scholarly journals A STUDY OF DRUG UTILIZATION IN PATIENTS OF CARCINOMA BREAST RECEIVING SYSTEMIC CHEMOTHERAPY IN TERTIARY CARE HOSPITALS

2021 ◽  
pp. 116-119
Author(s):  
SUCHI SHAH ◽  
ANIL SINGH ◽  
SHAILESH MUNDHAVA
Keyword(s):  
Breast Carcinoma ◽  
Drug Use ◽  
Drug Utilization ◽  
Systemic Chemotherapy ◽  
Tertiary Care ◽  
Chemotherapeutic Agents ◽  
Breast Cancer Patients ◽  
Local Data ◽  
Carcinoma Breast ◽  
Study Results

Objective: The objective of the study is to study drug utilization in patients with breast carcinoma receiving systemic chemotherapy in government as well as private set-up. Methods: This was a record-based, retrospective-prospective study, analyzing the prescription pattern of drugs used for systemic chemotherapy in patients diagnosed with carcinoma breast at government teaching hospital (GTH) and private trust hospital (PTH) for 1 year in 600 patients. Patient’s demographic, clinical, and therapeutic data were collected from the files and personal interviews and analyzed in Microsoft Excel. Results: Diagnosis of breast carcinoma was highest in age bracket of 40–49 years (32.33% GTH and 32.67% PTH), and the most common presenting symptom was painless lump (76.33% GTH and 83% PTH). In GTH, most frequently prescribed regimen was 4AC → 4T → RT (17.33%). In PTH, most commonly prescribed regimen was 6FEC → RT (19.33%). Highest prescribed drugs were A (32.8%), C (29.12%), and F (20.24%) in GTH and A (32.26%), F (31.68%), and E (16.45%) in PTH. Average number of drugs prescribed per prescription was 12.55 and 11.37; percentage of chemotherapeutic agents prescribed by generic name was 100 and 95.02, and from the WHO essential drug list (2015) was 96.43 and 82.77 in GTH and PTH, respectively (A= Cyclophosphamide, C= Doxorubicin, T=Taxanes [Paclitaxel/Docetaxel], F=5-fluorouracil, E=Epirubicin, RT=Radiotherapy, → followed by, the number indicates chemotherapy cycle). Conclusion: The study results can help in generating local data regarding drug use pattern of the systemic chemotherapeutic agents in breast cancer patients and promote rational drug use.

scholarly journals Drug utilization pattern and appropriateness of prescription in IPD geriatric patients in a tertiary care teaching hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 55
Author(s):  
Shuchisuta P. Pathy ◽  
Sachchidanand Pandey ◽  
Bhabagrahi Rath ◽  
Rinu Rani Dash
Keyword(s):  
Drug Use ◽  
Drug Utilization ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
World Health ◽  
Potentially Inappropriate Medications ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Prescribing Indicators ◽  
Inappropriate Medications

Background: Drug utilization research provides insights into different aspects of drug use and drug prescribing such as pattern, quality, determinants and outcomes of drug use. Polypharmacy is considered to be hazardous for the elderly, because of their greater vulnerability to drugs and multiple drug use. Prescription of potentially inappropriate medications (PIMs) has been found to be a common cause of morbidity and mortality among the geriatric population and has necessitated the creation of criteria for the safe use of medicines among them. Objectives of the study were to assess the drug utilization pattern in geriatric patients and analyse their prescriptions as per the World Health Organization (WHO) core prescribing indicators and STOPP and START criteria.Methods: An observational, cross-sectional study was conducted from May 2019 to August 2019 in inpatient department of general medicine of VIMSAR, Burla. Prescriptions of ≥65 year patients were collected and documented by active surveillance from the medicine ward.Results: Majority of the patients were in age group of 65-75. Stroke is the more common comorbidities among geriatric population. Average number of medication per prescription is 5.42. About 78.74% of drugs are injectable. The percentage of antibiotics prescribed to patient is 27.75%. Based on STOPP criteria potentially inappropriate medications PIM is 7% and START criteria PIM is 29%.Conclusions: Our study suggests that prevalence of polypharmacy was high which is usually unavoidable in geriatric patients and less PIM is suggestive of adherence to WHO core prescribing indicators, and prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.

scholarly journals DRUG PRESCRIPTION PATTERN OF BREAST CANCER PATIENTS IN A TERTIARY CARE HOSPITAL IN WEST BENGAL: A CROSS-SECTIONAL AND QUESTIONNAIRE-BASED STUDY

