Physiotherapy-Led Musculoskeletal Telephone Triage and Advice Service: A Valid Option for Patients Referred From the Emergency Department.

Introduction Musculoskeletal (MSK) conditions create a significant demand for healthcare services in the United Kingdom. The emergency department is one of the main providers of initial care for patients with MSK disorders or injuries. As attendances increase within the emergency department the demand for MSK physiotherapy services also increases. The MSK physiotherapy department at Queens Hospital, Burton, GBR introduced a telephone triage and advice (TTAD) service for patients referred from the emergency department to try and reduce waiting times and the number of initial appointments not attended. The primary outcome of the study was to investigate the number of patients discharged via the TTAD service. Secondly, the study aimed to assess if the TTAD service eased the pressures of face-to-face appointments as well as analyze the effects on the number of failed attendances and canceled appointments for both initial and follow-up face-to-face appointments. Method Data were collected retrospectively from the electronic medical records system Meditech Version 6 (Medical Information Technology, Inc., MA) from the months of August, September, and October in 2017 (pre-TTAD) and 2018 (post-TTAD). Once the data had been collected, analysis was performed comparing results from 2017 to 2018 using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) analysis software. Results The overall number of referrals from emergency to MSK physiotherapy increased by 11.2% between 2017 and 2018. Following the introduction of the TTAD service, 59.8% of the total referrals were offered a face-to-face initial appointment with 40.2% of patients referred being discharged via the TTAD service in 2018. The percentage of patients that failed to attend the initial appointment in 2018 also fell by 4.9%. Conclusion The introduction of a TTAD service for referrals from the emergency department has been demonstrated to be effective in reducing the number of face-to-face appointments required in the MSK physiotherapy management of these patients. Both initial and follow-up face-to-face appointments were lower in 2018 when compared to 2017, this is despite an 11.2% increase in the number of referrals throughout August, September, and October. It can therefore be concluded that the TTAD service also had a positive impact on the failed attendance rate of initial face-to-face appointments.

HPLC and chemometric methods for the simultaneous determination of cyproheptadine hydrochloride, multivitamins, and sorbic acid.

Three methods are presented for the simultaneous determination of cyproheptadine hydrochloride (CP), thiamine hydrochloride (B1), riboflavin-5-phosphate sodium dihydrate (B2), nicotinamide (B3), pyridoxine hydrochloride (B6), and sorbic acid (SO). The chromatographic method depends on a high performance liquid chromatographic (HPLC) separation on a reversed-phase, RP 18 column. Elution was carried out with 0.1% methanolic hexane sulphonic acid sodium salt (solvent A) and 0.01 M phosphate buffer containing 0.1% hexane sulphonic acid sodium salt, adjusted to an apparent pH of 2.7 (solvent B). Gradient HPLC was used with the solvent ratio changed from 20:80 to 70:30 (over 9 min), then to 80:20 (over 11 min) for solvent A:B, respectively. Quantitation was achieved with UV detection at 220 and 288 nm based on peak area. The other two chemometric methods applied were principal component regression (PCR) and partial least squares (PLS). These approaches were successfully applied to quantify each drug in the mixture using the information included in the UV absorption spectra of appropriate solutions in the range 250-290 nm with the intervals Deltalambda = 0.4 nm at 100 wavelengths. The chemometric methods do not require any separation step. The three methods were successfully applied to a pharmaceutical formulation and the results were compared with each other.

Spectrophotometric and chromatographic determination of rabeprazole in presence of its degradation products.

Three methods were presented for the determination of rabeprazole (RA) in presence of its degradation products. The first method was based on high performance liquid chromatographic (HPLC) separation of RA from its degradation products on a reversed phase, ODS column using a mobile phase of methanol-water (70:30, v/v) and UV detection at 284 nm. The second method was based on HPTLC separation followed by densitometric measurement of the spots at 284 nm. The separation was carried out on Merck HPTLC sheets of silica gel 60 F 254, using acetone-toluene-methanol (9:9:0.6 v/v) as mobile phase. The third method depends on first derivative of the ratio spectra (1DD) by measurement of the amplitudes at 310.2 nm. Moreover, the proposed HPLC method was utilized to investigate the kinetics of the oxidative and photo degradation processes. The pH-rate profile of degradation of RA in Britton-Robinson buffer solutions within the pH range 3-11 was studied. In addition, the activation energy of RA degradation was calculated in Britton-Robinson buffer solution pH 7.