scholarly journals Oral anti-tuberculosis drugs: An urgent medication reconciliation at hospitals in Indonesia

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Fauna Herawati ◽  
Eka Yuliantini Fahmi ◽  
Noer Aulia Pratiwi ◽  
Dewi Ramdani ◽  
Abdul Kadir Jaelani ◽  
...  
Keyword(s):  
Medical Records ◽  
Medication Reconciliation ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medication Discrepancies ◽  
Tuberculosis Patients ◽  
Medical Histories ◽  
Tuberculosis Therapy ◽  
Tertiary Care Hospitals

Background: Four oral anti-tuberculosis drugs are conceived to be the most effective ones to eradicate Mycobacterium tuberculosis bacteria and to obviate the resistant organisms. However, the patients' adherence and medication discrepancies are obstacles to achieving the goal. This study aimed to define the anti-tuberculosis drugs used in the hospitals and to detect the discrepancies in the continuity of the tuberculosis treatment.Design and Methods: This retrospective cross-sectional study was based on medical records of adult patients, and was conducted in two district tertiary care hospitals. Only 35 out of 136 patient records from Hospital A and 33 out of 85 records from Hospital B met the inclusion criteria.Results: The most common systemic anti-infective drugs in the study were ceftriaxone (51.80 DDD/100 patient-days) used in Hospital A and isoniazid (59.53 DDD/100 patient-days) used in Hospital B. The number of rifampicin prescriptions was less than that of isoniazid. Each patient received an average of two DDD/100 patient-days, which is an under dosage for an effective treatment.Conclusion: This study showed a medication discrepancy of Tuberculosis therapy. Tuberculosis patients’ medical histories are not under the full attention of treating physicians wherever they are admitted. Thus, medication reconciliation is needed to accomplish the goal of a Tuberculosis-free world in 2050.

Compliance and Adherence to Treatment in Hypertensive Patients in different Tertiary Care Hospitals in Lahore

2021 ◽  
Vol 15 (8) ◽  
pp. 1858-1860
Author(s):  
Junaid Mushtaq ◽  
Israr-Ul- Haq ◽  
Waqas Mahmood ◽  
Mujtaba H. Siddiqui ◽  
Atiq Ahmad ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Hospital Doctors ◽  
Tertiary Care Hospitals

Aim: To determine the factors that affect compliance and adherence to medications of hypertensive patients visiting OPD clinics. Study design: Descriptive-cross sectional study. Place and duration of study: Department of Medicine, Unit 1, Lahore General Hospital, Doctors Hospital & Medical Center and Farooq Hospital Lahore from 1st January 2019 to 31st December 2019. Methodology: One hundred and sixty five patients with hypertension were handed over questionnaire socio-demographic, compliance and adherence were recorded. Results: Patients who maintained BP charting were only 13(7.9%) and those without BP charting were 152(92.1%). Patients taking regular medications were only 20(12.1%). Forgetfulness in taking medications was found in 47.3% of patients. 20.6% of patients were unable to purchase medicines because of financial reasons. Thirty two patients (19.4%) thought that they should not take medicines as they were not having any symptoms. Conclusion: Major causes of non-adherence were expense of medications, lack of symptoms, lack of money, forgetfulness, lack of awareness due to poor educational status and nature of job. Keywords: Compliance, Adherence, Medications, Hypertension, Forgetfulness

scholarly journals Use of flexible bronchoscopy for rapid diagnosis of suspected tubercular cases in rural India

2009 ◽  
Vol 3 (11) ◽  
pp. 860-864 ◽  
Author(s):  
Sameer Singhal ◽  
Abhay M. Gaidhane ◽  
Nazli Khatib ◽  
Tripti Hrivastava ◽  
Sanjay Diwan ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Correct Diagnosis ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Flexible Bronchoscopy ◽  
Special Importance ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Negative Sputum ◽  
Tuberculosis Therapy

