A less-invasive-approach-of-medial-meniscectomy-in-rat-a-model-to-target-earl...science journals
In order for insulin to exert its biological actions on target cells in peripheral tissues like muscle and adipose tissues, Insulin must pass through the endothelial barrier into the interstitium.
Dr Vivek Baliga - Chronic Disease Management In Heart Failure And DiabetesDr Vivek Baliga
Dr Vivek Baliga, Consultant Internal Medicine at Baliga Diagnostics discusses the management of 2 common problems in medical practice - heart failure and type 2 diabetes, including the link between the two. For more articles for patients, visit http://heartsense.in/author/dr-vivek-baliga-b/. For scientific articles and short reviews, visit http://drvivekbaliga.net/
Hypertension is a silent, invisible killer that rarely causes symptoms. Increasing public awareness is key, as is access .Raised blood pressure is a warning sign that significant lifestyle changes are urgently needed. People need to know why raised blood pressure is dangerous, and how to take steps to control it.
A less-invasive-approach-of-medial-meniscectomy-in-rat-a-model-to-target-earl...science journals
In order for insulin to exert its biological actions on target cells in peripheral tissues like muscle and adipose tissues, Insulin must pass through the endothelial barrier into the interstitium.
Dr Vivek Baliga - Chronic Disease Management In Heart Failure And DiabetesDr Vivek Baliga
Dr Vivek Baliga, Consultant Internal Medicine at Baliga Diagnostics discusses the management of 2 common problems in medical practice - heart failure and type 2 diabetes, including the link between the two. For more articles for patients, visit http://heartsense.in/author/dr-vivek-baliga-b/. For scientific articles and short reviews, visit http://drvivekbaliga.net/
Hypertension is a silent, invisible killer that rarely causes symptoms. Increasing public awareness is key, as is access .Raised blood pressure is a warning sign that significant lifestyle changes are urgently needed. People need to know why raised blood pressure is dangerous, and how to take steps to control it.
There has been an increase in the predominance of diabetes mellitus over the past 40 years worldwide. The worldwide occurrence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This data interprets a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high risk population. Patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is associated with high prevalence of well-established risk factors such as hypertension, dyslipidaemia and obesity in these patients. Hypertension plays a major role in the development and progression of microvascular and macrovascular disease in people with diabetes. Lifestyle Modifications and pharmacotherapy are the choice for the Management of Hypertension in Patients with Diabetes.
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
A Study on Food Habits and Social Habits as Risk Factors among Patients Under...ijtsrd
AIM A study on food habits and social habits as risk factors among patients undergoing Percutaneous Transluminal Coronary Angioplasty PTCA OBJECTIVE To know the association of food habits and social habits as risk factors for PTCA. To observe various co morbidities among the patients To study the bio chemical parameters in patients such as heamoglobin, PVC, platelet count, bilirubin levels. To observe various social habits in the patient, such as smoking and alcohol consumption. Food consumption pattern. METHODOLOGY The sample population n = 60 of 28 80 years of age were chosen from a multi speciality hospital in Hyderabad. All the patients were of different age groups, sex, socio economic status, ethnicity with different co morbidities. A pre tested format consisting of patients profile, subjective data, objective data, biochemical data, medications and 24 hour dietary recall followed by medical nutrition therapy during the hospital stay. RESULTS Among n=60 subjects from 28 80 years of age, the detailed study identified the common risk factors with respect to cardiovascular diseases. The study showed a higher percentage of age from 28 70 years and is mostly in males. Majority of the patients are with increased BMI and are alcholics smokers. Obesity, Hypertension and Diabetes are predominant and dietary patterns recorded are mostly non vegetarians with high calorie, high fat and high protein consumption. CONCLUSION From the result it is very clear that majority of the patients studied with cardiovascular diseases belong to the age group 28 70 years and is mostly seen in males. Majority of them are accompanied with co morbidities with obesity, hypertension and diabetic. And predominantly follow a high calorie and high fat diet .Thus leading to a conclusion that consumption of high calorie and high fat food, presence of co morbidities and smoking could be the risk factors of PTCA. Mrs. Meena Kumari | Mrs. Y. V. Phani Kumari | Gwyneth Madhulika Bashapaga | Ittamala Jaya Rachel ""A Study on Food Habits and Social Habits as Risk Factors among Patients Undergoing Percatenous Transluminal Coronary Angioplasty (PTCA)"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23372.pdf
Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/23372/a-study-on-food-habits-and-social-habits-as-risk-factors-among-patients-undergoing-percatenous-transluminal-coronary-angioplasty-ptca/mrs-meena-kumari
Study on the Health Related Quality of Life of Patients with Ischemic strokeiosrjce
The work entitled, “Study on the health related quality of life of patients with ischemic stroke” was
conducted in the department of Neurology at a multispecialty hospital. After receiving the official approval, the
study was conducted for a period of eight months from December 2013 to August 2014. A total of 278 cases with
Neurological disorders were found, of which 117(42 %) patients were with ischemic stroke. Hypertension (59%)
and Diabetes (53%) were the major co-morbid conditions found. The Health related quality of life of the
patients was assessed by direct interviewing of individual patients with a stroke specific questionnaire. The
Health related quality of life of the patients was assessed by direct interviewing of individual patients with a
stroke specific questionnaire. Quality of life assessments are done by various methods like taking the floor and
ceiling effects of the scores, average score calculation etc. Assessment of the floor and ceiling effect showed the
potential for floor effects in the most difficult domain(strength) and the possibility of a ceiling effect in the
communication domain. Assessment of stroke severity is done by taking the mean and SD of the individual domains
this book having four doctors if you need you can get
Dr Abdifatah dahir nor ( manager)
Dr osman abas mohamed
Dr ibrahim sacid
Dr abdalla mohamud mohamed
Chronic Conditions of as Predictors of Hospitalization Following an Emergency...Shin Jeong, PhD
Accepted and Presented in the Session of Injury Control and Emergency Health Services of American Public Health Association 2016 Annual Meeting and Expo Held in October 31.
