scholarly journals Pharmacotherapy of Different Tuberculosis Patients its Analysis and Outcomes: A Retrospective Cohort Study

2021 ◽  
Vol 2 (11) ◽  
pp. 1154-1158
Author(s):  
Asim Shahzad ◽  
Muhammad Farhad Anwar ◽  
Abrar Hussain Mian ◽  
Abdul Rehman ◽  
Matiullah M

This study aim was to evaluate the prescribed therapies and to identify various drug-related problems as well as their causes in different TB patients admitted at the Pulmonology Department, Northwest General Hospital and Research Centre, Hayatabad, Peshawar, Pakistan. A 5-month retrospective study was conducted in which a total of 525 patients’ medical records were collected using predesigned standard data collection proforma. Among them, 25 patients having incomplete medical records were excluded and the rest of 500 cases were involved and analyzed accordingly. In all these cases, the causative agent was Mycobacterium tuberculosis. Overall 14 drugs of 133 different therapeutic classes were used in which the most frequently prescribed drugs to these patients were Anti-Tuberculosis drugs (100%), Antibiotic (100%), Multivitamins (78%), GIT drugs (55%) and Antihistamines (55%) followed by other drugs listed in the present study. Out of 500 cases, a total of 179 (35.8%) patients were identified had Drug-related problems, among them 23 (4.6%) cases were in untreated condition, in 12 (2.4%) cases drugs without indication problems were found, in 43 (8.6%) cases there were adverse drug reactions problems noted, in 75 (15%) cases total drug interactions problems were identified, while in 26 (5.2%) cases polypharmacy problems were found. The prescribed pharmacotherapy in all 500 cases meets with the standard pharmacotherapy. However, the discrepancies observed in the present study were due to lack of proper knowledge about the pharmacology of the drugs, overburden on doctors and proper lack of patient counseling. To better understand the proper management and reduction of these problems other health care professionals and proper clinical pharmacists are required to cooperate for the sake of improving the outcomes of the pharmacotherapy.

2018 ◽  
Vol 10 (1) ◽  
pp. 142
Author(s):  
Debby Dystra Maharani ◽  
Nadia Farhanah Syafhan ◽  
Yetti Hersunaryati

Objective: This study aimed at analyzing drug-related problems (DRPs) in hospitalized geriatric patients with diabetes mellitus.Methods: We prospectively collected data of 26 hospitalized geriatric patients at the Gatot Soebroto Army Hospital (age, >60 year) who underwentinpatient treatment for at least 1 month between February and April 2015. Readable data were obtained from prescriptions, medical records, andindex card/nurses records. We obtained data on 299 drug treatments for 26 patients and identified 166 DRPs. These were analyzed based on thePharmaceutical Care Network Europe Version 6.2.Results: The percentage of treatment effectiveness (50.6%) and adverse drug reactions (49.4%) was predominantly due to an inappropriate drug–drug or drug–food combination, including the incidence of drug interactions (20.4%).


2019 ◽  
pp. 30-40
Author(s):  
Ruri Renggani Sandra ◽  
Della Midi Wardhani ◽  
Woro Supadmi

   Autism spectrum disorders (ASD) adalah gangguan perkembangan saraf dengan penyebab yang kompleks dari banyak fakor Penggunaan obat pada pasien autis harus dimonitoring untuk mencegah terjadinya drug related problems. Intervensi farmasis dengan mengidentifikasi kejadian drug related problem adalah kegiatan pelayanan asuhan kefarmasian untuk meningkatkan keberhasilan terapi. Penelitian ini adalah observasional dengan pengumpulan data secara retrospektif berdasarkan data rekam medik. Evaluasi kejadian drug related problems meliputi indikasi yang tidak diterapi, terapi tanpa indikasi, pemilihan obat yang tidak tepat, overdosis, under dosis, adverse drug reactions dan interaksi obat. Literatur yang digunakan sebagai acuan adalah Drug Information Handbook, 18thed, Stockley Drug Interaction, Drugs Interaction Facts 2001, dan Pharmacotherapy A Pathophysiologic Approach 2005 dan jurnal yang relevan.   Hasil penelitian diperoleh pasien dengan jenis kelamin laki-laki 20 pasien (77%), perempuan 6 pasien (23%). Usia antara 6-11 tahun yaitu 15 pasien (58%), 1-5 tahun terdapat 9 pasien (34%), usia <1 tahun dan 12-17 tahun masing-masing sebanyak 1 pasien (4%). Penyakit penyerta ISPA merupakan kasus yang paling banyak terjadi, terbanyak kedua adalah epilepsi dan gastroenteritis akut (GEA). Kejadian DRPs Indikasi tidak diterapi 9%, Terapi tanpa indikasi 9%, Pemilihan obat tidak tepat 9%, Over dosis 31%, Under dosis 33% dan interaksi obat 9%.   Terdapat 24 pasien ( 92,3%) yang mengalami DRPs potensial dan 2 pasien (7,7%) yang tidak mengalami. Kriteria DRPs dengan persentase tertinggi adalah under dosis sebanyak 33% dan over dosis sebanyak 31%.


2021 ◽  
pp. 101053952110005
Author(s):  
Hyunjin Son ◽  
Jeongha Mok ◽  
Miyoung Lee ◽  
Wonseo Park ◽  
Seungjin Kim ◽  
...  

