Iranian Journal of Health Sciences
Volume:8 Issue: 3, Summer 2020

Drug utilization research evaluates the appropriateness of the prescriptions which is important in clinical practice. Psychotropic polypharmacy is a major problem in psychiatric practice, which can lead to the development of adverse effects of those drugs in patients. Therefore, this study was carried out to evaluate the utilization of psychotropic drugs being prescribed for various psychiatric illnesses.

A prospective, cross sectional, observational study was carried out in patients visiting the Psychiatric Out-Patient Department of B J Government Medical College and Sassoon General Hospital, Pune, INDIA; from December 2016 to May 2018. A total of 500 prescriptions were analysed using WHO Drug Use indicators and some other indicators.

Average number of drugs per prescription was 3.14 ± 1.18; while average number of Psychotropic drugs per prescription was 2.27 ± 0.90. 84.35% of the total drugs prescribed by Generic name. 43.89% and 41.67% of the total drugs were prescribed from National List of Essential Medicines 2015 and WHO Model List of Essential Medicines 2017, respectively. Antipsychotics was the most commonly prescribed group of Psychotropic drugs, while Olanzapine was the most commonly prescribed Psychotropic drug. 64.25% of the total drugs were prescribed from the hospital drugstore.

In the present study, drugs were prescribed rationally and judiciously. But there was a need to increase the prescription of drugs from essential drug lists. Apart from that, there was found a need to increase the availability of the commonly prescribed Psychotropic drugs in the hospital drugstore of the study institution.

Type 2 diabetes mellitus (T2DM) is the most common form of diabetes, and a metabolic disorder affecting patientschr('39') general health in various ways. The present study aimed to evaluate the oral health-related quality of life (OHRQoL) among older adults of Amirkola, Northern Iran.

A case-control study was conducted with a sample of 500 elderly people (250 with T2DM and 250 healthy controls) who answered geriatric oral health assessment index (GOHAI) questionnaire and a questionnaire evaluating xerostomia. Then, all participants underwent clinical dental examinations. The obtained data were then analyzed by t-test, chi-square test, and Pearsonchr('39')s correlation coefficient, and p < 0.05 was considered significant.

The prevalence of xerostomia was not statistically significant between the T2DM patients and control groups (p < 0.079). Greater number of patients suffering T2DM reported xerostomia according to the records; however, the correlation between this disorder and periodontal disease index (PDI), Plaque index (PI), oral health index-simplified (OHI-S), and geriatric oral health assessment index (GOHAI) in the subjects of the two study groups was not significant (p < 0.0001).

In the present study, there was no significant relationship between GOHAI and periodontal indices, demonstrating no difference in the OHRQoL of elderly patients with T2DM and older healthy adults.

Linked with high mortality rate, depression is common among acute coronary syndrome (ACS) patients. The current study sought to identify the factors associated with depression among ACS patients in Malaysia.

A cross-sectional study was conducted on 400 ACS patients in two Malaysian hospitals: Hospital Universiti Sains Malaysia (USM), Kelantan and Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. ACS patients were included if they were above 18 years of age, able to read and/or write in Bahasa Melayu language and had informed consent. Patients were excluded if they were intubated, had an altered mental status, mental retardation and had psychological problems prior to ACS. Depression in this study was defined as having dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest or involvement, anhedonia, and inertia among ACS patients. A questionnaire was distributed to all 400 ACS patients. Simple and multiple logistic regressions were used for data analysis.

The mean (standard deviation) age of ACS patients was 60.4 (11.3) years at Hospital USM and 61.2 (10.4) years at HSNZ. Nearly all of the depressive-ACS patients were Malay (79.4%), 85.9% were male, and 79.7% were married. Approximately 87.7% of depressive-ACS patients had ischemic heart disease, 87.1% had stroke, 83.4% had hyperlipidaemia, 81.8% had diabetes mellitus, and 80.7% had hypertension. The factors associated with depression were female gender (adjusted odd ratio (OR): 2.48, 95% confidence interval (CI): 1.50, 4.10, p<0.001) and ischemic heart disease (adjusted OR: 2.44, 95% CI: 1.41, 4.25, p=0.002).

The results showed that female gender and ischemic heart disease were the most significant associated factors of depression among ACS patients.

Lung cancer is one of the most common cancers around the world. The aim of this study was to use Extended Cox Model (ECM) with Bayesian approach to survey the behavior of potential time-varying prognostic factors of Non-small cell lung cancer.

Survival status of all 190 patients diagnosed with Non-Small Cell lung cancer referring to hospitals in Yazd were recorded from 2009 to 2013 by phone call. We fitted conventional Cox proportional hazards (Cox PH) as well as Bayesian ECM. Inference for estimated risk ratios was based on 90% credible intervals. Log pseudo marginal likelihood criteria (LMPL) was used for model comparison. Statistical computations were based on R language.

In this study, 190 patients with non-small cell lung cancer were followed, of whom 160 died because of the disease (84.2%). Median of survival time was 8 ± 0.076 month. After fitting the Cox PH Model, it was determined that the PH assumption was not satisfied for the type of treatment, the disease stage, and pathology status variables (p <0.001). LPML for Cox PH and Bayesian ECM was -431.593 and -401.01, respectively. Estimated hazard ratio curves based on Bayesian ECM showed that the risk ratio for these variables exhibited significant time varying behavior on hazard of lung cancer through follow up time.

Based on LMPL, Bayesian ECM was found to have a better fit than Cox PH Model which declares, results from Cox PH should be interpreted with care. Especially, from beginning of the study to about 20 month after, very high risk ratio was estimated for variables whose PH was not satisfying for them.

In order to have an imagination of glass government, it is a priority to consider corruption, transparency, trust, and awareness. The present research aimed to model the relationship between the mentioned variables in the hospitals of Mazandaran Medical Science University.

This was a cross-sectional descriptive research. The population included all medical and administrative staff of selected hospitals from east of Mazandaran in 2019, consisting of 4251 persons (1774 male and 2477 females), and the research was carried out on the basis of data from 353 subjects according to Cochran formula by classified sampling fitted to the size of each class. The required data were collected by using standard questionnaire and analyzed by SPSS and AMOS Software. In descriptive statistics, descriptive indicators, such as mean, variance, minimum and maximum and frequency tables, were used and in inferential statistics, the collected data were analyzed by using Kolmogorov-Smirnov tests to check the normality of the data, and path analysis.

The findings from confirmative factor analysis showed that transparency had a significant effect on perceived corruption (with standard deviation of 0.32 and T value of 4.814), public awareness (0.22 and 3.284), trust in government (0.23 and 3.303), trust in administrative evolution committee (0.48 and 7.109), perceived corruption on trust in government (0.28 and 4.436), trust in administrative evolution committee (0.33 and 5.483), public awareness on perceived knowledge (0.20 and 3.052), and trust in administrative evolution committee (0.16 and 2.878) and trust in administrative evolution committee had effect on trust in government (0.29  and 3.453), but public awareness had no significant effect on trust in government (0.10  and 1.715).

Glass government should pursue reducing corruption at the level of subordinate organizations with more transparency and awareness and by doing so, trust in the government and administrative evolution committees will be achieved.