showed the highest mean
changes in fasting and PP Blood Glucose while haloperidol and
Risperidone treated groups showed the lowest changes these findings
confirming many studies. Previous study [48] did not find any
significant changes in serum glucose in patients treated with the same
groupofantipsychotics[withtheexceptionofolanzapineP<0.02]after
14 weeks of follow up. Risperidone treated group showed the highest
increase in serum cholesterol, TG and HDL and clozapine treated
group showed the highest increase in LD. The interesting finding
is the statistically significant reduction of the mean value of HDL,
this needs further research to prove or disprove some studies [49]
reported non-significant change in HDL with clozapine treatment in
olanzapine treated group. Several studies showed increased TG with
clozapine [50] and olanzapine [51] while non-significant changes of
cholesterol with risperidone. Studies [52] reported that risperidone
has less impact on lipid profile compared to olanzapine.
Olanzapine treated group showed the highest changes in Liver
enzymes followed by clozapine treated group, haloperidol and
Risperidone treated groups are the lowest. The effect on hepatic
enzymes was reported by many studies [53] one study [54] reported
Biological parameters Haloperidol Clozapine Risperidone Olanzapine
Mean difference P Mean difference P Mean difference P Mean difference P
Blood Glucose
F.B. S -4.22 0.00 -8.96 0.00 -5.31 0.00 -12.00 0.00
PP -6.25 0.02 -16.21 0.00 -6.33 0.01 -19.61 0.00
Serum Lipid Profile
Cholesterol -19.05 0.00 -20.29 0.00 -24.00 0.00 -28.90 0.00
TG -24.22 0.00 -18.00 0.00 -39.62 0.00 -35.97 0.00
LDL -10.27 0.00 -28.04 0.00 -14.09 0.09 -15.92 0.00
HDL 1.19 0.03 0.96 0.27 -2.29 0.01 2.08 0.00
Morphological Changes
BWin kg -0.78 0.00 -2.21 0.00 -0.84 0.00 -3.03 0.00
WCC in cm -1.41 0.00 -2.42 0.00 -0.91 0.00 -1.68 0.00
Liver Enzymes
SGOT -1.19 0.09 -1.31 0.02 -1.38 0.02 -1.97 0.20
SGPT -1.22 0.09 -2.96 0.00 -1.18 0.11 -3.32 0.02
TLC -510.17 0.01 335.42 0.26 -200.00 0.45 -234.21 0.35
Table 3: The changes in the mean values of the biological parameters in different drug treated groups (difference between beginning and end ).
that the raised lever enzymes could predict metabolic syndrome in
patients with schizophrenia
Patient showed increase in the body weight and waist
circumference during the period of the study particularly in clozapine
and olanzapine treated groups.
In our study Patient showed increase in the body weight and
waist circumference during the period of the study particularly in
clozapine and olanzapine treated groups. Risperidone treated group
showed the least morphological changes among other three groups
but even in this group the changes were statistically significant.
studies identify predictive factors of acute weight change in patients
with schizophrenia. Similar factors across antipsychotic drugs in
predicting greater weight gain included better clinical outcome, low
BBMI, and nonwhite race. Factors differing between conventional
[haloperidol] and atypical [olanzapine] agents included increased
appetite and gender ere associated these differences to factors like.
studies [55] claimed that adiponectin as a potential biomarker for the
metabolic syndrome in clozapine treated patient, while others [56]
regard the anthropometric parameters as indicators of metabolic
derangements in schizophrenia patients stabilized on olanzapine.
The complex inter-effect of the parameter and the unclear direct
biochemical link between drug molecule and the increased body fat
deposition confirm the assumption that antipsychotics should not be
regarded the sole element for abnormal metabolic disturbance. Some
authors [57,58] emphasized the importance of appropriate baseline
screening and ongoing monitoring of weight gain and long-term
weight management facilities may help to reduce weight gain in some
patients.