Background: Reaching a correct diagnosis is a challenge for physicians treating any of the 30% to 50% of pulmonary tuberculosis patients who have negative sputum cultures or who present with no sputum.  Flexible bronchoscopy acquires special importance for these cases for whom empirical anti-tuberculosis therapy is the only option left. In our study we aimed to assess the diagnostic yield of flexible bronchoscopy in patients, suspected to have tuberculosis, whose sputum smears were negative. Methodology: In our hospital-based cross-sectional study, 42 patients were enrolled by consecutive sampling. Flexible bronchoscopy and selective bronchial washings were done in all patients.  Results: Bronchoscopy lavage smears were positive for M. tuberculosis in 10 (23.8%) patients. Fifteen (35.7%) patients had positive culture. Conclusion: Flexible bronchoscopy has an important role in the diagnosis of patients suspected to have tuberculosis, whose sputum smears are negative or who can not produce sputum.

scholarly journals Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Iqra Arshad ◽  
Sara Mohsin ◽  
Sana Iftikhar ◽  
Tahseen Kazmi ◽  
Luqman F. Nagi
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Early Initiation ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Creative Commons ◽  
Oral Medications ◽  
Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effect of psychiatric co-morbidity on adherence to anti tubercular treatment: a cross sectional study from North India

2021 ◽  
Vol 8 (3) ◽  
pp. 1325
Author(s):  
Ravdeep Kaur ◽  
Tarundeep Singh ◽  
Shubh Mohan Singh ◽  
Rajesh Kumar
Keyword(s):  
Depressive Disorder ◽  
Cross Sectional Study ◽  
North India ◽  
Directly Observed Therapy ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Short Course ◽  
Co Morbidity ◽  
Mdr Tb ◽  
Tuberculosis Therapy

Background: Study explores relationship between depressive disorder and adherence to DOTS (Directly Observed Therapy Short Course) and whether treatment of depressive disorder according to severity of depressive disorder should be an option to improve adherence to DOTS.Methods: Study included 182 newly diagnosed adult cases of tuberculosis who were on anti- tuberculosis therapy (ATT) as per program guidelines and were in third month under DOTS category I and category II therapy. Patients were screened for depressive and anxiety disorder using PHQ-9 and GAD-7. Modified ACTG baseline questionnaire was used to collect data about adherence and reasons for partial adherence.Results: Overall prevalence of depressive disorder amongst participants was found to be 37.9% and that of partial adherence (missed two or more than two doses) was 12.1%. Partial adherence was mostly seen in the first month, followed by third and second month of DOTS. Twenty- two percent patients with depressive disorder were partially adherent to ATT. Odds ratio suggests higher risk being partially adherent to ATT were greater in the participants who had depressive disorder.Conclusions: This study highlights the benefit of screening patients while diagnosing tuberculosis patients for depressive disorder, to improve disease outcome and reduce likelihood of MDR-TB.

scholarly journals A study on premenstrual syndrome symptoms and their association with sleep quality in nursing staff

2019 ◽  
Vol 8 (4) ◽  
pp. 1487
Author(s):  
Gauri Kore ◽  
Heena Merchant ◽  
Hiba Narvel ◽  
Ajita Nayak ◽  
Avinash De Sousa
Keyword(s):  
Sleep Quality ◽  
Nursing Staff ◽  
Premenstrual Syndrome ◽  
Rating Scale ◽  
Tertiary Care ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Premenstrual Symptoms ◽  
Tertiary Care Hospitals

Background: Symptoms in the premenstrual period can be debilitating and troublesome and impacts the general health of women. There is a dearth of studies examining the relationship between sleep quality and premenstrual symptoms in women, especially in Indian settings. The current study was conducted with the aim of looking at the frequency of premenstrual syndrome (PMS) in different age groups and the association of these symptoms with sleep quality in nursing staff.Methods: The cross-sectional study involved 450 female nursing staff between 25- 50 years of age from various tertiary care hospitals who were administered the Premenstrual Tension Syndrome Rating Scale (PMTS) and Pittsburgh Sleep Quality Index (PSQI). The data was then statistically analyzed.Results: The prevalence of premenstrual symptoms was found to be 85.6% amongst the participants (according to the ACOG criteria), while the proportion of females suffering from PMS (according to DSM IVTR criteria) was 36.5%. A correlation analysis between total scores of PMTS and PSQI showed a positive, linear and significant association.Conclusions: The intensity of PMS was associated with reduction in sleep quality in present study. Further studies on PMS and sleep related parameters need to carry out in larger samples to give impetus to our findings.