2018 ◽  
Vol 11 (3) ◽  
pp. 398
Author(s):  
Anjan Adhikari ◽  
Dipesh Chakraborty ◽  
Rania Indu ◽  
Sangita Bhattacharya ◽  
Moumita Ray ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
West Bengal ◽  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Care Hospital ◽  
Breast Cancer Patients ◽  
Cross Sectional

 Objective: Cancer is a disease of uncontrolled division of cells in any part of the body. Breast cancer most common in women accounts for 13% of the death worldwide. The objective of the present study was to evaluate the drug prescription pattern of breast carcinoma patients in a tertiary care hospital of West Bengal.Methods: This was a cross-sectional observational questionnaire-based study done for a period of 6 months at the Department of Pharmacology in Collaboration with the Department of Surgery and Department of Radiotherapy of a Tertiary Care Hospital at Kolkata, West Bengal, India. Female patients with breast cancer (originated from epithelial tissues) of different types and grade attending surgery outdoor patient department were taken as subjects for the study, after signing informed consent.Results: The present study evaluated 28 patients (n=28) diagnosed as breast cancer by the physicians of the department of surgery and radiotherapy. It was observed that breast cancer was mostly found in the middle age group. Breast carcinoma in postmenopausal women accounted to 75%. The most prevalent breast cancer was invasive ductal carcinoma, accounting to 75% of the study population. 5-Fluorouracil, epirubicin, doxorubicin, cyclophosphamide, docetaxel/paclitaxel, and carboplatin were mostly used as chemotherapeutic agent.Conclusion: Breast carcinoma being a prevalent type of cancer in females, the present study tried to evaluate the pattern of prescribing chemotherapeutic agents for breast cancer patients in a tertiary care hospital. Such study is essential to evaluate and refine the therapeutic regimen of the cancer patients to reduce their sufferings.

scholarly journals Drug utilization study in a neonatal intensive care unit of a government tertiary care hospital in Western Maharashtra

2018 ◽  
Vol 7 (8) ◽  
pp. 1572
Author(s):  
Arvind V. Kumbhar ◽  
Nimish R. Halasawadekar ◽  
Sunita J. Ramanand ◽  
Jaiprakash B. Ramanand ◽  
Praveen T. Patil ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Drug Use ◽  
Neonatal Intensive Care Unit ◽  
Drug Utilization ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Background: Presently drug utilization studies (DUS) are in an evolving era. Current literature search has shown paucity of epidemiological studies in the field of paediatric pharmacology. Hence the present study was designed to assess the drug utilization pattern in neonatal intensive care unit to improvise the current prescription practices, if required and to determine areas in neonatal pharmacology in need of further research.Methods: A prospective, observational study spanned for a period of one year from January 2015 to December 2015 was conducted at the neonatal intensive care unit (NICU), Government teaching tertiary care hospital, Maharashtra. Data of prescribed drugs was collected. WHO prescribing indicators were used for evaluating DUS. Assessment of exposure rates of different class of drugs in different gestational age groups was done. Data were analysed using descriptive studies.Results: Data of 205 neonates, showed male preponderance (53.17%) over female neonates (46.83%). With regard to the gestational age, 47.31% were term, 52.68% preterm. Average number of drugs per encounter was 6.69. 76.29% drugs were prescribed by generic name and 69.80 % drugs were from IAP list of essential medicines for children. Mean drug use was 6.23±3.34 per patient. Most common class of drug to which neonates were exposed was antibiotics (96.10%) and amikacin topped the list with exposure rate of 91.22%.Conclusions: The present study substantiates the need for implementation of institutional antibiotic policies, awareness regarding IAP list of essential drugs for children, prescription by generic name and rational drug use.

