scholarly journals Adverse drug reaction monitoring in patients of hypertension at a tertiary care hospital, Aurangabad, Maharashtra, India

2021 ◽  
Vol 10 (6) ◽  
pp. 720
Author(s):  
Shruti Chandra ◽  
Sukhmeen Kaur ◽  
Deepali Jayabhaye ◽  
Amol Ubale
Keyword(s):  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Tertiary Care ◽  
Term Therapy ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Long Term Therapy

Background: Hypertension is one of the highest prevailing diseases worldwide. Due to long term therapy antihypertensive drugs are commonly associated with adverse drug reactions (ADRs). Therefore, the study was conducted with the objective to examine the incidence of different types of ADRs in drug treated hypertensive patients.Methods: Present study was a prospective cross sectional observational study carried out in the outpatient of department of medicine of MGM hospital, a tertiary care teaching hospital, in Aurangabad. 320 diagnosed hypertensive patients were studied. Questionnaire was asked and their prescription were analysed and follow up was done.Results: Among 320 patient’s 75 patients were reported ADR. Males accounted for higher percent of ADRs 46 (61%) than females 29 (38.6%). Most of the patients 147 (55.9%) were on mono therapy. Calcium channel blocker was the frequently used class of drug, showed maximum number of ADR (30.6%) followed by ACE inhibitor (28%) and ARB (21.3%). As per WHO-UMC scale, type of reactions and their percentage were as certain (9.3%), Probable/ Likely (64%), possible (22.6%), and unlikely (4%). According to Naranjo scale most of the reactions were possible (64%). severity assessment is done by Hartwig and Siegel scale. No lethal ADR were reported. 4% reactions were severe, 32% were of moderate category and 64% were mild reactions.Conclusions: Such type of studies are helpful in selection of appropriate medicines for hypertensive patients, enhancing patient adherence with the therapy by selecting medicines of lesser ADR profile, reducing unnecessary economic burden to the patients due to unwanted effects of the therapy.

scholarly journals Pattern of use of anti-hypertensive drugs amongst hypertensive patients in a tertiary care hospital: a cross sectional, observational study

2019 ◽  
Vol 9 (1) ◽  
pp. 89
Author(s):  
Sharmin Khan ◽  
Ram N. Maiti ◽  
Sekhar Mandal
Keyword(s):  
Observational Study ◽  
Calcium Channel ◽  
Treatment Guidelines ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Renal Diseases ◽  
National Committee ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hypertensive Patients

Background: Hypertension is one of the primary modifiable risk factors for cardiac and renal diseases and is the single most important risk factor for stroke. Despite different guidelines for management of hypertension like Joint National Committee, British Hypertension Society, National Institute for Health and Care Excellence; there are still the clouds of controversy. The objective of the study was to evaluate the prescribing pattern of antihypertensive drugs among the patients attending medicine outpatient department of a tertiary care teaching hospitalMethods: A cross-sectional, observational study was conducted in our hospital over a period of six months. Relevant information was collected from medical records of 209 hypertensive patients fulfilling inclusion criteria. The collected data were sorted and analyzed.Results: Out of 209 patients, maximum were of age group of 45-65 years (55.02%). 115 (55.02%) were male and 94 (44.97%) were female. Diabetes mellitus (24.4%) was the most common associated disease with hypertension. Most of the patients had received single antihypertensive drugs (49.28%). Among the monotherapy category calcium channel blocker (82.78%) was the most commonly prescribed antihypertensive drug class followed by angiotensin receptor blocker (36.36%). Amlodipine (81.82%) was the most common among calcium channel blockers. The most frequent fixed drug combination prescribed consisted of amlodipine and atenolol. Most of the drugs were prescribed in generic name (90.9%).Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines.

Renal Toxicity of Long-Term Therapy With Tenofovir in HIV-Infected Patients

2012 ◽  
Vol 25 (5) ◽  
pp. 552-559 ◽  
Author(s):  
Maricelle O. Monteagudo-Chu ◽  
Mei H. Chang ◽  
Horatio B. Fung ◽  
Norbert Bräu
Keyword(s):  
Renal Toxicity ◽  
Care Center ◽  
Tertiary Care ◽  
Term Therapy ◽  
Kaplan Meier ◽  
Ckd Stage ◽  
Advanced Stages ◽  
Long Term Therapy

