scholarly journals Assessment of drug utilization pattern and impact of infographics in patients with chronic liver disease

Author(s):  
Naiema Shajihan ◽  
Shijin V. S. ◽  
Vismaya V. R. ◽  
Lallu Mariam Jacob ◽  
G. Jeladharan

Background: The current study was conducted to ensure that the drugs were effectively utilised and also to create awareness and knowledge by providing counselling with the help of infographics among study population.Methods: A prospective interventional study was conducted in the gastroenterology department of a tertiary care hospital in Kerala. A total of 100 patients diagnosed with chronic liver disease (CLD) were enrolled for the study and data were recorded in a predesigned pro forma. Statistical analysis (paired t test) was performed to assess whether the drug has been effectively utilized in patients. The study population was counselled with the help of infographics and its impact was assessed from the questionnaire, which was set based on 5- point Likert’s scale.Results: Among 100 patients, males are more prevalent between the age groups 60-70. Diabetes mellitus (DM) (66%) and alcohol (37%) are the most common risk factors. Most of the study subjects belong to Child A (50%) category and model for end-stage liver disease (MELD) score of 51% of the patients were ≤9 with estimated 3-month mortality rate of 1.9%. Liver function tests (LFT) had shown that there was a significant difference between prior to and after treatment with the level of significance p<0.05, indicating that the drugs had been properly utilized in patients and found to be effective. The distributed infographics had a great impact among the study population.Conclusions: The study concluded that the drugs had been properly utilized and found to be effective in patients. The Infographics showed a positive impact among the study population.

Author(s):  
Abeer Qadir ◽  
Muhammad Arif Nadeem ◽  
Atif Munir ◽  
Zafar Ullah Khan

There is a great geographical variation in disease burden around the world, which is due primarily to environmental, genetic, social and economic factors. Similar variations exist in worldwide mortality figures from a particular disease that can be attributed almost entirely to the access and efficacy of healthcare facilities. We did this audit to identify the major causes of morbidity and mortality in patients admitted in a medical unit of a tertiary care hospital and to highlight the importance of primary prevention. The audit was carried out in West Medical Ward Mayo Hospital Lahore, Pakistan from 1st January 2004 to 31st December 2004. All patients admitted with medical problems from the Outpatient and Emergency Departments were included. During the year 2004, a total of 2045 patients were admitted, out of which maximum number of patients admitted in the ward were suffering from chronic liver disease (17%) followed by ischemic heart disease (14.4%) cerebrovascular accidents (10.4%) and renal diseases. Total number of deaths were 321 with male mortality was 167 (14.40%) and female mortality 154 (17.40%). Chronic liver disease also had the highest mortality (16.8%) followed by cerebrovascular accidents (14%), renal disease (11.5%) and ischemic heart disease (7.8%). Even the mortality due to chronic liver disease was significantly higher (p <0.01) than ischernic heart disease. The number of patients having the four common diseases having age 45 years or more (770) was significantly greater (p <0.0001) then the number of patients (279) in the age range of 15 to 44 years. It was observed that significantly greater number of male patients (595) had morbidity than females (462), (p <0.0001), while mortality has no difference. Chronic liver disease, ischemic heart disease and cerebrovascular accidents are the diseases putting maximum burden on our health resources and disabling our productive population. This audit highlights the fact that all these three groups of diseases can be prevented and thus obviates the need of primary prevention of these major killers.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Sami Ullah Mumtaz ◽  
Amna Akbar ◽  
Humaira Waseem ◽  
Tayyeba Komal ◽  
Somia Iqtadar ◽  
...  

Chronic Liver Disease (CLD) progresses from hepatocyte inammation to brosis, regeneration, cirrhosis and in some cases to Hepatocellular Carcinoma (HCC). In general, the main etiologies of Liver Cirrhosis (LC) are viral infections (hepatitis C and B viruses), chronic alcohol abuse and Non-Alcoholic Fatty Liver Disease (NAFLD), including Non-Alcoholic Steato Hepatitis (NASH). Major complications of CLD are ascites, upper gastrointestinal bleeding, jaundice (acute or chronic) and hepatic encephalopathy. Abstract:Study Design: Cross-sectional.Conclusions: This study assesses the etiological factors and complications of CLD in a tertiary care hospital of Lahore, Pakistan. Objectives: Methods: Study was carried out in indoor and Accident & Emergency Departments of Mayo Hospital Lahore. 100 clinically diagnosed CLD cases were chosen through “Convenient Sampling” technique during 3 months. Observations: Most common complications of CLD were upper GI variceal Bleeding (48%) & hepatic encephalopathy (34%) and acute or chronic hepatitis (AVH) (33%). Other less common complications observed were hepatorenal syndrome (10%), Spontaneous bacterial peritonitis (15%), Ascites (5%) and HCC (10%). Hepatitis C was found as main etiological factor of CLD. Bleeding and hepatic encephalopathy are the common complications. Awareness programmes regarding CLD and its complications are mandatory in our society to improve human health.


