Monday, 29 February 2016

Complementary and Alternative Medicine (CAM) for Hyperlipidemia:



More Presentations from Dr.Naina Mohamed Pakkir Maideen

§   Excessively elevated levels of lipids or lipoproteins in the blood are termed Hyperlipidemia.
§   Any fat-soluble molecules are known as Lipids and the Lipoproteins are the capsules surrounding lipids and transporting them.
§   Cholesterol is one of the most common types of lipids. Elevated levels of cholesterol in the blood are referred as Hypercholesterolemia.
§   Triglycerides are the esters derived from glycerol and three fatty acids. Presence of high levels of Triglycerides in the blood is called Hypertriglyceridemia.
§   The risk factors of Hyperlipidemia include Obesity or Overweight, excessive Alcohol consumption, Physical inactivity, preexisting health conditions such as Diabetes, Hypothyroidism, or Kidney disease
§   CAM used to treat Hyperlipidemia may include 
o  Dietary Supplements
¨   Omega 3 Fatty acids
¨   Plant sterols and stanols
¨   Soy protein
¨   Flax seed
¨   Red yeast rice
¨   Blond Psyllium
¨   Oat bran
¨   Whole grain foods (Wheat, Corn, Barley)
¨   Nuts (Walnuts, Almonds)
o  Herbal Supplements
¨   Ginger
¨   Garlic
¨   Ginseng
o  Mind – Body Practices
¨   Transcendental Meditation
¨   Yoga
§   Before considering any dietary supplement, consult with a health care provider.
§   Do not replace scientifically proven antihyperlipidemics with unproven health products or practices.
§   Read and follow the label instructions for the safe use of dietary supplements.
§   Always remember that dietary supplements may interact with medications or other dietary supplements.
§   Discuss with the health care providers about the current use of any CAM approaches.
§   Limit foods high in calories such as soft drinks and candy.
§   Eat a variety of fruits, vegetables, legumes, nuts, soy products, low-fat dairy products, and whole grain breads, cereals, and pastas.
§   Eat baked or broiled fish at least twice per week.
§   Choose oils and margarines low in saturated and trans fat and high in omega-3 fat, such as canola, soybean, walnut, and flaxseed oils.
§   Avoid foods high in saturated and trans fats, such as red meat, whole milk products, and pastries.
§   Eat less than 6 g of salt or less than 2,400 mg of sodium per day.
§   Get at least 30 minutes of exercise daily.
§   Achieve and maintain ideal body weight.


Wednesday, 17 February 2016

Complementary and Alternative Medicine (CAM) for Diabetes:



More Presentations from Dr.Naina Mohamed Pakkir Maideen

§  Diabetes is a group of metabolic disorders characterized by prolonged Hyperglycemia (High blood glucose) having symptoms such as Polyuria (Frequent urination), Polydipsia (Increased thirst) and Polyphagia (Increased hunger).
§  Diabetes might be caused either by inadequate insulin production or by improper body’s response to insulin or both.
§  CAM used to treat Diabetes may include  
o  Herbal Supplements
¨  Bitter melon (Momordica charantia)
¨  Fenugreek (Trigonella foenum graecum)
¨  Cinnamon
¨  Tulsi (Ocimum sanctum)
¨  Neem (Azadirachta indica)
¨  Onion (Allium Cepa)
¨  Garlic (Allium Sativum)
¨  Ginseng
¨  Aloe vera
¨  Fig (Ficus carica)
¨  Mango Leaves (Mangifera indica)
¨  Eucalyptus globulus
¨  Bilberry (Vaccinium myrtillus)
¨  Black berry (Syzygium cumini)
¨  Banana (Musa sapientum)
¨  Gurmar (Gymnema sylvestre)
o  Dietary Supplements
¨  Chromium
¨  Vanadium
¨  Alpha Lipoic acid
o  Physical interventions
¨  Yoga
¨  Acupuncture
¨  Hydrotherapy
¨  Massage Therapy
¨  Aromatherapy
¨  Chromotherapy
¨  Biofeedback
§  Due to lack of strong scientific evidences, CAM should be used for diabetes with caution.
§  The safety and efficacy of CAM therapies for diabetes need to be further evaluated by well-designed and controlled clinical studies.
§  Do not replace scientifically proven antidiabetics with unproven health products or practices.
§  Before considering any dietary supplement, consult with a health care provider.
§  Always remember that dietary supplements may interact with medications or other dietary supplements.
§  In addition to conventional therapy, exercise, weight control and nutrition remain key elements of diabetes management.

Sunday, 31 January 2016

Complementary and Alternative Medicine (CAM) for Obesity:



More Presentations from from Dr.Naina Mohamed Pakkir Maideen

Ø  The imbalance between caloric intake and expenditure might result in to Overweight or Obesity.
Ø  Obesity can increase the risk of Type 2 diabetes, Cardiovascular diseases, Chronic kidney disease, Sleep apnea, Arthritis, Lung disease and several forms of Cancer.
Ø  CAM used to treat Obesity may include  Acupuncture or Acupressure, Yoga, Mindful meditation, Naturopathy and Dietary Supplements such as Ephedra (Ma Huang), Green Tea, Bitter Orange, Hoodia (Kalahari cactus), Acai (Amazonian palm berry), Chitosan, Chromium Picolinate, Garcinia cambogia, Glucomannan, Guar gum, Pyruvate, Yohimbe (Yohimbine), etc.
Ø Most of the dietary supplements marketed for weight loss or appetite suppression haven’t been proven safe or effective.
Ø There is no definitive scientific evidence to support the use of acai berry, bitter orange, and green tea supplements for weight loss.
Ø Ephedra can increase the risk of heart problems and stroke and in 2004 the FDA banned the U.S. sale of dietary supplements containing ephedra.
Ø Further research is needed to improve the understanding of the role of CAM in the treatment of obesity.
Ø Be cautious of the products marketed with exaggerated or unrealistic phrases like “Quick and Effective” or “Totally safe.”
Ø Be skeptical about information from personal “Testimonials” about the product’s benefits.
Ø The U.S. Food and Drug Administration (FDA) has found weight loss products sold as dietary supplements that contain hidden ingredients which can cause serious harm to consumers.
Ø Consider a mind and body approach such as mindfulness meditation or yoga. There is some emerging evidence suggesting that some mind and body approaches are generally safe and may be useful as complements to other weight-loss interventions.   
Ø Overweight and obese individuals should make lifestyle changes like healthy eating plan and regular physical activity for safe weight loss.


Sunday, 29 November 2015

Medication Errors (MEs):


More Presentations from from Dr.Naina Mohamed Pakkir Maideen

ØAny preventable event which may lead to inappropriate medication use or patient harm is termed Medication Errors (MEs).
Ø Major causes of MEs include…
ª  Missing patient information
ª  Missing drug information
ª  Miscommunication of drug order
ª  Drug name, label, packaging problem
ª  Drug storage or delivery problem
ª  Drug delivery device problem
ª  Environmental, staffing, workflow
ª  Lack of staff education
ª  Lack of Patient education
ª  Lack of Physician knowledge
Ø Types of MEs include…
§  Prescribing Errors
§  Dispensing Errors
§  Drug administration Errors
§  Monitoring Errors
§  Compliance Errors
Ø Contributing factors of Prescribing Errors include…
o  Inadequate knowledge
o  Calculation errors
o  Uncommon dosage regimen frequencies
o  Complicated dosage regimens
o  Poor patient history taking
o  Use of multiple dosage forms per dose
o  Use of abbreviations
o  Mental slips
o  Lack of adequate resources
o  Different drug formulations available
o  Excessive interruptions while involved in writing prescriptions or orders
o  Illegible handwriting
o  Drug name confusion (Look alike Sound alike)
o  Inappropriate use of decimal points
o  Use of verbal orders.
Ø Methods to minimize Prescribing errors include…
¨  Ensuring up-to-date reference sources.
¨  Use of computerised physician order entry.
¨  Ensuring knowledge of a drug before prescribing.
¨  Ensuring an accurate drug history is taken.
¨  Printing the drug name and patient details clearly on the prescription
¨  Including all details of drug therapy i.e. name of drug, dose, directions, duration of therapy
¨  Avoiding the use of abbreviations e.g. AZT, ISMN, FeSO4, U
¨  Being aware of Look-alike and sound alike (LASA) products.
Ø Contributing factors of Dispensing Errors include…
vConfusing the name of one drug with another.
vTwo or more drugs have a similar appearance or similar name (look-a-like/sound-a-like)
vSelection of the wrong strength/product.
vLack of knowledge on new medicines.
vUse of outdated and/or incorrect references.
vPoor dispensing procedures with inadequate checking.
vUnreasonable workloads.
vPoor housekeeping standards.
vDistractions and interruptions.
vDispensing unfamiliar products.
vDispensing before seeing a written order.
vThe use of computerized labelling   
Ø Methods to minimize Dispensing errors include…
·      Ensuring a safe dispensing procedure.
·      Using different brands or separating LASA (Look alike and Sound alike) products.
·      Focusing on the task in hand.
·      Keeping interruptions to a minimum.
·      Maintaining workload at a safe and manageable level
·      Being aware of high risk drugs (HAM) e.g. Hypertonic Electrolytes (Potassium chloride, Calcium chloride, Magnesium Sulphate), cytotoxic agents, IV Insulin.
·      Introducing good housekeeping practices.
Ø Contributing factors of Administration Errors include…
ª  Failure to check the patient’s identity prior to administration.
ª  Storage of look-a-like preparations side by side in the drug trolley.
ª  Environmental factors such as noise, interruptions and poor lighting while undertaking the drug round.
ª  Incorrect calculation to determine the dose.
Ø Methods to minimize Administration errors include…
§  Checking patients’ identity.
§  Having dosage calculations checked independently by another healthcare professional before the drug is administered.
§  Having the prescription, the drug and the patient in the same place so they can be checked against one another.
§  Ensuring that medication is given at the correct time.
§  Minimizing interruptions during drug rounds.
Ø Reasons for underreporting of MEs…
¨  Disagreement over the definition of an error
¨  Staff’s disability to recognize an error has occurred
¨  Staff’s belief that the error does not warrant reporting
¨  Staff’s belief that she/he has not committed the error
¨  Staff’s embarrassment
¨  Staff fear for the reputation on of their service or unit
¨  Staff’s fear of punishment/disciplinary actions
¨  Degree of reporting effort/ time to complete reports
¨  Wrong reporting time
¨  Local/unit’s culture
¨  Confusing reporting mechanisms, policies, or procedures