Biomedical subjects

Deepa Rao

Publications and source records attributed to Deepa Rao.

7 recordsLinked to original sources

PubMed2006

Community pharmacists in Australia: barriers to information provision on complementary and alternative medicines.

OBJECTIVE: To determine, by surveying Australian community pharmacists, the perceived barriers to the provision of information about complementary and alternative medicines (CAMs) and suggestions for overcoming them. METHOD: Anonymous, self-administered survey sent to a random sample of 701 pharmacists registered in three states of Australia in 2004. MAIN OUTCOME MEASURE: Pharmacists' perceived barriers to the provision of information about CAMs. RESULTS: A total of 344 questionnaires were returned by pharmacists (49% response) of which 211 (30%) were currently practising in community pharmacy. Ninety-five percent of surveyed community pharmacists indicated that they personally received enquires about CAMs, with fewer than 15% reporting they were "very confident" in answering queries about safety, interactions or benefits of CAMs. Frequently used CAM information sources were those from manufacturers and distributors, professional newsletters and journals and textbooks. Pharmacists' perceived barriers to the provision of CAM information included a lack of suitable training (most training was informal), deficiencies in available information sources, a lack of managerial support, the need for regulatory changes, consumer beliefs about CAM safety and time constraints due to competing demands in daily practice. Pharmacists proposed improvements to overcome these barriers including improvements to training. CONCLUSION: There is scope for pharmacy professional organisations and educational institutions to further support pharmacists in their practice through providing information on the best information sources available and training that meets the needs of undergraduate students, pharmacists and other pharmacy staff. There is a need to examine regulatory requirements concerning the provision of product information with CAMs in Australia and to implement mechanisms for increasing consumer awareness of regulatory procedures for these medicines.

Adolescent↗

PubMed2006

Choice of medicine and hierarchy of resort to different health alternatives among Asian Indian migrants in a metropolitan city in the USA.

UNLABELLED: Medical pluralism is common among Asian Indians and the increasing popularity of complementary and alternative medicines in the USA has now provided Asian Indian immigrants with a wide variety of treatment options to choose from for their ailments. Many a times, these options are used simultaneously with each other. OBJECTIVE: The objective of the study was to examine the choice of medicine and the hierarchy of resort to the different health alternatives by a selected Asian Indian immigrant population in the USA. DESIGN: In-depth interviews were conducted with 21 informants from a metropolitan city in the USA regarding their choice of alternatives and the order in which they choose the different health alternatives. Thematic analysis was carried out to interpret the data. RESULTS: The different choices for treatment of illness included folk remedies, ayurveda, homeopathy and allopathic medicine. Home remedies and Indian medical alternatives were the first resort in case of minor ailments while allopathic medicine was the first choice for serious and chronic illnesses. CONCLUSIONS: The decision to choose from among different alternatives for treatment of illness depends on people's beliefs about the severity of illness and the effectiveness of treatment options while the hierarchy of resort depends on the kind of illness. The hierarchy of resort to treatment followed the counter-acculturative pattern for minor illnesses and acculturative pattern for major or chronic illnesses.

Acculturation↗

PubMed2005

The Modified Rush Sexual Inventory: preliminary psychometric findings.

Sexual dysfunction associated with psychiatric disorders and the treatment of these disorders can impede a patient's optimal recovery and quality of life. Patients are typically reluctant to report their sexual difficulties. Therefore, self-report measures that comprehensively and concisely assess sexual difficulties are a beneficial contribution to clinical research and practice. The Modified Rush Sexual Inventory (MRSI) not only assesses sexual functioning and satisfaction using a multiple-choice format, but it also includes an introductory section for patients' medical histories and free responses. Though the MRSI has been used in clinical trial research, the reliability and validity of the measure is unknown. This study presents the initial reliability and validity findings of the MRSI.

Female↗

PubMed2005

Naturopaths practice behaviour: provision and access to information on complementary and alternative medicines.

BACKGROUND: The increasing use of complementary and alternative medicines in Australia has generated concern regarding the information on these products available to both healthcare providers and the public. The aim of this study was to examine the practice behaviours of naturopaths in relation to both the provision of and access to information on complementary and alternative medicines (CAM). METHODS: A representative sample of 300 practicing naturopaths located nationally were sent a comprehensive survey which gathered data on self reported practice behaviour in relation to the provision of information on oral CAM to clients and the information needs of the practitioners themselves. RESULTS: A response rate of 35% was achieved. Most practitioners (98%) have a dispensary within their clinic and the majority of practitioners perform the dispensing themselves. Practitioners reported they provided information to clients, usually in the form of verbal information (96%), handwritten notes (83%) and printed information (75%). The majority of practitioners (over 75%) reported always giving information on the full name of the product, reason for prescribing, expected response, possible interactions and contraindications and actions of the product. Information resources most often used by practitioners included professional newsletters, seminars run by manufacturers, patient feedback and personal observation of patients. Most practitioners were positive about the information they could access but felt that more information was required in areas such as adverse reactions and safe use of CAM in children, pregnancy and breastfeeding. Most naturopaths (over 96%) were informed about adverse events through manufacturer or distributor newsletters. The barriers in the provision of information to clients were misleading or incorrect information in the media, time constraints, information overload and complex language used in printed information. The main barrier to the practitioner in information access was seen as the perceived division between orthodox and complementary medicine practitioners. CONCLUSION: Our data suggest most naturopaths were concerned about possible interaction between pharmaceuticals and CAM, and explore this area with their patients. There is scope to improve practitioners' access to information of adverse events including an increased awareness of sources of information such as the Australian Therapeutic Goods Administration (TGA) website.