Data are sparse on long-term renal toxicity of tenofovir as measured by estimated glomerular filtration rate (eGFR) and progression to advanced stages of chronic kidney disease (CKD). The objective of the study is to determine the incidence of renal impairment associated with the use of tenofovir in HIV-infected patients, using abacavir as a control. In a single tertiary care center, all HIV-infected patients with baseline CKD stage 0 or 1 (CKD-1), who were started on either tenofovir or abacavir from 1998 to 2008 and had at least 1 follow-up eGFR measure on therapy, were included in this retrospective analysis. Progression to CKD stages 2 to 5 was compared using Kaplan-Meier analysis. Progression to CKD-2 and CKD-3 occurred more frequently in patients who received tenofovir than those receiving abacavir (CKD-2, 2-year actuarial frequency, 48.8% vs 23.7%; P < .001, log rank; CKD-3, 5.8% vs 0.0%; P = .028). Only 1 patient in the tenofovir group progressed to CKD-4 and none to CKD-5. Treatment with tenofovir was the only independent factor associated with progression to CKD-2 (hazard ratio [HR], 2.12; 95% confidence interval [CI]: 1.41-3.18; P < .001) and to CKD-3 (HR, 4.91; 95% CI, 1.02-23.7; P = .048). In HIV-infected patients, long-term therapy with tenofovir is associated with mild-to-moderate nephrotoxicity which is significantly higher than in abacavir-treated patients.

scholarly journals Amlodipine-Induced Pedal Edema and Its Relation to Other Variables in Patients at a Tertiary Level Hospital of Kathmandu, Nepal

2018 ◽  
Vol 35 (2) ◽  
pp. 51-55
Author(s):  
Sitaram Khadka ◽  
Rinku Joshi ◽  
Dhan Bahadur Shrestha ◽  
Drishti Shah ◽  
Niroj Bhandari ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Dose Combination ◽  
Pedal Edema

Background: Vasodilatory edema is a frequently encountered side effect among hypertensive patients using antihypertensive drugs. This dose-dependent adverse effect is seen more commonly with amlodipine, so low-dose combination therapy is often used and preferred in practice. Pedal edema following use of amlodipine is scarcely studied in Nepalese population so far. Objectives: To find out the prevalence of amlodipine-associated pedal edema and its relation with other variables among patients presenting to a tertiary care center of Kathmandu, Nepal. Methods: A prospective cross-sectional study was conducted among hypertensive patients using amlodipine in combination with or without other antihypertensive medications under regular follow-up in an outpatient department of internal medicine of Shree Birendra Hospital, Kathmandu, Nepal, during the 7-month period from September 2017 to March 2018. The prevalence of pedal edema and its relation with amlodipine dose, duration, and other factors were studied using χ2 test and logistic regression using SPSS version 22. Results: A total of 505 patients were observed during the study period, with the mean age of the population being 61.5 ± 13.4 years. Among the cases studied, edema was present in 79 (15.6%) cases. Use of amlodipine longer than 5 years was 21.65 (confidence interval [CI] = 9.575-48.970, P ˂ .001) times more likely to exhibit pedal edema; similarly, there was 2.149 (CI = 1.209-3.820, P = .009) times higher risk of having pedal edema in hypertensive individuals with other comorbidities. Increasing the dose of amlodipine has increased the likelihood of having pedal edema, but it is not statistically significant (odds ratio = 2.804, CI = 0.423-18.584, P = .285). Conclusion and Relevance: Significant number of hypertensive patients using amlodipine developed pedal edema. Likelihood of vasodilatory edema increases with the presence of comorbidities, higher dose, along with longer duration of amlodipine use.

scholarly journals Medication Adherence and Its Determinants among Women of Cardiovascular Disease of Tertiary Care Hospital, Hyderabad

2020 ◽  
Vol 5 (04) ◽  
pp. 315-321
Author(s):  
Haritha Arnipalli ◽  
Sudha Bala ◽  
Harshal Pandve
Keyword(s):  
Medication Adherence ◽  
Health System ◽  
Tertiary Care ◽  
Developed Countries ◽  
Term Therapy ◽  
Care Hospital ◽  
Women Patients ◽  
Related Condition ◽  
Cross Sectional

Abstract Background and Aim Adherence to long-term therapy for chronic illnesses in developed countries averages to 50%. In developing countries, the rates are even lower. Poor adherence to long-term therapies severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Cardiovascular diseases (CVDs) are the most common disorders affecting most of the productive age group. Therefore, an attempt has been made to determine medication adherence using the Morisky medication adherence scale-4 (MMAS-4) and its determinants in women patients with CVD. Material and Methods A Hospital based cross-sectional study was conducted at outpatient block of General Medicine and Cardiology departments which included 175 women patients who were already diagnosed with CVD (with at least 3 months of medication) and those who were willing to give informed consent for participation. Semi structured questionnaire was used which consisted of sociodemographic variables, MMAS-4 to measure the level of adherence and various determinants such as socioeconomic, patient related, condition related, therapy related, and health system related. Results Prevalence of medication adherence among women of CVDs using MMAS-4 was high, medium, and low among 39, 51, and 10%, respectively. Significant determinants found were socioeconomic, patient related, health system, and therapy related. Conclusion Low-to-medium medication adherence was found to be high which needs to be addressed to reduce the morbidity and mortality associated with CVDs.

