Marlene Julyan - Academia.edu (original) (raw)
Papers by Marlene Julyan
Not only did the Romans work very hard during the night, but they also enjoyed eating, drinking a... more Not only did the Romans work very hard during the night, but they also enjoyed eating, drinking and partying. Although there were only limited sources of light, they used their evenings and nights optimally. During the first and second centuries A.D., there was a definite renaissance in commercial life, in cities as well as in the country. Basic concepts were standardised, such as the calendar (by Caesar), time reckoning by means of sun dials and water clocks. There were also improvements in the ways of recreation, entertainment and different kinds of artificial light. In this study primary sources of information were used. The chapter on the sources is an endeavour to combine the biographical information of the specific writers and the influence of their milieu on their writing and way of life, with the extracts from their work. Martial and Juvenal give an exaggerated reconstruction, which however contains many apt descriptions of the social milieu. Pliny in his encyclopaedia (Natu...
Southern African Journal of Infectious Diseases
Background: Worldwide, the leading cause of invasive candidiasis and the fourth leading cause of ... more Background: Worldwide, the leading cause of invasive candidiasis and the fourth leading cause of hospital-acquired infections are the Candida species (spp.) group. One of the most important tools in fighting such drug-resistant fungi is the appropriate use of antifungal agents.Objectives: The study aimed to determine echinocandins’ general prescribing patterns and how they are associated with the treatment period.Method: A quantitative, observational, and descriptive was used, and included patients receiving antifungal treatment in a private hospital in Gauteng, South Africa between 01 January 2015 to 31 December 2015.Results: Of the 146 patient files included, 102 patients (69.9%) received caspofungin and 44 patients (30.1%) were treated with anidulafungin. For the former, 99 (97.1%) patients received a loading dose (LD) of 70 mg, while 200 mg anidulafungin was only prescribed to 30 patients (68.2%). In line with maintenance dose guidelines, the majority (98.1%) of caspofungin-trea...
Southern African Journal of Infectious Diseases
Background: Antibiotic consumption (ABC) surveillance is a critical component of the strategic pr... more Background: Antibiotic consumption (ABC) surveillance is a critical component of the strategic priority response to the increasing antibiotic resistance threat. Levels of ABC at the national and provincial levels in South Africa are unknown because of inadequate ABC surveillance systems and literature. Antibiotic consumption in the public sector of Limpopo province, South Africa, 2014-2018Methods: This retrospective study used sales data retrieved from a pharmaceutical warehouse distribution database to quantify ABC. Antibiotic consumption was measured by the defined daily dose (DDD) per 1000 inhabitants per day (DID) and 75% drug utilisation index (DU75%). Change in consumption was measured by the compound annual growth rate (CAGR).Results: Between 2014 and 2018, the mean ABC was 4.6 ± 1.0 DID, with an overall decrease of 1.6% in the CAGR. Penicillins (2.3 ± 0.8; 50.0%), sulphonamide and trimethoprim combinations (1.4 ± 0.3 DID; 30.4%) were the most consumed antibiotics. Macrolides...
Southern African Journal of Infectious Diseases
Background: The World Health Organization (WHO) classified antibiotics into three categories in 2... more Background: The World Health Organization (WHO) classified antibiotics into three categories in 2017 – Access, Watch and Reserve (AWaRe) – intending to reduce the consumption of Watch and Reserve antibiotics while increasing the use of Access antibiotics. Antibiotic consumption by AWaRe in South Africa is undetermined because of data and research scarcity.Objectives: The aim of this study was to quantify, describe and track antibiotic consumption between 2014 and 2018 in the public sector of the Limpopo province, South Africa, using the WHO’s AWaRe classification for 2021.Method: Antibiotic consumption was quantified from pharmaceutical sales data for 2014–2018 by defined daily dose (DDD) per 1000 inhabitants per day (DID) and described according to the AWaRe classification. The change in antibiotic consumption was measured by compound annual growth rate (CAGR), Access-to-Watch index (AW-I), 75% drug utilisation index (DU75%) and amoxicillin index (AI).Results: The absolute consumpt...
Journal of Endocrinology Metabolism and Diabetes of South Africa, Dec 20, 2018
According to the literature, parenteral testosterone replacement therapy (TRT)-induced polycythae... more According to the literature, parenteral testosterone replacement therapy (TRT)-induced polycythaemia is associated with cardiovascular events. No or minimal data exist for the prevalence of TRT-induced polycythaemia in lateonset hypogonadism (LOH) patients from South Africa. Polycythaemia is the side effect most frequently associated with parental TRT formulations. Design: This was a quantitative, observational, descriptive, retrospective study. Setting: The study setting was a private practice male clinic in Emalahleni. Subject: An all-inclusive sampling method was used. Outcome measures: The main outcome measure for polycythaemia was haematocrit (Hct). An Hct percentage of > 50% at month 3 (post-treatment initiation) constituted a positive diagnosis for polycythaemia. For the rise in total testosterone (TT) and Hct, the variance was used as documented between pre-and post-treatment initiation. Results: The prevalence of polycythaemia was 34%. A statistically significant increase in both TT and Hct was observed. The Cohen's d effect size was 0.68 and 0.73, respectively, for TT and Hct. Conclusion: Depot-testosterone undecanoate parenteral formulation induces polycythaemia in LOH patients, where the rise in TT demonstrates the effectiveness of therapy.
