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1.
Article | IMSEAR | ID: sea-240696

ABSTRACT

This study explores the awareness and engagement levels of college students in Ramanathapuram District, Tamil Nadu, regarding the Right to Information Act (RTI). Despite the RTI's role in promoting transparency, findings show high awareness among students but low usage of the RTI for accessing information. The gap between theoretical knowledge and practical application highlights the need for improved educational strategies. Data from 100 students were collected using a structured questionnaire assessing familiarity with RTI procedures, information sought, and perceptions of its impact. Key barriers identified include the complexities of the filing process and a lack of perceived need. The study suggests integrating RTI into curricula, simplifying the process through workshops, leveraging digital media, and encouraging community engagement to foster informed, active citizens, thereby enhancing civic education and democratic participation.

2.
Article | IMSEAR | ID: sea-227910

ABSTRACT

Global mental health, impacting over a billion individuals, is addressed by the World Health Organization’s (WHO) 2023 special initiative for mental health, targeting accessible community-based care for 100 million people. The complexity of mental health dynamics, influenced by diverse factors, shapes an individual's position on the continuum. Depression and suicide rates highlight the global crisis, with 970 million affected in 2019. India grapples with a treatment gap and economic implications, exacerbated by mental health stigma. Neglected in public health agendas, mental health imposes a significant burden, necessitating targeted policies and interventions. Breaking barriers requires collective efforts, including celebrity advocacy, organizational initiatives, and public education. Global interventions focus on suicide prevention through access restriction and responsible media reporting. Child and adolescent mental health necessitate policies promoting well-being and caregiver support, as seen in India's Mental Healthcare Act of 2017. In conclusion, global mental health, a priority, faces persistent barriers, particularly stigma. Urgent action is needed to integrate mental health into broader public health strategies, dismantle discriminatory practices, and ensure equitable access to care for a future prioritizing universal well-being.

3.
Article | IMSEAR | ID: sea-240016

ABSTRACT

Background: Girl children are vulnerable to gender biases throughout the economic and social strata. From the moment of conception, a girl’s existence is an ongoing struggle for survival, development, and growth. Gender equality has gained recognition in the past 10 years as essential to a country’s social and economic progress and overall health. Aims and Objectives: The aim of the study was to know the awareness and attitude of antenatal mothers regarding the preconception and prenatal diagnostic techniques (PCPNDT) act, gender preference, and their awareness regarding related social issues. Materials and Methods: A hospital-based cross-sectional study was conducted after obtaining ethics committee approval and consent from 200 antenatal mothers attending a maternity hospital from September to December 2022. Data were collected using a predesigned, pre-tested, semi-structured questionnaire. The analysis was done with Statistical Package for the Social Sciences software version 26.0. Results: Out of 200 study subjects, 80% were in the age group of 19–25 years, 60.5% were aware of the PCPNDT act, and 43.8% of mothers had knowledge about the PCPNDT act from hospital sources. Of the 56% of mothers who preferred a male child, 35.7% said it was first being a girl child. In this study, awareness of the PCPNDT act was significantly associated with age, area of living, religion, education, occupation, and socio-economic status, but not with type of family. Conclusion: Despite better knowledge regarding the PCPNDT act, the attitude toward sex determination, female foeticide, and son preference has to be changed. For this reason, strict implementation of the PCPNCDT act is essential.

4.
Article | IMSEAR | ID: sea-240751

ABSTRACT

The word 'ostensible' can be explained as something that appears to be true but is not actually true. The ostensible owner of a property is thus cannot be a real owner of a property. He can merely represent himself as the real owner to the third parties or to the public at large. The ostensible owner of a property possesses all the rights of ownership in a property but without being the real owner of the same. These rights are acquired by him through the explicit or implied consent of the real owner. He is the full but unqualified owner and the real owner remains the qualified owner of the property. The doctrine of transferring a property by ostensible owner can be seen as an exception to the maxim "nemo dat quod non habet" i.e. no one has the power to confer a higher right on the property that is possessed by himself. The paper will be elaborating upon the concept ostensible owner and will be covering the rights and duties of the ostensible owner of a property in a detailed manner. The primary focus of the research work will be to focus on the justification and validation of the concept of ostensible owner and how such concept is supported by statutory and jurisprudential methods with the help of various conditions and specifications in form of principles and laws.

