scholarly journals ANTIHYPERTENSIVE PHARMACOTHERAPY IN HYPERTENSIVE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL AND MEDICAL COLLEGE IN INDIA

2021 ◽  
pp. 30-36
Author(s):  
RANJODH JEET SINGH
Keyword(s):  
Heart Rate ◽  
Tertiary Care ◽  
General Medicine ◽  
Olmesartan Medoxomil ◽  
Joint National Committee ◽  
National Committee ◽  
Total Period ◽  
Medical College ◽  
Group B ◽  
Stage 1

Aim and Objectives: The aim of the study was to compare the efficacy of Atenolol and Olmesartan in Stage-1 hypertension (HTN), and the adverse effect profile of Atenolol and Olmesartan in Stage-1 HTN. Methods: A prospective, randomized, open, and parallel study was carried out in 100 patients attending the outpatient department of General Medicine Department MMIMSR, Mullana, Ambala, India with Stage -1 HTN according to joint national committee VII. The patients were randomly divided into two groups to receive Tab. Atenolol 50 mg od (Group A, n=50) and Tab. Olmesartan medoxomil 20 mg (Group B, n=50) od for a total period of 12 weeks with regular follow up every 2 weeks from the baseline. At each visit, blood pressure (BP), heart rate, and adverse effects were evaluated. Laboratory investigations were carried out at baseline and end of the study period. p<0.005 was considered statistically significant. Results: Atenolol and Olmesartan medoxomil both significantly reduce BP and heart rate (p<0.005). Olmesartan medoxomil is more efficacious in reducing BP. Conclusion: Olmesartan medoxomil is a better choice for Stage -1 HTN between the two drugs as it leads to a greater decrement in BP.

scholarly journals A study of clinical profile of renal involvement in diabetic patients in correlation with diabetes complication at tertiary care center, Gujarat, India

2020 ◽  
Vol 7 (4) ◽  
pp. 630
Author(s):  
Virendra Kosamiya ◽  
Niyati Gosai
Keyword(s):  
Diabetic Patient ◽  
Microvascular Complications ◽  
Care Center ◽  
Renal Involvement ◽  
Tertiary Care ◽  
General Medicine ◽  
Diabetic Patients ◽  
Female Ratio ◽  
Medical College ◽  
Male Female Ratio

Background: The chronic complications of diabetes are broadly divided into microvascular and macrovascular, with the former having much higher prevalence than latter. Microvascular complications include neuropathy, nephropathy and retinopathy. Objectives of the study was to assess the clinical and biochemical profile of renal involvement in diabetic patient and complications due to diabetes mellites.Methods: This was a hospital based prospective study done in which total of 250 cases attended and admitted at general medicine department, Government Medical College, Sir. T. Hospital, Bhavnagar. Study included Diabetic patient having age - >12 years, Both Gender and Patient who gives consent for study.Results: Almost 54.8% having age between 41-60 years, Male: female ratio 0.87:1 and 44.0% were to ‘obese 2’ Body mass index (BMI) category. Around 22.4% participants have retinopathy, 30.0% have anemia, 62.4% have HTN and 26.8% have Ischemic Heart Disease (IHD). Almost 59.6% participants have S. creatinine level was 1.3 to 4 mg/dL and 43.6% have stage 5 of Chronic Kidney Disease (CKD).Conclusions: Incidence of DM Nephropathy increase with age. With increasing numbers of years of diagnosed DM, the chances of DM Nephropathy are increased and as the duration of DM as well as duration of uncontrolled glycemia increases GFR decreases and DM Nephropathy progresses. HbA1c is a useful marker to account for the glycemic control over the past months, and hence the better indicator to the development as well as progression of DM Nephropathy.

scholarly journals A study of clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center

2019 ◽  
Vol 6 (3) ◽  
pp. 574
Author(s):  
Rahul Gandhi G. ◽  
Taha Mahboob Ali Khalid
Keyword(s):  
Ct Scan ◽  
Care Center ◽  
Tertiary Care ◽  
General Medicine ◽  
Clonic Seizure ◽  
Clinical Profile ◽  
Medical College ◽  
Common Presentation ◽  
Common Etiology ◽  
The Brain

