Adverse Drug Events Associated with Hospital Admission

2003 ◽  
Vol 37 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Hélène Peyriere ◽  
Stéphanie Cassan ◽  
Edith Floutard ◽  
Sophie Riviere ◽  
Jean-Pierre Blayac ◽  
...  
Keyword(s):  
Medical History ◽  
Adverse Drug Events ◽  
Previous History ◽  
Drug Reactions ◽  
Benefit Ratio ◽  
Drug Intolerance ◽  
History Of ◽  
A Prospective Study ◽  
Reason For Admission ◽  
Dosage Error

OBJECTIVE To increase the knowledge base on the frequency, causality, and avoidability of adverse drug events (ADEs) as a cause for admission in internal medicine or when occurring during hospitalization. METHODS A prospective study was performed for 6 periods of 8 days each. Epidemiologic data (e.g., age, gender, medical history), drug utilization, and adverse drug reactions on patients hospitalized during these periods were collected by a pharmacy student. RESULTS A total of 156 patients (70 men and 86 women) were included in the study. The patients’ mean age ± SD was 66.5 ± 18.1 years and mean length of stay was 13.2 ± 9 days. Renal and hepatic insufficiency and previous history of drug intolerance were observed in 17.9%, 10.2%, and 2% of the hospitalized patients, respectively. Thirty-eight ADEs occurred in 32 patients; in 15 cases, ADEs were identified as the reason for admission, 10 cases occurred during hospitalization, and 13 cases were present at admission, but were not the cause of admission. The most frequent ADEs involved the neurologic (23.6%), renal (15.7%), and hematologic (13.1%) systems. Among these 38 ADEs, 22 were considered avoidable (57.9%); 20 of these were associated with therapeutic errors (inappropriate administration, drug–drug interactions, dosage error, drug not stopped despite the onset of ADEs). Patients with ADEs stayed longer in the hospital and took more drugs both before and during their hospital stay (p < 0.05). CONCLUSIONS Most of the ADEs observed in this study were avoidable. The risk/benefit ratio of administered drugs could be improved with better knowledge of the patients’ medical history and the risk factors of ADEs.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

COVID-19 WITH RHINO-ORBITO-CEREBRAL MUCORMYCOSIS : A SUDDEN SURGE

2021 ◽  
pp. 130-133
Author(s):  
Seema Patel ◽  
A. Z. Nitnaware ◽  
R. T. Pawar ◽  
Ashish Keche ◽  
Tanvi Rekhade
Keyword(s):  
Diabetes Mellitus ◽  
Early Diagnosis ◽  
Prospective Study ◽  
Previous History ◽  
Diagnosis And Treatment ◽  
Temporal Association ◽  
Concomitant Infection ◽  
History Of ◽  
A Prospective Study

Recently an increase in the incidence of mucormycosis is noticed in COVID-19 cases. The main aim of this study is to present our experience of rhino-orbito-cerebral mucormycosis in COVID-19 patients and thereby aid its early diagnosis and treatment. This is a prospective study of 12 cases diagnosed as Rhino-orbito-cerebral mucormycosis . Presentation of mucormycosis in COVID-19, their temporal association and outcome of treatment was studied. Pre-existing comorbidities were seen in 91.67% patients, Diabetes Mellitus (83.33%). Previous history of COVID-19 infection and treatment for the same in 41.67% cases, concomitant infection in 16.67% and asymptomatic undiagnosed covid (antibodies positive) was detected in 41.67%. All patients showed improvement in general and nasal condition (100%). Early diagnosis is must.