Awareness Level of Nurses about Carcinoma Breast Risk Factors in Mayo Hospital Lahore

2021 ◽  
Vol 15 (11) ◽  
pp. 2869-2871
Author(s):  
Nadia Majid ◽  
Usman Ali Rahman ◽  
Muhammad Kaleem Akhter ◽  
Farzana Iqbal ◽  
Humiara Yousaf ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Risk Factor ◽  
Breast Carcinoma ◽  
Public Hospital ◽  
Tertiary Care ◽  
Carcinoma Breast ◽  
Breast Awareness ◽  
Random Probability ◽  
Symptoms And Signs

Aim: To assess level of awareness in nurses regarding risk factors related to carcinoma breast at a tertiary care public hospital Lahore Methods: It was a descriptive study. This study took place at Mayo Hospital Lahore. The nurses of different departments especially the oncology department were recruited. A sample of n=300 was recruited through random probability sampling methods. An adopted close ended questionnaire was applied. The data was interpreted and analyzed by SPSS version 25. The data was analyzed in the form of tables and graphs. Results: Of the participants nurses 67% knew that smoking is a risk factor for carcinoma breast. It was also found that 59% agreed that exposure to another person’s cigarettes smoke also can cause breast carcinoma. Results also suggest that 88% agreed that drinking more than one glass of alcohol a day also can cause breast cancer. Moreover results suggest 71% agreed that being overweight (BMI>25) also can cause breast carcinoma. Results also suggest that 54% agreed that being over 70 years old can lead to breast cancer. Conclusion: Overall knowledge related to risk factors of breast carcinoma among nurses was satisfactory. Top rating risk factors were, smoking cigarettes and family history. Moreover, nurses knowledge regarding breast carcinoma symptoms and signs was also good among participants MeSH: Carcinoma Breast, Awareness, Risk Factor

Undesirable Cytokeratin Immunoreactivity of Native Nonepithelial Cells in Sentinel Lymph Nodes From Patients With Breast Carcinoma

2000 ◽  
Vol 124 (9) ◽  
pp. 1310-1313 ◽  
Author(s):  
Xiaowei Xu ◽  
Shelley A. Roberts ◽  
Theresa L. Pasha ◽  
Paul J. Zhang
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Sentinel Lymph Nodes ◽  
Breast Cancer Patients ◽  
Paraffin Sections ◽  
Reticulum Cells ◽  
Antibody Cocktail

Abstract Context.—Use of cytokeratin immunohistochemistry on histologically negative sentinel lymph nodes (SLNs) in patients with breast carcinoma has been shown to be efficient in detecting false-negative nodes. Several recent studies have shown that micrometastases detected by immunohistochemistry constitute an independent predictor of disease-free period and overall survival for breast cancer patients. It has been demonstrated that the fibroblastic type of reticulum cells in lymph nodes also express cytokeratin, and unawareness of such cytokeratin reactivity in SLNs could result in difficulty in the interpretation of the results of immunohistochemistry. Objectives.—To study the incidence of undesirable cytokeratin reactivity in reticulum cells and other native nonepithelial cells of SLNs and to compare the immunoreactivity of 3 commonly used cytokeratin antibodies (AE1/AE3, pancytokeratin [pan-CK], and CAM5.2). Design.—Immunohistochemistry with pan-CK, AE1/AE3, and CAM5.2 antibodies was performed on paraffin sections of SLNs from patients with breast cancer. Correlation of undesirable cytokeratin reactivity with size and metastatic status of the SLNs was also analyzed. Patient Material.—Paraffin sections of 84 SLNs from 38 consecutive patients with breast cancer in our tertiary-care, teaching hospital. Results.—Cytokeratin reactivity was found in reticulum cells and plasma cells in 29 (35%) and 9 (10%) of the 84 SLNs, respectively, with pan-CK and CAM5.2 but not with AE1/AE3 (P < .001). The presence of cytokeratin-positive reticulum cells did not correlate with the size and metastatic involvement of the SLNs. Conclusions.—The incidence of undesirable keratin reactivity in SLNs from breast cancer patients could be limited by using an AE1/AE3 antibody cocktail. The AE1/AE3 antibody cocktail is a sensitive epithelial marker and appears to be more specific in recognizing epithelial cells in SLNs.

scholarly journals Study of ER PR receptors in breast carcinoma: a study of 30 cases

2018 ◽  
Vol 5 (11) ◽  
pp. 3738
Author(s):  
Himanshu R. Patel ◽  
Ankur Shrimal ◽  
Harsh P. Trivedi
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Breast Carcinoma ◽  
Hormone Receptors ◽  
Tertiary Care ◽  
Progesterone Receptors ◽  
Care Hospital ◽  
Breast Cancer Patients ◽  
Estrogen And Progesterone Receptors ◽  
Medical College

