scholarly journals Study of Drug Use Evaluation and Bleeding Risk of Anticoagulants by Has-Bled In Geriatrics

2021 ◽  
Vol 11 (4) ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Use ◽  
Anticoagulant Therapy ◽  
Tertiary Care ◽  
Bleeding Risk ◽  
Clinical Decision ◽  
Care Hospital ◽  
Score Distribution ◽  
Coronary Syndrome ◽  
Drug Use Evaluation

Anticoagulant therapy being the most conventional form of therapeutic intervention is the cornerstone for the treatment and prevention of various ailments including Atrial Fibrillation (AF), Acute Coronary Syndrome (ACS), Venous Thromboembolism (VTE) and patients undertaking cardiac procedures1. Bleeding is the principal complication of anticoagulants even though used within its therapeutic limit. An innovative tool HAS-BLED score come up with the assessment of bleeding risk among patients under anticoagulant therapy supporting the physicians in a better clinical decision making2,3. The objective is to evaluate drug use and bleeding risk of anticoagulant drugs using HAS-BLED Score among geriatric patients. A prospective observational study was conducted in a tertiary care hospital among hundred patients for a period of six months. It was found that 61% were males and 49% were females. Most of the patients were from the age group of 65-70 (53%), 71-75 (31%) and least less than 75 (16%). The most commonly prescribed dosage form was parenteral (79%) and drug was heparin (52%). The bleeding risk of twenty patients taking warfarin was assessed using HAS- BLED Score, the risk categories shows greater than or equal to 3 (60%) high risk and score between 1-2 (40%) moderate risk. Drug use pattern of anticoagulants needs uninterrupted and repeated surveillance not only to discern therapeutic efficacy but also to scrutinize potential adverse drug reaction. From the HAS-BLED score distribution of patients taking warfarin conveys the need to monitor the parameters especially INR before and after initiation of anticoagulant therapy. Keywords: Drug Use Evaluation, Anticoagulant Therapy, HAS-BLED Score, Atrial Fibrillation, Bleeding Risk, Warfarin

scholarly journals Rational Drug Use Evaluation of Metronidazole at an Egyptian Tertiary Care Hospital

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Tarek Mostafa ◽  
Mona El-Tamalawy ◽  
Bassant Mahboub ◽  
Nagwan Farhoud ◽  
Mai Mousa ◽  
...  
Keyword(s):  
Drug Use ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Rational Drug Use ◽  
Drug Use Evaluation ◽  
Rational Drug

scholarly journals Drug use evaluation of cephalosporins in a tertiary care hospital

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
PS Manjesh ◽  
YashashriC Shetty ◽  
Widhi Churiwala ◽  
SakshiM Jain ◽  
VishalK Singh
Keyword(s):  
Drug Use ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Use Evaluation

Drug use evaluation of dabigatran in a tertiary care hospital in United Arab Emirates

2012 ◽  
Vol 20 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Sahar Hussain ◽  
Nicole Gebran ◽  
Kosar Hussain ◽  
Karem Soliman
Keyword(s):  
Drug Use ◽  
United Arab Emirates ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Use Evaluation

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals Impact of Anticoagulation Clinic Intervention on Patient Centred Outcomes in a Tertiary Care Hospital

2020 ◽  
Author(s):  
S Sunil Kumar ◽  
Oliver Joel Gona ◽  
Nagaraj Desai ◽  
B Shyam Prasad Shetty ◽  
KS Poornima ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Therapeutic Range ◽  
Tertiary Care ◽  
Anticoagulation Clinic ◽  
Care Hospital ◽  
Thromboembolic Events ◽  
Co Morbidity

