scholarly journals Clinical profiling of patients with Acid Peptic Disorders (APD) in India: a cross-sectional survey of clinicians

Author(s):  
Ramesh Roop Rai ◽  
A. Gangadhar ◽  
Mayur M. Mayabhate

Background: Acid peptic disorders (APD) which include GERD and peptic ulcer disease (PUD) are common conditions reported in daily clinical practice. This survey aimed to understand the epidemiology, clinical presentation and associated overlapping comorbidities in Indian patients with APD.Methods: This was an interview based cross-sectional survey of 1000 clinicians (specialist gastroenterologists and non-specialists) across India who treated patients of APD in their practice. Information related to patient demographics, diagnosis and clinical presentation (common symptoms and their duration, alarming, lower GI and extra-esophageal symptoms) were assessed. Indications for upper GI endoscopy, esophageal pH monitoring and esophageal manometry were also collected. Descriptive analyses were done.Results: About 39.2% and 37.1% patients had reported GERD and PUD respectively (duodenal ulcer: 10.5%, gastric ulcer: 9.9% and peptic ulcer-non-specified: 16.7%); 25.2% patients were reported to have non-ulcer dyspepsia. Heartburn was the most common symptom in GERD (60.5%); epigastric pain was common in PUD (72.3%); 49% GERD patients presented with alarming symptoms, mainly dysphagia (67%), whereas for PUD, GI bleeding was the most common alarming symptom (47.6%). Profiles of patients visiting clinicians were similar with respect to the presenting symptoms and associated conditions. Functional dyspepsia (25.9%), constipation (23.4%) and irritable bowel syndrome (23.4%) were the most common overlapping conditions associated with both GERD and PUD.Conclusions: APD (GERD and PUD) was more common in 18-59 yrs. age group with heart burn as the common symptom for GERD and epigastric pain for PUD. Diagnosis was mostly based on clinical symptoms; nearly 50% patients of APD presenting with alarming symptoms needed prompt endoscopy. Thus, there is need to focus on these overlapping disorders while managing patients of APD.

2011 ◽  
pp. 122-129
Author(s):  
Quang Di Bui ◽  
Phuoc Lam Nguyen

Objectives: The aim of study is to evaluate the efficacy, tolerability and adverse effects of a standard triple therapy including Rabeprazole, Clarithromycin and Amoxicilline at Sai gon Hoan My hospital in order to consider treatment H.pylori for patients who have not yet eradicated before or need to be undertaked by alternative regimens. Methods: By descriptive cross-sectional study, the authors have examined 116 patients sufferring from peptic ulcer received 10-day therapy including Rabe (20mg b.d) plus Clari(500mg b.d) plus Amoxi(1g b.d). Eradication is confirmed with endoscopy after 4 weeks from completing of treatment. Results and Discussion: 100% of patients were initially included and noboby was dropped out of the follow-up satges. The mean age was 49 in which 62% was male, 73(62,9%) presented duodenal ulcer, 28(24,1%) gastric ulcer and 15(13%) simultaneous gastric and duodenal ulcers. All patients took medications correctly. Per-protocol and intention to treat eradication rates were both 75%(95% CI=73,4-78,3). Additionally, 62(53,4%) patients had at least one risky factor for peptic ulcer disease, smoking being the most common one 44(37,9%).The adverse effects were reported overall in 67% of the patients, mainly including changed taste, very bitter, tired 49%, trouble sleeping 12% and diarrhea 5%. Conclusion: this ten-day standard triple therapy used in this study is ineffective with high adverse effects.The first line eradication with new regimens should be alternative.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mi Hong Yim ◽  
Keun Ho Kim ◽  
Bum Ju Lee

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.


2005 ◽  
Vol 45 (4) ◽  
pp. 331-339 ◽  
Author(s):  
Stuart D M Thomas ◽  
Mairead Dolan ◽  
Jenny Shaw ◽  
Samantha Thomas ◽  
Graham Thornicroft ◽  
...  