South African Family Practice, 2020
Background Prophylactic venous thromboembolism (VTE) strategies have the greatest impact on patie... more Background Prophylactic venous thromboembolism (VTE) strategies have the greatest impact on patient outcomes. Both global and local guidelines support VTE prophylaxis for hospitalised patients. However, studies have reported that these measures are routinely under-prescribed. This study evaluated prescribing patterns of VTE prophylaxis in one of the largest South African (SA) private hospital groups. Methods A quantitative, retrospective analysis of the hospital group’s patient database was conducted for patients admitted between 01 September 2015 and 31 August 2016. Those younger than 18 years with trauma or suffering from contraindications to anticoagulation were excluded. Additionally, patients with warfarin billed were also excluded as they possibly required therapeutic anticoagulation. Included prophylactic measures were compared with published SA guidelines by abstracting prophylaxis type and dosing, according to corresponding individual patients’ VTE risk ratings. Results Amo...
Kabelo, this is the first book chapter I'm trying to submit. Could you please look at the for... more Kabelo, this is the first book chapter I'm trying to submit. Could you please look at the format I used. Thanks
South African Family Practice
Background: Little is known about longitudinal prescribing practices for anti-epileptic drugs (AE... more Background: Little is known about longitudinal prescribing practices for anti-epileptic drugs (AEDs) in South Africa. The prescribing patterns and associated direct medicine costs of AEDs in the private health sector were investigated, using claims data from January 1, 2008 to December 31, 2013.Methods: The annual prevalence of prescriptions, AEDs and AED generics per patient with epilepsy (ICD-10 code G40) was determined. Cost analyses conducted included the calculation of the total direct cost of AEDs (medical scheme contribution, patient co-payment, and single exit price (SEP)), and the average cost per AED per year.Results: Prevalence of patients claiming anti-epileptics ranged between 0.87% and 0.91% from 2008 to 2013. AED prescriptions/patient ranged from 11.76 (95% CI, 11.56–11.95)] in 2008 to 11.90 (95% CI, 11.71–12.09) in 2013. Patients aged 40–65 years had the highest number of AED prescriptions/year. Valproate was most prescribed, followed by lamotrigine and carbamazepine...
Patient preference and adherence, 2016
To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to obser... more To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to observe the association between adherence status and age, sex, active ingredient prescribed, treatment period, and number of comorbidities; and to determine the effect of nonadherence on direct medicine treatment cost of AEDs. A retrospective study analyzing medicine claims data obtained from a South African pharmaceutical benefit management company was performed. Patients of all ages (N=19,168), who received more than one prescription for an AED, were observed from 2008 to 2013. The modified medicine possession ratio (MPRm) was used as proxy to determine the adherence status to AED treatment. The MPRm was considered acceptable (adherent) if the calculated value was ≥80%, but ≤110%, whereas an MPRm of <80% (unacceptably low) or >110% (unacceptably high) was considered nonadherent. Direct medicine treatment cost was calculated by summing the medical scheme contribution and patient co-pay...
The plant species Daturastramonium L.,which is a member of the Solanaceae family was well known t... more The plant species Daturastramonium L.,which is a member of the Solanaceae family was well known to the Greeks and Romans as a soporific, narcotic and anodyne. Modern pharmacology and phytochemistry ascribe these properties to the plant’s possession of with tropane alkaloids. We can now understand how the ancient herbalists determined a particular dosage to achieve a desired effect.
The use of papaver somniferum (from the Latin fero ferre = 'to bear/bring' and somnium = 'sleep')... more The use of papaver somniferum (from the Latin fero ferre = 'to bear/bring' and somnium = 'sleep') as a narcotic, goes back to the 13 th century BC. The works of ancient authors such as Dioscorides, Celsus, Galen, Theophrastus and Pliny the Elder provide us with detailed information about the morphology of the plant, its processing and the administration of the drug. 1 These authors make it clear that opium was mainly employed as anodyne and narcotic but they also documented its use as a drug in the treatment of a variety of ailments, either as one of many ingredients in a medicinal recipe or as the main ingredient. Modern botanical and pharmaceutical analysis of the plant and its active ingredients provide us with some surprising conclusions regarding its effectiveness in the treatment of the medical conditions for which it was prescribed in the 1 st and 2 nd century. References to the information supplied by these sources will be found throughout this article.