Does Teaching Clinical Ethics to Medical Students Improve Knowledge, Attitude, and Practice of Medical Ethics Among Clinicians? An Observational Study in a Tertiary Care Hospital in Nepal.

2020 ◽  
Author(s):  
Carmina Shrestha ◽  
Jasmin Joshi ◽  
Ashma Shrestha ◽  
Shuvechchha Karki ◽  
Sajan Acharya ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical Ethics ◽  
Clinical Ethics ◽  
Core Curriculum ◽  
Tertiary Care ◽  
Medical Schools ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background: The importance of doctors being aware of medical ethics has been highlighted in a number of studies. Our first study (Study-1) aims to assess the knowledge, attitude, and practices of medical ethics among clinicians at Patan Academy of Health Sciences (PAHS). We then follow up with the effect of teaching clinical ethics to medical students (Study-2). The purpose of this study is to assess the awareness regarding appropriate ethical principles, application of medical ethics and the effect of teaching medical ethics to students. Methods: There are two studies presented: Study-1 is a cross-sectional questionnaire-based study. A total of 72 participants, selected by simple random sampling, included doctors working as interns, medical officers and consultants in six departments of PAHS. Study-2 was a follow-up, cross-sectional online questionnaire-based comparative study conducted at PAHS to compare KAP of medical ethics among medical officers with and without formal medical ethics training. We used the validated questionnaire from our previous study. All graduates of PAHS 2016 and all medical officers employed at PAHS at the time of study who had graduated from other medical schools that did not include Medical Ethics in their core curriculum were included. Results: Study-1: A positive correlation between Knowledge(p = 0.088), Attitude (p = 0.002), Practice of medical ethics(p = 0.000), and years of practice was found. No significant difference in KAP of medical ethics between MBBS graduates from Nepal and abroad (p = 0.190) was found. The majority scored poorly in issues concerning autonomy. The follow-up study found a statistically significant difference (p = 0.000) in the knowledge between the doctors who were taught medical ethics and those who were not. Conclusions: Doctors find it easier to discuss ethical dilemmas with their colleagues rather than department heads. The KAP of the consultants were found to be better than that of the interns and medical officers. Autonomy is the least understood ethical principle. ‘Medical Ethics’ as a part of the core curriculum in medical schools would improve ethical practice.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

Follow-up of patients with prolactinomas after discontinuation of long-term therapy with bromocriptine

1983 ◽  
Vol 104 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Arturo Zárate ◽  
Elías S. Canales ◽  
Carlos Cano ◽  
Carlos J. Pilonieta
Keyword(s):  
Sella Turcica ◽  
Ct Scanning ◽  
Serum Levels ◽  
Primary Treatment ◽  
Term Therapy ◽  
History Of ◽  
Permanent Cure ◽  
Long Term Therapy

Abstract. The effects of bromocriptine discontinuation after a 2 year course of therapy on prolactin (Prl) serum levels and the radiological size of the sella turcica were investigated in 16 women with amenorrhoea-galactorrhoea due to prolactinoma. During therapy, all but 2 patients had normalized serum Prl levels, and 4 women with macroprolactinomas exhibited a reduction in the size of the tumour as documented by CT-scanning and tomography of the sellae. After bromocriptine withdrawal and follow-up during 2 additional years, Prl levels remained normal in 6 patients, 2 of them with microprolactinomas and 4 with macroprolactinoma. The remaining 10 women developed hyperprolactinaemia associated with amenorrhoea and galactorrhoea within 3 months after discontinuation of therapy. No tumour expansion was observed in any case during the 4 year observation period. In the present study bromocriptine treatment seemed to result in permanent cure in 6 out of 16 cases of prolactinomas; nevertheless it is difficult to justify an indefinite medical treatment since the natural history of prolactinoma remains unknown. We presently feel that bromocriptine is more appropriate than neurosurgical transsphenoidal exploration for the primary treatment of prolactinomas. Further investigation is needed before a more definitive conclusion regarding the management of prolactinomas can be reached.

scholarly journals Pattern of compliance to anti- hypertensive medications in hypertensive patients in a tertiary care hospital in Bangladesh

2016 ◽  
Vol 24 (1) ◽  
pp. 62-66
Author(s):  
Syed Zakir Hossain ◽  
Mohammad Rofiqul Islam ◽  
Sarmistha Biswas ◽  
Prodip Kumar Biswas ◽  
Mohammad Zaid Hossain ◽  
...  
Keyword(s):  
Negative Impact ◽  
Care Delivery ◽  
Tertiary Care ◽  
Health Care Delivery System ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Hypertensive Patients ◽  
Medical College ◽  
Physician Patient