scholarly journals Adverse Reactions to Antituberculosis Drugs in Iranian Tuberculosis Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Aliasghar Farazi ◽  
Masoomeh Sofian ◽  
Mansoureh Jabbariasl ◽  
Sara Keshavarz
Keyword(s):  
Social Sciences ◽  
Medical Records ◽  
Adverse Reactions ◽  
Cross Sectional Study ◽  
Close Monitoring ◽  
Questionnaire Data ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Antituberculosis Therapy

Background. Antituberculosis multidrug regimens have been associated with increased incidence of adverse drug reactions (ADRs). This study aimed to determine the incidence and associated factors of ADRs due to antituberculosis therapy.Methods. This is a retrospective cross-sectional study on tuberculosis patients who were treated in tuberculosis clinics in Markazi province in Iran. The information contained in the medical files was extracted and entered into the questionnaire. Data was descriptively analyzed by using statistical package for social sciences (SPSS 18).Results. A total of 940 TB patients of 1240 patients’ medical records available in 10 medical offices were included in this study. Of the 563 ADRs found in this study, 82.4% were considered minor reactions and 17.6% were major reactions. No death from antituberculosis ADR was observed. We found that the risk of major ADRs was higher in females (P  value=0.0241), age >50 y (P  value=0.0223), coinfection with HIV (P  value=0.0323), smoking (P  value=0.002), retreatment TB (P  value=0.0203), and comorbidities (P  value=0.0005).Conclusions. This study showed that severe side effects of anti-TB drugs are common in patients who have risk factors of ADRs and they should be followed up by close monitoring.

scholarly journals Trimester-specific reference ranges for thyroid hormones of pregnant females at tertiary care hospitals in Lahore, Pakistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asim Mumtaz ◽  
Fauzia Sadiq ◽  
Saima Zaki ◽  
Hijab Batool ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Thyroid Function Test ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
Thyroid Peroxidase ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Pregnant Females ◽  
Tertiary Care Hospitals

Abstract Background The significance of investigation for diagnosing and managing thyroid dysfunction in pregnant females has been extensively documented in the medical literature. This study aimed to determine trimester-specific reference ranges for thyroid-stimulating hormones (TSH), free T3 (FT3), and free T4 (FT4) in apparently healthy pregnant women attending tertiary care hospitals in Lahore. Methods This cross-sectional study was conducted at two tertiary care Hospitals in Lahore, Pakistan. In this multi-centric study, 500 pregnant females were initially enrolled from September 2019 to December 2019 who fulfilled the inclusion criteria. For measurement of serum FT3, FT4, thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO), and thyroglobulin antibodies, 5 ml of the blood sample was drawn, under aseptic conditions, from each subject using Maglumi 800 chemiluminescence immunoassay (CLIA) system. Results Out of 500 subjects, 23 subjects with positive anti-TPO, 19 subjects with anti-TG antibodies, and 12 subjects due to less volume of serum yielded from whole blood (serum less than 3 ml) were excluded from the analysis. Ten samples were hemolyzed and not included in the analysis. A total of 436 samples were examined for analysis. Of the remaining 436 subjects, 133 (30.5%) were from 1st trimester, 153 (35.1%) from 2nd trimester, and 150 (34.4%) from 3rd trimester. As the data were non-normal, the 2.5th, 50th, and 97.5th percentiles were calculated to express each group's results. Trimester specific range of TSH 0.168-4.294, 0.258-4.584 and 0.341-4.625 mIU/mL, FT31.857-4.408, 1.958-4.621 and 2.025-4.821 pmol/L and FT4 8.815-18.006, 8.306-17.341 and 7.402-17.292 pmol/L. Conclusion In this study, we established a trimester-specific reference range for our local population's thyroid function test. The results of this study have complemented the results of previous studies.

