scholarly journals Non-Adherence to Anti-Hypertensive Treatment

2020 ◽  
Vol 32 (1) ◽  
pp. 126-129
Author(s):  
Shalini . ◽  
Manish Kumar Goel

Background: In developed countries, adherence among patients suffering from chronic diseases averages only 50%; in developing countries it is assumed to be much lower. Aims & objectives: To find out the prevalence of non-adherence to antihypertensive treatment among individuals seeking anti-hypertensive treatment from tertiary care hospital in New Delhi & to find out the factors related to non-adherence to the anti-hypertensive treatment among study subjects. Material and Methods: A cross-sectional hospital-based study was conducted from June to October 2018 among 150 diagnosed cases of hypertension. The drug adherence was assessed by using standard Brief Medication Questionnaire I (BMQ I) and to know the determinants of non-adherence a semi-structured (self-designed and pre tested) questionnaire was used. The association of different factors with adherence was analyzed by applying chi square (χ2) test. Results: Among total of 150 participants 44% were males and 56% were females. The magnitude of non-adherence to anti-hypertensive drugs was 35.3%. Side effects of anti-hypertensive drugs was significant risk factor for non-adherence to anti-hypertensive drugs and common reasons for non-adherence were unwanted side effects (64.2%) followed by worry about long term side effects (62.3%). Conclusion: Prevalence of non-adherence to anti-hypertensive drugs was quite high, most common reason for non-adherence to anti-hypertensive medication was unwanted side effects and worry about long term side effects.

2020 ◽  
Vol 5 (04) ◽  
pp. 315-321
Author(s):  
Haritha Arnipalli ◽  
Sudha Bala ◽  
Harshal Pandve

Abstract Background and Aim Adherence to long-term therapy for chronic illnesses in developed countries averages to 50%. In developing countries, the rates are even lower. Poor adherence to long-term therapies severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Cardiovascular diseases (CVDs) are the most common disorders affecting most of the productive age group. Therefore, an attempt has been made to determine medication adherence using the Morisky medication adherence scale-4 (MMAS-4) and its determinants in women patients with CVD. Material and Methods A Hospital based cross-sectional study was conducted at outpatient block of General Medicine and Cardiology departments which included 175 women patients who were already diagnosed with CVD (with at least 3 months of medication) and those who were willing to give informed consent for participation. Semi structured questionnaire was used which consisted of sociodemographic variables, MMAS-4 to measure the level of adherence and various determinants such as socioeconomic, patient related, condition related, therapy related, and health system related. Results Prevalence of medication adherence among women of CVDs using MMAS-4 was high, medium, and low among 39, 51, and 10%, respectively. Significant determinants found were socioeconomic, patient related, health system, and therapy related. Conclusion Low-to-medium medication adherence was found to be high which needs to be addressed to reduce the morbidity and mortality associated with CVDs.


Author(s):  
Sarwat Memon

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.


Author(s):  
Susmita Bhattacharya ◽  
Amit Kyal ◽  
Payel Mondal ◽  
Partha Mukhopadhyay ◽  
Mrinalini Chowdhury ◽  
...  

Background: Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life, more so if it is a primary infertility. Studies regarding the prevalence and role of infertility-specific stress especially in eastern part of India is very limited. The objective of the present study was to estimate the prevalence of infertility-specific stress and its role in marital adjustment in women diagnosed with infertility.Methods: It was a cross-sectional study done on 80 married couple diagnosed with infertility (both primary and secondary) over 1 year from July 2016 to June,2017. Dyadic Adjustment Scale (DAS), "semi-structured questionnaire" compiled by the authors and "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)" were used for the evaluation. The analysis was done using SPSS (version 16) and Chi-square test.Results: Around 86% infertile women and 21% infertile men were found to suffer from mental stress. Infertility related stress were more in patients with primary infertility than in secondary one. Women mostly (56.5%) coped with stress by self-blaming whereas men (58.2%) by blaming the partner.Conclusions: Mental stress was significantly associated with infertility. In fact, maladjustment in marital relation caused by the stress adversely affected the conjugal life and thus also the fertility. Proper counselling of both partners might be helpful to solve this problem.


2021 ◽  
Vol 11 (3) ◽  
pp. 151-157
Author(s):  
Raima Asif ◽  
Naila Azam ◽  
Fatima Ali Raza ◽  
Mehwish Riaz ◽  
Shaista Zulfiqar ◽  
...  