Background: Non-adherence to anti-hypertensive medications can have a negative impact on long term cardiovascular outcome. Various studies have been conducted on this issue but factors are not yet explored properly, particularly in Bangladesh. This study was conducted to find out the prevalence and factors associated with pattern of compliance to anti-hypertensive medications in a tertiary level hospital.Methods: This descriptive study was done on 146 indoor hypertensive patients, included by purposive sampling in july’2015 who were taking anti-hypertensive for last 6 months. Data were collected through a questionnaire after obtaining informed consent.Results: This study revealed that 55.47% patients were compliant and 44.53% were noncompliant. Age >60 yrs. are more non-compliant (56.6%). Female (65.11%), house wife and urban population are more compliant. Population, with longer duration of hypertension are more non-compliant. Among the co-morbidities diabetic patients are more non-compliant. Population taking two anti-hypertensive are more compliant (76.47%).Conclusion: In our study most of the populations are compliant but yet significant number of populations are non-compliant. Collective participation of physician, patient and health care delivery system can improve the situation more. As consequence of non-compliance to antihypertensive is grave, community based studies should be conducted to explore the extent of non-compliance.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 62-66

scholarly journals A study on demographic pattern of idiopathic inflammatory myopathies in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 236
Author(s):  
Srujith C. H. ◽  
Kavitha Mohanasundaram ◽  
Jagadeesan M. ◽  
Halleys Kumar E. ◽  
Kannan R. ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Lactic Dehydrogenase ◽  
Idiopathic Inflammatory Myopathies ◽  
Care Hospital ◽  
Inflammatory Myopathies ◽  
Muscle Enzymes ◽  
Cross Sectional ◽  
Inflammatory Myositis ◽  
Idiopathic Inflammatory Myositis

Background: Idiopathic inflammatory myopathies (IIMs) are a group of chronic systemic autoimmune diseases characterized by proximal muscle weakness and elevated muscle enzymes. Aim and Objective was to analyze the demographic profile of patients with idiopathic inflammatory myopathies (IIM).Methods: This was a cross sectional observational study conducted over a period of two years (2016-2018). After obtaining institutional ethical committee clearance, informed consent from patients. 16 patients who fulfilled the criteria were included in the study. The demographic and the clinical data were analysed.Results: The mean age was 47.3±11.2 years. The study showed female predominance. ANA was positive in 11(68.7%) patients. Among the 16 patients, 5 (31.25%) had polymyositis and 11 (68.7%) had dermatomyositis. The median enzymes levels were creatinine kinase 1134 U/L, lactic dehydrogenase 477U/L, ALT (alanine aminotransferase) 154 IU/L, AST (aspartate aminotransferase) 236IU/L. Raynaud's phenomenon was seen in 37.5%. In our study, 31.25% had hypothyroidism and 6.25% had diabetic mellitus. On follow up 37.5% developed interstitial lung disease (ILD) and 18.75% were found to have malignancy.Conclusions: Steroids and immunomodulators are the mainstay of treatment in patients with idiopathic inflammatory myositis. All our patients improved with steroids. It is important to evaluate these patients during early stages and follow up to prevent complications.

scholarly journals ASSESSMENT OF AWARNESS, KNOWLEDGE AND RISK FACTORS OF CHRONIC KIDNEY DISEASE AMONG DIABETES MELLITUS AND HYPERTENSIVE PATIENTS AT A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 1-3
Author(s):  
K. Jesindha Beyatricks ◽  
Deepa shruthi G ◽  
Fizia Mohammadi ◽  
Feba Thomas ◽  
Omid Reza
Keyword(s):  
Risk Factors ◽  
Positive Attitude ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Negative Attitude ◽  
Good Knowledge ◽  
Care Hospital ◽  
Cross Sectional ◽  
Poor Knowledge ◽  
Hypertensive Patients

A prospective cross sectional study on the awareness, knowledge and risk factors of CKD among Diabetic and Hypertensive patients was conducted in the outpatient and inpatient wards of a tertiary care hospital in Bengaluru. A total number of 100 patients were included in the study. The results indicated that, out of 100 patients, 38% was having knowledge and 62% were without knowledge. 43% were having positive attitude and 57% with a negative attitude. It was found that majority of the people were without knowledge, that is 62% and negative attitude 57%. The study revealed that among educated people, 55.55% was having poor knowledge and 44.44% was having good knowledge. Among uneducated people, 64.86 % was having poor knowledge and 35.13 % was having good knowledge. Among 100 participants, 43% has positive attitude and 57% has negative attitude.

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