Historically, a substantial proportion of women have been unduly detained in conditions of high security in England due to the lack of suitable alternative facilities. There have been no studies that have comprehensively examined the individual needs of these women in relation to their placement needs. A cross sectional survey was undertaken of the individual and placement needs of all females detained in the three high security psychiatric hospitals (HSPHs) in England on 18th October 1999. Whilst there are clearly differences in accommodation needs among the women, those requiring lower secure services are significantly less likely to have needs in relation to violence (OR 0.29, 95% CI 0.14-0.62) and drugs (OR 0.29, 95% CI 0.12-0.67) when length of stay is taken into account. They also have lower security, treatment and dependency needs than women still requiring HSPH treatment. A significant reorganisation of services is required. There is a need to gain further understanding of the relationships between traumatic histories, clinical presentation and antisocial behaviour and how these impact on assessed risk, treatment and care needs and outcome. The special needs of these women should be considered a priority when developing treatment and care packages.


2021 ◽  
Author(s):  
Cong Luo ◽  
Lei Chen ◽  
Qi Xu ◽  
Jingjing Li ◽  
Qing Wei ◽  
...  

Abstract Background Chemotherapy-induced nausea and vomiting (CINV) is a common symptom in patients who undergoing chemotherapy, it is very important to control CINV to maintain dose intensity and patients' quality of life. To analyze the current situation of CINV for the tumor patients who undergoing chemotherapy, we used a cross-sectional survey to assess CINV status in those patients, and whether the drugs used by doctors in each department met the guidelines, and compared the incidence of acute and delayed CINV overall post-chemotherapy periods. Methods This was a single-center, cross-sectional retrospective study of patients with chemotherapy discharged from different departments of Zhejiang Cancer Hospital in China. Participants reported the occurrence, severity, and impact on daily life of nausea and vomiting from the day of chemotherapy administration up to 5 days, and physicians collected the clinical data from the medical records. Results Data were collected from 875 responses totally. In this study, the overall incidence rate of CINV was 44.34%, acute CINV was 24.57%, and delayed CINV was 39.66%. 19.89% patients had both acute and delayed CINV. The consistency rates of antiemetic with guideline in different departments showed significant gap between the actual usage of drugs and the recommended guidelines (P=0.001). In 875 patients, 518 patients received guideline recommended antiemetic regimen, the CINV rates of complete control (CC), defined as the absence of any symptoms, were 61.58%. While the CC rates in other 357 patients were 47.06%(P<0.001). Conclusion Overall, clinician adherence to antiemetic guideline recommendations in different departments remained poorly characterized with varying degrees. Future studies should focus on the complete rate as a primary end point rather than complete remission. The standardized management of CINV in patients need to be further strengthened and doctors need to use drugs more regularly to reduce the occurrence of CINV in patients.


Author(s):  
Kim Lan Lại Thị

EVALUATING THE EFFECT OF CHRONIC PAIN TO PATIENT’S GENERAL HEALTH AT TRADITIONAL MEDICINE DEPARTMENT OF HUE CENTRAL HOSPITAL BRANCH 2 Background: Pain is a very common symptom in the community and it is a leading cause of patients have to meet doctors and come to hospitals. Chronic pain results in poor quality of life, many days lost from work and high direct and indirect costs for the health care system. Objective: To investigate on chronic pain and general health with their ralated factors on patients at Traditional medicine department. To evaluate the effects of chronic pain to general health. Participants and method: A cross-sectional survey was performed for patients at Traditional medicine department with the pain and general health questionaire from 6/2018 to 6/2019. Results: Duration of chronic pain is very long. The common location of pain is low back. Majority of patients reported their pain condition is from moderate to severe level. Majority of patients have general health is lower moderate level. Conclusion: Chronic pain is one of the major health problems of the population. The common location of pain is low-back. The first is not to determine the effect of pain to general health of patient. Keywords: chronin pain, general health


2019 ◽  
Vol 15 (1) ◽  
pp. 1
Author(s):  
Novi Yana Santika ◽  
Rise Desnita ◽  
Muhammad Akib Yuswar