Introduction: Vitamin K Antagonists (VKAs) have been in use for more than 50 years. They have remained as mainstay therapy in the prevention of thromboembolic events in atrial fibrillation, mechanical heart valves and venous thromboembolism. Despite many years of clinical experience with VKAs, the quality of anticoagulation achieved in routine clinical practice is suboptimal. Aim: To study the effects of structured Anticoagulation Clinic (ACC) interventions on patient centred outcomes in subjects taking VKAs. Materials and Methods: A retrospective study was conducted among patients taking VKAs enrolled in ACC. A total of 169 patients receiving VKAs for at least six months with 4 INR (International Normalised Ratio) values and completed 12 months of follow-up were analysed. Anticoagulation related quality measures like Time in the Therapeutic Range (TTR), Percentage of International Normalised Ratios in the therapeutic Range (PINRR) and clinical outcomes like stroke, systemic embolic events and bleeding was analysed at the time of enrolment and compared with those during ACC care. Results: Among 352 patients enrolled in ACC, 169 patients were eligible for analysis. The mean age of the study population was 55.62±13.77 years. Atrial fibrillation (59%) was the most common indication for VKA therapy. Hypertension (66.3%) was the most common co-morbidity. Mean TTRs were significantly higher in the ACC care when compared with the pre-ACC care at 12 months follow-up (77.58±8.85% vs 51.01±16.7%, p<0.0001). There was a significant improvement in TTRs as early as three months of ACC intervention (73.18±13.56%). At the time of enrolment, 21.9% of patients had individual TTRs (i-TTR) >70% which increased to 70.4% at 12 months of follow-up. INR testing was done more frequently in ACC care. Adverse clinical events were higher in pre-ACC care than ACC care (4.7% vs 2.4%, p>0.05). Major bleeding and thromboembolic events were higher in pre-ACC care than ACC care (1.8% vs. 0.6% and 2.4% vs. 0.6% respectively). Conclusion: ACC services helps in achieving better quality of anticoagulation control as measured by time in therapeutic range translating into better clinical outcomes.

A STUDY OF RISK FACTORS, CLINICAL PRESENTATION AND CORONARY ANGIOGRAPHIC PROFILE IN YOUNG PATIENTS WITH ACUTE MYOCARDIAL INFACTION IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

2021 ◽  
pp. 24-26
Author(s):  
Auriom Kar ◽  
Mainak Mukhopadhyay ◽  
Shivesh Sahai ◽  
Kajal Ganguly ◽  
Sukanya Banerjee
Keyword(s):  
Tertiary Care ◽  
Geographical Area ◽  
Young Patients ◽  
Myocardial Necrosis ◽  
Regional Wall Motion ◽  
Healthy Person ◽  
Cerebrovascular Diseases ◽  
Care Hospital ◽  
Medical College ◽  
Coronary Syndrome

INTRODUCTION Acute coronary syndrome is a devastating disease because an otherwise healthy person may die or become disabled without warning. Cerebrovascular diseases (CVD) are no longer conned by geographical area or by age, sex, or socioeconomic boundaries. Heart disease has already reached epidemic proportions in poorer countries also. AIMS AND OBJECTIVESAMI was dened as typical rise and fall of cardiac markers of myocardial necrosis with at least one of the following: Ischemic symptoms, Electrocardiogram (ECG) changes indicative of ischemia (ST elevation or depression), Development of Pathological Q waves in ECG and Echocardiograph evidence of new regional wall motion abnormality. MATERIALS AND METHODS SETTING AND STUDYPOPULATION- Hospital based study in Nil Ratan Sircar Medical College and Hospital among the patients admitted in department of Cardiology SAMPLE SIZE- 50 patients STUDYPERIOD- From January 2016-December 2017 STUDYDESIGN- Prospective observational study. RESULT AND ANALYSIS We found that 30% of our patients were hypertensive this is more than reported in various studies .61,62 Though Hypertension is therefore less common in young MI patients than in older patient but in my study 30% of patients less than 40 yrs were hypertensive. CONCLUSION Normotensive and non obese patients had more likelihood of normal CAG and their association was statistically signicant. Young patients with positive family h/0 CAD had more prevalence of LMCAdisease and thrombus and their correlation is statistically signicant.

Sign in / Sign up

Export Citation Format

Share Document