scholarly journals Clostridioides difficile infections: Epidemiology, correlations and treatment in a Lebanese cohort with use of ATLAS scoring

2020 ◽  
Vol 14 (12) ◽  
pp. 1461-1465
Author(s):  
Jacques Choucair ◽  
Rami Waked ◽  
Elie Haddad ◽  
Marie Chedid ◽  
Nabil Chehata ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Therapeutic Response ◽  
Tertiary Care ◽  
Dual Therapy ◽  
Care Hospital ◽  
Oral Vancomycin ◽  
Clostridioides Difficile ◽  
Significant Difference ◽  
History Of

Introduction: The objectives of the present study were to investigate epidemiology, correlations, severity, and therapeutic response of Clostridioides difficile infections in a Lebanese tertiary care hospital. Methodology: In this retrospective cohort study, patients having at least one positive Clostridioides difficile test (antigen glutamate dehydrogenase/GDH with toxins, or PCR) were studied. Results: Among 58 patients, 20 (34.5%) and 53 (91.4%) had positive antigen GDH and toxins, respectively. PCR was performed in 25 (43.1%) patients without any positive ribotype 027. Fifteen (25.9%) patients were immunocompromised, 35 (60.3%) patients received antibiotics prior to the infection and 34 (58.6%) on proton pump inhibitors. Fifty-four (93%) patients had a resolution of their symptoms after a mean period of 4.2 days of treatment. Twenty-two (38%) participants were treated with oral vancomycin, 11 (19%) with intravenous metronidazole and 23 (39.6%) with both antibiotics. Resolution of symptoms was significantly more rapid with monotherapy (p = 0.007) with no significant difference between vancomycin and metronidazole (p = 0.413). A positive correlation was found between ATLAS score and delay to symptoms resolution (r = 0.553; p < 0.001; N = 54), as well as between ATLAS score and prevalence of complications (p = 0.003). Conclusions: History of treatment with antibiotics, proton pump inhibitors, and hospital admission during the previous year were prevalent among our patient cohort. Rates of symptomatic resolution were similar with monotherapy and dual therapy.

scholarly journals A study of the prevalence of gestational diabetes mellitus and its maternal and fetal outcomes in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 4011 ◽  
Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Significant Difference ◽  
History Of

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.

scholarly journals Over prescription of Proton Pump Inhibitors on discharge of Medical Inpatients

2017 ◽  
Vol 18 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Sarmistha Biswas ◽  
ABM Abu Sufian ◽  
Prodip Kumar Sarkar ◽  
Mostofa Kamal Chowdhury ◽  
Joybaer Anam Chowdhury ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Safety And Health ◽  
Medical Inpatients ◽  
Study Population ◽  
Potential Risks ◽  
The Mean

Background: Proton pump inhibitors (PPIs) are the drugs used to treat and prevent acid peptic conditions. Their efficacy and safety profile has led to injudicious prescription of these drugs exposing patients to various potential risks and increased healthcare expenditure.Methodology: A retrospective observational study was done from 10th January to 24th January, 2015 in Medicine Indoor in a tertiary care hospital to determine the trend of prescribing PPIs on discharge of Medical inpatients.Result: We found 117 patients were discharged in the study period; 83 were male and 34 were female. Among them 102 (87.17%) were prescribed PPIs on their discharge. Mean age was 44.79 years. Among the study population only 29 patients (28.5%) truly needed PPIs during their discharge. The mean duration of prescribed PPIs was 28 days.Conclusion: Amore rational prescription of PPI during discharge will have better impact on patient safety and health care expenditure.J MEDICINE January 2017; 18 (1) : 27-29

scholarly journals Drug utility pattern of antiulcer agents used in osteoarthritis patients at tertiary care hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 2029
Author(s):  
Syed Ubaid Razvi ◽  
Shrikant B. Lahamate
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Ulcer Healing ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
H2 Blockers ◽  
Antiulcer Agents ◽  
Healing Agent ◽  
Antiulcer Drugs