The obstetric and neonatal outcome of pregnancy in women with a previous history of infertility: a prospective study

1991 ◽  
Vol 98 (11) ◽  
pp. 1087-1092 ◽  
Author(s):  
T. C. LI ◽  
I. MACLEOD ◽  
V. SINGHAL ◽  
S. L. B. DUNCAND
Keyword(s):  
Prospective Study ◽  
Neonatal Outcome ◽  
Previous History ◽  
History Of ◽  
A Prospective Study

Elevated Prothrombin Fragment F1+2 Levels during Pregnancy in Women with Previous Venous Thromboembolism.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1055-1055
Author(s):  
Rainer B. Zotz ◽  
Andrea Gerhardt ◽  
Steffi Marzotko ◽  
Karl J. Wagner ◽  
Hans G. Bender ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Pregnant Women ◽  
Mixed Model ◽  
Previous History ◽  
Normal Pregnancy ◽  
Prothrombin Fragment ◽  
History Of ◽  
Additional Approach ◽  
A Prospective Study ◽  
Over Time

Abstract Changes in blood coagulation and fibrinolysis during pregnancy create a state of hypercoagulability. This phenomenon predisposes to venous thromboembolism. Indicators of hypercoagulation in normal pregnancy are circulating thrombin-antithrombin complexes and increased levels of prothrombin fragment 1+2. A significant positive correlation between gestational age and elevated prothrombin fragment 1+2 has been shown. We hypothesized that women with previous venous thromboembolism are at a higher hypercoagulable state during subsequent pregnancies than women without prior thrombotic complications. In a prospective study, we determined prothrombin fragment F1+2 over pregnancy among 109 women (175 measurements) with previous venous thromboembolism, and among 75 pregnant women (75 measurements) without previous venous thromboembolism. The prothrombin fragment F1+2 levels were statistically analyzed over time using a Mixed Model. This model allows a longitudinal analysis of the influence of a between-subjects factor (e.g. history of thrombosis) on prothrombin fragment F1+2 levels, the influence of a within-subjects factor (weeks of gestation) on prothrombin fragment F1+2 levels, and the interaction of the history of thrombosis and weeks of gestation representing a change of risk factor-dependent differences over time (weeks of gestation). Among women with a previous history of venous thrombosis, prothrombin fragment F1+2 values were significantly higher during the course of pregnancy than among pregnant women without venous thromboembolism (p=0.0014). The results were adjusted for the physiological increase of prothrombin fragment F1+2 over pregnancy and were independent of heparin prophylaxis. Thus, determination of indicators of hypercoagulation like prothrombin fragment F1+2 represent an additional approach independent of known and unknown risk determinants of thrombosis to identify women at risk for venous thromboembolism during pregnancy.

scholarly journals Recommendations for Pathologic Evaluation of Reduction Mammoplasty Specimens: A Prospective Study With Systematic Tissue Sampling

2017 ◽  
Vol 141 (11) ◽  
pp. 1523-1528 ◽  
Author(s):  
Abiy B. Ambaye ◽  
Andrew J. Goodwin ◽  
Susan E. MacLennan ◽  
Shelly Naud ◽  
Donald L. Weaver
Keyword(s):  
Reduction Mammaplasty ◽  
Previous History ◽  
The United States ◽  
Reduction Mammoplasty ◽  
Atypical Hyperplasia ◽  
Pathologic Evaluation ◽  
Microscopic Evaluation ◽  
Pathologic Findings ◽  
History Of ◽  
A Prospective Study

Context.— Breast reduction mammaplasty (RMP) for symptomatic macromastia or correction of asymmetry is performed in more than 100 000 patients per year in the United States. The reported incidence of significant pathologic findings (SPF), that is, carcinoma and atypical hyperplasia, ranges from 0.06% to 12.8%. No standard pathology assessment for RMP exists. Objectives.— To propose standard sampling for microscopic evaluation in RMP specimens, to evaluate the incidence of occult carcinoma and atypical hyperplasia, and to identify clinical risk factors for SPF in patients undergoing RMP. Design.— All RMP specimens from 2006 to 2013 at a single institution were prospectively examined. After baseline gross and microscopic evaluations, each specimen was subjected to systematic additional sampling. The incidence of SPF was tabulated, and variables such as age, specimen weight, previous history of SPF, and results of preoperative mammogram were examined. Clinical follow-up review was also subsequently undertaken. Results.— A total of 595 patients were evaluated. Significant pathologic findings were present in 9.8% (58 of 595) of patients. No cancer was identified in patients younger than 40 years; the rates of carcinoma were 2.4% (14 of 595) in all patients, 3.6% (14 of 392) in patients aged 40 years or older, and 4.3% (10 of 233) in patients aged 50 years or older. No carcinoma or atypical hyperplasia was identified on preoperative mammogram. Increased sampling was associated with a significantly greater frequency of SPF only in patients aged 40 years or older. Conclusions.— In patients younger than 35 years, gross-only evaluation is sufficient. However, increased sampling may be necessary in patients older than 40 years.

