Cost Estimations of Water Pollution for the Adoption of Suitable Water Treatment Technology

This study analyzed the cost implications of using suitable technologies and the cost of inaction when addressing water pollution. This was achieved by developing three main models for the costs (model one) and benefits (model two and model three). The first model accounts for the operational costs of adopting suitable technologies, namely the use of diatomaceous earth for textile wastewater treatment. The second model analyzed the cost of inaction through analyzing the cost of treatment for water pollution-related diseases for the affected population. The occurrence and cost of treatment for three diseases, namely diarrhea, amoebiasis and bacterial infection, were used as indicators of water pollution in the area. The third model included the contingent valuation method (CVM) data on the willingness to pay for environmental restoration of the surveyed population. The benefit–cost ratio (BCR) of the resulting data from the three models were used to highlight the economic viability of the proposed project. A BCR of (0.67) for the cost of the proposed project versus the benefits of the project on human health using data from one hospital was obtained. There is a high possibility that the real BCR would increase if more data from other hospitals or other diseases were included. The results imply that the use of D.E can be considered a good candidate for treating wastewater. To thoroughly discuss the BCR of treating wastewater from one factory, the BCR of the proposed restoration project along River Sosiani, and the value of using DE as suitable technology, more studies are needed to evaluate the unaccounted costs and benefits for accurate economic estimations of the proposed project. The outcome of the study is a framework of numbers and figures that can be presented to decision makers and policy makers as critical information when making decisions.

The effectiveness and safety of switching therapy with an original drug to biosimilars in treatment of inflammatory bowel diseases

Introduction. Inflammatory bowel diseases are a group of chronic, immune-mediated diseases of unknown etiology. Etiotropic therapy of IBD does not exist, all drugs used to treat IBD have a pathogenetic effect. In the treatment of IBD biologic therapy is used. The most previously registered group of biologics are anti-TNF-α. But, after the expiration of the relevant patents, biosimilars appeared on the market (analogs, comparable in quality to the already approved reference product).Materials and methods. A retrospective study was conducted on the basis of the Ryzhikh Natianal Medical Research Centre for Coloproctology of the Ministry of Health of the Russia, which included 46 patients who switched from therapy with the original infliximab or adalimumab to biosimilar therapy.Discussion. This study showed that when switching therapy with the original drugs infliximab and adalimumab to biosimilars, the effectiveness of therapy does not significantly decrease with the use of biosimilars Infliximab BIOCAD and Dalibra. However, a statistically significant decrease in efficacy was revealed when switching from therapy with the original Infliximab to Flammegis. Considering that the use of biosimilars can reduce the cost of treatment and reduce the burden on the health budget, it is necessary to continue this study in order to obtain longer-term results.

Total flavonoid in Epimedium koreanum Nakai alleviated chronic renal failure via promoting AMPK activation

Chronic renal failure (CRF) is a result of the progression of chronic kidney diseases (CKD), a global health problem with high cost of treatment and no ideal therapy. The aim...

Rare Neurological Diseases: an Overreview of Pathophysiology, Epidemiology, Clinical Features and Pharmacoeconomic Considerations in the Treating

Rare diseases (RD) are serious chronic diseases affecting small number of people compared to the general population. There are between 6000 and 8000 RDs, which affect about 400 million people worldwide. Drugs used for causal treatment of RDs are called orphan drugs. RDs bear great clinical and economic burden for patients, their families, healthcare systems and society overall. There are at least two reasons for the high cost of treatment of RDs. First, there is no causal therapy for majority of RDs, so exacerbations, complications, and hospitalizations in those patients are common. The second reason is high price of available orphan drugs, which are not cost-effective when traditional pharmacoeconomic evaluation is employed. The pharmacoeconomic aspect of the treatment of RDs is especially important in the field of neurology, since at least one fifth of all RDs is composed of neurological conditions. The aim of this paper was to provide a concise overview of the pathophysiological, epidemiological and clinical characteristics of some of the most important and common rare neurological diseases, with special reference to their impact on society and economy.