Background: The objective is to assess the knowledge, attitude and practices regarding first aid towards home related injuries among mothers of children less than 5 years of age at tertiary care hospital of Islamabad. Methods: A questionnaire based cross sectional study was conducted in Fauji Foundation Hospital Islamabad. 400 participants were selected using convenience sampling the mother of children under 5 years of age were included and mother of children with any major co morbidity, congenital abnormalities and who didn’t give consent were excluded from the study. A pretested, structured, self-administered questionnaire was used for data collection after obtaining permission from Institutional Ethical Committee. Statistical analysis was carried using SPSS version 20. Frequencies and percentages were computed, descriptive statistical analysis was done. Chi- Square was applied for association between socio demographic variables and knowledge of mothers regarding first aid. Results: About 44% of the mothers and 63% children fall in age group of 31 and 2-5 years respectively. Half of the mothers (48%) are below intermediate level of education. About 34% of the respondents stated bleeding as most urgent and important injury requiring first aid. Regarding attitudes, 50% of the mothers strongly agree towards necessity of first aid and lack of awareness about dealing with domestic injuries. Sixty-five (65%) of the mothers had given first aid to their child. About 33%, 75%, 44% and 39% of the mothers have faced a child with difficulty in breathing; bleeding, burning and insect/sibling bite respectively. Age of mother (p=0.041), education of mother (p=0.001) and total no of children (p=0.001) were significantly associated with knowledge of first aid. Conclusion: Although home accidents are a common problem, mother’s knowledge regarding home accidents was deficient although majority of the respondents have positive attitude.


2020 ◽  
Vol 11 (3) ◽  
pp. 3-7

Background: Burns are physically, psychologically and economically challenging injuries and the factors leading to them are many and under studied. Different studies have associated burn injuries with psychiatric disorders from different parts of the world. Objective: To determine the frequency of depression among the burn patients. Methodology: This cross sectional study was conducted at the Pak Italian Modern Burn Unit, Nishtar Medical University, Multan and the Department of Psychiatry, Nishtar Medical University, Multan. Non probability consecutive sampling technique was used to collect the data from study subjects, which consisted of 150 patients of burn. All patients were assessed by a single psychiatrist on Hospital Anxiety and Depression scale (HADS) scale for screening of depression. Chi square test was applied to determine association between the socio demographic factors of burn patients and depression. Results; Of these 150 study cases, 91 (60.7 %) were male patients while 59 (39.3 %) were female patients. Mean age of our study cases was 33.94 ± 8.88 years. The frequency of depression was noted as 88 (58.7%). Post stratification Pearson chi square test revealed significant associations between age (p=0.001), residential status (p=0.038), occupation (p= 0.000), etiology of burn (p=0.044) and duration of illness (p=0.000) with depression. Conclusion: A high frequency of depression was noted among burn patients in our study. Depression was significantly associated with age, residential status, occupation, duration of illness and etiology of the burn. Healthcare professionals treating such patients should anticipate depressive symptoms in these patients and treat them accordingly.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad Hanif Khan ◽  
Raheela Hanif ◽  
Rumina Tabassum ◽  
Waris Qidwai ◽  
Kashmira Nanji

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.


Author(s):  
Nitin A. Lodha

Background: Antenatal care is the care of a woman during pregnancy. The primary aim of antenatal care is to achieve at the end of pregnancy a healthy mother and a healthy baby. To improve maternal health, barriers which limit access to quality maternal health services must be identified and addressed at all levels of health system. Objectives were to determine demographic and obstetric factors affecting utilization of ANC service and prevalence of anaemia among pregnant women.Methods: This is cross-sectional descriptive study carried out in tertiary care hospital, using structured questionnaire, interviews were conducted with married pregnant women age between 18-45 years, who visited ANC clinic. Total 170 pregnant women visited hospital during a period was included in study. Data was analysed using MS excel and Epi info. Chi –square test was applied.Results: Maximum number of study subjects (42.9%) from age 23-27 years. 66.5% were Hindu, 56.5% study subjects from joint family. 14.7% were illiterate. 45.3% were primigravida, 54.7% were multigravida. 71.1% study subjects were from third trimester of pregnancy. 94.7% were taken at least one dose of Tetanus Toxoids. Iron folic acid tablets were taken by 87.6%. Prevalence of anaemia was 55.8%.Conclusions: Majority of pregnant women came for antenatal check-up, but regularity was not seen in most of cases. The presence study has brought out no significant socio-cultural barrier like women’s literacy, socio economic class and parity of women affecting the utilization of services.