scholarly journals Computed Tomograpy Venography diagnosis of iliocaval venous obstruction in advanced chronic venous insufficiency

2014 ◽  
Vol 13 (4) ◽  
pp. 306-311 ◽  
Author(s):  
Fabio Henrique Rossi ◽  
Carlos Alexandre Rosa Gama ◽  
Igor Yoshio Imagawa Fonseca ◽  
Keilyanne Jaira Ferreira Barros ◽  
Thiago Osawa Rodrigues ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Medical History ◽  
Linear Trend ◽  
Previous History ◽  
Previous Treatment ◽  
Positive Association ◽  
Venous Hypertension ◽  
Venous Obstruction ◽  
History Of

Objective:Iliocaval obstruction is associated with venous hypertension symptoms and may predispose to deep venous thrombosis (DVT). Ultrasonography may fail to achieve noninvasive diagnosis of these obstructions. The possibility of using Computed Tomography Venography (CTV) for these diagnoses is under investigation.Methods:Patients with CVI graded at CEAP clinical classes 3 to 6 and previous treatment failure underwent evaluation with CTV. Percentage obstruction was rated by two independent examiners. Obstruction prevalence and its associations with risk factors and CEAP classification were analyzed.Results:A total of 112 limbs were prospectively evaluated. Mean patient age was 55.8 years and 75.4% were women. Obstructions involved the left lower limb in 71.8% of cases and 35.8% of patients reported a medical history of deep venous thrombosis. Overall, 57.1% of imaging studies demonstrated venous obstruction of at least 50% and 10.7% showed obstruction of >80%. The only risk factor that was found to be independently associated with a significantly higher incidence of >50% venous obstruction was a medical history of DVT (p=0.035) (Fisher's exact test). There was a positive relationship between clinical classification (CEAP) and degree of venous obstruction in the limbs studied (Chi-square test for linear trend; p=0.011).Conclusion:Patients with advanced CVI are often affected by obstructions in the iliocaval venous territory and CTV is able to diagnose the degree of obstruction. There is a positive association between degree of obstruction and both previous history of DVT and severity of symptoms of CVI.

scholarly journals Sex Preferences Among Mothers Delivering at Patan Hospital

2012 ◽  
Vol 9 (4) ◽  
pp. 229-232 ◽  
Author(s):  
U D Chhetri ◽  
I Ansari ◽  
S Bhandary ◽  
N Adhikari
Keyword(s):  
Sex Ratio ◽  
Previous History ◽  
Life Time ◽  
Sex Selection ◽  
Sex Ratio At Birth ◽  
Female Birth ◽  
Old Age Security ◽  
Sex Preferences ◽  
History Of ◽  
A Prospective Study

Background High sex ratios at birth (SRB) are seen in China, Taiwan, South Korea, parts of India and Vietnam. The imbalance is the result of son preference, accentuated by declining fertility. Prenatal sex determination and female feticides are common in many countries. It is reflected in sex ratio Objective To determine reasons for the preferences for different sex; to find out whether there is altered sex ratio at birth and to find out whether female feticide are common among women who had abortion. Method It is a prospective study. Women who had previous history of abortion and had delivered at Patan Hospital in the year 2066 were interviewed as per questionnaires. Results Among 560 women with total live births of 965, (462 male and 503 female) during their life time the overall sex ratio was 92 male per 100 female birth; total abortions were 663. Preferences for male were 10%, female 15.4% and either was for 74%. The reason for male preference was to continue family lineage, to bring honor, old age security, and performing funeral rites while the reasons for daughter preferences were that they understand mother’s pain, help in household work. The sex ratio of the babies born during the study period was 113 male per 100 female births. The Sex ratio at birth from 1st to 6th deliveries was 61, 79, 101, 210, 286 and 1100 male per 100 female birth respectively. Prenatal sex selection was 8% (by USG) but none had sex selected abortion. ConclusionSex ratio of those delivered during the study period was skewed (136 boys per 100 girls) towards male. There was shift in SRB in 4th and subsequent pregnancies in favor of boys. As the male sex ratio increased the number of induced abortion decreased in subsequent pregnancies.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6334 Kathmandu Univ Med J 2011;9(4):229-232 