scholarly journals Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

2021 ◽  
Vol 28 (09) ◽  
pp. 1239-1244
Author(s):  
Umair Toqueer ◽  
Muhammad Usama Zardad ◽  
Mahwish Toqueer ◽  
Anila Riyaz ◽  
Sana Khan ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Junior Doctors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Distress Scale ◽  
Tertiary Care Hospitals ◽  
Distress Scale ◽  
The Impact

Objectives: To determine stress grades of doctors working in tertiary care  hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of  Kessler’s score was greater for junior doctors as  compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

scholarly journals Awareness of human papilloma virus (HPV) vaccine female doctors working in tertiary care centres.

2021 ◽  
Vol 28 (04) ◽  
pp. 464-469
Author(s):  
Zahra Safdar ◽  
Faisal Ashraf ◽  
Alia Bashir
Keyword(s):  
Hpv Vaccine ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Common Causes ◽  
Tertiary Care Hospitals

Objectives: The aim of the study is to assess the awareness about various aspects of HPV infection and vaccine among female doctors working in tertiary care centres. Study Design: Cross Sectional study. Setting: 3 Tertiary Care Hospitals Lahore. Period: Jan 2018 Jan 2019. Material & Methods: 478 female doctors from 03 tertiary care hospitals (Lady Atchison hospital, Lahore General Hospital and Services Institute of Medical Sciences) in Lahore who voluntarily filled 18-point self-administered questionnaire assessing their knowledge about HPV infection (8) HPV vaccine (5) and opinions about it (5). Knowledge score (range 0-8), assuming adequate knowledge > median. Factors associated with opinions were explored and analysed. Results: Most replied knowledge questions correctly 67.2%, 39.5% perceived it as frequently occurring infection. Median knowledge was 6 out of 8 questions; lack of knowledge was associated with non ob-gynae speciality or junior level. None of the participants were immunized but 46.3% were willing to get vaccinated themselves 78.1% were willing to get their daughters vaccinated. Self-perceived under exposure of HPV infection was 67.9%. Lack of feeling it as important in our social setting (28.6%), and expensiveness (19.4%) were most common causes of not counselling the patient about HPV vaccine and counselling to get vaccinated was most commonly done as it saves patients from cervical cancer (86.8%). Conclusions: Despite adequate knowledge of HPV infection and effectiveness of its vaccination, female doctors working in tertiary care hospitals of Lahore’s are not efficiently spreading awareness to the society and prescription of the vaccination is also deficient.

scholarly journals Reconciliation of medications upon the admission of patients to the cardiology sector of a university hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 0353
Author(s):  
Lorena S. Miranda ◽  
Ana L. Cavalcante ◽  
Rafael M. Pinheiro ◽  
Dayani Galato ◽  
Emília V. Silva
Keyword(s):  
Medical Records ◽  
Medication Reconciliation ◽  
Adverse Reactions ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Medical Prescription ◽  
Cross Sectional ◽  
Cardiology Department ◽  
The University

Introduction: The reconciliation of medications is an important process that impacts on patient safety during the level of care transition, a moment with high discrepancy rates that can lead to adverse reactions. Objective: To analyze the results of medication reconciliation in order to identify discrepancies between the medical prescription and the medications previously used by the patient. Method: A descriptive, cross-sectional study was conducted between May and November 2017 (until the second fortnight of the month), with patients admitted to the cardiology department of the University Hospital of Brasília. Data was collected through interviews with patients, relatives and/or caregivers, and through consultation of the medical records. The reconciliation of medications was performed daily, from Monday to Friday, within 48 hours of the patient’s admission to the unit, through a medication reconciliation form prepared by the author. Results: 90 patients were included in the study and a total of 297 discrepancies were found, 267 (90%) being intentional and 30 (10%), unintentional. Among the unintentional discrepancies, the most frequent was omission of medication in use by the patient (56%). Of the intentional discrepancies, the dosage modifications were more common in 45% of the cases. Conclusion: The reconciliation of medications was a crucial clinical service for the identification and resolution of unintentional discrepancies between previously used medications and hospital medical prescription.

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