2021 ◽  
Vol 8 (25) ◽  
pp. 2222-2228
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Jasleen Kaur ◽  
Navjot Kaur Layal ◽  
Gurkiran Kaur

BACKGROUND Chronic liver diseases frequently are associated with haematological abnormalities. Anaemia occurs in about 75% of patients with chronic liver disease. The most common type of anaemia seen in liver cirrhosis is normocytic normochromic anaemia, due to the chronic inflammatory state, blood loss from oesophageal and rectal varices. The purpose of this study was to study the haematological manifestations in patients with chronic liver disease. METHODS A cross-sectional observational study was conducted at Sri Guru Ram Das Institute of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients with chronic liver disease were included in the study. The population was divided into 2 groups based on the model for end-stage liver disease (MELD) score and the various haematological abnormalities were assessed in these 2 groups. Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the ChildTurcotte-Pugh (CTP) classification. RESULTS There was a significant correlation between hemoglobina and CTP class (P < 0.001), with the lowest haemoglobin levels in CTP class C group. The correlation coefficient of MELD score and haemoglobin was -0.504 which was significant statistically. Thus, confirming the fact that haemoglobin levels decreases with the progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8 g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis was observed in 41 patients and leucopoenia in 14 patients. The mean prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin time prolonged by more than 6 sec indicating liver damage alters coagulation profile. CONCLUSIONS We found an association between anaemia and indicators of advanced liver disease such as a higher MELD and CPS scores. This study inferred that levels of haemoglobin decrease as the severity of liver disease progresses. Thus, this measure can be used in the initial assessment of cirrhosis patients that needs urgent identification and correction to reduce morbidity and mortality. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class


2020 ◽  
pp. 9-18
Author(s):  
Richmond Ronald Gomes ◽  
Akmat Ali

Background: Now-a-days chronic liver disease is one of the major health problems in the world. In developing countries, chronic liver disease due to hepatitis virus (like hepatitis B and hepatitis C virus) is increasing day by day. It is rapidly emerging as a major health problem. So the present study was conducted to document the hepatitis B and hepatitis C virus in patient with chronic liver disease by an easy and simple marker like HBsAg, Anti HBc (total) and Anti HCV in a tertiary hospital. Methods: Serum samples were collected from 100 selected cases who were diagnosed as a case of chronic liver disease in medicine and gastroenterology department of DMCH. Study period was from April 01, 2016 to September 30, 2018. For detection of HBsAg, Anti HBc (total) and Anti HCV, Immunochromatographic test (ICT) was done in every case. Results: Out of 100 cases, HBsAg seropositive with negative Anti HCV was found in 64% cases, Anti HCV positive with negative HBsAg was found in 16% cases, both HBsAg and anti HCV positive was found in 4% cases, both HBsAg and anti HCV negative was found in 16% cases. Among these cases, 74% were male and 26% were female. Here male: female was 3:1 and among them, 75% male was seropositive for either HBsAg or Anti HCV. Conclusion: The high frequency of seropositivity in patients with chronic liver disease with male predominance is found in tertiary care settings. The number of Anti HCV seropositive patient indicates that it is an emerging health problem in our country. Keywords: Chronic liver disease; HBsAg; Anti HCV; ICT


2019 ◽  
Vol 10 (4) ◽  
pp. 44-48
Author(s):  
BS Nagaraja ◽  
R Madhumati ◽  
HR Avinash ◽  
KJ Umesh

Background: Liver cirrhosis is the end result of chronic liver injury. Cirrhosis of liver may progressively deteriorate from a well-compensated state to decompensated conditions. Aims and Objective: Our study aims at evaluating the AST to Platelet Ratio Index (APRI) for predicting the in-hospital mortality and also comparing APRI, MELD and albumin for predicting in hospital mortality in chronic liver disease. Materials and Methods: Data of Patients with Chronic liver disease were retrospectively reviewed. MELD and APRI scores were calculated for the patients and results from ROC curves were analysed. Results: In our study conducted on 299 patients, the age distribution was between 18-64 years with mean age of patients being 46.47+/-10.9 years, sex ratio Male: Female: 266:37 with mortality rate of 17.7%. The area under curves of ROC of APRI, MELD and Albumin are 0.63, 0.76 and 0.55. Conclusion: APRI is an independent predictor of mortality. The prognostic performance of all 3 was comparable but MELD has better prognostic significance than APRI score.


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