scholarly journals A study on prescribing pattern of drugs in patients with rheumatic heart disease at tertiary care hospital

2018 ◽  
Vol 7 (2) ◽  
pp. 25-29
Author(s):  
Rinku Ghimire ◽  
Sahadeb Prasad Dhungana
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Oral Anticoagulants ◽  
Tertiary Care ◽  
College Teaching ◽  
Secondary Prophylaxis ◽  
Channel Blockers ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Rheumatic Heart

Introduction: Rheumatic heart disease (RHD) is a common cardiac problem. Medical therapy is directed toward secondary prophylaxis and supportive treatment for heart failure (HF), rhythm disorder and anticoagulation to prevent thromboembolism. Drug utilization patterns thus provide a favorable feedback to physicians and help to modify treatment strategies. Materials and Methods: This is a cross sectional study on 140 patients with RHD who received care at Nobel Medical College Teaching Hospital from October 2017 to September 2018. A semi structured questionnaire was administered to record the demographic characteristics, co-morbid conditions and use of different drugs. Results: Mean age was 50.09 ± 10.99 years. RHD was more common in females (75.7%). Penicillin prophylaxis was prescribed for 38 (27.1%) patients. Out of which, 22.8% were on daily oral penicillin and 4.2% were receiving three weekly benzathine benzylpenicillin. Beta blockers were the most frequently used drug for heart rate control for patients (51.4%) with both atrial fibrillation (AF) and/or symptomatic mitral stenosis (MS). Digoxin was used in 10% and calcium channel blockers were used in 3.5% of patients who have AF. Different diuretics were used in 88.5% of patients with features of systemic or pulmonary congestion. Out of 20 cases of AF, eleven (55%) were receiving aspirin and nine (45%) were on oral anticoagulants. Out of nine patients receiving warfarin, only four (20%) had therapeutic international normalized ratio (INR). Conclusions: This study focuses on prescription pattern of drugs for different indications in patients with RHD. There is a need for improved use of secondary prophylaxis to prevent recurrence of RF and antithrombotic in patients with AF.

scholarly journals Study of prevalence of heart disease in antenatal mothers along with fetal and maternal outcome from a tertiary care hospital, Salem, Tamil Nadu, India

2019 ◽  
Vol 8 (12) ◽  
pp. 5027 ◽  
Author(s):  
Subha Sivagami Sengodan ◽  
Shobhika Selvaraj
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Tamil Nadu ◽  
Congenital Heart ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Maternal Outcome ◽  
Care Hospital ◽  
Rheumatic Heart

Background: Incidence of pregnancy in women with heart disease is increasing due to the increasing number of women with congenital heart disease. Although most cardiac conditions are well tolerated during pregnancy, there are some conditions that have adverse fetal and maternal outcome. Objective of this study is to study the prevalence of heart disease in antenatal mothers and fetal outcome with obstetric management.Methods: This is a prospective observational study carried out in the Department of Obstetrics and Gynaecology at Government Mohan Kumaramangalam Medical College and Hospital during January 2018 to March 2019 for a period of fifteen months. Authors included 149 antenatal mothers with heart disease and analysed the data using percentage analysis through excel software.Results: Incidence of heart disease in pregnancy was observed to be 1.2%. Rheumatic heart disease being 73.8%, congenital being 22.8% and complete heart block was 3.4%. Among rheumatic heart disease mitral stenosis was the most common lesion. Atrial septal defect was the most common congenital heart disease. The mean gestational age of delivery was 37 to 38 weeks. 58% delivered by vaginal route. Most common neonatal complication was prematurity. Pregnancy and neonatal outcome were favorable.Conclusions: Heart disease complicating pregnancy has increased due to late marriage, obesity, hypertension and diabetes. Early referral, regular follow-up and multi-disciplinary approach with tertiary care back-up will bring a favorable maternal and neonatal outcome in patients with heart disease.

scholarly journals Pattern of Valvular Involvement in Rheumatic Heart Disease Patients in a Tertiary Care Hospital of Western Nepal

2016 ◽  
Vol 13 (2) ◽  
pp. 29-31 ◽  
Author(s):  
Ram Chandra Kafle ◽  
Vijay Madhab Alurkar ◽  
Navaraj Paudel ◽  
Girija Shankar Jha
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Low Income ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Care Hospital ◽  
Age Group ◽  
Female Ratio ◽  
Rheumatic Heart

Background and Amis: Rheumatic Heart Disease (RHD) is among the commonest diseases of young adults in low-income countries like Nepal. Mitral and aortic valves are more commonly affected than others in RHD. Echocardiography is simple and cost effective tool to identify the patterns of valvular involvement that helps in diagnosis and determines the timing of surgery. This study aimed at determining the pattern of RHD in patients who underwent Echocardiography in a tertiary care hospital of western Nepal.Methods: A retrospective analysis of trans-thoracic echocardiographic record of patients from January 2009 to December 2015 was done. Data were collected in a pre-structured proforma and analyzed.Results: Among 12567 echocardiography, 609 (4.84%) were recorded to have RHD including post valve replacement patients. Females predominated with male to female ratio of 1:2.8. Most patients, 308 (50%) belonged to age group of 21-40 years. The commonest isolated lesion was mitral regurgitation (MR) in 119 (26.21%) patients followed by mitral stenosis (MS) in 31(6.82%) patients. The commonest mixed lesion was MS with MR and aortic regurgitation (AR) seen in 99 (21.8%). The frequency of atrial fibrillation (AF) and stroke was 18% and 3% respectively in RHD patientsConclusions: The proportion of RHD was high in our study. Majority of RHD patients were females of reproductive age group. The commonest lesion was MR followed by mixed valvular lesions.Nepalese Heart Journal 2016; 13(2): 29-31

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