RESUMO
Objective: To assess the influence of pharmaceutical care activities on Knowledge, Attitude and Practice (KAP) among type 2 diabetic patients. Methods: A total of about 301 patients with type 2 Diabetes Mellitus were recruited from a tertiary care hospital. Patients were educated about their disease condition, lifestyle modifications and diet regimen to be followed and were given instructions for improving medication adherence. In the initial session, no pharmaceutical care was given, in the second session patient counseling was given verbally and in the last session patient counseling was given both verbally and non-verbally by means of pamphlet distribution. KAP questionnaire and glycemic levels (glycated hemoglobin, fasting blood sugar and post-prandial blood sugar) of participants were obtained at baseline and at follow up. Results: The baseline values of FBS in patients before intervention was found to be 176.5±74.46 mg/dL and it was reduced to 140.7±43.9 mg/dL after 3 mo. Henceforth, there was also an improvement in the PPBS values which was found to be 254±77.3 mg/dL at the baseline and was 212.9±54.2 mg/dL after intervention. The baseline values of HbA1c is 8.144±1.727% and after intervention, value reduced to about 7.173±2.768%. After the intervention, it was found to be that 30%, 16% and 12% reduction in FBS, PPBS and HbA1c values and the P-value (<0.0001) found to be statistically significant. KAP scores also found to be improved after the intervention and statistically significant. The results clearly indicate that through proper guidance and educating the patients by the pharmacist is beneficial in managing the glycemic levels and reduce further complications. Conclusion: The study concluded that the pharmaceutical care by the pharmacist is highly essentially and useful for the patients to manage the glycemic index and prevent further diabetic complications.
RESUMO
A seroepidemiology study using TES-ELISA was carried out in 1,020 children aged 1-12 years in the Hindagala Community Health Project, Sri Lanka. Toxocariasis seroprevalence was 43% with 16.6% showing high antibody levels. Unconditional logistic regression analysis showed 7-9 year olds to be at the highest risk (OR 3.0820; CI = 1.95-4.87). Dog ownership, especially puppies (OR 29.28; CI = 7.40-116.0), and geophagia-pica (OR 6.3732; CI = 3.87-10.50), were significant risk factors. Family clustering of toxocariasis was significant (chi2 = 88.000; p = 0.0001). Abdominal pain (45%), cough (30%), limb pain (23%) and skin rashes (20%) were significantly associated with seropositivity indicating that toxocariasis causes covert morbidity. These findings are, overall, applicable to other areas in Sri Lanka. However, in the dry zone, survival of infective eggs in the soil could be affected by the climate while more importantly, in agricultural areas with a high buffalo population, Toxocara vitulorum could account for human toxocariasis. Using a species specific double sandwich ELISA based on 57 kDa protein of T. canis ES antigen, it is demonstrated that 91% of the seropositives were due to T. canis. Thus along with rabies and dirofilariasis, toxocariasis is an important zoonotic health hazard from dogs in Sri Lanka and prevention is indicated.