For APHA member access, https://apha.confex.com/apha/144am/icehs/papers/index.cgi?username=359723&password=722348
A cross-sectional study on the prevalence of cardiovascular risk factors amon...Jameel Hijazeen
YouTube Video of me presentation these results: http://www.youtube.com/watch?v=YocIOa-5eI8
By Jameel Khaleel Hijazeen (1); Oday Zayid Al-Ma'aitah (1); Mahmoud Yaseen Abuznaid, MD (2); Ahmed Nader Abo.sharak (1); Khaled Ali AlShar' (1); Imad Farjou, MD, PhD (3).
[1] Sixth-year medical students, Faculty of Medicine, Mu'tah University, Karak, Jordan.
[2] Intern, Al-Bashir Teaching Hospital, Amman, Jordan.
[3] Department of Pharmacology, Faculty of Medicine, Mu'tah University, Karak, Jordan.
طلاب السنة السادسة: جميل خليل حجازين، عدي زايد المعايطة ، احمد نادر ابوشرخ، خالد علي الشرع.
طبيب إمتياز، مستشفى البشير: محمود ياسين أبوزنيد.
الأستاذ المشرف: عماد فرجو.
----------------------------------------------------------------
It was presented by me, Jameel Khaleel Hijazeen, sixth-year medical student at Mu'tah University, today, April 11th, 2013, at the 9th Scientific Conference of the Faculty of Medicine at Mu'tah University, Karak, Jordan.
There is always something better! Especially when you are doing something you never did before. Therefore, any feedback is more than welcome.
Some photos and more details about this research and the conference: http://amanfrommoab.com/2013/04/11/the-ninth-scientific-conference-of-the-faculty-of-medicine-at-mutah-university-karak-jordan-april-3-4-2013-2/
There has been an increase in the predominance of diabetes mellitus over the past 40 years worldwide. The worldwide occurrence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This data interprets a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high risk population. Patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is associated with high prevalence of well-established risk factors such as hypertension, dyslipidaemia and obesity in these patients. Hypertension plays a major role in the development and progression of microvascular and macrovascular disease in people with diabetes. Lifestyle Modifications and pharmacotherapy are the choice for the Management of Hypertension in Patients with Diabetes.
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
A Study on Food Habits and Social Habits as Risk Factors among Patients Under...ijtsrd
AIM A study on food habits and social habits as risk factors among patients undergoing Percutaneous Transluminal Coronary Angioplasty PTCA OBJECTIVE To know the association of food habits and social habits as risk factors for PTCA. To observe various co morbidities among the patients To study the bio chemical parameters in patients such as heamoglobin, PVC, platelet count, bilirubin levels. To observe various social habits in the patient, such as smoking and alcohol consumption. Food consumption pattern. METHODOLOGY The sample population n = 60 of 28 80 years of age were chosen from a multi speciality hospital in Hyderabad. All the patients were of different age groups, sex, socio economic status, ethnicity with different co morbidities. A pre tested format consisting of patients profile, subjective data, objective data, biochemical data, medications and 24 hour dietary recall followed by medical nutrition therapy during the hospital stay. RESULTS Among n=60 subjects from 28 80 years of age, the detailed study identified the common risk factors with respect to cardiovascular diseases. The study showed a higher percentage of age from 28 70 years and is mostly in males. Majority of the patients are with increased BMI and are alcholics smokers. Obesity, Hypertension and Diabetes are predominant and dietary patterns recorded are mostly non vegetarians with high calorie, high fat and high protein consumption. CONCLUSION From the result it is very clear that majority of the patients studied with cardiovascular diseases belong to the age group 28 70 years and is mostly seen in males. Majority of them are accompanied with co morbidities with obesity, hypertension and diabetic. And predominantly follow a high calorie and high fat diet .Thus leading to a conclusion that consumption of high calorie and high fat food, presence of co morbidities and smoking could be the risk factors of PTCA. Mrs. Meena Kumari | Mrs. Y. V. Phani Kumari | Gwyneth Madhulika Bashapaga | Ittamala Jaya Rachel ""A Study on Food Habits and Social Habits as Risk Factors among Patients Undergoing Percatenous Transluminal Coronary Angioplasty (PTCA)"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23372.pdf
Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/23372/a-study-on-food-habits-and-social-habits-as-risk-factors-among-patients-undergoing-percatenous-transluminal-coronary-angioplasty-ptca/mrs-meena-kumari
Study on the Health Related Quality of Life of Patients with Ischemic strokeiosrjce
The work entitled, “Study on the health related quality of life of patients with ischemic stroke” was
conducted in the department of Neurology at a multispecialty hospital. After receiving the official approval, the
study was conducted for a period of eight months from December 2013 to August 2014. A total of 278 cases with
Neurological disorders were found, of which 117(42 %) patients were with ischemic stroke. Hypertension (59%)
and Diabetes (53%) were the major co-morbid conditions found. The Health related quality of life of the
patients was assessed by direct interviewing of individual patients with a stroke specific questionnaire. The
Health related quality of life of the patients was assessed by direct interviewing of individual patients with a
stroke specific questionnaire. Quality of life assessments are done by various methods like taking the floor and
ceiling effects of the scores, average score calculation etc. Assessment of the floor and ceiling effect showed the
potential for floor effects in the most difficult domain(strength) and the possibility of a ceiling effect in the
communication domain. Assessment of stroke severity is done by taking the mean and SD of the individual domains
this book having four doctors if you need you can get
Dr Abdifatah dahir nor ( manager)
Dr osman abas mohamed
Dr ibrahim sacid
Dr abdalla mohamud mohamed
Chronic Conditions of as Predictors of Hospitalization Following an Emergency...Shin Jeong, PhD
Accepted and Presented in the Session of Injury Control and Emergency Health Services of American Public Health Association 2016 Annual Meeting and Expo Held in October 31.