Background: Estrogen and Progesterone receptors are found in breast cancer cells that depend on estrogen and related hormones to grow. These are steroidal nuclear type of receptors. The most common method currently used to test a tumor for estrogen and progesterone receptors is immunohistochemistry or IHC. Patients with positive hormone receptor cancer have better survival. They are candidates of anti-hormonal therapy.Methods: This is a retrospective study was carried out in the Department of Surgery of a tertiary care hospital, affiliated to Government Medical College. This is a retrospective study in which 30 randomly selected case records of breast cancer patients, who presented in the period between 2011 to 2016, and who had undergone surgery, were taken and studied in terms of history, examination, investigations, treatment given, histopathology report and development of recurrence, metastasis and survival.Results: In this study out of 30 patients, 25 patients received adjuvant chemotherapy. 2 patients developed recurrence at local site.1 patient was ER/PR both negative and 1 patient was ER +/PR-. 3 patients developed metastasis. Among these, 2 patients were ER/PR both negative and 1 patient was having ER/PR both positive.Conclusions: Hormone receptors play a significant role in breast carcinoma. Breast cancer is more common in postmenopausal group as compared to premenopausal group. Mean age at diagnosis of breast cancer in western countries is 61 years and in India it is 50 years.

scholarly journals PROFILE OF BREAST CANCER PATIENTS ATTENDING A TERTIARY CARE CENTRE: A CROSS-SECTIONAL STUDY

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Ganpat Singh Choudhary ◽  
Man Singh Bairwa
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Rural Areas ◽  
Tertiary Care ◽  
Nipple Discharge ◽  
Cross Sectional Study ◽  
Breast Cancer Patients ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College

Background: World-wide breast cancer is the most frequent type of cancer among females with increasing incidence. Methods: This study was retrospective and prospective both. Total 40 Female patients of Breast cancer, from all age group admitted in Department of Surgery, Dr. S.N. Medical College, Jodhpur were included. Results: Lump was presenting feature in all cases 100%. The next most common presenting feature was pain, which was present in 62.5% cases. 10%, 17.5% and 2.5% cases had nipple discharge, nipple retraction and skin ulceration. Conclusion: The highest incidence of breast carcinoma was in 4th, 5th and 6the decades.Majority of the patients was Hindus and of rural areas and all the patients were married female. Keywords: Breast Carcinoma, Histopathologically Positive, Metastasis

scholarly journals Clinicopathological Characteristics of Breast Carcinoma in Premenopausal Women

2019 ◽  
Vol 8 (4) ◽  
pp. 193-197
Author(s):  
Nazia Ishaque ◽  
Muhammad Asad
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Tnm Classification ◽  
Tertiary Care ◽  
Positive Family History ◽  
Premenopausal Women ◽  
Tumor Type ◽  
Carcinoma Breast ◽  
Breast Feed

Background: Breast cancer is one of the leading causes of mortality world-wide. The objective of this study was to see the pattern and characteristics of carcinoma breast in premenopausal women reporting at a tertiary care hospital.Material and Methods: This cross-sectional study was conducted at surgical unit of Pakistan Institute of Medical Sciences (PIMS), Islamabad from May 2012 to April 2015. A total of 144 female patients were admitted during this period as diagnosed cases of carcinoma breast. Of these patients, all cases of breast carcinoma diagnosed in premenopausal women were selected and assessed for tumor type, TNM classification and involved breast quadrants.Results: Out of 144 patients 70 (48.6%) cases of carcinoma breast were reported in premenopausal women. The ages ranged from 14 to 48 years with a mean age of 33 ± 7.95 years. According to TNM classification, 2.9% patients were in T1, 25.7% were in T2, 32.9% were in T3 and 38.6% were in T4. Similarly, 37.1% patients presented with a nodal status of N0, 38.1% with N1, 21.4% with N2 and 2.9% with N3. Out of 70 patients, 11 (15.7%) presented with distant metastasis (M1) at the time of diagnosis. The upper outer quadrant of breast (32.9%) was most commonly involved site, followed by upper inner, lower outer and lower inner quadrants, respectively. Most common tumor type was invasive ductal carcinoma (85.7%), followed by invasive lobular carcinoma (7.1%), papillary carcinoma (4.3%), medullary carcinoma (1.4%) and malignant phylloides (1.4%). Regarding exposure to risk factors of breast cancer in these patients, 35.7% women did not breast feed and 27.1% were nulliparous. There was no history of use of oral contraceptive pills in 82.8% and positive family history was reported in 27.1% patients.Conclusions: Late presentation with advanced disease in premenopausal women is more common in our part of the world as compared to international literature. More studies on larger sample sizes should be carried out to validate these findings.

