PRIORITIZING FALL RISK MANAGEMENT: IRRESPECTIVE OF PARKINSON’S DISEASE PROGRESSION DURING REHABILITATION

Background and Aims: It has been established that the hazard of falling in Parkinson's patients is a primary cause of loss of independence, and hence it is a significant component to the disease's burden. As a result, the goal of this study is to evaluate the relationship between level of disease progression and the risk of falling in order to understand the critical need for rehab intervention in Parkinson's disease. Methodology: A cross-sectional survey was conducted on 24 participants participated in study through convenience sampling technique from primary and tertiary care institutes/ hospitals. Tinetti balance and gait test was used to evaluate the risk of fall among patients while The Hoehn and Yahr Scale was used to track the progression of Parkinson's symptoms and disability. Results: Total 24 (n=24) participants with idiopathic Parkinson’s disease were enrolled in the study in which the majority of the participants belong to age group 59-69 years. The balance and gait of Parkinson’s patient is strongly negative correlated i.e. -8.33 with the severity of Parkinson’s disease with .000 level of significance which is strongly negative correlated with the severity of Parkinson’s disease (p<0.05). Conclusion: This demonstrates that the balance and gait of a Parkinson’s person is not related to the severity level Parkinson’s disease thus fall management in PD patients must be kept in priority during the rehab intervention for ADL independence and social participation.

A Study of Pioglitazone Biokinetics, Renal Clearance and its Effect on Glycation Level

Pioglitazone is an oral anti-diabetic agent which belongs to a class “thiazolidinediones”. It is used in the treatment of type 2 diabetes mellitus. It acts primarily by increasing peripheral sensitivity to insulin through binding to peroxisome proliferators activated receptor gamma. In recent years, due to variation in pharmacokinetic parameters under different environmental conditions, drug pharmacokinetics has received increasing attention. Therefore, the present study was designed to evaluate the biokinetics, renal clearance and effect on glycation level of pioglitazone in human beings under indigenous conditions. After through clinical examination healthy male volunteers (n = 24), female volunteers (n = 12) and diabetic patients (n = 8) were selected for the study. Each volunteer was given a therapeutic dose of 30 mg pioglitazone tablet orally. Patients were given a dose of 30 mg pioglitazone daily up to 12 weeks. In healthy volunteers scheduled plasma and urine samples were collected at different time intervals. Concentration of pioglitazone in plasma and urine samples was determined by validated high performance liquid chromatographic method. For the estimation of renal clearance of pioglitazone, the endogenous creatinine level was measured in plasma and urine samples spectrophotometrically using kit method based on Jaffe reaction. In plasma samples obtained from healthy volunteers and patients, amount of glucose was estimated by kit method, proteins by Biuret method and glycation level was measured by Thiobarbituric acid (TBA) method, spectrophotometerically. Both differences and similarities are present in the values of different calculated parameters and the values reported in the literature. After comparison minor sex differences were also found to be present in the values of different calculated parameters but statistically these differences were found to be non-significant. A single dose of pioglitazone (30 mg) has no effect on glucose concentration and glycation level in healthy male volunteers. Long term treatment of pioglitazone in diabetic patients, significantly decreased the glucose concentration and glycation level. This indicates that pioglitazone acts as an inhibitor of glycation.