The Use of Vildagliptin-Dapagliflozin Fixed Dose Combination in Different Patient Profiles in Indian Settings: An Opinion-Based Consensus

/in /by

Objective: To evaluate the opinions of Indian clinical experts and aid in clinical choices for the optimal use of vildagliptin-dapagliflozin fixed-dose combination (FDC) for treating type 2 diabetes (T2D) in Indian patients.

Methods: The virtual round table meetings (RTMs) were conducted with healthcare professionals (HCPs) across India. A questionnaire that highlighted the role of vildagliptin-dapagliflozin FDC in treating T2D and determining the correct patient profile was created. The experts held the questionnaire discussion, and their comments were documented. The collected data were evaluated and categorized into four grades: Level A, very strong (≥80% responses); Level B, strong (≥50-79% responses); Level C, moderate (25-49% responses); Level D, neutral/no consensus (<25% responses).

Results: More than 200 HCPs participated in 15 RTMs held between July 15 and October 22, 2022. With a consensus level A (Very strong), HCPs believed that vildagliptin-dapagliflozin FDC is an attractive option and suitable for a wide range of Indian T2D patient profiles, including those with atherosclerotic cardiovascular disease (ASCVD), those with a history of heart failure, older and obese individuals. The experts regarded vildagliptin-dapagliflozin FDC as the first-line treatment for T2D patients who were obese and hypertensive, with a consensus level of C (Moderate). Vildagliptin-dapagliflozin FDC was recommended as second-line treatment for obese and hypertensive T2D patients who are uncontrolled on metformin by experts with consensus level B (Strong). The clinical experts at consensus level B (Strong) agreed that T2D patients taking two oral antidiabetic drugs (OADs) and uncontrolled if HbA1c > 8% might be suitable candidates for initiating vildagliptin-dapagliflozin FDCs.

Conclusion: Based on the present expert opinion-based consensus, most clinical experts believe that vildagliptin – dapagliflozin FDC is an appealing treatment option for a broad range of Indian T2D patients. Nevertheless, more multicentric studies are needed to support these recommendations.

Proposed Risk Mitigation for PT ABC to Maximize Income (Hospitality Industry Sector)

/in /by

The questions on the research are what are the risks that influence business PT ABC, what are the impacts of these risks, what are the mitigation techniques used to reduce the severity of the impacts. This study aims to identify and examine the risks that influence the business continuity and operations of the company PT ABC, aims to examine the impact of these risks and to investigate risk mitigation in reducing risk. Despite the global economic downturn, Indonesia continues to create increasing number of tourists. As tourists and businesspeople come to visit Indonesia, hotel demand is expected to grow in the next years and decades. Cotah (2019) why hotel investment fails because of not aligned with the right people / team, poor service and maintenance, inflexible management, blasted by new competition, cost overrun to starting any construction or renovation project and poor projection and not understanding location that weakening over time. However, without careful risk management the chance of failing is relatively high. The concept used is the risk management guideline by ISO 31000 which contains the scope, definition, principles, framework and process of risk management. The sources for risk identification research come from interviews and brainstorming. The Analytical Hierarchy Process (AHP) is used to make a risk analysis with the help of Expert Choice version 11 software to analyse the weight of the respondent’s perspective, after obtaining the results of the risk evaluation then create a risk mapping to get the level of risk. Next, the final step is to create risk mitigation and implementation plans to reduce risk. Based on this research, 29 risk factors were found from 4 risk categories, which are Operational, People, Construction and Finance. There are 14 risk factors that are categorized at high risk level, then there are 7 risk factors that are categorized at a moderate risk level, and there are 8 risk factors that are categorized at a low risk level.

Human Immunodeficiency Virus, Cardiac abnormalities on Echocardiogram and the use of Highly Active Antiretroviral Therapy in Nigerian Patients

/in /by

Background: An increasing relationship between HIV/AIDS, highly active anti – retroviral therapy (HAART) and cardiovascular diseases (CVD) have been noted over time. The occurrence of acquired immunodeficiency syndrome (AIDS) – associated heart disease found in post – mortem studies is notably higher than those diagnosed clinically implying that many HIV/AIDS patients may have cardiac abnormalities that are not diagnosed during their lifetime. This misdiagnosis persists even in the presence of dire consequences such as overt heart failure or even death.

Aim: This study set to determine what cardiac abnormalities are present in Nigerian HIV positive patients and what differences exist in the manifestations of these cardiac abnormalities between HIV positive patients who have been on HAART and those who are non-treated with HAART.