Not only did the Romans work very hard during the night, but they also enjoyed eating, drinking a... more Not only did the Romans work very hard during the night, but they also enjoyed eating, drinking and partying. Although there were only limited sources of light, they used their evenings and nights optimally. During the first and second centuries A.D., there was a definite renaissance in commercial life, in cities as well as in the country. Basic concepts were standardised, such as the calendar (by Caesar), time reckoning by means of sun dials and water clocks. There were also improvements in the ways of recreation, entertainment and different kinds of artificial light. In this study primary sources of information were used. The chapter on the sources is an endeavour to combine the biographical information of the specific writers and the influence of their milieu on their writing and way of life, with the extracts from their work. Martial and Juvenal give an exaggerated reconstruction, which however contains many apt descriptions of the social milieu. Pliny in his encyclopaedia (Natu...
Southern African Journal of Infectious Diseases
Background: Worldwide, the leading cause of invasive candidiasis and the fourth leading cause of ... more Background: Worldwide, the leading cause of invasive candidiasis and the fourth leading cause of hospital-acquired infections are the Candida species (spp.) group. One of the most important tools in fighting such drug-resistant fungi is the appropriate use of antifungal agents.Objectives: The study aimed to determine echinocandins’ general prescribing patterns and how they are associated with the treatment period.Method: A quantitative, observational, and descriptive was used, and included patients receiving antifungal treatment in a private hospital in Gauteng, South Africa between 01 January 2015 to 31 December 2015.Results: Of the 146 patient files included, 102 patients (69.9%) received caspofungin and 44 patients (30.1%) were treated with anidulafungin. For the former, 99 (97.1%) patients received a loading dose (LD) of 70 mg, while 200 mg anidulafungin was only prescribed to 30 patients (68.2%). In line with maintenance dose guidelines, the majority (98.1%) of caspofungin-trea...
Southern African Journal of Infectious Diseases
Background: Antibiotic consumption (ABC) surveillance is a critical component of the strategic pr... more Background: Antibiotic consumption (ABC) surveillance is a critical component of the strategic priority response to the increasing antibiotic resistance threat. Levels of ABC at the national and provincial levels in South Africa are unknown because of inadequate ABC surveillance systems and literature. Antibiotic consumption in the public sector of Limpopo province, South Africa, 2014-2018Methods: This retrospective study used sales data retrieved from a pharmaceutical warehouse distribution database to quantify ABC. Antibiotic consumption was measured by the defined daily dose (DDD) per 1000 inhabitants per day (DID) and 75% drug utilisation index (DU75%). Change in consumption was measured by the compound annual growth rate (CAGR).Results: Between 2014 and 2018, the mean ABC was 4.6 ± 1.0 DID, with an overall decrease of 1.6% in the CAGR. Penicillins (2.3 ± 0.8; 50.0%), sulphonamide and trimethoprim combinations (1.4 ± 0.3 DID; 30.4%) were the most consumed antibiotics. Macrolides...
Southern African Journal of Infectious Diseases
Background: The World Health Organization (WHO) classified antibiotics into three categories in 2... more Background: The World Health Organization (WHO) classified antibiotics into three categories in 2017 – Access, Watch and Reserve (AWaRe) – intending to reduce the consumption of Watch and Reserve antibiotics while increasing the use of Access antibiotics. Antibiotic consumption by AWaRe in South Africa is undetermined because of data and research scarcity.Objectives: The aim of this study was to quantify, describe and track antibiotic consumption between 2014 and 2018 in the public sector of the Limpopo province, South Africa, using the WHO’s AWaRe classification for 2021.Method: Antibiotic consumption was quantified from pharmaceutical sales data for 2014–2018 by defined daily dose (DDD) per 1000 inhabitants per day (DID) and described according to the AWaRe classification. The change in antibiotic consumption was measured by compound annual growth rate (CAGR), Access-to-Watch index (AW-I), 75% drug utilisation index (DU75%) and amoxicillin index (AI).Results: The absolute consumpt...
Journal of Endocrinology Metabolism and Diabetes of South Africa, Dec 20, 2018
According to the literature, parenteral testosterone replacement therapy (TRT)-induced polycythae... more According to the literature, parenteral testosterone replacement therapy (TRT)-induced polycythaemia is associated with cardiovascular events. No or minimal data exist for the prevalence of TRT-induced polycythaemia in lateonset hypogonadism (LOH) patients from South Africa. Polycythaemia is the side effect most frequently associated with parental TRT formulations. Design: This was a quantitative, observational, descriptive, retrospective study. Setting: The study setting was a private practice male clinic in Emalahleni. Subject: An all-inclusive sampling method was used. Outcome measures: The main outcome measure for polycythaemia was haematocrit (Hct). An Hct percentage of > 50% at month 3 (post-treatment initiation) constituted a positive diagnosis for polycythaemia. For the rise in total testosterone (TT) and Hct, the variance was used as documented between pre-and post-treatment initiation. Results: The prevalence of polycythaemia was 34%. A statistically significant increase in both TT and Hct was observed. The Cohen's d effect size was 0.68 and 0.73, respectively, for TT and Hct. Conclusion: Depot-testosterone undecanoate parenteral formulation induces polycythaemia in LOH patients, where the rise in TT demonstrates the effectiveness of therapy.