Access to Information↗

PubMed2005

Using a novel multicompartment dissolution system to predict the effect of gastric pH on the oral absorption of weak bases with poor intrinsic solubility.

A novel multicompartment dissolution system was developed by modifying a conventional six-vessel United States Pharmacopoeia dissolution system to study the dissolution and possible precipitation of poorly soluble weak bases after oral administration. The modified system includes a "gastric" compartment, an "intestinal" compartment, an "absorption" compartment, and a reservoir to simulate the dissolution and absorption in the gastrointestinal tract. Dissolution profiles of 50-mg dipyridamole (pK(a) 6.0, 12.5) tablet (2 * 25 mg Persantine tablets), 25- and 50-mg cinnarizine (pK(a) 1.95, 7.5) powders, which are poorly soluble weak bases, were generated in the system using dissolution medium with different pHs in the "gastric" compartment. The in vitro dissolution results were compared with the in vivo oral exposure data in humans. For both dipyridamole and cinnarizine, the in vitro dissolution using the multicompartment system was able to predict the pH effect on oral exposure. The results from the multicompartment system are more closely correlated with the in vivo data, compared with that from the conventional dissolution test. The system showed that although both dipyridamole and cinnarizine completely dissolved in the gastric compartment at lower pH, approximately 36% (at 25-mg dose) and 40% (at 50-mg dose) of cinnarizine precipitated in the "intestinal" compartment whereas the precipitation of dipyridamole was <10% of the initial dose. The difference in the amount "absorbed" between these two compounds in vitro is therefore primarily attributed to the precipitation potential, although no in vivo data are available to confirm this result. The difference in the amount precipitated may be explained by the lower solubility and consequently higher degree of supersaturation of cinnarizine in the "intestinal" compartment.

Algorithms↗

PubMed2002

Chemical Asphyxiants and Noise.

The damaging effects of noise on auditory function can be altered significantly by exposure to additional agents that may or may not by themselves be ototoxic. This chapter focuses on the ability of chemical asphyxiants present in both occupational settings and ambient environments to potentiate noise induced hearing loss in a laboratory animal model. Since the chemical agents under study do not produce permanent impairment of hearing by themselves, the finding of auditory impairment in excess of that which is produced by noise exposure alone can be defined as noise potentiation. This chapter focuses both on the exposure conditions that favour such potentiation and also on potential mechanisms for potentiation. The data show that low to moderate exposure levels of carbon monoxide (CO) and hydrogen cyanide can potentiate noise induced hearing loss (NIHL) and the relationship between such levels and those permitted in work environments is provided. Finally, evidence is presented that free oxygen radicals may be responsible for potentiation of NIHL by the chemical asphyxiants. First, the ability of a free radical spin trap agent, PBN, to prevent the adverse effects of CO is demonstrated. Then, in an additional experiment, electron paramagnetic spin resonance is used to demonstrate a high level of free radicals in the cochlea with combined exposure to CO + noise while individual exposures to CO and noise do not produce free radicals at levels detectable by this method.

Journal Article↗

PubMed2000

Characterising conditions that favour potentiation of noise induced hearing loss by chemical asphyxiants.

Hearing loss is the most common occupational disease in the United States with noise serving as the presumed causative agent in most instances; noise is identified as a prominent factor in approximately 10 million individuals in the United States with hearing impairments. Despite the characterisation of noise exposures that yield temporary and permanent threshold shifts and partial elucidation of mechanisms that are responsible for noise-induced hearing loss (NIHL), there remain significant knowledge gaps concerning factors causing NIHL. One such knowledge gap concerns potentiation of NIHL by simultaneous exposure to chemical agents. We have pursued investigation of the exposure conditions that facilitate the potentiation of NIHL by carbon monoxide. The selection of these specific agents is predicated upon the ubiquitous nature of exposure to chemical asphyxiants and a preliminary understanding of the mechanisms by which chemical asphyxiants disrupt hearing. Our data indicate that the potentiation of NIHL by carbon monoxide increases as a function of carbon monoxide concentration at levels of 500 ppm and above, but that the extent of potentiation shows a non-linear relationship to total noise energy with the greatest potentiation shown at moderate noise exposures that produce limited permanent threshold shifts. Further, the potentiation of NIHL by carbon monoxide appears to saturate as noise severity is increased such that at the most severe conditions used, the effects of carbon monoxide on NIHL are obscured totally by the noise effect. Finally, the data presented demonstrate that carbon monoxide is able to impair the recovery of NIHL that normally occurs when periods of silence are interspersed within noise exposure.

Journal Article↗