Background: Confusion lies over the diagnosis when the patients show ring enhancing lesions of the brain on CT scan. Some consider it as tuberculoma while some consider it as cysticercosis. More studies are required to give clear picture of ring enhancing lesions of the brain. The objective was to study clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center.Methods: This study was conducted in the Department of General Medicine, SVS Medical College, Mahabubnagar district which is a tertiary care referral hospital in the state of Telangana. This study was done during the period from July 2006 to October 2008. A total of 50 cases were taken up for this study. After selecting the patients for the study, already prepared protocol was followed strictly for each patient. The protocol contained identification data, detailed history and examination of central nervous system and peripheral signs for tuberculosis and cysticercosis.Results: The males were more than the females and 14-24 years age group was most affected. The most common presentation of ring enhancing lesions was seizures alone in 72% of the cases. Out of these cases the most common presentation was generalized tonic-clonic seizure in 40% of the cases. Majority i.e. 45 had single ring enhancing lesion on CT scan of the brain. The most common etiology of the ring enhancing lesion was found out to be neurocysticercosis in 54% of the cases of ring enhancing lesions.Conclusions: Ring enhancing lesions should be considered in differential diagnosis of those who present with seizures in endemic areas like India. 

Spontaneous Adverse Drug Reaction Monitoring in a Tertiary Care Centre

2020 ◽  
Vol 15 (3) ◽  
pp. 215-221
Author(s):  
Kirandeep Kaur ◽  
Preet Kanwal ◽  
Pardeep Goyal ◽  
Paramjit Singh ◽  
Sahil Yakhmi ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
General Medicine ◽  
Individual Case ◽  
Tertiary Care Centre ◽  
Adverse Drug Reaction Monitoring ◽  
Medical College ◽  
Spontaneous Adverse Drug Reaction ◽  
The Individual ◽  
Almost All

Background and Objective: Adverse drug reactions (ADRs) are associated with increased economic burden on the society. Monitoring of ADRs can help in decreasing the incidence of preventable adverse reactions. Methods: Under Pharmacovigilance Program of India, collection and reporting of ADRs has been going on at Dayanand Medical College and Hospital since January 2011. Here, we have analyzed the individual case safety reports (ICSRs) reported and uploaded between January 2017 and June 2019 from our centre. The ADR form provided by PvPI was used for collecting information, and the causality assessment was done according to the WHO-UMC scale. Results: A total of 498 ICSRs were uploaded through Vigiflow software during this period. Highest number of ADRs were recorded in the age group of 31-45 years (29.01%) and the least number of ADRs were recorded in the children less than 15 years of age (6.76%). General Medicine ward reported the highest number of ADRs and the antibiotics were most commonly associated with ADRs (26.21%), followed by antipsychotics (13.83%) and NSAIDs (12.14%). More than 90% of ADRs were non-serious (93.17%) and most of the ADRs were skin and soft tissue related (49.20%). Conclusion: Spontaneous reporting among indoor patients shows highest number of ADRs with use of antibiotics and almost all of the ADRs were non-serious in nature. Almost half of the total ADRs were skin and subcutaneous tissue related. Continuous efforts are required for further strengthening of the pharmacovigilance program of India.