5.
Article | IMSEAR | ID: sea-240173

ABSTRACT

Background: Package inserts (PIs) are source of drug information provided for the effective use of marketed drugs by prescribers and patients. Aims and Objectives: This study was done to evaluate the completeness of information provided in medicinal PIs. Materials and Methods: This descriptive study was done using 100 PIs collected from the drug store in a tertiary care hospital located in South Kerala for 2 months. They were evaluated in terms of completeness as per the criteria mentioned in Schedule D of the Drug Cosmetic Act 1945 and graded into Grade A (>20), Grade B (10–20), and Grade C (<20) based on the degree of completeness and scores obtained. Data were analyzed in Microsoft Excel, expressed in percentages and whole numbers. Results: Out of 100 PIs, majority (23%) were antimicrobials, followed by bronchodilators (12%). Most of them (86%) were oral preparations, followed by injectable (12%) and topical (2%). On evaluation, 19% of them belonged to Grade A, 78% to Grade B and 3% to Grade C. There were deficiencies in clinical data regarding: Last update (37%), the effect of the ability to drive/use machines (42%), use in pediatric and geriatric information (46%). 49% of them lack information on shelf life. 19% of PIs were from multinational companies and 81% were from Indian companies. Conclusion: As PIs are incomplete as per regulatory guidelines, it is essential to improve the standards of preparing and monitoring PIs for avoiding medication errors.

6.
Article in Chinese | WPRIM | ID: wpr-1023391

ABSTRACT

Comprehensive improvement in course teaching quality is an important link in deepening the reform of undergraduate education and teaching. Since 2018, West China Medical School, Sichuan University, has implemented the collective lesson preparation system of "two meetings, seven decisions, and three preparation sessions" for undergraduate clinical courses, thereby effectively implementing subject cooperation, organizational guidance, and resource integration among clinical teachers and determining the key elements of the course through "teaching, learning, and exam preparations" before class. In the process of course operation, the concept of quality control based on plan-do-check-act cycle is deeply integrated with the collective lesson preparation system, and active implementation of the whole-process quality control loop of planning (plan), organization and implementation (do), inspection of results (check), and treatment and improvement (action) has effectively improved the teaching quality of undergraduate clinical courses.

7.
China Pharmacist ; (12): 264-271, 2024.
Article in Chinese | WPRIM | ID: wpr-1025943

ABSTRACT

Objective To explore the strategy of constructing a scientific management system for antibiotics in a tertiary hospital,and to provide reference to strengthen the management and rational use of antibiotic.Methods Using PDCA management tools to build a scientifically effective antimicrobial drug management system.Evaluation of management quality of antimicrobial stewardship was constructed by 14 indicators of 5 dimensions.The entropy weight TOPSIS method was used to comprehensively evaluate and analyze the changes in various indicators after the implementation of PDCA improvement.Results Based on the entropy weight TOPSIS analysis,the management quality of antibiotics in 2018 was the lowest with the Ci value 0.313 5,and the management quality of antibiotics in 2022 was the highest with the Ci value 0.747 4.The evaluation of antimicrobial stewardship was divided into five dimensions:for the evaluation of antibiotics use density,the Ci value in 2017 was highest;for the evaluation of antibiotics usage rate,the Ci value in 2021 was the highest;for the evaluation of the submission rate before use of antibiotics,the Ci value in 2022 was the highest;for the evaluation of preventive medication for type I incisions,the Ci value was highest in 2022;the evaluation of the cost dimension of antibiotics for hospitalized patients showed the highest Ci value in 2022.The application of PDCA method for antibiotics management had shown an overall improvement trend.Conclusion Based on PDCA method,collaboration through multiple departments for antibiotics management had achieved significant results.The entropy weight TOPSIS method can be used to evaluate the effectiveness of antibiotics management,to provide reference for the direction of hospital antibiotics control and policy formulation.