Methods: This was a cross-sectional analytical study with a comparison group in which two groups consisting of 76 HIV positive treatment naïve and 76 HIV positive HAART treated patients who met the inclusion criteria were sampled. The study protocol was reviewed and approved by the Research and Ethics Committee of the University of Benin Teaching Hospital, Benin City. All patients had an echocardiography done and data obtained was entered into and analyzed using the IBM-SPSS version 22.0. A p-value ≤ 0.05 was considered significant for all statistical comparisons done.

Results: Total prevalence of ECHO abnormalities was 91.4% in HIV Positive patients. Echocardiographic cardiac abnormalities were more prevalent in HAART treated patients [94.7%] than treatment naïve patients [ECHO = 88.2%]. The cardiac abnormalities found include increased LVMI, left ventricular diastolic dysfunction, increased left ventricular mass, pericardial effusion and abnormalities in left ventricular geometry. Pericardial effusion was more prevalent in treatment naïve patients with treatment naïve patients also noted to have the worst form of left ventricular geometry with over half having abnormal left ventricular geometric patterns compared to about 1/3rd in HAART treated patients.

Conclusion: Overall, HAART treated patients had cardiac abnormalities on echocardiogram than treatment naïve patients.

Comparative Performance of Distribution Channels of Public and Private Life Insurers in India

/in /by

Selling products through an intermediary has always been advantageous for the manufacturer of goods or service providers. This becomes more relevant when you are selling services and particularly a financial service.  The selling of insurance products is in the ambit of financial services.  Therefore, the relevance of intermediary channels has increased to the highest, because selling insurance product is a subject of persuasion, so personal contact to increase market efficiency become relevant.  In the present study, an emphasis has been made to study the marketing channels exhausted by the life insurance industry for selling their products, further, a comparison has been made between the public and private sector companies concerning to channels these two companies are using to sell their insurance products.  The span of the study is 2016-17 to 2021-22 because during this period a few new marketing channels came into existence in the insurance market. The performance of these channels has been measured in terms of first-year individual premiums collected and policies issued by these commonly used distribution channels.  At last, it is found that in the case of Life Insurance Corporation of India, the channel ‘Individual Agent’ is more significant as compared to other channels; whereas Corporate Agent-bank is significant for private life insurance companies.  To conclude two way ANOVA and Tukey Post Hoc test have been applied to the data.

Effect of Substituents on the Biological Activity of Isatin Hybrids – A SAR Study

/in /by

Isatin (2,3-dioxindole) is a benzopyrrole derivative that belongs to a large class of heterocyclic chemicals. Isatin derivatives are essential synthetic substrates that can be utilized as starting materials to build a wide range of heterocycles with diverse applications in pharmaceutical sciences. Isatin derivatives therefore have recently gained a lot of attention. This review emphasizes on the Schiff base derivatives from isatin, isatin quinoline/flouroquinone, isatin -thiazole, isatin–azole hybrids, all possessing potential biological activity. The structure–activity relationships of these potential leads are also discussed.

Impact Prenatal Yoga Training on the Length of Labor in Kendari City

/in /by

Background: Prenatal yoga is a slow movement exercise combined with breathing exercises to maintain the posture of the mother-to-be, calm the soul, and prepare for birth by reducing pain, increasing physical and psychological comfort.

Purpose: To determine the effect of the combination of prenatal yoga on the length of labor at the Nambo Public Health Center.

Method: quasi-experimental with Non-Equivalent Group Design. The sample is pregnant women in the working area of the NamboPublic Health Center, totaling 60 people consisting of 30 treatment groups and 30 control groups. Sampling with purposive sampling technique. Data analysis using t-test.

Conclusion: There is an effect of prenatal yoga practice on the duration of the second stage of labor in the working area of the Nambo Health Center, Kendari City.

Internal and External Determinants of Firm Value: A Study on the Manufacturing Companies in Indonesia

/in /by

This study describes the influence of internal and external factors of the company on firm value which is a verification study using an explanatory survey method. The data used is secondary data available on the official website of the Indonesia Stock Exchange. While the type of data used is quantitative data. The sampling method is to use a purposive sampling method, so that 7 companies can be sampled in this study.

The results of this study indicate that all variables indicate that the company’s internal and external factors have an influence on the Firm Value of the food and beverage sub-sector listed on the Indonesia Stock Exchange in 2014-2020. Suggestions for companies, namely companies need to improve company performance in order to increase Firm Value, especially the use of costs and working capital management which can increase positive perceptions from investors so that they are reflected in Firm Value.