For APHA member access, https://apha.confex.com/apha/144am/icehs/papers/index.cgi?username=359723&password=722348
A cross-sectional study on the prevalence of cardiovascular risk factors amon...Jameel Hijazeen
YouTube Video of me presentation these results: http://www.youtube.com/watch?v=YocIOa-5eI8
By Jameel Khaleel Hijazeen (1); Oday Zayid Al-Ma'aitah (1); Mahmoud Yaseen Abuznaid, MD (2); Ahmed Nader Abo.sharak (1); Khaled Ali AlShar' (1); Imad Farjou, MD, PhD (3).
[1] Sixth-year medical students, Faculty of Medicine, Mu'tah University, Karak, Jordan.
[2] Intern, Al-Bashir Teaching Hospital, Amman, Jordan.
[3] Department of Pharmacology, Faculty of Medicine, Mu'tah University, Karak, Jordan.
طلاب السنة السادسة: جميل خليل حجازين، عدي زايد المعايطة ، احمد نادر ابوشرخ، خالد علي الشرع.
طبيب إمتياز، مستشفى البشير: محمود ياسين أبوزنيد.
الأستاذ المشرف: عماد فرجو.
----------------------------------------------------------------
It was presented by me, Jameel Khaleel Hijazeen, sixth-year medical student at Mu'tah University, today, April 11th, 2013, at the 9th Scientific Conference of the Faculty of Medicine at Mu'tah University, Karak, Jordan.
There is always something better! Especially when you are doing something you never did before. Therefore, any feedback is more than welcome.
Some photos and more details about this research and the conference: http://amanfrommoab.com/2013/04/11/the-ninth-scientific-conference-of-the-faculty-of-medicine-at-mutah-university-karak-jordan-april-3-4-2013-2/
CARDIOVASCULAR DISEASE
CARDIOVASCULAR DISEASE
Cardiovascular Disease
Introduction
Cardiovascular disease posits a major cause of premature deaths and disability throughout the world and contributes to a significant increase in healthcare costs, particularly in medication, healthcare services, and production loss. Specifically, heart diseases and stroke accommodate the highest prevalence rate in the USA; accommodate an average of 610,000 and 365,000 annual deaths from CVD (CDC, 2015). Similarly, every year, CVD causes the USA approximately, $207 billion for medication, healthcare services, and productivity loss. Noteworthy, heart diseases and stroke incidences vary with factors such as ethnicity, gender, age, and individuals with certain disorders. Similarly, the project accommodates notable articulations on intervention, comparison, outcome, and time as a fundamental consideration in heart diseases and stroke in the USA. Thus, an enriched articulation on heart diseases and stroke are underscoring for the project presentation.
Definition
According to (Mayo Clinic, 2018), Heart disease describes a condition that affects the heart; including blood vessels diseases arrhythmias, and other heart defects. Significantly, the heart disease is interchangeable for the CVD, articulating on the infections involving narrowed or blocked blood vessels, causing a heart attack, chest pain, and stroke, among other clinical presentations. Similarly, (Mayo Clinic, 2018) acknowledges that many CVD is preventable and treatable with healthy lifestyle choices.
Epidemiology
Cardiovascular diseases posits an undying cause of death in the USA, projected at 840, 678 deaths in 2016, averagely one in three deaths (Salim et al. 2020). Similarly, between 2013 and 2016 121.5 million adults Americans presented notable for of the CVD. Notably, between 2013 and 2015 direct and indirect costs of managing the CVD in the USA, recorded $213.8 billion and $137.4 billion respectively. Statistically, between 2013 and 2016, 57.1% of non-HN black females and 60.1% of non-HN black males presenting CVD manifestations (Salim et al. 2020). According to the researcher causes of the CVD Include atherosclerosis resulting from an unhealthy diet, lacking exercise, overweight, and smoking. In the epistemology studies, risk factors such as age, sex, family history, smoking, chemotherapy and radiation drugs, high blood pressure, poor diet, obesity, physical inactivity, stress, and poor hygiene are underscoring risk factors in the CVD (Mayo Clinic, 2018). Thus, heart disease epistemological indicates the patterns, causes, risk factors, and specific populations in the USA.
Clinical Presentations
Cardiovascular disease acclaims clinical presentations that may differ between men and women. According to (Mayo Clinic, 2018), men present significant chest pain that women and women clinical presentations such as shortness in breathing, nausea, and fatigue are more evident than in men. Admi ...
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
The Hidden Risk That Is Tearing Your Company Apart Acbg 3 30 10leanhealthguru
The ACBG Edge is an process that allows construction companies manage the health and productivity risk of their employees. This complements American Construction Benefits Group\’s Lean Health Insurance Advantage. Together, these construction wellness processes create champion companies in 3 short years.