Evaluation of Pattern of Use of Prescribed Oral Hypoglycaemic Drugs in Newly Diagnosed Diabetic Nephropathy Patients Visiting a Tertiary Care Hospital of Southern Bihar

2020 ◽  
Vol 7 (43) ◽  
pp. 2492-2496
Author(s):  
Rajan Goyal ◽  
Himanshu Jindal ◽  
Abhilasha Singh ◽  
Abhishek Kamendu
Keyword(s):  
Renal Function ◽  
Diabetic Nephropathy ◽  
Tertiary Care ◽  
General Medicine ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Oral Hypoglycaemic Agents ◽  
Total Study Population ◽  
Medical College ◽  
Oral Hypoglycaemic Drugs

BACKGROUND Diabetes is the most important risk factor for chronic kidney disease. Because of this, clearance of many oral hypoglycaemic drugs from our body is hampered and time of exposure to these drugs increases. Therefore, patients of diabetes need to be assessed frequently for the development of diabetic nephropathy and the dosage of oral hypoglycaemic drugs should also be modified accordingly. So, the purpose of this study was to evaluate the doses of prescribed OHAs in newly diagnosed diabetic nephropathy patients. METHODS A hospital based observational study was conducted at Narayan Medical College and Hospital, Sasaram, Bihar, India. A total of 600 diagnosed patients of diabetic nephropathy of age more than 18 years visiting for the 1 st time in OPD of general medicine / nephrology department were included in the study after obtaining an informed consent. The results were expressed as a percentage of the assessed population. RESULTS Only about 38% of the total study population was taking doses of Oral Hypoglycaemic Agents (OHAs) according to their GFR status. 62% were taking wrong doses of OHAs with their respective renal function. CONCLUSIONS Treatment of diabetes in a CKD patient is more difficult than in non-CKD patient. GFR status should be monitored on regular basis in patients of diabetes with CKD. A significant number of these patients are still treated with wrong dosage of OHAs for their respective renal function. KEYWORDS Wrong Dose of OHA, Diabetic Nephropathy, Oral Hypoglycaemic Drugs

scholarly journals ASSESSMENT OF PROFESSIONAL’S ADHERENCE TO JOINT NATIONAL COMMITTEE 8 GUIDELINES IN THE MANAGEMENT OF HYPERTENSION

2019 ◽  
Vol 12 (1) ◽  
pp. 101
Author(s):  
Schnell Jennifer D’souza ◽  
Ancel Neethu Mani ◽  
Nimisha Kurian ◽  
Jaikanth C
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
General Medicine ◽  
Joint National Committee ◽  
Optimal Choice ◽  
National Committee ◽  
Care Hospital ◽  
Antihypertensive Medications ◽  
Dialysis Unit ◽  
Pressure Threshold

Objectives: Hypertension is the most insidious ailment in primary care with its management being a daily affair. The avail of antihypertensive medications has affirmed their efficacy in blood pressure alleviation. Yet, the methodical choice of medication with which treatment ought to commence at the precise blood pressure threshold and maintained at a target level was undiscerned. Consequently, the Eighth Joint National Committee grants an evidence-based tool, which was employed in the appraisal of professional’s adherence to joint national committee 8 guidelines.Methods: A prospective, observational study was governed. Aggregate patients with hypertension with/without diabetes mellitus (DM) and/ or chronic kidney failure admitted in general medicine and the dialysis unit of the tertiary health care hospital, for 4 months were enrolled. The rationality of antihypertensive medications and target blood pressure was noted.Results: Patients matriculated to 125, 90 males and 35 females. Average age perceived was between 51 and 60 years, with the length of stay 14.39 (standard deviation [SD]±1.52) and 9.3 (SD±0.46) days in the respective unit. The gross medication endorsed represents 1085 medications, incorporating 337 antihypertensive medications. The optimal choice of an antihypertensive medicine was clonidine and amlodipine. Adherence in the populace with lone hypertension was cent percent, trailed by hypertension with DM 82.35% and minimal in hypertension with chronic kidney disease.Conclusion: 86-medication compiled adherence to the guidelines (25.52%). Rationality of medication depicts 25.6% were rational and 73.6% distinguish as non-rational, amid a demise of a sole victim. A significant high-grade defiance of health-care practitioners to the Eighth Joint National Committee guidelines was evidenced from our study.

scholarly journals A STUDY ON TREATMENT PATTERN AND OUTCOMES OF POISONING CASES IN A TERTIARY CARE AND GOVERNMENT DISTRICT HOSPITAL

