scholarly journals An observational study on patient compliance and adverse drug reactions of antihypertensives drugs in a tertiary care center of Bihar

Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar

Hypertension is among the most common non-communicable and lifestyle disease in our country that affects adult population of both the genders from all socio-economic backgrounds and urban and rural population. In-spite of this, early diagnosis and appropriate treatment are suboptimal. Adherence of prescribed treatment has been studied in patients of hypertension in this study. : An observational and cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between January 2021 and June 2021.A predesigned pretested interview schedule was used to collect the data from the 247 study participants. This schedule contained information related to socio-demographic variables, comorbidity, a format to assess the compliance to antihypertensive drugs prescribed and any adverse event. : A significant improvement in maintain optimal in blood pressure was observed in patients treated with one pill per day as compared to patients prescribed with two and three pills per day. Compliance was significantly better in patients in combination therapy as compared to monotherapy. : Low dose combination therapy has been stated to be more effective than high dose monotherapy in controlling blood pressure. It shows better compliance and lesser incidence of side-effects.

Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar

Making affordable drugs accessible to all strata of society is an inevitable part of health care. This situation makes Drug Utilization Study inevitable. With this background, the current study was planned to obtain knowledge on the prescribing pattern and drug utilization trend in ophthalmology department at a tertiary care teaching hospital with ultimate goal to promote rational use of drugs among prescribers. An observational cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between March 2021 and August 2021. Prescriptions of 550 patients who were treated during the course of the study were surveyed prospectively by using a specially designed form. The WHO drug use indicators like prescribing indicators and patient care indicators were determinedThe average number of drugs per prescription was 2.6, ranging from 0-7 drugs. The dosage forms, the frequency of administration and duration of treatment of the drugs were recorded for 99.9% of the prescriptions given. This analysis of the prescriptions showed that 93.8% of the prescriptions were written in the form of various trade names. Antibiotics were prescribed in 52.5% of the prescriptions. The present study revealed certain lacunae in the prescribing practices of the Ophthalmologists at the selected institute and this is evident by the low generic prescribing in many prescriptions.


2018 ◽  
Vol 35 (2) ◽  
pp. 51-55
Author(s):  
Sitaram Khadka ◽  
Rinku Joshi ◽  
Dhan Bahadur Shrestha ◽  
Drishti Shah ◽  
Niroj Bhandari ◽  
...  

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.


2021 ◽  
Vol 9 ◽  
pp. 205031212110124
Author(s):  
Selladurai Pirasath ◽  
Thadchanamoorthy Sundaresan

Introduction: Hypertension is one of the common non-communicable diseases and public health problem among developed and developing countries. The lack of knowledge and awareness on hypertension and poor adherence of medication are a major challenge to control hypertension and prevent its complications. Our study aimed to assess the knowledge, awareness of hypertension and adherence to medication among hypertensive patients attending the medical clinics of a tertiary care center, Eastern Province of Sri Lanka. Methods: A descriptive cross-sectional study was conducted among hypertensive patients to assess knowledge, awareness of hypertension and adherence to medication in medical clinics in a tertiary care for 6 months duration. Data were collected by using pretested and validated Hypertension Facts Questionnaire. Their medication adherence and the reasons for nonadherence were studied using Medication Adherence Scale. Data were analyzed using SPSS (version 18) analytical package and the chi-square test was performed. The scoring system was used to categorize the level of knowledge and awareness of hypertension among patients. Results: The majority of patients had moderate-to-high knowledge (101, 65.8%) about hypertension and had moderate-to-high awareness (111, 73.2%) on hypertension. Even though, 134 (87.6%) patients knew that they have hypertension, and 108 (70.6%) patients did not know their blood pressure value at the time of diagnosis. Most of the patients (90, 58.8%) had good drug adherence, and most of them (141, 92.1%) thought that taking medicine plays a key role to control their blood pressure. The main reasons for nonadherence of medication were forgetfulness (39, 32%) and expenses (46, 35.4%). The knowledge and awareness about hypertension among respondents were significantly associated with educational level (p < 0.05) Conclusion: Most of the patients had adequate knowledge on the risk factors and complications of hypertension. But they were unaware about their disease status, and their diagnosis, target organ damage and recent blood pressure values. The drug adherence was reasonably adequate. The main reasons for nonadherence of medication were forgetfulness and expenses.


2020 ◽  
Vol 8 (4) ◽  
pp. 5-8
Author(s):  
Ekta Acharya

Background : Sometimes, diarrhea may co-exist with vomiting, fever, abdominal pain, etc. depending upon its etiology. Diarrheal diseases can also lead to significant malnutrition and dehydration. Thus, at the tertiary care center, a study was conducted with an aim to center on the clinical and sociodemographic profile of infants and children presenting with acute diarrhea. Subjects and Methods: It was a prospective, observational clinical study that began after obtaining approval from the Institutional Ethics Committee. It was conducted at the Department   of Pediatrics, Gujarat Adani Institute of Medical Science, Bhuj, Kutch for a period of 2 years. The sample size was 200 with 2 groups A and    B having 100 patients each. Accordingly, their clinical and demographic profile was also noted and studied in 2 groups. Various parameters analyzed were age and gender distribution, chief complaints, feeding practices, nutritional status and assessment of dehydration. Results: Mean age S.D were (2.25 1.40) and (2.49 1.39) years in group A and B respectively. Exclusive breastfeeding (EBF) for 6 months was given in a  large no. of group A and B patients i.e. 52 (52%) and 58(58%) respectively. Few others were given for 4, 5, or 7 months. Maximum patients 58 (58%) of A and 52 (50%) of B group had no dehydration whereas remaining 42 (42%) and 48 (48%) patients had some dehydration respectively. Conclusion: Fever and vomiting were the complaints mainly regularly linked with diarrhea. a bit fewer than half of the children under research had some-dehydration. Greater parts of the patients were completely breastfed for six months.


Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.


Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Claudia Pileggi ◽  
Rosa Papadopoli ◽  
Caterina De Sarro ◽  
Carmelo Giuseppe Angelo Nobile ◽  
Maria Pavia

<b><i>Introduction:</i></b> Several studies in the adult population have shown that obesity is an independent risk factor for elevated intraocular pressure (IOP), whereas data in the paediatric population are sparse and controversial. The purpose of the present study is to investigate the relationship between body mass index (BMI), blood pressure (BP), and IOP in healthy school children. <b><i>Methods:</i></b> The survey was conducted among a random sample of 8-year-old Italian students. Data were collected on their health status and behaviours related to obesity (physical activity, food and drinking habits, etc.). Physical examinations, conducted at school, included measurements of height, weight, BP, and IOP. <b><i>Results:</i></b> Five hundred and seventy-six subjects were recruited (92.8% response rate); 42.4% were overweight or obese, 58.9% consumed inadequate daily servings of fruit and vegetables, and 87.5% were involved in sedentary activities. Elevated BP/hypertension (HTN) affected 3.6% and high IOP was revealed in 12.5% of the children. In the multivariate analysis, elevated BP/HTN was the only significant determinant of ocular HTN (OR 5.36, 95% CI 1.95–14.73, <i>p</i> = 0.001). <b><i>Conclusions:</i></b> Our results show that high IOP affects 12.5% of 8-year-old school children and appears to be associated with high BP related to a high BMI.


2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 


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