Knowledge and Perceptions Related to Hypertension, Lifestyle Behavior Modific...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Global death causes & preventive strategyDeepikaHarish
The snapshot approaches to answer the
following problem statement, along with relevant data points, leads & outlining a potential healthcare framework which acts around preventive approach to combat the disease onset & progression
- What are top causes of death worldwide & their impact on
healthcare expenditure
- Is there any insightful characteristic/ common pattern
associated with these indications
- What can be potent lead to develop a strategy plan to
prevent the onset & progression of these disease indications
study of compliance of diabetic patients to prescribed mediationTehreemRashid
This research comprises of data which depicts the prevalence of adherence to medication by diabetic patients and different factors that affect their compliance
Running head CREATING A PLAN OF CARE .docxsusanschei
Running head: CREATING A PLAN OF CARE 1
CREATING A PLAN OF CARE 10
Creating a Plan of Care
South University
NSG4055 Illness & Disease Management across Life Span
Professor
Creating a Plan of Care
The chronic disease selected for the plan of care is cardiovascular disease. This disease continues to pose major challenges not only for patients and their family members but also to the nation’s health care system. The rationale for choosing cardiovascular disease is because of the high rates of mortality and the effects of the co-morbidities associated with the chronic illness. According to Santulli (2013), cardiovascular disease is the single leading cause of fatalities in the United States, accounting for approximately 600,000 deaths annually. In 2011, approximately 26.6 million Americans were living with the chronic disease. The health care costs associated with the disease account for more than $500 billion annually. There are also many disparities in prevalence of risk factors, mortality, access to treatment and treatment outcomes based on race/ethnicity, socioeconomic status, gender, age and geographic area. Hence, tackling the disease should be a major priority for the US government. The main objective of the Healthy People 2020 initiative for cardiovascular disease is “improving cardiovascular health through early detection, prevention and treatment of the risk factors for stroke and heart attack”. This report outlines a comprehensive plan of care that can help in addressing and mitigating cardiovascular disease.
Holistic Plan of Care
Creating a holistic plan of care will indeed be essential for ensuring that people with chronic conditions such as cardiovascular disease lead a healthy life. Cardiovascular disease has a significant impact on the patient and the health care system. Apart from the emotional distress, patients with this condition also face some financial burdens, social burdens and increased levels of discrimination (Earnshaw & Quinn, 2012). In the course of completing the project, I administered a questionnaire to a coworker by the initials C.K. during week 2 to find out how she deals with the condition.
The questionnaire looked into various aspects such as family history, related medical conditions, the risk factors of cardiovascular disease, lifestyle choices and the coping strategies or support received by the patient. Understanding all these aspects can help in developing a well-managed care plan (Larsen & Lubkin, 2013). The results of the questionnaire revealed that C.K. observes healthy lifestyle, has the right levels of support and adheres to the medication regimen. All these factors helped her to cope effectively with the condition. However, even though she attested to leading a healthy lifestyle, C.K. also revealed that her family faced s ...
Helping Corporations reduce health care cost while by optimizing employee health with simple on site biometric testing, weekly phone conferences, as well as personal coaching and online tracking.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The use of mobile solutions in cardiovascular disease trials
1. Authored by
Rashmi K Gurnani
Vikrant Patnaik
"THE USE OF MOBILE SOLUTIONS IN
CARDIOVASCULAR TRIALS - DATA
CAPTURE AND TRIAL ADHERENCE"
2. 2 | www.padisys.com
Clinical trials pave the way for safe and effective medical products i.e.;
drugs, devices, and biologics to enter into the market. We are in an era
where people are aware and conscious about the kind of medication they
consume with regulatory authorities becoming very stringent in the drug
approval process. It has been observed that there have been trials which
have given rise to drugs which were in widespread use and have later been
found to be detrimental raising concerns that extend much beyond just the
cost implication. Hence the use of any technology that can improve
capturing of patient data pertaining to the desired drug effects vis-a vis the
real effect in subjects can prove to save time, money and also ensure the
safety of subjects in a clinical trial.
CARDIOVASCULAR DISEASE PREVALENCE:
Cardiovascular diseases are caused by disorders of the heart and blood
vessels, and includes coronary heart disease (heart attacks),
cerebrovascular disease (stroke), raised blood pressure (hypertension),
peripheral artery disease, rheumatic heart disease, congenital heart disease
and heart failure.(1)
Cardiovascular diseases are the prime cause of death worldwide. A World
Health Organization report suggests that by 2030, almost 23.6 million
people will die from cardiovascular diseases, mainly heart disease and
stroke. (2)
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RISK FACTORS FOR CARDIOVASCULAR DISEASES:
21st Century - has certainly brought in a world full of changes in our daily
lives. With more comforts, high tech gadgets and machines to cater to our
smallest needs, cheese filled hamburgers and pizzas! All of these bringing a-
“WOW! What a life”. What most of us sitting in air conditioned offices feel is
the ease in carrying out a particular activity as against how it was done a
couple of decades back. It feels awesome no doubt, but what we are
forgetting is the warm welcome that we give to lifestyle diseases due our
modified lifestyle.
While genetic factors do play a part in causing cardiovascular diseases, 80 to
90% of people dying from coronary heart disease have one or more major
risk factors that are influenced by lifestyle.
Behavioral risk factors such as unhealthy diet, physical inactivity and
tobacco use are the most important causes of heart diseases and strokes.