8.
Article in English | WPRIM | ID: wpr-1031904

ABSTRACT

Objective@#To compare PhilHealth case rate versus actual charge of hospitalization of common general surgery procedures in a Level 3 government hospital from 2017-2019.@*Methods@#The five most common procedures were determined and records were reviewed. Hospital bills and professional fees (PF) were compared to the PhilHealth rates using t-test. The range of perceived acceptable PF was determined by an online survey.@*Results@#The most common procedures were open appendectomy, open cholecystectomy, initial repair of inguinal hernia, total thyroidectomy and modified radical mastectomy. The study included 1934 charts. For service cases, the hospital bill for appendectomy was significantly lower than the PhilHealth institutional fee, while the rest were significantly higher. For private cases, hospital bills for open cholecystectomy and modified radical mastectomy were significantly higher, while that of open appendectomy was lower. The average PF of private patients in all procedures were significantly higher than the PhilHealth rate, also reflected on the survey.@*Conclusion@#The significant discrepancies between the actual charges and the PhilHealth case rates showed that the PhilHealth rates were insufficient for the five most common general surgery procedures in a Level 3 government hospital.


Subject(s)
Philippines , Insurance
9.
Article in Chinese | WPRIM | ID: wpr-1013337

ABSTRACT

ObjectiveTo investigate the effect of Xuanfei Zhisou prescription on the interleukin-17 (IL-17) signaling pathway in model rats with chronic obstructive pulmonary disease (COPD). MethodA total of 60 Wistar rats were randomly divided into a blank group (10 rats) and a model group (50 rats), and COPD model rats were established by tracheal infusion of lipopolysaccharide combined with passive fumigation. After modeling, the rats were divided into the model group, dexamethasone group, and high, medium, and low-dose Xuanfei Zhisou prescription groups (3.6, 1.8, 0.9 g·kg-1·d-1) according to the random number table. Rats in the blank group and model group were given normal saline of 10 mL·kg-1·d-1 by gavage administration, and the intervention groups of Xuanfei Zhisou prescription were given corresponding drugs. Rats in the dexamethasone group were given dexamethasone of 2.57×10-4 g·kg-1·d-1 for 28 days. The level of pulmonary function indexes in rats was measured by a pulmonary function detector. The contents of interleukin-6 (IL-6), interleukin-8 (IL-8), IL-17, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). The positive expressions of IL-17A, IL-17RA, nuclear factor-κB activator 1 (Act1), tumor necrosis factor-associated factor 6 (TRAF6), p-p38 mitogen-activated protein kinase (p-p38 MAPK), nuclear factor-κB p65 (NF-κB p65), and phosphorylation were detected by immunohistochemistry (IHC). The protein expression levels of IL-17A, IL-17RA, Act1, and TRAF6 in the lung tissue were detected by Western blot. The mRNA expressions of IL-17A, IL-17RA, Act1, and TRAF6 in the lung tissue were detected by Real-time polymerase chain reaction (Real-time PCR). ResultCompared with the blank group, the serum contents of IL-6, IL-8, IL-17, IL-1β, and TNF-α in the model group were significantly increased (P<0.05), and the flow rate and volume indexes of pulmonary function in the model group were significantly decreased (P<0.05), while the time indexes and other indexes were significantly increased (P<0.05). The mRNA and protein expression levels of IL-17A, IL-17RA, Act1, and TRAF6 in pulmonary tissue and the positive expressions of downstream NF-κB p65, p-NF-κB p65, and p-p38 MAPK were increased (P<0.05). Compared with the model group, the levels of IL-6, IL-8, IL-17, IL-1β, and TNF-α in the serum of all treatment groups were decreased to varying degrees (P<0.05), and the indexes of pulmonary function were improved to different degrees (P<0.05). The mRNA and protein levels of IL-17A, IL-17RA, Act1, and TRAF6 and the positive expression of downstream NF-κB p65, p-NF-κB p65, and p-p38 MAPK in high and medium-dose Xuanfei Zhisou prescription groups were significantly decreased (P<0.05). ConclusionXuanfei Zhisou prescription can effectively resist inflammation of COPD rats. The mechanism may be related to down-regulating the protein expression of IL-17A, IL-17RA, Act1, and TRAF6, inhibiting downstream NF-κB and p38 MAPK signaling pathways, and reducing the release of IL-6, IL-8, TNF-α, IL-17, and IL-1β, thus reducing the airway inflammation response.