This is a retrospective cohort study using notification data in South Korea. We evaluated the nationwide status, regional differences, and the determinants of treatment outcomes among tuberculosis patients. Treatment success rate improved from 77.0% in 2012 to 86.0% in 2015. The lost to follow-up rate was higher among older people, males, and foreign nationals. Health care facilities designated for the Public-Private Mix (PPM) project showed higher success rate and lower rate of lost to follow-up. Moreover, municipalities with low regional deprivation index had higher PPM project coverage. Since there is a large regional difference in the coverage of the PPM project, an additional community-based support program should be implemented, especially for tuberculosis patients residing in region with low PPM project coverage.


2020 ◽  
Vol 10 (04) ◽  
pp. e369-e379
Author(s):  
Amanda Yeaton-Massey ◽  
Rebecca J. Baer ◽  
Larry Rand ◽  
Laura L. Jelliffe-Pawlowski ◽  
Deirdre J. Lyell

Abstract Objective The aim of this study was to evaluate rates of preterm birth (PTB) and obstetric complication with maternal serum analytes > 2.5 multiples of the median (MoM) by degree of elevation. Study Design Retrospective cohort study of singleton live-births participating in the California Prenatal Screening Program (2005–2011) examining PTB and obstetric complication for α-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A (INH) by analyte subgroup (2.5 to < 6.0, 6.0 to < 10.0, and ≥ 10.0 MoM vs. < 2.5 MoM). Results The risk of obstetric complication increased with increasing hCG, AFP, and INH MoM, and were greatest for AFP and INH of 6.0 to <10.0 MoM. The greatest risk of any adverse outcome was seen for hCG MoM ≥ 10.0, with relative risk (RR) of PTB < 34 weeks of 40.8 (95% confidence interval [CI]: 21.7–77.0) and 13.8 (95% CI: 8.2–23.1) for obstetric complication. Conclusions In euploid, structurally normal fetuses, all analyte elevations > 2.5 MoM confer an increased risk of PTB and, except for uE3, obstetric complication, and risks for each are not uniformly linear. These data can help guide patient counseling and antenatal management.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junette Arlette Mbengono Metogo ◽  
Theophile Njamen Nana ◽  
Brian Ajong Ngongheh ◽  
Emelinda Berinyuy Nyuydzefon ◽  
Christoph Akazong Adjahoung ◽  
...  

Abstract Background Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. Methods We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. Results We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. Conclusion The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA.


2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Aishatu L. Adamu ◽  
Muktar A. Gadanya ◽  
Isa S. Abubakar ◽  
Abubakar M. Jibo ◽  
Musa M. Bello ◽  
...  

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016546 ◽  
Author(s):  
Jesus Maria Aranaz Andrés ◽  
Ramon Limón Ramírez ◽  
Carlos Aibar Remón ◽  
Maria Teresa Gea-Velázquez de Castro ◽  
Francisco Bolúmar ◽  
...  

BackgroundAdverse events (AEs) epidemiology is the first step to improve practice in the healthcare system. Usually, the preferred method used to estimate the magnitude of the problem is the retrospective cohort study design, with retrospective reviews of the medical records. However this data collection involves a sophisticated sampling plan, and a process of intensive review of sometimes very heavy and complex medical records. Cross-sectional survey is also a valid and feasible methodology to study AEs.ObjectivesThe aim of this study is to compare AEs detection using two different methodologies: cross-sectional versus retrospective cohort design.SettingSecondary and tertiary hospitals in five countries: Argentina, Colombia, Costa Rica, Mexico and Peru.ParticipantsThe IBEAS Study is a cross-sectional survey with a sample size of 11 379 patients. The retrospective cohort study was obtained from a 10% random sample proportional to hospital size from the entire IBEAS Study population.MethodsThis study compares the 1-day prevalence of the AEs obtained in the IBEAS Study with the incidence obtained through the retrospective cohort study.ResultsThe prevalence of patients with AEs was 10.47% (95% CI 9.90 to 11.03) (1191/11 379), while the cumulative incidence of the retrospective cohort study was 19.76% (95% CI 17.35% to 22.17%) (215/1088). In both studies the highest risk of suffering AEs was seen in Intensive Care Unit (ICU) patients. Comorbid patients and patients with medical devices showed higher risk.ConclusionThe retrospective cohort design, although requires more resources, allows to detect more AEs than the cross-sectional design.


2008 ◽  
Vol 26 (33) ◽  
pp. 5374-5379 ◽  
Author(s):  
V. Shane Pankratz ◽  
Lynn C. Hartmann ◽  
Amy C. Degnim ◽  
Robert A. Vierkant ◽  
Karthik Ghosh ◽  
...  

Purpose An accurate estimate of a woman's breast cancer risk is essential for optimal patient counseling and management. Women with biopsy-confirmed atypical hyperplasia of the breast (atypia) are at high risk for breast cancer. The Gail model is widely used in these women, but has not been validated in them. Patients and Methods Women with atypia were identified from the Mayo Benign Breast Disease (BBD) cohort (1967 to 1991). Their risk factors for breast cancer were obtained, and the Gail model was used to predict 5-year–and follow-up–specific risks for each woman. The predicted and observed numbers of breast cancers were compared, and the concordance between individual risk levels and outcomes was computed. Results Of the 9,376 women in the BBD cohort, 331 women had atypia (3.5%). At a mean follow-up of 13.7 years, 58 of 331 (17.5%) patients had developed invasive breast cancer, 1.66 times more than the 34.9 predicted by the Gail model (95% CI, 1.29 to 2.15; P < .001). For individual women, the concordance between predicted and observed outcomes was low, with a concordance statistic of 0.50 (95% CI, 0.44 to 0.55). Conclusion The Gail model significantly underestimates the risk of breast cancer in women with atypia. Its ability to discriminate women with atypia into those who did and did not develop breast cancer is limited. Health care professionals should be cautious when using the Gail model to counsel individual patients with atypia.


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