The intermediate risk factors thus are high blood pressure, raised blood
glucose, raised blood lipids and obesity. The other factors could be the ones
such as ageing, poverty, stress etc.
Hypertension as a risk factor:
Hypertension is one of the most important preventable causes of
premature deaths worldwide. Hypertension contributes to around half
of all cardiovascular diseases. High blood pressure is a phenomenon
that affects both young and old in several countries. It has been
estimated that 50 to 60% of the adults worldwide would be in better
health if they reduced their blood pressure by increasing physical
activity, maintaining ideal body weight and eating more fruits and
vegetables. (3)
4. 4 | www.padisys.com
High cholesterol as a risk factor:
High cholesterol causes one third of all cardiovascular diseases
worldwide. (3)
Adequate exercise and diet control can effectively bring
down cholesterol levels.
Tobacco as a risk factor:
Although cigarette smoking is primarily responsible for causing lung
cancer, by far more smokers suffer from cardiovascular diseases,
particularly heart attack and stroke. Quitting smoking effectively
reduces cardiovascular risk to close to that of a person who has never
smoked.
Obesity as a risk factor:
Obesity plays a major role in causing cardiovascular diseases. Obesity
ranges are determined by calculation of Body Mass Index (BMI). Since
BMI is directly proportional to body weight of an individual, it is
essential that an obese person makes efforts to keep his weight under
control. This can be achieved by regular exercise and proper diet.
Diabetes as a risk factor:
Diabetes is another essential risk factor that causes cardiovascular
diseases. Diabetes is more prevalent in developed countries, but
modernization and lifestyle changes are likely to result in a future
epidemic of diabetes in developing countries. Lifestyle changes in
childhood, in particular unhealthy diets and low exercise levels, are
leading to an increasing prevalence of type 2 diabetes in children.
Socioeconomic status as a risk factor:
A WHO report states that “Low- and middle-income countries are
disproportionally affected: 82% of CVD deaths take place in low- and
middle-income countries and occur almost equally in men and women”
[4]
. Studies in developed countries suggest that low income is
associated with higher incidence of coronary heart disease and with
5. 5 | www.padisys.com
higher mortality after a heart attack. The prevalence of risk factors for
heart disease such as high blood pressure, smoking and diabetes is
also higher in the low socioeconomic status groups as compared to the
higher.
THE CARDIOVASCULAR TRIALS ARENA:
The cardiovascular therapeutic area has been the largest or second-largest
in conduct of clinical trials for the past decade, making up 15.5% of all
clinical trials [5]
. Correspondingly, the cardiovascular therapeutic area
commands the largest market for prescription drugs – nearly one fourth of
branded prescription drug sales – as the dominant indication for branded
medicines sold commercially during the past few years. The total worldwide
cardiovascular market is expected to show revenues of $91.2 billion in 2008,
an increase of 6.9% compared with 2003 [6]
.
Globally, the population of people over 65 years of age is increasing by
750,000 each month. The older population is expected to triple in many
developing countries within the next 30 years [7]
.
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IMPORTANCE OF PATIENT REPORTED OUTCOMES IN
CARDIOVASCULAR TRIALS:
Patient reported outcomes play a vital role in of cardiovascular trials as the
medical intervention is aimed at to improving the health related quality of
life of the patient or to prevent premature deaths which are important
aspects when concerning a heart patient. These patient reported outcomes
become particularly important when the intervention aims at improving
symptoms or the functional status of the patient.
In cases of cardiovascular clinical trials, the primary aim is to improve
observation and capturing of patient symptoms, functional status or quality
of life of the patients, hence patient reported outcome measures become
crucial.
A study has shown that cardiovascular trials that mention quality of life have
increased more than three fold since 1997. By 2009, about 14% of trials
mentioned quality of life. (8)
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THE CARDIOVASCULAR TRIALS SCENARIO:
It has been observed that due to the various risk factors which cause
cardiovascular diseases, these diseases are now prevalent in both young and
the elderly. Hence, a large number of trials are being conducted in this
therapeutic area. With such high numbers of trials being conducted, there
are several factors which the sponsors and investigators have to consider
while conducting the trial.
1. Patient adherence to treatment:
Cardiovascular diseases may be both acute and chronic. In both these
cases, the patients adherence to the treatment medication as per the
protocol is very essential as missing even a single dose of the
medication in cardiovascular disease treatment such as for angina may
lead to disastrous results for the patient enrolled in the trial.
Additionally the patient may represent a geriatric group wherein due to
poor memory the patient may not consume his/her medication at the
prescribed time or may forget their visit schedule. Also sometimes the
protocol is so complex that it becomes difficult for the patient to
remember about his/her next visit to the investigator thus making
them non- adherent to the protocol.
2. Patient compliance to protocol:
The cardiovascular trials conducted these days are mostly efficacy
based trials. These trials include both the young and the elderly.
Although such trials include varied age groups, since the population of
the elderly (65 and above) is growing, and there are several trials that
focus on improving health related quality of life of the elderly. In such
a scenario wherein the patient population consists of the elderly, it
becomes very important for the investigators and sponsors to ensure
8. 8 | www.padisys.com
that the patients comply with the protocol and participate in getting on
board better trial results.
3. Loss to follow up:
There are several reasons due to which there may be patient dropouts
or loss to follow up during clinical trials. Some of the reasons may be
as follows:
Inability of the patient to come to the clinic which may further be due
to transportation problems- fatigue which is most commonly observed
in cardiovascular disease patients
Plain ignorance in not following the study protocol
The patient may have migrated to a far off region due to which there
may be loss to follow up
Demise of the patient.