Conclusion
From the results of this study we can confirm the previous
conclusions that metabolic disturbance in patients of schizophrenia is
realty and worsens by time. Antipsychotics treatment may contribute
in this effect particularly the novel ones but this effect could be a
perpetuating or precipitating. The significant difference between
patients and control at the beginning of the study makes us unable
to go beyond this conclusion Calculating the risks and benefits of
the use of antipsychotics is an important contributing factor in
7. J Schizophr Res 5(1): id1035 (2018) - Page - 07
Mubarak A Austin Publishing Group
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lowering both psychiatric and physical morbidity of our patients. This
calculation should not only consider the type of antipsychotic but
also other factors like the nature of the illness the stress, the lifestyle
and nutritional habits of the patients. This should raise our awareness
about the continuous monitoring not only the side effects of the drugs
but also the quality of life and healthcare delivery of our patients.
Our study is one of the view prospective studies that considered
a wide range of biological profile of both typical and atypical
antipsychotics for a considerable period and not funded by third
party. However, our findings and conclusions should be viewed in
context of some limitations regarding the limited number of patients
in each drug treated groups, the heterogeneity of antipsychotic
treatment and the convenience sampling. We tried to overcome these
limitations by the appropriate statistical tools as much as we can. So,
our results and conclusions should be considered in this context.
Acknowledgement
I must express my thanks and gratitude for Dr Rajeev A. Associate
professor of public health and medical biostatistics in Oman Medical
College, Sohar sultanate of Oman for his advice and revision of every
step of statistical analysis we spent hours in selecting the appropriate
statistical analysis for this study.
References
1. Newcomer JW. Medical risk in patients with bipolar disorder and
schizophrenia. The Journal of clinical psychiatry. 2006; 67: 25-30.
2. Colton CW, Manderscheid RW. Congruencies in increased mortality rates,
years of potential life lost, and causes of death among public mental health
clients in eight states. Preventing chronic disease. 2006; 3: 42.
3. Collins PY, Varma VK, Wig NN, Mojtabai R, Day R, Susser E. Fever and acute
brief psychosis in urban and rural settings in north India. Br J Psychiatry.
1999; 174: 520-524.
4. Mojtabai R, Varma VK, Malhotra S, Mattoo SK, Misra AK, Wig NN, et al.
Mortality and long-term course in schizophrenia with a poor 2-year course: a
study in a developing country. Br J Psychiatry: the journal of mental science.
2001; 178: 71-75.
5. Casey DE, Haupt DW, Newcomer JW, Henderson DC, Sernyak MJ, Davidson
M, et al. Antipsychotic-induced weight gain and metabolic abnormalities:
implications for increased mortality in patients with schizophrenia. J Clin
Psychiatry. 2004; 65: 4-18.
6. Bushe C, Holt R. Prevalence of diabetes and impaired glucose tolerance in
patients with schizophrenia. Br J Psychiatry Suppl. 2004; 47: 67-71.
7. Buchsbaum MS, Buchsbaum BR, Hazlett EA, Haznedar MM, Newmark
R, Tang CY, et al. Relative glucose metabolic rate higher in white matter
in patients with schizophrenia. Am J Psychiatry. 2007; 164: 1072-
1081.
8. Newcomer JW, Hennekens CH. Severe mental illness and risk of
cardiovascular disease. Jama. 2007; 298: 1794-1796.
9. Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia:
is the differential mortality gap worsening over time? Archives of general
psychiatry. 2007; 64: 1123-1131.
10. Gray DS. Diagnosis and prevalence of obesity. Med Clin North Am. 1989;
73: 1-13.
11. Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis
RJ, et al. Body-mass index and mortality among 1.46 million white adults. The
New England journal of medicine. 2010; 363: 2211-2219.
12. Banerji MA, Lebowitz J, Chaiken RL, Gordon D, Kral JG, Lebovitz HE.
Relationship of visceral adipose tissue and glucose disposal is independent
of sex in black NIDDM subjects. The American journal of physiology. 1997;
273: 425-32.
13. Thakore JH, Mann JN, Vlahos I, Martin A, Reznek R. Increased visceral
fat distribution in drug-naive and drug-free patients with schizophrenia.
International journal of obesity and related metabolic disorders: journal of the
International Association for the Study of Obesity. 2002; 26: 137-141.