10.
aSEPHallus ; 19(38): 20-33, 2024.
Article in Portuguese | LILACS | ID: biblio-1585317

ABSTRACT

O suicídio é considerado um tema de saúde pública pela OMS e é um tema frequente entre os usuários da internet. Além de grupos de suporte ou incentivo à prática entre os adolescentes, a modalidade de transmissão da passagem ao ato ao vivo cria um interesse por essa cena no virtual. A partir de um dos primeiros casos de suicídio transmitidos pela internet no Brasil, nos perguntamos: frente à audiência anônima, que mensagem o suicídio transmitido transmite? Há um Outro a quem dirigir esta morte? Quando passa ao ato na rede, o sujeito sai ou entra na cena?


Considéré comme un problème de santé publique par l'OMS, le suicide est un sujet fréquemment abordé par les utilisateurs d'Internet. Outre les groupes de soutien ou d'encouragement à la pratique chez les adolescents, la modalité de diffusion du passage à l'acte en direct crée un intérêt pour cette scène dans le virtuel. A partir d'un des premiers cas de suicide diffusé sur Internet au Brésil, nous nous interrogeons : face à un public anonyme, quel est le message transmis par la diffusion du suicide ? Y a-t-il un Autre à qui adresser cette mort ? Lorsque le sujet se suicide sur le web, sort-il ou entre-t-il en scène ?


Suicide is considered a public health issue by the WHO and is a frequent topic among internet users. In addition to support groups or encouragement of the practice among adolescents, the form of live transmission of the passage to the act creates an interest for this scene in the virtual universe. Based on one of the first cases of suicide broadcasted online in Brazil, we ask ourselves: facing an anonymous audience, what message does the publicized suicide convey? Is there an Other to whom this death is directed? When it becomes an act on the web, does the subject leave or enter the scene?


Subject(s)
Suicide , Public Health , Adolescent , Internet , Death , Social Networking
11.
Barbarói ; (64): 142-166, jul.-dez. 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1566918

ABSTRACT

A pesquisa a qual tratamos neste artigo visou a produção de questões clínicas do trabalho com Agentes Socioeducadores, problematizando a expansão do poder de agir em meio às tensões educar/punir/vigiar características do exercício neste campo. Amparamo-nos na Clínica da Atividade e Ergologia. Tais perspectivas afirmam que trabalhar implica em gerir a distância entre o prescrito e o real, buscando analisar como trabalhadores efetuam cotidianamente microgestões dos processos laborais mediante imprevisibilidades e os modos como experimentam o trabalho, produzindo transformações através de relações entre si e o mundo. A metodologia operou pela pesquisa-intervenção cartográfica, utilizando diários de campo, observações, análise documental, acompanhamento das situações concretas de trabalho, formação de espaços coletivos junto aos trabalhadores e Instrução ao Sósia. As análises permitiram explorar peculiaridades da dinâmica expansão-constrangimento do poder de agir no trabalho da Socioeducação, discutindo que cuidar da saúde pelo cuidado do ofício abre perspectivas para a instauração de relação éticas por entre a expansão do poder de agir no trabalho socioeducativo.(AU)


The research we covered in this article aimed at the production of clinical questions of the work with Socioeducational Agents, problematizing the expansion of the power to act amid the tensions to educate / punish / monitor characteristics of the exercise in this field. We are supported by the Clinic of Activity and Ergology. Such perspectives affirm that working implies managing the distance between what is prescribed and what is real, seeking to analyze how workers perform micro-management of work processes on a daily basis through unpredictability and the ways in which they experience work, producing transformations through relationships between themselves and the world. The methodology operated by cartographic research-intervention, using field diaries, observations, document analysis, monitoring of concrete work situations, formation of collective spaces with workers and Instruction to the Double. The analyzes allowed to explore peculiarities of the dynamic expansion-constraint of the power to act in the work of Socioeducation, arguing that taking care of health by taking care of the work opens up perspectives for the establishment of ethical relationships between the expansion of the power to act in socio-educational work.(AU)