2017 ◽  
Vol 9 (4) ◽  
pp. 193
Author(s):  
Pathan Amanulla Khan ◽  
Dileep Chary M. ◽  
M. Manoj Kumar ◽  
B.b. Sarah Nousheen
Keyword(s):  
District Hospital ◽  
Tertiary Care ◽  
General Medicine ◽  
Treatment Pattern ◽  
Research Centre ◽  
Morbidity Rate ◽  
Medical College ◽  
Organophosphorus Poisoning ◽  
Different Types ◽  
Government District

Objective: Poisoning is a major prevalent problem, with thousands of deaths occurring every year, mainly in developing countries. The present study sought to identify the treatment pattern and outcomes of poisoning cases admitted to Basaveshwara Medical College and Hospital and Research Centre (BMCH and RC) and Government District Hospital and to determine the type of poison cases.Methods: This is a prospective observational study aimed to analyse the poisoning cases admitted to general medicine departments and emergency departments of BMCH and RC and Government District Hospital, Chitradurga, Karnataka for a period of six months. Results: A total of 100 cases were enrolled in this study. 63% of the cases were identified from BMCH and RC, with the remainder being from Government Hospital. The study shows that 41% of the cases were 21-30 y old. 48% (n=48) were males and 52% (n=52) were females. Different types of poisoning cases were observed; organophosphorus poisoning (OP) taking the lead, followed by snake bite cases. The study denotes a mortality rate of 4% and morbidity rate of 96%. A majority of cases were reported in the second quarter of the year.Conclusion: It was concluded from the above findings that young age adults constituted a significant percentage of the subjects. It is essential, therefore, to propose policies that can terminate the free trade of poisonous pesticides and to create awareness and periodically counsel the vulnerable group of the population.

scholarly journals Clinical and investigational study for the aetiological evaluation of patients in nontraumatic altered sensorium and its outcome

2019 ◽  
Vol 7 (4) ◽  
pp. 1113
Author(s):  
Siba Narayan Jali ◽  
Sachida Nanda Nayak ◽  
Biju K. Alexander ◽  
Diptimayee Tripathy ◽  
Bijaya K. Behera
Keyword(s):  
Tertiary Care ◽  
General Medicine ◽  
Diagnostic Methods ◽  
P Value ◽  
Care Hospital ◽  
College Hospital ◽  
Metabolic Encephalopathy ◽  
Altered Sensorium ◽  
Medical College ◽  
Gcs Score

Background: Apart from head injury many patients present to the tertiary care hospital in unconscious state, the etiology of which is obscure in most of the cases. The present study was conducted with on objective to provide insight into the clinical features and diagnostic methods to know the aetiology of patients with non-traumatic cases of altered sensorium and to study the outcome of these patients.Methods: This is an observational study on 100 patients of altered sensorium of non-traumatic origin during the period from October 2012 to September 2014 conducted in the Department of General Medicine, MKCG Medical College Hospital, Berhampur, Odisha, India. All patients were selected for the study based on the inclusion exclusion criteria. Detailed history, clinical evaluation, laboratory investigations like neuroimaging studies etc. were carried out. Statistical data analysis was done using Graph pad Prism 6 and Microsoft Excel. P value <0.0001 was considered statistically extremely significant.Results: Out of 100 patients of altered sensorium, 64 were males and 36 were females. All patients were in the age group of 19 to 89 years. Cerebrovascular accident was the most common aetiology of altered sensorium followed by metabolic encephalopathy and infection. Altered sensorium in patients with CVA carries a high mortality. Metabolic causes and younger age indicated a better prognosis, patients with low (Glasgow Coma Score) GCS score of 3 to 4 had poorer prognosis.Conclusions: The results suggest that clinical assessments yield accurate predictive information about the potential for recovery in cases of altered sensorium. So, this study concludes that empirically based estimates of prognosis in the neurologically severely ill provides great reassurance to those involved in a decision-making process, including patients’ families and physicians.

scholarly journals Expenses incurred by hospitalised patients in Era’s Lucknow Medical College, Lucknow