Background: Osteoarthritis is the most common form of joint disease and the leading cause of pain in elderly people. Osteoarthritis (OA) is a progressive and painful chronic disease that mainly affects knee, hand and hip joints.Aim of study was to evaluate current trend of antiulcer drugs and to assess the group of antiulcer agents use in osteoarthritis patient.Methods: A prospective observational study was conducted in a tertiary care hospital for period of twelve months in collaboration with department of orthopaedics. Patients data recorded in case report form and analysed to study prescription pattern and related information Results: Total of 630 cases were enrolled in this study. Prescribed antiulcer drugs in OA were ranitidine, omeprazole, pantoprazole, rabeprazole, sucralfate and esomeprazole. Most commonly prescribed drug was Ranitidine i.e. 80.79% followed by omeprazole i.e. 8.42% pantoprazole i.e. 3.97% rabeprazole i.e. 3.81%, sucralfate i.e. 2.53% and esomeprazole i.e. 0.48% respectively. In this study, the commonest group prescribed was H2 blockers i.e. 80.79% followed by proton pump inhibitors i.e. 16.68%, and ulcer healing agent i.e. 2.53% respectively.Conclusions: Most commonly prescribed drug was ranitidine followed by omeprazole, pantoprazole, rabeprazole, sucralfate and esomeprazole respectively. In this study, the commonest group prescribed was H2 blockers followed by proton pump inhibitors, and ulcer healing agent respectively. 

scholarly journals Use of proton pump inhibitors in dialysis unit in tertiary care hospital: a pharmaco-epidemiological study

2021 ◽  
Vol 10 (6) ◽  
pp. 643
Author(s):  
Shabbir R. Pendhari ◽  
Kedar S. Joshi ◽  
Ramchandra P. Limaye
Keyword(s):  
Interstitial Nephritis ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Case Reports ◽  
Tertiary Care ◽  
Case Series ◽  
Acute Interstitial Nephritis ◽  
Case Report Form ◽  
Care Hospital ◽  
Dialysis Unit

Background: Proton pump inhibitors (PPI) are generally thought to be safer drug with fewer adverse effects. Though this class of the drug is thought to be well tolerated, a detail study about actual use of these agents in nephrology department is still awaited in many parts of India. There had been case reports and case series which were reporting PPIs producing acute interstitial nephritis progressing to acute renal failure. The risk of PPI treatment in haemodialysis patients remains unexplored. The aim of the study was to evaluate a drug utilization of PPI in patient undergoing haemodialysis procedure.Methods: In this study every day visit to the dialysis units of the hospitals was carried out. After taking consent from the patients, the information from the case-report form was noted like; age, sex, diagnosis, laboratory reports and drug prescried. No personally identifiable information about patient or physician was collected. After this an interview of patients was taken.Results: In this study, out of 126 patients 76.6% were male and 23.4% were female. Out of these 126 patients 88.89% patients were on PPI. Nearly 54% were using PPI for more than six months. Nearly 29% patients were using PPI for more than 12 months.Conclusions: As many case-reports and studies are suggesting, there is co-relation of PPI and acute interstitial nephritis from this study we suggest that especially in nephrology unit patients’, more caution must be exercised while using PPI.

scholarly journals Drug prescribing pattern in patients of myocardial infarction in a tertiary care teaching hospital of North India

2020 ◽  
Vol 9 (9) ◽  
pp. 1357
Author(s):  
Akanksha Mehra ◽  
Nusrat K. Bhat ◽  
Sushil K. Sharma ◽  
Kanika Khajuria
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Family History ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Tertiary Care ◽  
North India ◽  
Drug Prescribing ◽  
Prescribing Pattern ◽  
History Of

Background: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Aims of this study were to assess drug prescribing pattern in patients of myocardial infarction and to compare prevalence of MI according to age, gender, diet, smoker or non-smoker, alcoholic or non-alcoholic, family history of cardiovascular disease.Methods: This observational study was conducted at department of pharmacology, in association with department of cardiology and included all patients of myocardial infarction visiting cardiology outpatient department or indoor patients and proforma was used to evaluate drug prescribing pattern.Results: Total 200 patients of acute myocardial infarction were analysed. Incidence of MI was more common in males (76%); age group 51-60 years (28.5%); non-vegetarians (68.5%); smokers (52.5%) and reduced physical activity (70.5%). 59.5% of patients had family history of cardiovascular disease. Commonly prescribed drugs were antiplatelets (100%) followed by hypolipidemic (99.5%), proton pump inhibitors (92%), antianginal (90.5%), anticoagulants (68.5%), thrombolytics (24.5%).Conclusions: This study provides insight towards drug prescribing pattern in MI patients. Most frequently prescribed drugs were antiplatelets followed by hypolipidemic and proton pump inhibitors. Patients had multiple risk factors and these can be reduced by lifestyle modifications.

scholarly journals Cytogenetic investigation of couples with recurrent spontaneous miscarriages