South African Family Practice, 2020
Background Prophylactic venous thromboembolism (VTE) strategies have the greatest impact on patie... more Background Prophylactic venous thromboembolism (VTE) strategies have the greatest impact on patient outcomes. Both global and local guidelines support VTE prophylaxis for hospitalised patients. However, studies have reported that these measures are routinely under-prescribed. This study evaluated prescribing patterns of VTE prophylaxis in one of the largest South African (SA) private hospital groups. Methods A quantitative, retrospective analysis of the hospital group’s patient database was conducted for patients admitted between 01 September 2015 and 31 August 2016. Those younger than 18 years with trauma or suffering from contraindications to anticoagulation were excluded. Additionally, patients with warfarin billed were also excluded as they possibly required therapeutic anticoagulation. Included prophylactic measures were compared with published SA guidelines by abstracting prophylaxis type and dosing, according to corresponding individual patients’ VTE risk ratings. Results Amo...
Kabelo, this is the first book chapter I'm trying to submit. Could you please look at the for... more Kabelo, this is the first book chapter I'm trying to submit. Could you please look at the format I used. Thanks
South African Family Practice
Background: Little is known about longitudinal prescribing practices for anti-epileptic drugs (AE... more Background: Little is known about longitudinal prescribing practices for anti-epileptic drugs (AEDs) in South Africa. The prescribing patterns and associated direct medicine costs of AEDs in the private health sector were investigated, using claims data from January 1, 2008 to December 31, 2013.Methods: The annual prevalence of prescriptions, AEDs and AED generics per patient with epilepsy (ICD-10 code G40) was determined. Cost analyses conducted included the calculation of the total direct cost of AEDs (medical scheme contribution, patient co-payment, and single exit price (SEP)), and the average cost per AED per year.Results: Prevalence of patients claiming anti-epileptics ranged between 0.87% and 0.91% from 2008 to 2013. AED prescriptions/patient ranged from 11.76 (95% CI, 11.56–11.95)] in 2008 to 11.90 (95% CI, 11.71–12.09) in 2013. Patients aged 40–65 years had the highest number of AED prescriptions/year. Valproate was most prescribed, followed by lamotrigine and carbamazepine...
Patient preference and adherence, 2016
To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to obser... more To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to observe the association between adherence status and age, sex, active ingredient prescribed, treatment period, and number of comorbidities; and to determine the effect of nonadherence on direct medicine treatment cost of AEDs. A retrospective study analyzing medicine claims data obtained from a South African pharmaceutical benefit management company was performed. Patients of all ages (N=19,168), who received more than one prescription for an AED, were observed from 2008 to 2013. The modified medicine possession ratio (MPRm) was used as proxy to determine the adherence status to AED treatment. The MPRm was considered acceptable (adherent) if the calculated value was ≥80%, but ≤110%, whereas an MPRm of <80% (unacceptably low) or >110% (unacceptably high) was considered nonadherent. Direct medicine treatment cost was calculated by summing the medical scheme contribution and patient co-pay...
The plant species Daturastramonium L.,which is a member of the Solanaceae family was well known t... more The plant species Daturastramonium L.,which is a member of the Solanaceae family was well known to the Greeks and Romans as a soporific, narcotic and anodyne. Modern pharmacology and phytochemistry ascribe these properties to the plant’s possession of with tropane alkaloids. We can now understand how the ancient herbalists determined a particular dosage to achieve a desired effect.
The use of papaver somniferum (from the Latin fero ferre = 'to bear/bring' and somnium = 'sleep')... more The use of papaver somniferum (from the Latin fero ferre = 'to bear/bring' and somnium = 'sleep') as a narcotic, goes back to the 13 th century BC. The works of ancient authors such as Dioscorides, Celsus, Galen, Theophrastus and Pliny the Elder provide us with detailed information about the morphology of the plant, its processing and the administration of the drug. 1 These authors make it clear that opium was mainly employed as anodyne and narcotic but they also documented its use as a drug in the treatment of a variety of ailments, either as one of many ingredients in a medicinal recipe or as the main ingredient. Modern botanical and pharmaceutical analysis of the plant and its active ingredients provide us with some surprising conclusions regarding its effectiveness in the treatment of the medical conditions for which it was prescribed in the 1 st and 2 nd century. References to the information supplied by these sources will be found throughout this article.