Evaluation of Physical Fitness and Motor Ability of Brazzaville’s U19 Football Players According to the Playing Positions

/in /by

This study aims to evaluate the physical fitness and motor ability of Brazzaville’s U19 footballers according to playing position. Method: A cross- sectional study was conducted with a total of 33 U19 football players aged 18.75 ± 0.95 years. Data collection consisted of anthropometric measurements, physical fitness (YYIR1 distance and VO2max) and motor ability (agility, explosive power and upper limbs strength) and the playing positions. Agility, explosive power and upper limbs strength (Barrow moter ability test) whereas YYIR1 distance and VO2max (YO-YO intermittent recovery level 1) were measured on three separate days. The data were analyzed using SPSS software 25.0. Results: Explosive powers as well as upper limb strength were significantly higher in goalkeepers than in midfielders, attackers and defenders (p < 0.001; p < 0.001). The distance covered by midfielders and VO2max were significantly higher than that of defenders, attackers and goalkeepers (p < 0.001; p <0.001). Conclusion: Physical fitness was high among midfielders while motor ability was high among goalkeepers. The different playing positions on the field are characterized by specific activities and physical requirements.

Prevalence and Pattern of Sexual Assaults among the Mentally Ill attending the University of Port Harcourt Teaching Hospital

/in /by

Background: Sexual assault among the mentally ill has become a common trend of public health concern occurring in various forms and perpetrated by different classes of individuals. It has become a more accurate predictor of suicidal ideation and attempt than any other form of abuse.

Aim: This study determined the prevalence and pattern of sexual assaults among the mentally ill attending the University of Port Harcourt Teaching Hospital.

Materials and Methods: This was a descriptive cross-sectional study conducted among attendees of Neuropsychiatric Outpatient Clinic of the University of Port Harcourt Teaching Hospital (UPTH). A structured questionnaire covering socio-demographic characteristics and other factors were self-administered to 75 patients diagnosed with various psychiatric disorders by consultant Psychiatrists at the out-patient clinic via a systematic random sampling method. Ethical approval was obtained from the ethical committee of the University of Port Harcourt Teaching Hospital. Descriptive statistics was used to analyze the data.

Results: Majority of the mentally ill patients were male (81%), had tertiary education (58.7%), and between the ages of 21 and 30 (44%). The most common mental illness experienced by victims of sexual assault include depression 21(28.0%), the least being sleep and personality disorders 1(1.3%). 16% reported that they had experienced sexual assault, and majority (38.7%) reported that the assault occurred when they were between the ages of 10 and 18. Majority of perpetrators of sexual assault were siblings 5(6.7%), followed by mother 3(4.0%). Some percentage was strangers (1.3%), with the rest being either a visitor to the house (1.3%), or neighbor (1.3%). Only (2.7%) of those who experienced sexual assault reported the assault, (9.3%) did not report it, while 66 (88%) had no response.

Conclusion: Sexual assault among the mentally ill is on the rise and manifests in several forms. Measures should be taken by all stakeholders including the government to curb this ugly trend.

Measurement of Service Quality Perception, Customer Satisfaction, and Customer Loyalty in PT Medika Antapani

/in /by

Indonesia had 11,347 clinics in 2020, 10,238 Pratama, and 1,109 Utama. West Java Province had the most clinics in 2021, with 6,572 Pratama and 1,042 Utama. Private Bandung public health provider PT. Medika Antapani 2020–2021 customer visits decreased. Pratama clinics in Kiaracondong have almost doubled to 15 clinics, giving cash clients many options. To compete, health services must constantly improve service quality to satisfy customers and build loyalty.

This research helps PT. Medika Antapani meet customer service needs. The author uses a descriptive and causal research design. The author distributes Likert scale questionnaires to 200 respondents who meet the criteria. According to a descriptive analysis of 200 respondents, most are male, 60-74 years old, live in Cisaranten Endah, are employees, and use general practitioner services. The total average for causal analysis was 3,088, 3,127, and 2.93 for service quality, satisfaction, and loyalty. Satisfaction and service quality affect loyalty by 84.1%.

Service quality improvements are needed in PT Medika Antapani for addressing six areas, including low scores on the latest equipment, recruiting Ob-Gyn doctors, and providing reminder messages. For future recommendations, PT Medika Antapani must evaluate its services to maintain quality and develop in areas service users need.