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Misbah Iqbal Hanif ◽  
Ayesha Khan ◽  
Afsheen Arif ◽  
Erum Shoeb
Keyword(s):  
Pregnancy Loss ◽  
Chromosomal Abnormalities ◽  
Tertiary Care ◽  
Marker Chromosome ◽  
Female Carrier ◽  
Care Hospital ◽  
Spontaneous Miscarriage ◽  
Significant Difference ◽  
Cytogenetic Investigation ◽  
History Of

Background & Objective: Spontaneous pregnancy loss has always been the frustrating experience for the couples and concern clinician. Chromosomal abnormality in either of the parent is considered to be the one of the leading cause of recurrent spontaneous miscarriages. This study was designed to evaluate the possible chromosomal etiology of miscarriage and the subsequent intimacy of maternal or paternal genetic abnormality. Methods: This case-control study was conducted between January 2016 and October 2016 at a tertiary care hospital in Karachi. A total of thirty-two couples were selected who had suffered with recurrent spontaneous miscarriages (RSM). Using conventional cytogenetic technique karyotyping was performed on all of the subjects. For the control twenty couples were also selected with no history of pregnancy loss. All the karyotypes were recorded on the standard method. Data was analyzed through SPSS version 22. Results: Among thirty-two cases nine cases were found to have abnormal karyotype. In which sex chromosomal trisomy=02 (46,XY/47,XXY), marker chromosome=01 (47,XX,+mar), Robertsonian translocation=01 (45,XY,der,(14:21),(q10;q10)), reciprocal translocation=01 (46,XX,t(11;22)(q23;q11.2)), inversion=02 (46,XX,inv(9)(p11q13)) and minor structural abnormalities=02 (46,XX,15PS+) were found. Approximately equal ratio with 1:1.25 was observed among male and female carrier respectively. Non-significant difference was found between the ages of both carriers (p=0.34). Though a significant different value was calculated in the case of number of miscarriage (p=0.004*). Moreover, no significant association was found among spontaneous miscarriage (SM) and recurrent spontaneous miscarriage (RSM) with respect to maternal age (p= 0.157). Conclusion: In the recent study possible chromosomal abnormalities suggested the evaluation of the patient with the history of recurrent spontaneous miscarriage must include conventional cytogenetic. Moreover, probe development and extended investigation can ease the prognosis among pregnancy related complication. doi: https://doi.org/10.12669/pjms.35.5.678 How to cite this:Hanif MI, Khan A, Arif A, Shoeb E. Cytogenetic investigation of couples with recurrent spontaneous miscarriages. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.678 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Evaluation of the Clinical Features of 81 Patients with COVID-19: An Unpredictable Disease in Children

2020 ◽  
Author(s):  
Hayrettin Temel ◽  
Mehmet Gündüz ◽  
Hüseyin Arslan ◽  
Füsun Ünal ◽  
Emine Atağ ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pediatric Patients ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Asymptomatic Infection ◽  
Care Hospital ◽  
Significant Difference ◽  
History Of

Abstract Objective Data on the prognosis of clinical features of pediatric patients affected by the coronavirus disease 2019 (COVID-19) pandemic is insufficient. This study aimed to examine the clinical, laboratory, and radiology findings of pediatric patients diagnosed with COVID-19. Methods A total of 81 pediatric patients with a confirmed diagnosis of COVID-19 who were admitted to the pediatric clinics of our tertiary care hospital in Istanbul between March 22 and May 1, 2020, were included in the study. Results Of the patients, 40 (49.6%) were boys and 41 (50.6%) were girls. The mean age of the patients was 9.3 ± 5.5 years (range: 1 month–16 years). The most common symptoms were cough (28.4%) and fever (25.9%). A total of 26 patients (32.1%) had pharyngeal erythema. There was no significant difference between age groups in terms of symptoms, findings, clinical picture, history of contact, and clinical course (p > 0.001 for each). Abnormal findings were observed in seven (8.6%) patients on chest X-ray, and in four patients (4.9%) on thorax computed tomography. Only three of the patients were hospitalized and all of them discharged with healing. Conclusion The present study is the most comprehensive study on children diagnosed with COVID-19 in our country, which showed that the COVID-19 picture was mild in pediatric patients, but the signs and symptoms in children were not specific to the disease. Our findings also showed that the rate of asymptomatic infection in children was high and that it was difficult to recognize COVID-19 in children.

scholarly journals Snapshot of proton pump inhibitors prescriptions in a tertiary care hospital in Switzerland: less is more?