Peptic ulcer is an upper gastrointestinal tract disease caused by hypersecretion of acids and pepsin of gastric mucosa. Peptic ulcer disease can be caused by several factors such as smoking, fast food, alcoholic beverages, NSAIDs and Helycobacter pylori. The purpose of this research was to obtain the distribution of antiulcer and itsrationality on peptic ulcer inpatients at the RSUD Sultan Syarif Mohamad Alkadrie Pontianak. This study is a descriptive observational study with cross sectional design. Data from medical record collected retrospectively.  This research using medical record peptic ulcer inpatients from January to December in 2017. The samples used were 34 of 44 patients who met  the  inclusion criteria. Based on results, the distribution of anti ulcer were omeprazole (2.94%), pantoprazole (73.53%), lansoprazole (26.47%), ranitidine 5.89%, 58.82% antacids and 85.29% sucralfat. The result of rationality evaluation on criteriaof appropriate indication (100%);appropriate drug (55.88%); appropriate patient (97.06%); and appropriate (61.76%). Overall,the rationality of treatment that meets all four rational treatment criterias was 78.68%.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seyedeh Amineh Hojati ◽  
Sara Kokabpeyk ◽  
Salma Yaghoubi ◽  
Farahnaz Joukar ◽  
Mehrnaz Asgharnezhad ◽  
...  

Abstract Background Helicobacter pylori (H. pylori) infection is the most important risk factor for gastritis and peptic ulcer. However, factors other than H. pylori are involved in its pathogenesis. In the current study, we aimed to compare the clinical manifestations and endoscopic and histopathological findings of patients with and without H. pylori infection. Methods In this cross-sectional study, 233 patients with dyspepsia, referred for endoscopy, were examined regarding the presence of H. pylori infection. During an endoscopic exam, 5 biopsy specimens were taken from the stomach. The criteria for the presence of H. pylori infection was the presence and identification of bacteria in pathology. Two groups of H. pylori-positive and H. pylori-negative patients were compared regarding their demographic, endoscopic, and pathological findings. Results Of 233 patients, 154 (66.1%) were non-smokers, 201 (86.3%) were not alcohol users, and 153 (65.7%) used tap water. The most common symptom, reported in 157 (67.4%) patients, was epigastric pain. There was a significant difference between patients with and without H. pylori infection in terms of the educational status, occupational status, family history of gastrointestinal cancer, and some gastrointestinal symptoms. Also, there was a significant relationship between the endoscopic and pathological findings of patients with H. pylori. Conclusions The results of the present study revealed that H. pylori infection was not associated with sex, alcohol consumption, or non-steroidal anti-inflammatory drug use. The role of H. pylori in the pathophysiology of peptic ulcer was clarified. Also, there was a significant difference in the endoscopic and pathological findings of patients with H. pylori.


Author(s):  
Albatool Abumunaser

This chapter will discuss a peptic ulcer disease (PUD) case. PUD is a common gastrointestinal tract disease (GIT) that affects the stomach and duodenum. It is characterized by deep lesions into the mucosal thickness. Various dietary and behavioral choices could aggravate the epigastric pain associated with PUD and interfere with the healing process leading to complications. Management of PUD includes medical treatment with medications along with behavioral and nutritional changes. This case presents a complication of PUD, and choices exacerbating the condition. It will also discuss the role of medical nutrition therapy in minimizing the symptoms and promoting ulcer healing. Additionally, it will allow the dietetic professional to methodically assess the elements in the case that are relevant for planning the nutrition intervention; in addition to, educating the patient about dietary modifications to improve the patient's quality of life.


Author(s):  
Ingo Hartlapp

This chapter gives an overview of the most important clinical presentations involving the gastrointestinal (GI) tract commonly seen in the field, including hepatitis, cirrhosis, peptic ulcer disease, and GI bleeding, from typical clinical presentation to specific diagnosis and treatment. Recognizing the challenges with diagnosis and management of such conditions in humanitarian settings, this chapter provides doctors who practise in low-resource settings with the guidance to implement more specialized GI medicine


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