EVALUATION OF CHRONIC INSOMNIA: An American Academy of Sleep Medicine Review
Summary: Insomnia is a condition which affects millions of individuals, giving rise to emotional distress, daytime fatigue, and loss of productivity. Despite its prevalence, it has received scant clinical attention. An adequate evaluation of persistent insomnia
requires detailed historical information as well as medical, psychological and psychiatric assessment. Use of a classification system for sleep disorders and familiarity with major diagnostic groups will facilitate the clinician's evaluation and treatment. Thorough assessment also requires attention to the unique aspects of presentation and specific set of etiologies which are associated with particular age groups.
Epilepsy in Women
October 15, 2002 - American Family Physician
Abstract:
Epilepsy in women raises special reproductive and general health concerns. Seizure frequency and severity may change at puberty, over the menstrual cycle, with pregnancy, and at menopause. Estrogen is known to increase the risk of seizures, while progesterone has an inhibitory effect. Many antiepileptic drugs induce liver enzymes and decrease oral contraceptive efficacy. Women with epilepsy also have lower fertility rates and are more likely to have anovulatory menstrual cycles, polycystic ovaries, and sexual dysfunction. Irregular menstrual cycles, hirsutism, acne, and obesity should prompt an evaluation for reproductive dysfunction. Children who are born to women with epilepsy are at greater risk of birth defects, in part related to maternal use of antiepileptic drugs. This risk is reduced by using a single antiepileptic drug at the lowest effective dose and by providing preconceptional folic acid supplementation. Breastfeeding is generally thought to be safe for women using antiepileptic medications.
Current pharmacologic options for patients with Alzheimer's disease
Annals of General Hospital Psychiatry | Full text |
ABSTRACT:
Background
The aim of the current study was to provide general practitioners with an overview of the available treatment options for Alzheimer's disease (AD). Since general practitioners provide the majority of medical care for AD patients, they should be well versed in treatment options that can improve function and slow the progression of symptoms.
Design
Biomedical literature related to acetylcholinesterase inhibitors (AChEIs) was surveyed. In the United States, there are four AChEIs approved for the treatment of AD: tacrine, donepezil, rivastigmine, and galantamine. There are other agents under investigation, but at present, AChEIs are the only approved drug category for AD treatment.
Measurements and Main Results
AD is becoming a major public health concern and underdiagnosis is a significant problem (with only about half of AD patients being diagnosed and only half of those diagnosed actually being treated). Clinical trials have demonstrated that patients with AD who do not receive active treatment decline at more rapid rates than those who do.
Conclusions
Given that untreated AD patients show decline in three major areas (cognition, behavior, and functional ability), if drug treatment is able to improve performance, maintain baseline performance over the long term, or allow for a slower rate of decline in performance, each of these outcomes should be viewed a treatment success.
Open, Online and Global
Online J Health Allied Scs. 2003;4:1
"What is the point of scientific research if the results are not shared freely?" This question has become the epicenter of thought internationally as a good number of scholars are being categorically denied access to vital research information that could create a difference- and in the health domain, it is most often between life and death. For scholars from poor and developing countries, this has been even worse.
Well, why is this question so significant now? There have been scientific journals before and they probably will continue to exist. But the so-called 'serials crisis' has taken a significant impact just now, with the omnipotent Internet affording cheap access to Information. The unique crisis, which is by itself a vicious circle of increasing prices and lower access, has taken its toll. Even well funded universities of affluent societies have been worstly affected- not to mention those in poor and developing countries.
Whisking Research into Medical Curriculum
Calicut Medical Journal 2004;2(1):e1
Introduction:
Medical education is undergoing sea changes worldwide with new innovative concepts being integrated to meet the challenges of the rapidly changing Medical scenario. The need to attain self-reliance in Healthcare is seen as a priority policy of many developing nations including India. This needs immense effort from the already functioning research network, which needs to be beefed up by talent and expertise from the vibrant young generation. This is where integrating Research and innovation gains prime importance in Medical Education.