scholarly journals Risk factors for ectopic pregnancy; an institutional study in a tertiary care hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4741
Author(s):  
Ranjita Ghadei ◽  
Swayamsiddha Mohanty ◽  
Sushree Sovana Mishra ◽  
Debashis Giri
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Previous History ◽  
Diagnostic Tools ◽  
P Value ◽  
Care Hospital ◽  
Pregnancy Risk ◽  
History Of ◽  
A Prospective Study

Background: Ectopic pregnancy is the leading cause of maternal death during the 1st trimester of pregnancy, accounting for approximately 10% of all pregnancy related deaths. A better understanding of ectopic pregnancy risk can help prevent its occurrence. The present study was designed to evaluate the ectopic pregnancy risk factors and their strength of association with ectopic pregnancy at a tertiary care hospital.Methods: It was a prospective study with 104 cases of ectopic pregnancy and 125 controls conducted in the Department of Obstetrics and Gynecology, SCB Medical College, Cuttack for a period of 1 year. Detailed history suggestive of risks factor for ectopic pregnancy, menstrual and obstetrics history was taken. General, systemic, abdominal and vaginal examination was done. Diagnosis of ectopic pregnancy was confirmed by clinical examination, urine pregnancy test, ultrasonography and culdocentesis and only confirmed cases were included in the study group. Healthy pregnant women were taken as control group.Results: The study revealed that the risk of ectopic pregnancy was associated with the traditional risk factors including previous EP [Adjusted odds ratio (AOR) = 9.98, 95% CI: 0.89-11.1%], previous infertility (AOR= 7.29, 95% CI:2.53-21.0) and previous history of sterilization (AOR=12.47,95% CI: 3.50 - 44.4) and previous history of abortion (AOR= 3.10, 95% CI: 1.53-6.30). Age comparison between cases and controls revealed that the ODDS of having ectopic pregnancy was 4 times in the age group 30 to 35 years as compared to uterine pregnancy and this difference was statistically significant (P value = 0.007).Conclusions: Risk factors such as previous ectopic pregnancy, induction of ovulation, intra uterine device usage, abortion as well as increased maternal age along with recent diagnostic tools aid in early detection of ectopic pregnancy in women resulting in proper and timely treatment.

Gut instinct: a diagnostic tool?

2015 ◽  
Vol 129 (4) ◽  
pp. 365-368 ◽  
Author(s):  
I Z Iqbal ◽  
N Kara ◽  
C Hartley
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cancer Diagnosis ◽  
Previous History ◽  
Diagnostic Procedures ◽  
Clinical Suspicion ◽  
History Of ◽  
Diagnosis Of Cancer ◽  
A Prospective Study

AbstractObjectives:It is generally accepted that with experience clinicians develop the ability to identify patients who present with malignancy prior to a formal diagnosis. This ability cannot be quantified, nor is it a plausible substitute for investigation. This study aimed to evaluate the association between instinct and head and neck cancer diagnosis.Methods:A prospective study of patients requiring urgent diagnostic procedures for suspected cancer between August and December 2010 was performed. Risk factors, symptoms, signs and the clinician's impression were recorded. These were graded and subsequently correlated with histology findings.Results:Twenty-seven patients, with a mean age of 62.2 years, underwent a diagnostic procedure. Thirty per cent of patients were referred under the two-week pathway and 18.5 per cent had a previous history of head and neck cancer. A diagnosis of cancer was made in 37 per cent of patients. There was a positive correlation between clinical suspicion and cancer diagnosis (Kendall's tau-b = 0.648749).Conclusion:This study highlights the importance of clinical suspicion in cancer diagnosis. Although clinical suspicion cannot be quantified, it should be regarded as an integral part of patient assessment.

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