2019 ◽  
Vol 6 (4) ◽  
pp. 1680
Author(s):  
S. Prabkaran ◽  
K. Kasthuri Thilagam

Background: Tracheo-esophageal fistula (TEF) is a rare congenital abnormality often associated with several other anomalies including renal, vertebral column, gastrointestinal or cardiovascular defects. This study was carried out to evaluate the outcome of trachea esophageal fistula among patients who underwent various surgeries for the anastomosis of trachea esophageal fistula.Methods: This study was conducted as a record based cross sectional study among 88 patients who were diagnosed and treated for trachea-esophageal fistula in tertiary care hospital between 2015 and 2018. Data regarding the type of anomaly, presence of associated anomalies, type of surgery and outcomes were documented. Findings of echocardiography and ultrasonography were also documented. Data was analyzed using SPSS software. Chi square test was used to evaluate the outcome of the surgical procedures for management of TEF.Results: Majority of the participants in our study belong to <1 month of age and were males (56.8%). Type 3 tracheo esophageal fistula (80.7%) was the most common type. Associated cardiovascular anomalies were present in 50% of the participants. Thoracotomy with TEF repair was most preferred surgery (76%). Present study demonstrated that surgical techniques improve the physical and physiological outcome of the patients (p <0.05).Conclusions: Trachea esophageal fistula needs to be corrected with surgical procedure. Modern techniques like thorocoscopic anastomosis, thorocosopic techniques to achieve an anastomosis can also be explored. Future studies may be directed in detecting congenital anomalies during the pre-natal period with the help of genetic techniques.


Author(s):  
Usharani H. Patted ◽  
Hema N. G. ◽  
Anil Kumar Mysore Nagaraj

Background: Psychiatric disorders are one of the major causes of morbidity and the burden of illness is enormous and remains grossly under represented. Psychotropic drugs have had a remarkable impact in psychiatric practice. Currently a large number of atypical antipsychotics available in the market are endorsed as better options for treating schizophrenia than the typical antipsychotics. The main objective of the study was to find the commonly prescribed antipsychotics in schizophrenia patients in a tertiary care center.Methods: After Institutional Ethics Committee approval, a retrospective cross-sectional drug utilization study of 400 prescriptions was under taken from 1st July 2015 to 30th July 2016 in the outpatient department of psychiatry of a tertiary care hospital. The prescribing pattern of antipsychotics in schizophrenia patients (N=107) was measured.Results: Out of 400 cases in the outpatient department, schizophrenia cases were predominant (N=107 i.e. 27%) out of which 42.1% were females and 57.9% were males. This was followed by mood disorders and neurotic & somatoform disorders. The most common antipsychotic used was olanzapine followed by risperidone. Least commonly used antipsychotic was haloperidol. Most of the patients who received risperidone also received an anticholinergic trihexyphenidyl (91.8%).Conclusions: Olanzapine and risperidone are the most commonly used antipsychotics. Anticholinergics should be used only in selected patients on antipsychotics as tolerance develops to extrapyramidal side effects. Anticholinergics are unnecessary after 3-6 months in all except 10% of patients. Moreover, it has its own side effects and adversely interacts with antipsychotics.


2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Sahithi A ◽  
◽  
Aggarwal R ◽  
Prakash A ◽  
Jain SK ◽  
...  

Background: In thalassemia patients erythrocyte turnover rate increases due to chronic hemolysis and ineffective erythropoiesis leading to increase in uric acid production. Hyperuricosuria is one of the marker of proximal tubular dysfunction. Splenectomy can increase the risk of hyperuricemia by increasing erythrocyte turnover rate in Transfusion Dependent Thalassemia (TDT). Deferasirox enhances uric acid excretion from renal tubules leading to low serum uric acid levels. Methods: An institution based cross-sectional study was conducted from November 2018-March 2020 which included 60 adult TDT patients (≥18 years) attending Adult Thalassemia Day Care Centre at tertiary care hospital. Serum uric acid (mg/dl), 24 hour urinary uric acid (mg/dl), serum ferritin (ng/ml) were done. Results: Hyperuricemia was present in 20%, hypouricemia in 3.33%. Hyperuricosuria was present in 80%. Mean SUA levels were higher in males than females which was statistically significant (5.77±1.66 vs 4.64±1.44, p=0.007). There was statistically significant positive correlation between serum uric acid and serum creatinine(p = 0.0036) and age (p=0.0129). Hyperuricemia was more in subjects with intact spleen but was not statistically significant(p=0.104). Hyperuricemia had negative association with deferasirox therapy [1 (3.03%) vs 11 (40.74%), p=0.0004] compared with normouricemia subjects. Conclusion: Uric acid abnormalities were seen in 23.3% of patients. Hyperuricemia was present in one fourth of the patients and significant risk factors were increasing age, male gender, rising serum creatinine. Deferasirox therapy was negatively associated with hyperuricemia. Tubular dysfunction is relatively common in TDT as more than three fourth patients had hyperuricosuria. Regular monitoring of serum uric acid and urinary uric acid is recommended.


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