14. Srisurapanont M, Likhitsathian S, Boonyanaruthee V, Charnsilp C,
Jarusuraisin N. Metabolic syndrome in Thai schizophrenic patients: a
naturalistic one-year follow-up study. BMC psychiatry. 2007; 7: 14.
15. Hasnain M. Schizophrenia and metabolic dysregulation: shared roots? The
lancet Psychiatry. 2016; 3: 10031005.
16. Said MA, Hatim A, Habil MH, Zafidah W, Haslina MY, Badiah Y, et al.
Metabolic syndrome and antipsychotic monotherapy treatment among
schizophrenia patients in Malaysia. Preventive medicine. 2013; 57: 50-53.
17. Softic R, Sutovic A, Avdibegovic E, Osmanovic E, Becirovic E, Hajdukov
MM. Metabolic syndrome in schizophrenia - who is more to blame: FGA
polypharmacy or clozapine monotherapy? Psychiatria Danub. 2015; 27: 378-
384.
18. Tirupati S, Chua LE. Obesity and metabolic syndrome in a psychiatric
rehabilitation service. The Australian and New Zealand journal of psychiatry.
2007; 41: 606-610.
19. Koller E, Schneider B, Bennett K, Dubitsky G. Clozapine-associated diabetes.
The American journal of medicine. 2001; 111: 716-723.
20. Koller EA, Doraiswamy PM. Olanzapine-associated diabetes mellitus.
Pharmacotherapy. 2002; 22: 841-845
21. American Diabetes A, American Psychiatric A, American Association
of Clinical E, North American Association for the Study of Consensus
development conference on antipsychotic drugs and obesity and diabetes.
The Journal of clinical psychiatry. 2004; 65: 267-272.
22. Haupt DW, Newcomer JW. Hyperglycemia and antipsychotic medications.
The Journal of clinical psychiatry. 2001; 62: 15-26.
23. Kropp S, Grohmann R, Hauser U, Ruther E, Degner D. Hyperglycemia
associated with antipsychotic treatment +in a multicenter drug safety project.
Pharmacopsychiatry. 2004; 37: 79-83.
24. Gouveia C, Chowdhury TA. Diabetes, schizophrenia and metabolic effects of
antipsychotic drugs. Mental health today. 2013: 24-27.
25. Newcomer JW, Haupt DW, Fucetola R, Melson AK, Schweiger JA, Cooper
BP, et al. Abnormalities in glucose regulation during antipsychotic treatment
of schizophrenia. Archives of general psychiatry. 2002; 59: 337-345.
26. Henderson DC, Cagliero E, Copeland PM, Borba CP, Evins E, Hayden D, et
al. Glucose metabolism in patients with schizophrenia treated with atypical
antipsychotic agents: a frequently sampled intravenous glucose tolerance
test and minimal model analysis. Arch Gen Psychiatry. 2005; 62: 19-28.
27. Kane JM. Clinical efficacy of clozapine in treatment-refractory schizophrenia:
an overview. Br J Psychiatry Suppl. 1992: 41-45.
28. Meltzer HY, Alphs LD, Bastani B, Ramirez LF, Kwon K. Clinical efficacy of
clozapine in the treatment of schizophrenia. Pharmacopsychiatry. 1991; 24:
44-45.
29. Eskelinen S, Sailas E, Joutsenniemi K, Holi M, Suvisaari J. Clozapine use
and sedentary lifestyle as determinants of metabolic syndrome in outpatients
with schizophrenia. Nord J Psychiatry. 2015; 69: 339-345.
30. McEvoy JP, Freudenreich O. Review: clozapine shows some improved
clinical efficacy over risperidone and zotepine in treatment of schizophrenia,
but robust evidence is lacking. Evid Based Ment Health. 2011; 14: 53.
31. Fleischhacker WW, Heikkinen ME, Olie JP, Landsberg W, Dewaele P,
McQuade RD, et al. Effects of adjunctive treatment with aripiprazole on
body weight and clinical efficacy in schizophrenia patients treated with
clozapine: a randomized, double-blind, placebo-controlled trial. Int J
Neuropsychopharmacol. 2010; 13: 1115-11125.
32. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al.
The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development