A Simple Diagnosis-Related Groups-Based Reimbursement System Is Cost Ineffective for Elderly Patients With Displaced Femoral Neck Fracture Undergoing Hemiarthroplasty in Beijing

Displaced femoral neck fractures (FNF) in the elderly are a major public health concern that necessitates hemiarthroplasty (HA) as the mainstay treatment option. Diagnosis-Related Groups (DRG) are a patient classification system that categorizes patients based on the resources expended on them. The first objective of this study was to evaluate if a simplified DRG-based reimbursement system in Beijing would lower total HA treatment costs for elderly patients with displaced FNF. In addition, we aimed to determine how age, gender, year of admission, length of in-hospital stay, and the Charlson index affected total treatment costs. This retrospective study included 513 patients from the Peking Union Medical College Hospital. The patients were diagnosed with unilateral displaced femoral neck fractures and had HA. Medical information was gathered, including baseline demographic and clinical data, as well as treatment costs. Patients were classified into two groups: those who spent more than the predetermined cut-off cost and those who did not. The cost did not include the use of a bipolar prosthesis. Data from the two groups were compared, and multiple regression analysis models were constructed. The median total cost of treatment was ¥49,626 ($7,316). The majority of the patients (89.7%; 460/513) were categorized as exceeding the cost cut-off. Multiple linear regression analysis revealed that total treatment cost was positively correlated with age (p < 0.01) and the duration of in-hospital stay (p < 0.01) but not with gender (p = 0.160) or the Charlson index (p = 0.548). On implementing the DRG-based reimbursement system, the overall treatment costs increased by ¥21,028 ($3,099) (p < 0.01). The implementation of simplified DRG-prospective payment systems did not result in a significant reduction in total treatment costs for elderly patients with FNF who underwent HA in Beijing. The overall cost of treatment was associated with several factors, including age, length of hospitalization, and year of admission.

Coagulation performance evaluation of alginate as a natural coagulant for the treatment of turbid water

Alginates are quite abundant in nature as they occur both as a structural component in marine brown algae (Phaeophyceae) comprising up to 40% of dry matter and as capsular polysaccharides in soil bacteria. Alginic acid is the only polysaccharide, which naturally contains carboxyl groups in each constituent residue, and possesses various abilities for functional materials. Experiments were carried out for the water of turbidity 300 NTU. Alginate as such doesn't act as a coagulant instead it should be converted to calcium alginate by adding calcium ions. Calcium chloride was used for imparting calcium ions necessary for the reaction. The dosage of calcium was fixed as 50 mg/L, 75 mg/L, 100 mg/L, 150 mg/L, 200 mg/L, and alginate doses between 2 to 10 mg/L. Calcium dosage below 50 mg/L was not sufficient enough for the formation of egg-box structure which is responsible for the coagulation and flocculation process. For the mechanism of charge neutralization to take place effectively, calcium should be added first followed by alginate. pH and conductivity of the sample remain constant before and after the treatment. The dosage of alginate required for the treatment is less so the cost of treatment also will be very less, thus alginate can replace the usage of chemical coagulants like alum.

Cost of Myopia Correction: A Systematic Review

Myopia is one of the leading causes of visual impairment globally. Despite increasing prevalence and incidence, the associated cost of treatment remains unclear. Health care spending is a major concern in many countries and understanding the cost of myopia correction is the first step eluding to the overall cost of myopia treatment. As cost of treatment will reduce the burden of cost of illness, this will aid in future cost-benefit analysis and the allocation of healthcare resources, including considerations in integrating eye care (refractive correction with spectacles) into universal health coverage (UHC). We performed a systematic review to determine the economic costs of myopia correction. However, there were few studies for direct comparison. Costs related to myopia correction were mainly direct with few indirect costs. Annual prevalence-based direct costs for myopia ranged from $14-26 (USA), $56 (Iran) and $199 (Singapore) per capita, respectively (population: 274.63 million, 75.15 million and 3.79 million, respectively). Annually, the direct costs of contact lens were $198.30-$378.10 while spectacles and refractive surgeries were $342.50 and $19.10, respectively. This review provides an insight to the cost of myopia correction. Myopia costs are high from nation-wide perspectives because of the high prevalence of myopia, with contact lenses being the more expensive option. Without further interventions, the burden of illness of myopia will increase substantially with the projected increase in prevalence worldwide. Future studies will be necessary to generate more homogenous cost data and provide a complete picture of the global economic cost of myopia.