scholarly journals Assessment of drug utilization pattern and rationality of drug use in treatment of dilated cardiomyopathy in a tertiary care teaching hospital of rural Bengal

2016 ◽  
Vol 6 (1) ◽  
pp. 123
Author(s):  
Prasun Banerjee ◽  
Ananya Mandal ◽  
Dipankar Mukhopadhyay ◽  
Tanmoy Gangopadhyay ◽  
Sonai Mandal ◽  
...  
Keyword(s):  
Drug Use ◽  
Dilated Cardiomyopathy ◽  
Drug Utilization ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Tertiary Care ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
World Health ◽  
Converting Enzyme Inhibitors ◽  
Mortality And Morbidity

Background: Dilated cardiomyopathy (DCM) is an important underlying cause of congestive heart failure and/or arrhythmias. The introduction of therapy combining diuretics, digoxin and angiotensin converting enzyme inhibitors (ACEI) has significantly decreased mortality and morbidity. The aim of the study was undertaken to identify the pattern of drugs most commonly prescribed for DCM and to assess the rationality behind such use.Methods: This was a prospective study undertaken between 1st July and 31st August 2015. Prescriptions were reviewed and analyzed using the World Health Organization (WHO) indicators for drug utilization studies. Rationality and cost of therapy per prescription was also evaluated.Results: We encountered 78 patients of DCM in the OPD of Cardiology (prevalence of 4.94%). The average number of drugs per prescription was 6.64. Generic prescriptions were made in 90% encounters. As part of therapy, diuretics and ACE inhibitors or angiotensin receptor blockers, were prescribed in all cases. Our results show a distinctive drug use pattern where beta blockers were used more commonly than digoxin. Other commonly prescribed agents were antiplatelet drugs and statins. Antibiotics were prescribed in 8.7% cases and no injectable drug was prescribed. Average drug cost per encounter was 10.63 INR.Conclusions: To conclude, we found a typical and rational pattern of drug use. Diuretics, ACEI and beta blockers were found to be most commonly used agents. This study provides a clear picture of drug use in this special clinical condition in rural Bengal and paves the way for larger and long term studies.

scholarly journals A Study of drug utilization and clinical outcomes in indoor patients of hypertensive disorders of pregnancy

2017 ◽  
Vol 6 (10) ◽  
pp. 2401
Author(s):  
Smita L. Gaidhankar ◽  
Jaiprakash B. Ramanand ◽  
Parashram G. Kadam ◽  
Ajitkumar M. Zende ◽  
Rama R. Bhosale ◽  
...  
Keyword(s):  
Drug Use ◽  
Clinical Outcome ◽  
Pregnant Women ◽  
Drug Utilization ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Common Symptom ◽  
Care Hospital ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Background: Hypertensive disorders of pregnancy are an important determinant of drug use during pregnancy. The aim of study was to assess the clinical outcome and evaluate drug utilization according to WHO core drug prescribing indicators in hypertensive disorders of pregnancy.Methods: This prospective, observational study in a tertiary care hospital was conducted in 150 pregnant women with hypertensive disorders of pregnancy from January 2014 and December 2014 who fulfilled the inclusion criteria. Antepartum and intrapartum care and the maternal and perinatal outcome were noted. The data was analyzed to evaluate clinical outcome and drug utilization according to WHO core drug use indicators.Results: Gestational hypertension was most common among hypertensive disorders of pregnancy seen in 62/150 (41.3%) women. The most common symptom was headache (48%) while sign noted was edema (69%). A total of 66% women had preterm delivery and 42% babies weighed less than 2.5 kg. Average number of drugs per encounter was 9.7. Percentage of drugs prescribed by generic name and from essential drug list was 64% and 79% respectively. The most commonly used drugs were vitamins and minerals prescribed in 100% patients followed by antihypertensive drugs (92%). The most common antihypertensive used were calcium channel blockers and anticonvulsant was magnesium sulphate.Conclusions: There was increased maternal and perinatal morbidity and operative intervention among pregnant women with hypertensive disorders of pregnancy. Most of the drugs were used appropriately and were in accordance with standard guidelines. The important problems identified were inappropriate use of antimicrobials, use of sublingual nifedipine and use of brand names in 1/4th of prescriptions. 

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