4. Patient monitoring:
In cardiovascular diseases, it is not only the treatment adherence
which is important, the monitoring of various other factors which
influence the patients’ well being need to be monitored. The patient
has to also avoid the risk factors which may cause a cardiovascular
disease other than what he may be suffering from. In addition the
patient may have to avoid risk factors which may deteriorate his
present condition. Hence it becomes important for the investigator to
keep a check that the patient is following the specified exercise and
physical activity regimen, following the right diet, refrain from
smoking, maintain the right body weight etc.
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5. Measuring vitals:
For any patient participating in a cardiovascular trial, it is paramount
to keep track of his/her vitals such as blood pressure levels which is an
indication of whether the patient suffers from hypertension and weight
conditions, to check if the patient is progressing towards maintaining a
normal BMI.
Apart from this, in cardiovascular trials, the measurement of
cholesterol levels is very important. A sponsor, investigator and the
trial staff has to ensure that the patient vitals are recorded on regular
intervals based on the protocol.
Research on treatment and treatment adherence for people suffering from
cardiovascular diseases has been going on for many years and several
measures have been adopted towards improving patient care at different
levels. Treatment regimen is of utmost importance for the treatment of
cardiovascular diseases. Until recent times’ technology only empowered
physicians to monitor patients and their treatment regimen but today, we
certainly can improve the same by allowing the patients to be performing a
part of the doctors’ job and proactively manage their medication intake, be
compliant to the treatment regimen, follow strict site visit schedules etc.
Mobile technology in such cases proves to be a boon to the clinical research
industry and appears to be a one stop solution to sponsors, CRO’s, trial staff
and most importantly the trial patients.
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THE INFORMATION TECHNOLOGY ADVANTAGE
A clinical trial is largely dependent on the data provided by the subjects
enrolled into the trial, who consume the drug under question. A drug for it to
be launched in the market after extensive research takes anywhere around
15 to 20 years. Also millions of dollars are spent each year by Sponsors on
clinical trials. With such a lot of effort, time and money going into trials, the
success of the trial becomes very essential. This success can largely be
achieved by the right data reported within the right frame of time by the
patient.
Till date most trials have this data (PRO) captured by using the paper based
system wherein all the questionnaires are administered by means of paper.
With the modernization of the world and tremendous development of
technology, time has come where all the players of the clinical research
industry should use the features of information technology for improved
results.
The ePRO (Electronic patient reported outcomes) and mPRO(Mobile Based
Patient Reported Outcomes) provide an edge over the traditional paper
based system allowing:
Rapid data capture,
Avoidance of data entry errors,
Ability to trigger alerts/notifications for specific responses of concern
Elimination of double data entry processes
Real-time tracking of survey and compliance
Reduction in missing information as compared to with paper
administration
Increase in patients’ willingness to report sensitive information
Secure data storage in a compliant environment
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Easy access and storage of data which omits the problem of data archival
which is a huge problem with data storage as the regulations require
the data to be stored for a minimum of 15 years after the start of the
trial and 3-5 years after the drug has obtained marketing approval.
INTERNET vs. MOBILE
The internet certainly has played a very important role in giving a new
dimension to the way things were and how they are today, however, with
the advent and prevalence of mobile phones, there is a new dimension that
can be explored and benefited from. Today we can achieve higher
compliance ratios, better treatment follow up and intervention in
cardiovascular trials using mobile technology. Global statistics show that
there are more than 4 billion mobile phone users across the globe which
constitutes of 2/3 rd of the world’s population, which is three times that of
the internet users.
HOW MOBILE SOLUTIONS CAN BE ADVANTAGEOUS IN
CARDIOVASCULAR TRIALS:
In cardiovascular trials it is very important to make sure that the patient
follows the protocol and it is also important to track the patients’ progress
after medication intake. Since there are various reasons for loss to follow up
of a patient in any clinical trial, the sponsors should adopt means which can
better monitor the patient. In such cases mobile solutions serve as an
affordable, easy and reliable solution.
The most important aspect of cardiovascular trials is to make sure that the
patients enrolled in the trial consume medication on time, eat food at the
prescribed times as per the protocol, follow the prescribed diet, follow a
strict exercise regimen, visit the clinic for biochemistry assessments on time,
provide required data to the investigator for their own betterment and
12. 12 | www.padisys.com
successful completion of the trial. All these aspects can be taken care of with
ease, using a mobile solution.
PaDiSys – NEXT GENERATION PATIENT DATA CAPTURING AND
TRIAL ADHERENCE MANGEMENT SYSTEM
Patient Diary System (PaDiSys) allows patients enrolled in clinical trials to
use smart phone devices to report their clinical outcomes electronically.
PaDiSys is a mobile technology platform built from a ground up approach,
complying with international regulatory and compliance guidelines such as
CFR 21 Part 11, FDA, EMEA etc. The PaDiSys System has two major
configurations, namely;
1. PaDiSys mPRO – Mobile Based Patient Reported Outcome Capturing
Solution
2. PaDiSys mTA – Mobile Based Patient Trial Adherence Solution
The aforementioned mobile solutions can be used across therapeutic areas;
however, can find high utility in cardiovascular trials and treatments.