Esta investigación que cubrimos en este artículo tuvo como objetivo la producción de preguntas clínicas del trabajo con Agentes Socioeducativos, problematizando la expansión del poder de actuar en medio de las tensiones para educar / sancionar / monitorear características del ejercicio en este campo. Nos avala la Clínica de Actividad y Ergología. Tales perspectivas afirman que trabajar implica gestionar la distancia entre lo prescrito y lo real, buscando analizar cómo los trabajadores realizan la microgestión de los procesos de trabajo en el día a día a través de la imprevisibilidad y las formas en que viven el trabajo, produciendo transformaciones a través de las relaciones entre ellos mismos y el mundo. La metodología operada por investigación-intervención cartográfica, utilizando diarios de campo, observaciones, análisis documental, seguimiento de situaciones concretas de trabajo, formación de espacios colectivos con trabajadores e Instrucción a Sósia. Los análisis permitieron explorar peculiaridades de la dinámica expansión-constreñimiento del poder de actuar en el trabajo de Socioeducación, argumentando que cuidar la salud cuidando el trabajo abre perspectivas para el establecimiento de relaciones éticas entre la expansión del poder de actuar en el trabajo socioeducativo.(AU)


Subject(s)
Humans , Male , Prisoners/education , Work , Education
12.
Article | IMSEAR | ID: sea-218914

ABSTRACT

Medical abortions have been a national as well as social concern for the society, especially in India. There have been certain laws, acts and amendments that have been designed to promote safe abortions. Despite, the rules in place, there is still need to have more awareness as the women still face difficulties in accessing abortion services. The reasons may include legal hurdles, stigma, financial concerns and many more. Through this article, we would like to emphasize the role of government, medical professionals, health care providers to come together and form more dependable guidelines that may help women to access safer abortions.

13.
Article | IMSEAR | ID: sea-232118

ABSTRACT

Background: Ovarian cancer is the fourth most common cancer in Indian women with an incidence of 4.9 cases per 100,000. Epithelial ovarian cancer is a silent killer disease as it presents at an advanced stage with minimal signs and symptoms.Methods: It is a type of research article. The present study was conducted in Department of Obstetrics and Gynecology, Cama and Albless Hospital, Mumbai, Maharashtra, India, from a period of January 2018 to July 2019, during which 53 cases of EOC were studied.Results: Out of 53 cases of EOC, 45 cases were advanced stage EOC, they were either operated as PDS-ACT or NACT- IDS.Conclusions: NACT is recommended wherein optimal cytoreduction appears unlikely, or in patients where upfront surgery is high risk and extensive causing high morbidity post-surgery. Places where there is non-availability of special surgical expertise and hospital resources, there too NACT-IDS is recommended.

14.
Article | IMSEAR | ID: sea-220774

ABSTRACT

Being a democratic country India has brought in various acts and reforms to uphold citizen centricity. Right to service act has been one of such initiatives. As on 2023, the state of Karnataka has been able to provide highest number of services under this act. This study explores and investigates citizen's perspective of service quality & service satisfaction attained by availing the public services. A questionnaire survey was formulated and study found that the ve factors 'Reliability' 'Assurance', 'Empathy', 'Valence', and 'Waiting Time' are determinants of the quality of citizen/government services. The outcome indicate that overall service quality has signicantly positive impact on service satisfaction. This research is of greater value to scholars who are interested in the area of governance, administration, and service delivery.