2019 ◽  
Vol 41 (6) ◽  
pp. 1634-1641 ◽  
Author(s):  
Camille Lenoir ◽  
Myriam El Biali ◽  
Christophe Luthy ◽  
Olivier Grosgurin ◽  
Jules Alexandre Desmeules ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
University Hospitals ◽  
Cross Sectional ◽  
Less Is More ◽  
Adequate Dosage

Abstract Background Proton pump inhibitors are among the most widely prescribed drugs in the world, but more than half of the indications for prescription are unjustified. The misuse of this therapeutic class has heavy consequences such as additional health costs, adverse drug reactions following long-term use and gastric acid rebound when the proton pump inhibitor is discontinued. Objective The overprescription of proton pump inhibitors is therefore becoming a public health problem, which led us to evaluate their use within the Geneva University Hospitals. Setting Patients hospitalized in two divisions of the department of internal medicine of the Geneva University Hospitals on a single day. Methods This is a register-based cross-sectional study and it collected data about the prescription pattern of proton pump inhibitors by consulting the electronic records of patients included. Main outcome measure To determine if the proton pump inhibitors prescription is made according to the market authorization and the available guidelines. Results Hundred-eighty patients were included. 54% of patients were on proton pump inhibitors, 29% of whom had their treatment initiated at hospital. Of the indications for treatment, 72% were not justified and 63% of the justified indications did not have an adequate dosage. Therefore, in all patients with a proton pump inhibitor at hospital, only 11% had a justified indication with an adequate dose. Finally, 87% of known home prescriptions were renewed on admission and among them, 71% did not have a justified or possibly justified indication according to the guidelines. Conclusion Indication for treatment inside the hospital was not justified in 72% of patients and only 11% had a justified indication with an adequate dosage. Precise guidelines with evidence-based indications and adequate daily doses would help to correctly prescribe proton pump inhibitors. Moreover, patients should benefit from a thorough evaluation of their treatment.

scholarly journals Prescribing Pattern of Proton Pump Inhibitors (PPI) and Histamine Blockers in a Tertiary Care Hospital

2020 ◽  
Author(s):  
Anjali Manoj Goyal ◽  
Alpa Pragnesh Gor
Keyword(s):  
Drug Interactions ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fixed Dose ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
H2 Blockers ◽  
Patient Department

Introduction: Gastric problems are the most common diseases seen in many countries for which majority of the population prefer Proton Pump Inhibitors (PPI) and Histamine (H2) Blockers. They are prescribed most commonly for Gastroesophageal Reflux Disease (GERD), Dyspepsia, Peptic Ulcer Disease, along-with medications like Non-Steroidal Antiinflammatory Drugs (NSAIDs) and other drugs. Concerns have been raised about the increasing costs associated with prescription of these drugs as they are often prescribed for minor symptoms and without clear indications. Prescribing pattern should be evaluated periodically to promote rational use of medicines. Aim: To assess the prescribing pattern of PPIs and H2 Blockers in Surgery and Medicine Department of a Tertiary Care Hospital. Materials and Methods: An observational study was conducted in a Tertiary Care Hospital, Karamsad over a period of one year from November, 2018 to October, 2019, among patients visiting to Out Patient Department (OPD) and In Patient Department (IPD) of Medicine and Surgery Department that were prescribed PPI and H2 Blockers. Total 1100 prescriptions and 1265 PPI, H2 Blockers were analysed. The data were analysed for socio-demographic variables along with details of PPI and H2 Blockers. co-prescribing drugs, Fixed Dose Combinations (FDCs) and drug interactions of each prescription was analysed. Results: In the study, PPI and H2 Blockers were prescribed more in males (54.36%). The predominant age group was 18-40 years (42%). Among studied drugs, most commonly prescribed single drug was Pantoprazole and FDC was Ranitidine + Domperidone. The drugs were most commonly prescribed through oral route (90.9%). They were most commonly prescribed along with an NSAID for gastroprotection (28.9%). Pharmacokinetic drug interactions were observed more in the study. Conclusion: This study showed that physicians prescribe PPI and H2 Blockers as a co-medication for gastroprotection. There is a need to increase documentation for prescribing PPI and H2 Blockers.

scholarly journals Prospective Assessment of Prescribing Pattern of Proton Pump Inhibitors in A Tertiary Care Hospital in Chennai

2021 ◽  
Vol 66 (1) ◽  
pp. 38-42
Author(s):  
Maria K Manu ◽  
Feba John ◽  
Kolli Manikanteswara Rao ◽  
Dr. Samhitha Chetty ◽  
Dr Adarsh Surendranath ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Prospective Assessment
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