2021 ◽  
Vol 8 (11) ◽  
pp. 5451
Author(s):  
Digvijay Chaudhary ◽  
M. M. A. Faridi ◽  
Tarannum Fatima ◽  
Aysha Rahman
Keyword(s):  
Tertiary Care ◽  
General Medicine ◽  
Total Cost ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Hospitalised Patients ◽  
Private Teaching ◽  
Surgical Conditions ◽  
The Cost ◽  
Tertiary Care Hospitals

Background: Significant amount is spent by the patients when they attend tertiary care hospitals for treatment inspite of free services. The objective of this study was to account expenses on the medication, consumable items for patient care and food and transport.Methods: Fifty patients were recruited, 10 patients each from pediatrics, general medicine, obstetrics and gynaecology, general surgery and orthopaedics indoor wards. First two patients admitted on the day of admission were enrolled and followed for three days. The cost of patient’s expenses on investigations, medicines and consumables, travel to the hospital and food on self and relatives during hospitalization was estimated with the help of a questionnaire.Results: The expenditure was more on the patients suffering from surgical conditions. Total expenditure on the patients admitted in the orthopedics, surgery and surgical cases of obstetrics and gynaecology wards was INR 31985/, INR 11798/- and INR 14746/- for 3 days respectively. Out of the total expenses INR 1095/-, INR 1150/- and INR 1316/- were spent on food and travel of the patients and family members to the hospital for admission in orthopedics, surgery and surgical cases of obstetrics and gynaecology wards respectively. In patients with non-surgical conditions like medicine, pediatrics and non-operative cases of obstetrics and gynaecology the total cost per patient was INR 5610/-, INR 5037/- and INR 4416/- respectively.Conclusions: Patients treated in the private teaching hospital spent significant number of rupees. The expenditure by the patients undergoing surgical treatment spent two to three times more as compared to patients admitted in the general medicine and pediatric wards.

scholarly journals A comparative single dose study of oral acetaminophen 650 mg to its standard 500 mg dose in adult pyrexia patients in a tertiary care hospital

2020 ◽  
Vol 9 (3) ◽  
pp. 388
Author(s):  
Pradeepkumar B. T. ◽  
Jayanthi C. R. ◽  
Raveendra K. R. ◽  
Ramya Y. S.
Keyword(s):  
Adverse Effects ◽  
Tertiary Care ◽  
Age Groups ◽  
General Medicine ◽  
Low Grade ◽  
Care Hospital ◽  
Single Dose Study ◽  
Hospitalised Patients ◽  
Group A ◽  
Group B

Background: Acetaminophen commonly called as paracetamol is the most used ‘over-the-counter’ analgesic for headache, musculoskeletal pain, dysmenorrhoea etc. It is the best drug to be used as antipyretic for fever due to any cause and safest to be prescribed in all age groups. Antipyretic dose of acetaminophen is 325 to 650 mg; 3 to 4 times a day and is available in the strength of 650 mg and 500 mg tablets. This study was conducted to analyse the antipyretic efficacy and safety profile of two different doses of acetaminophen in patients with low grade fever.Methods: 300 hospitalised patients aged more than 18 years, in department of General Medicine, having low grade fever (38º to 39º C) were randomly allocated into two groups of 150 each, group A received 500 mg and group B received 650 mg of single oral dose of acetaminophen tablets. Oral temperature was measured before dosing, 30 minutes after dosing, one hour, two hourlies thereafter for 6 hours after the dose. Safety was assessed by monitoring for adverse effects during the study and 24 hours after administration of the assigned drug.Results: There was a statistically significant decrease in temperature in group B patients from baseline 39.06±0.87º C to 37.02±0.89º C at the end of 6th hour as compared with 39.18±0.80º C to 38.03±0.77º C in Group A patients (p=0.031).Conclusions: Our study concluded that acetaminophen in a dose of 650 mg is highly efficacious antipyretic drug compared to acetaminophen 500 mg with no adverse effects.

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