15.
Article | IMSEAR | ID: sea-218055

ABSTRACT

Background: Over the counter (OTC), drugs are found to be safe and appropriate for use without supervision of a healthcare professional such as physician and they can be purchased by consumers without prescription. The study gains its importance because of the spreading of misuse of antibiotics and various drugs adverse drug reactions in the society. Aims and Objectives: The main aim of the study is to observe as to how many pharmacists/chemists/drug store sellers follow or violate the drug cosmetic act. Materials and Methods: It is an observational and cross-sectional study conducted among pharmacies of Udaipur city, urban areas of Southern Rajasthan. The study includes a sample size of 200 pharmacies selected through convenient random sampling. A detailed semi-structured questionnaire is administered to the pharmacists. The set of questions include types of drugs, reason for dispensing, knowledge, and attitude of pharmacist toward dispensing non-OTC drugs. All the private pharmacies willing to participate were included in the study. Data are entered in Microsoft Excel and statistically analyzed. Results: The results throw light on the behavior and pattern of dispensing habits of the drug store sellers of the city of Udaipur, Southern Rajasthan. It was observed that many pharmacists are in fact in the habit of dispensing non-OTC drugs in almost all the areas. Conclusions: Results give insights about the groups of drugs, logic, behavior, and knowledge level of pharmacists involved in dispensing practices in the city of Udaipur. There should be structured educational campaigns (or use of media, internet, newspaper, radio, television, advertisements, mobiles, etc.) for both pharmacists and public.

16.
Int J Pharm Pharm Sci ; 2023 May; 15(5): 20-23
Article | IMSEAR | ID: sea-231228

ABSTRACT

Objective: To evaluate the package inserts of antimicrobial drugs utilized in a tertiary care Hospital of North KarnatakaMethods: A cross-sectional, observational, prospective study was undertaken to analyze the package inserts of antimicrobial drugs utilized in a tertiary care hospital in North Karnataka for two months. 218 that belonged to antimicrobials were included in our study and analyzed based on criteria mentioned in Schedule D of the Drug and Cosmetic Act of 1945.Results: None of the Package Inserts analyzed by us adhered to the standard guidelines. Legibility, Approved generic name of active ingredients, and Content of active ingredient per dosage was mentioned in all. In contrast, the least mentioned criteria included References (n=2) and Retail price of the drug (n=9).Conclusion: Updating the existing ones and stricter adherence to the PI with the standard guidelines will achieve better quality and, in turn, improve health care in our society, especially by these antimicrobial agents, which can prevent the development of antimicrobial resistance.

17.
Article | IMSEAR | ID: sea-231125

ABSTRACT

Background: Interferential Therapy (IFT) is the administration of two medium-frequency currents to the skin, stimulating varying systems in the body using specific frequencies and frequency ranges. IFT in the thoracic region aims to reduce muscle soreness in the chest and upper back, reduce muscular fatigue and induce mucus expectoration. This study is designed to test the efficacy of IFT on bronchial asthma patients exposed to the SARS-CoV-2 virus.Methods: IFT will be administered as an intervention to 28 asthma patients with and without a history of COVID-19 exposure for 20 minutes. Six continuous outcome variables at different points will be utilized as an outcome measure; the selected Baseline Pulmonary Function Test (PFT) and Cardiopulmonary Variables (CVS) will be assessed upon entry into the study and after every intervention, while asthma quality of life and asthma control test will be measured fortnightly. In addition, participants will be required to visit the study location 3 times per week for 12 weeks. Results: The means ± SD will be compared, while the participant's outcome variables will be evaluated for study homogeneity at baseline. Repeated measures of MANOVA will be used to evaluate the study outcome within group participants. In contrast, a one-tail independent t-test will be used to evaluate the efficacy of IFT on bronchial asthma patients with Post COVID-19 exposure across groups. The level of significance will be set at P<0.05.Discussion and Conclusion: Asthma control in the SARS-CoV-2 virus is still unclear; this study aims to evaluate the effect of airway smooth muscle relaxation induced by IFT on the possible long-term manifestations of SARS-CoV-2 virus on asthma control, quality of life, and selected cardiopulmonary variables of asthma patients. This study will add to the knowledge of managing severe acute respiratory syndrome.