Changes in the oropharyngeal microbiome in patients with viral-bacterial pneumonia associated with сovid-19 on the background of antibiotic therapy and monitoring of antibioticaresistentie strains

The relevance of the infection caused by COVID-19 today is beyond doubt. According to the Protocol “Provision of medical care for the treatment of coronavirus disease (COVID-19)” approved by the order of the Ministry of Health of Ukraine dated April 2, 2020 № 762, antibacterial drugs are prescribed only in the presence of confirmed bacterial co-infection ( after receiving positive bacteriological results) blood and / or sputum analysis). But given that the results of the analysis must wait a few days, antibiotics, under certain indications, can be prescribed empirically. The aim of our work was to analyze the structure of the oropharyngeal microbiome, patients with viral and bacterial pneumonia who received antibiotics, to determine clinically significant strains and their sensitivity to antibacterial agents. In the structure of the oropharyngeal microbiome, fungi of the genus Candida significantly prevailed, which were found in 50 (45.6%) subjects, in second place in terms of frequency of detection were S. pneumoniae – 29 (26.4%). Much less often from the oropharynx of patients with viral-bacterial pneumonia associated with COVID-19 were isolated K. pneumoniae – 13 (11.8%), S. aureus – 11 (10.0%) and E. coli – 7 (6.4 %). Among the isolated S. pneumoniae, the maximum number of resistant strains was detected for such fairly new antibiotics as ceftriaxone – 37.9% and azithromycin – 31.0%. Among fungi of the genus Candida resistant to nystatin and amphotericin were 38.5% and 26.9%, respectively. Therefore, the administration of antibacterial agents, taking into account the sensitivity of clinically significant strains, will guarantee effective treatment, prevent the development of antibiotic resistance, prevent the development of oropharyngeal and intestinal dysbiosis, and thus reduce the cost of treatment of antibiotic side effects, including probiotics.

Pharmaco-economic features of hospital treatment of acute community-acquired pneumonia in children

The goal. Тo analyze the features of treatment and medical expenses in children hospitalized for acute community-acquired pneumonia. Materials and methods. The study analyzed medical records and examined 51 children aged 2 to 17 months hospitalized for pneumonia. In patients studied clinical symptoms, severity, structure and duration of basic treatment measures, their cost. Results. The duration of inpatient treatment was 13.3±0.62 days with subsequent outpatient treatment and rehabilitation. Antibiotics, antipyretics, antihistamines, mucolytics and corticosteroid hormones were used in the treatment. The total cost of treatment for one case averaged 2346.9±145.7 hryvnias. The most expensive were the costs of antibiotics, and the cheapest - the antipyretics. Given the community-acquired nature of the process, the initial use of third- and fourth-generation cephalosporins was irrational and significantly increased the cost of treatment. Conclusions. The introduction of a new model of medicine focuses on the optimization of treatment tactics and the rational choice of antibiotics for acute community-acquired pneumonia. In antibacterial therapy is still inadequate, from a clinical and economic point of view, the choice of drugs. In the treatment of this disease, the role of pathogenetic therapy to restore the processes of mucociliary clearance and prevention of dysbiosis on the background of the use of antibiotics has increased.

The effectiveness of moxifloxacin in the treatment of community-acquired pneumonia

The article presents the results of domestic and international studies of the use of the fourth-generation fluoroquinolone moxifloxacin in the treatment of commu-nity-acquired pneumonia and pneumonia caused by SARS-CoV-2. Analysis of the clinical use of moxifloxacin in the treatment of complications of the respiratory tract infec-tions indicates its high efficiency and bioavailability, a low risk of resistance, which makes it possible to recommend it for widespread use in the work of a practicing doctor. Ge-neric drug Maxicin (Yuria-Pharm), available as a 20 mg/ml concentrate in a 20 ml vial, can significantly reduce the cost of treatment and optimize infusion therapy by choosing both volume and solvent.