13. 13 | www.padisys.com
ENHANCING EFFICIENCY OF PATIENT REPORTED OUTCOMES IN
CARDIOVASCULAR TRIALS USING PaDiSys:
PaDiSys mPRO incorporates a feature of capturing patient data at source- as
per the clinical trial protocol or the treatment regimen. The mPRO
configuration allows the patient to fill up assessments/questionnaires to
monitor patient’s health status as per the requirement of study protocol or
the treatment being administered to the patient. With such a solution the
patient or in critical cases the patient’s caregiver fills up questionnaires that
appear on a mobile phone device at the convenience of their
homes/sites/care centers, without having to go to the site to submit the
same.
Understanding the need to capture and collect valid information, the system
allows the information and data transfer to happen over secure and
compliant environment- REAL TIME. Real time data capture makes the task
at the investigator/cardiologists’ end much simpler and quicker with them
able to take further actions and for making amendments to the treatment
faster. The system allows investigators to manage multiple patient groups
and send specific group related information or customized individual alerts
and instructional messages.
In cardiovascular trials a huge emphasis is laid on improvement of health
related quality of life, symptoms and functional status of patients enrolled in
the trial. Any drug/medical device/surgical procedure which improve the
quality of life of patients by even a minor percentage is of great value to
sponsors and investigators in cardiovascular trials keeping in mind the high
number of deaths happening every year due to cardiovascular diseases. To
determine the levels of stress, depression and the quality of life of the
subjects in the trial, several questionnaires are to be filled up by the
patients. The same holds true for measuring the quality of life of subjects in
14. 14 | www.padisys.com
a cardiovascular trial for which Quality Of Life (QOL) questionnaires need to
be filled by the subjects. To fill up these questionnaires, the patient will have
to visit the clinic several times. This stress to the patient can be avoided by
allowing patients to complete such assessments via the mobile phone using
the PaDiSys mPRO solution. All the responses provided by the patient reside
on a secure database and also the data is captured real time. Hence the
information provided by the patient can be viewed by the investigator
immediately. Immediate visibility to information can help the investigator
know if the drug is effective on a patient and incase the investigator decides
based on his experience that the drug may cause side effects to the patient
or if the drug is already causing some side effect to the patient, the
medication can be immediately discontinued without waiting for the patients
next visit to the clinic and hence stopping the situation from worsening. Any
side effects experienced by the subject can be immediately reported to the
investigator using the PaDiSys mPRO. In case of severe visible side effects, a
picture can be immediately taken by the patient and sent to the trial staff.
With the usage of such a system, there are reduced chances of inaccurate
data capture from patients.
- Cardiovascular diseases are caused by a group of risk factors. The protocol
of such trials may be a little more complex as it may consist of consumption
of concomitant medications such as anti-hypertensives or insulin
administration in case of diabetic patients along with the drug under study.
Also the protocol consists of instructions about the kind of diet to be taken at
various time schedules, exercise regimens etc. It becomes difficult for the
patients, research coordinators and the investigators to remember the
schedule of every assessment, visit, drug intake etc. To make things easier,
the PaDiSys mPRO is provided with a patient calendar where the patient can
view his medication, assessment and site visit schedules in advance. This is
a boon also to the investigators and the coordinators as they need not
15. 15 | www.padisys.com
remind the patient of their visits and also it ensures patients’ adherence to
the protocol.
- Patient follow up in cardiovascular trials is extremely valuable to gather
safety and efficacy end point information which is essential to the study as
well as the life of the trial subject. It is observed in clinical trials that several
patients are lost to follow up or dropout, which can prove to be very
expensive. In addition it also extends the trial duration which again proves
to be costing the sponsors hugely. The loss to follow up may be due to
inability of the patient to visit the clinic often. This problem is taken care of
by PaDiSys mPRO as the patient can fill his vital information using a simple
cellular smart phone while he/she is at home. Another reason of loss to
follow up or patient dropout is the migration of patients to far off regions, in
the case of which the patient is not able to visit the clinic. This aspect of
follow up also is easily taken care of by PaDiSys mPRO as these products are
portable, light and handy.
- Cardiovascular diseases may be caused by a number of factors such as
stress, depression, obesity, and hypertension etc. sometimes cardiovascular
diseases such as strokes may make the patient bed ridden. In such cases
apart from the medication, palliative care also becomes very important. At
every point in the trial it becomes imperative to check the levels of stress,
depression, anxiety and various other parameters essential and important in
cardiovascular trials.
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FEATURES OF THE PADISYS mTA THAT CAN BE USED IN CVD TRIALS:
PaDiSys mTA, is a subdued version of the PaDiSys mPRO solution,
essentially focused towards improving trial/treatment compliance in trials
which not necessarily, need patient data capture. In this system, text
messages or mobile alerts are generated for the trial patients regarding the
consumption of medication, their next visit to the doctor, and the dates of
biochemistry evaluation in which case blood draws are required.
Such reminder systems are extremely useful in cases of cardiovascular trials
as reminders for exercises, food intake, abstaining from tobacco etc can be
sent to patients own mobile phone which ensures that the patient stays
away or at least controls the risk factors which may worsen the patients
clinical condition.
PADISYS IN CARDIOVASCULAR MEDICAL DEVICES AND SURGICAL
TRIALS:
Cardiovascular disease conditions can be greatly improved by using medical
devices such as stents, pacemakers, implantable cardioverter-defibrillator
(ICD) etc. There are many trials which are being conducted in the
development of new and more effective medical devices which can prove to
be much more beneficial than the existing medical devices for the heart.
Such developments include devices such as drug eluting stents, devices
using microchips etc; which require extensive trials with quality data as they
are implanted within the human body.