18.
Article | IMSEAR | ID: sea-227061

ABSTRACT

Background: Law concerns with every field of human life and dentistry is no exception. Therefore, knowledge of legal aspects is as important as knowledge of medicine in life of health care professionals. The patient-dentist relationship had undergone a significant transition over the past few decades with upsurge anxiety in the community and increased lawsuits against dentists. Thus, a health care professional must know about medico-legal problems to protect oneself from legal issues. Methods: A cross-sectional questionnaire was pre-tested among the group of 10 professionals prior to the study. It was made available to dental practitioners residing in Ahmedabad city. It was mandatory to answer all the questions. Data was collected through online survey forms and were subjected to descriptive statistics. Results: The results showed that there was lack of knowledge in majority of dentists regarding medico-legal issues. Nearly half (53%) of the participants were unaware concerning consumer protection act and 81.33% of the candidates were not aware regarding minimum duration for the preservation of dental records. Around 56% were unaware about revised code of ethics and less than half know about negligence and non-negligence acts. Conclusions: The present study depicted that majority of the dentists lack knowledge concerning medico-legal issues. Therefore, seminars should be arranged to intensify their knowledge regarding legal facets or more information should be added in dental curriculum.

19.
Article in Chinese | WPRIM | ID: wpr-989594

ABSTRACT

Objective:To explore the mechanism of Fuyuan Xingnao Decoction in treatment of cerebral infarction based on network pharmacology and molecular docking.Methods:The active components and action targets of Fuyuan Xingnao Decoction were screened by using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP),Traditional Chinese Medicine Integrated Database (TCMID),Bioactivity data of small organic molecules (PubChem),Universal Protein (Uniprot) and Swiss Target Prediction database platform. The databases of GeneCards, Online Mendelian Inheritance in Man (OMIM), Therapeutic Target Database (TTD), and Drug Bank and Pharmacogenomics Knowledgebase (PharmGKB) were used to screen targets of cerebral infarction. The drug target genes in Fuyuan Xingnao Decoction were intersected with those of cerebral infarction, the intersecting targets were introduced into Cytoscape 3.8.2 software to construct the component target network, and the PPI protein interaction network was constructed by using STRING analysis platform and Cytoscape 3.8.2 software to screen the core targets. Gene Ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) function enrichment analysis were carried out on the common target genes of Fuyuan Xingnao Decoction and cerebral infarction disease to obtain the relevant signal pathways. Finally, AutoDock and Pymol software were used for molecular docking between the predicted target and its corresponding components.Results:After screening, 80 effective components of Fuyuan Xingnao Decoction for treatment of cerebral infarction and 214 common targets of Fuyuan Xingnao Decoction and cerebral infarction were obtained. The core targets such as MAPK1, RELA, TP53, JUN, AKT1 and HSP90AA1 were related to the key targets of cerebral infarction, and they participated in the biological process of regulating the response to drugs, lipopolysaccharide and oxygen level, etc. The cell composition involved membrane raft, membrane micro region and nerve cell body, etc. Molecular functions mainly focused on nuclear receptor activity, ligand activated transcription factor activity, DNA binding transcription factor binding, etc.; it also involved in signal pathway of lipid and atherosclerosis, chemical carcinogen and receptor activation, fluid shear stress and atherosclerosis, etc. Molecular docking showed that good binding activities were seen between Quercetin and HSP90AA1 (-9.4 kJ/mol), between Kaempferol and HSP90AA1 (-9.4 kJ/mol), between Isorhamnetin and HSP90AA1 (-9.1 kJ/mol), and between Quercetin and JUN (-8.6 kJ/mol).Conclusion:Fuyuan Xingnao Decoction can prevent and treat cerebral infarction by regulating vascular endothelial function, promoting blood circulation, repairing and improving neural function, protecting blood-brain barrier, reducing cell apoptosis, and regulating immune and inflammatory response.