In the same way there are various surgeries which are done to relieve a
patient from cardiovascular disease which result from blockage of small
blood vessels that supply blood to the heart (coronary heart disease). There
have been innovations in this field too. Since there are innovations, clinical
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trials in this field are necessary prior to surgeries being done on normal
patient population. An example of such an innovation is the robotic surgery.
The end points of such trials are more subjective in nature. Thus, after the
medical device trial or surgical trial for the cardiovascular system is
conducted, it is important that the patient is followed up over time efficiently
and the levels of distress, pain and anxiety of the patient is checked
periodically. Also in surgical trials, it is evident that concomitant medications
need to be taken by the patient and some cases may also require exercises.
In case of medical device implantation and surgeries patients are bed ridden
and may not be able to visit the clinical/hospital to fill up the required
assessments. In such cases, questionnaires may be administered over the
mobile phone which enables to assess the patient condition immediately. By
this any deterioration in patient condition can be immediately known and
addressed. Also reminders of medication intake, food intake, exercise alerts
can be sent which in better patient outcome. This proves beneficial to
patients (in terms of improved health), investigators (in terms of improved
monitoring), and sponsors (in terms of better chances of trial success).
COST EFFECTIVENESS
The pharmaceutical industry spends approximately 26.4 billion dollars
annually for research and development (4.1 billion dollars in cardiovascular
products) (8)
. This implies that around 15.5% of the investment is in
cardiovascular research and development. With such huge investments in
cardiovascular trials, it is essential to ensure that there are no losses
encountered in the conduct of trials and maintain patient’s safety and well
being as well. Every aspect of cardiovascular trials beginning from the
selection of the site, compensation to trial subjects to final regulatory
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submissions takes investment, time and resources. If any inaccurate data is
recorded during the trial, it ultimately results in further losses to the sponsor
as the required safety and efficacy end points which are essential to the
study will not be obtained. Every patient lost to follow up is a loss to the
study. Also it results in a delay in the completion of the study. In clinical
trials, each day lost, is thousands of dollars lost in added expenses and loss
of opportunities. The PaDiSys mPRO and PaDiSys mTA are low cost solutions
that ensure patient compliance to protocol, treatment adherence, regular
and timely visit to the clinic/investigator and most importantly accurate data
capture that can bring down the costs of loss to day, by a significant
amount. It is estimated that in the long run the trial/treatment cost for a
cardiovascular study or treatment would be reduced by a very large extent
using mobile technology. All this in turn result in timely submissions to the
regulatory authorities and above all appropriate trial results which can prove
to be useful to cardiovascular disease patients worldwide.
CONCLUSION:
As clinical trials continue to evolve, investigators and sponsors will be
challenged to find the optimum balance between trial data quality and
scientific and medical integrity that can best evaluate new interventions at
lowest costs possible. This can be efficiently achieved by using mobile
solutions. It is important that the industry experts both in the Life Sciences
and healthcare spheres understand this requirement and take action to
implement such available technology services for treating patients suffering
from chronic and terminal illnesses. Cardiologists and sponsors across the
globe must take the initiative of using cost effective methods to monitor
their patients and provide better point of care.
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REFERENCES:
1. http://www.who.int/topics/cardiovascular_diseases/en/
2. http://www.who.int/mediacentre/factsheets/fs317/en/
3. "The Atlas of Heart Disease and Stroke" by WHO in collaboration with
US Centers for Disease Control and Prevention (CDC) -
http://www.who.int/cardiovascular_diseases/resources/atlas/en/
4. Key Facts- Cadriovascular Diseases – WHO Media centre -
http://www.who.int/mediacentre/factsheets/fs317/en/index.html
5. Hovde M. Getting to the heart of the cardiovascular indication. GCPj.
2003. pp. 30–31.
6. Cardiovascular Markets Global Markets & Developments. Theta
Reports.p.202.http://www.marketresearch.com/product/display.asp?p
roductid=974912&SID=13585805-288440936-301862885&xs=r April
7, 2004, Pub ID: VB974912.
7. The World Health Report Life in the 21st
century: a vision for all.
Geneva: WHO. 1998
8. Outcome selection and role of patient reported outcomes in
contemporary cardiovascular trials: systematic review Kazem Rahimi,
specialist registrar and senior clinical researcher, Aneil Malhotra,
specialist registrar in cardiology, Adrian P Banning, consultant
cardiologist, Crispin Jenkinson, professor of health services research
9. Reducing the costs of phase III cardiovascular clinical trials- Eisenstein
EL, Lemons PW 2nd, Tardiff BE, Schulman KA, Jolly MK, Califf RM.
About the Authors:
Rashmi K Gurnani: Assistant Business Analyst, Global Marketing and Comm.
Vikrant Patnaik: Sr. Manager Global Marketing and Comm.
20. 20 | www.padisys.com
About the Company:
NowPos M-Solutions is a Mobile Technology Development and Services
Organization specializing in Life Sciences and Healthcare. In the past years
the organization has gained significant expertise in the mobile and web
domain with several mobile based products.
NowPos is primarily focusing on developing end to end mobile solutions for
capturing Patient Related Outcomes in the Clinical Trials Domain of the Bio-
pharma and Life Sciences Industry. Working in a completely secure
environment and adhering to international compliance guidelines and
following the GAMP 4/5 development methodology, NowPos as an
organization believes in bringing a paradigm shift in the way things were
being done earlier.
As an initiative to cater to the fast growing mobile applications and
technologies, the NowPos Technology Services Group offers custom mobile
application development on upcoming mobile technologies. The Technology
Services Group also offers consulting services for development on iPhone,
Android and Symbian applications.