20.
Article in English | WPRIM | ID: wpr-980373

ABSTRACT

@#Stigma due to an HIV diagnosis is a well-known phenomenon and is a major barrier to accessing care.1 Over the last forty years, HIV has been transformed from a fatal disease to a manageable one, thanks to the remarkable success of antiretroviral (ARV) medication.2 When people living with HIV (PLHIV) start ARV treatment early, their life expectancy is almost completely restored. Moreover, a suppressed viral load means that PLHIV are no longer able to infect other people.3 They can have children naturally without risk to their seronegative partner or their child. PLHIV nowadays are more likely to die with HIV, not of HIV. While a cure remains elusive, the successful global rollout of ARVs means that there is no good reason for a PLHIV to die of AIDS and its complications due to lack of access to proper treatment. The Philippine AIDS Law Republic Act 8504 and its successor, Republic Act 11116 explicitly states that the State should “ensure access to HIV and AIDS-related services by eliminating the climate of stigma and discrimination that surrounds the country’s HIV and AIDS situation, and the people directly and indirectly affected by it.” Unfortunately, despite this admonition, stigma remains a significant cause of delayed HIV testing and of not seeking treatment in our country. In this issue of the journal, Dr. De Los Santos and her colleagues examine the effect of healthcare facility stigma on PLHIV accessing care in the Philippines.4 They report that 81% of their Filipino PLHIV respondents experienced stigma, which is an unacceptably high number. They identify which facilities are more likely to be correlated with stigma and make suggestions on how to address this problem. This study is very timely and comes at a time when the Department of Health is shifting first line antiretrovirals to dolutegravir-based regimens.5 Dolutegravir-based treatment is associated with fewer side effects than efavirenz-based regimens and is much more durable against resistance.6 With an HIV transmitted-drug resistance rate of 11.7%, it is imperative that PLHIV are started on more durable regimens which they are less likely to discontinue.7 Properly addressing stigma means that more people will access care. Better regimens will ensure that people stay in care. This will go a long way towards minimizing the impact of HIV and AIDS on Filipino PLHIV. Stigma among PLHIV is a complicated subject matter. Aside from the stigma associated with diagnosis, there is also stigma associated with the mode of acquisition of the disease. The most-at-risk populations are highly stigmatized. Men who have sex with men, people who inject drugs, and female sex workers experience additional stigma on top of the stigma from an HIV diagnosis.8 Aside from societal stigma, PLHIV are also prone to self-stigma.9 This phenomenon occurs when PLHIV believe they no longer deserve to live since they contracted the disease from deviant or sinful behavior. High rates of depression are found among these self-stigma sufferers. This significantly impacts the entire HIV healthcare cascade, starting from early diagnosis, to accessing treatment, and staying in care. The finding that Public Rural Health Units are the most stigmatizing healthcare facilities is very concerning since these are usually the only facilities available to PLHIV in far-flung areas. This needs to be addressed with better sensitivity training as well as concrete guidelines on avoiding stigma. It is very troubling that facilities that are supposed to cater to vulnerable populations inadvertently make it difficult for them to access care.10 Unfortunately, even facilities in urban areas are not immune to discrimination and stigmatizing behavior. I recall the experience of one of my early PLHIV patients who developed and eventually succumbed to a disseminated fungal infection.11 He told me that he had tried getting tested several years earlier but he had a traumatic experience in the government health facility that he accessed. He made a wrong turn and entered a different clinic in that hospital and when he asked for an HIV test, people recoiled from him in horror. Because of that terrible experience, he put off getting his HIV test for years until he started developing the fungal infection that eventually killed him. Had he been started on proper treatment earlier, he could have been saved. For me, it wasn’t just the fungus that killed him but it was the delay in diagnosis and care as a direct result of stigma. Addressing HIV-related stigma in our country entails a whole-of-society and a whole-of-nation approach. Mental health services to address self-stigma and depression should be standard of care not just among confirmed PLHIV but among the most-at-risk populations. Proactive education of all members of society, especially healthcare workers in facilities that diagnose and care for PLHIV is essential for ensuring sustained linkage to care. Ensuring that the majority of the PLHIV population are properly diagnosed, enrolled in treatment hubs, and have suppressed viral loads will ultimately lead to fewer transmissions and less AIDS-related deaths.


Subject(s)
HIV , Acquired Immunodeficiency Syndrome
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