scholarly journals An Analysis of Drug-Drug Interactions in a Tertiary Care Hospital in Kerala: A Retrospective Study

2021 ◽  
Author(s):  
Jihana Shajahan
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Positive Correlation ◽  
Duration Of Hospital Stay ◽  
The Impact

Introduction: Concomitant use of several drugs for a patient is often necessary for achieving therapeutic response. Understanding the profile of Drug-Drug Interactions (DDI) will help health care providers to optimise therapy for better patient outcomes, reinforcing the concept of rational drug use. Aim: To analyse the frequency, mechanisms and severity of DDIs in a tertiary care hospital at Kerala. Materials and Methods: A retrospective cross-sectional study among 350 inpatients of a tertiary care hospital in Kerala from August 2020 to September 2020. Prescriptions containing ≥3 drugs were collected from inpatient medical records. A drug interaction check was performed using the Lexicomp drug interaction checker software. Results: DDIs were present in 74.6% of prescriptions and the average number of interactions was found to be 2.78. Most number for interactions was in the age group 61-80. Average number of DDI was significantly high among patients >60 years. Percentage of prescriptions with DDI and average number of DDI was found to be increasing with increase in number of drugs. Average number of interactions were maximum (5.01) in the group >10. Drug groups most commonly involved in interactions were antiplatelets, oral hypoglycaemic agents, bronchodilators, antibiotics, diuretics, insulin, statins, beta blockers, Proton Pump Inhibitors (PPI) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). The most common interventions for minimising the impact of DDIs were changing the timing of drug administration, monitoring for symptoms/signs/lab values/drug levels or both. There was a significant positive correlation between duration of hospital stay and number of DDI. Conclusion: This study threw light upon the pattern and profile of DDIs among inpatients of a tertiary care hospital in Kerala. Elderly people (>60 years) were most prone for DDIs. Percentage of prescriptions with DDI and average number of DDIs was found to be increasing with increase in number of drugs. There was a positive correlation between duration of hospital stay and number of DDI.

EVALUATION OF DRUG-DRUG INTERACTIONS IN HOSPITALISED GERIATRIC PATIENTS AT TERTIARY CARE HOSPITAL

INDIAN DRUGS ◽  
2021 ◽  
Vol 58 (03) ◽  
pp. 62-66
Author(s):  
Jalpa Suthar ◽  
Avni Tandel ◽  
Varsha Patel ◽  
◽  
◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Prospective Observational Study ◽  
Geriatric Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
The Elderly ◽  
Care Hospital ◽  
Contributing Factors ◽  
Associated Conditions

A study was planned to evaluate the prevalence, nature, and severity of drug-drug interactions (DDI) in geriatrics. A prospective observational study was carried out in hospitalized patients. DDIs were evaluated using a medscape drug interaction checker. Data of 300 patients were collected who were followed up for 3 days and analyzed over a period of 7 months. The prevalence rate of DDI was 90.3 %, as 271 out of 300 prescriptions showed drug-drug interaction. Out of 300 patients, 4797 possible DDIs were identified, of which 39 (0.81 %) were contraindicated, 290 (6.04 %) serious drug interactions, 3312 (68.85 %) significant interactions and 1156 (24.09 %) minor interactions. Out of 4797 possible DDIs, 2962 (62.91 %) were pharmacodynamics. 1835 (37.08 %) were pharmacokinetic type. Antihypertensive class of drug showed potential for DDIs. Total 244 (81.33 %) cases were found with potentially inappropriate medicines(PIM). The prevalence of DDIs in geriatric patients was 90.3 %. Poly pharmacy and multiple associated conditions in the elderly were the major contributing factors for DDIs.

scholarly journals DRUG-DRUG INTERACTIONS (DDIs);

2017 ◽  
Vol 24 (02) ◽  
pp. 239-243
Author(s):  
Ali Qureshi ◽  
Muhammad Ali Ghoto ◽  
Abdullah Dayo ◽  
Mudassar Iqbal Arain ◽  
Rabia Parveen ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
The Other ◽  
Care Hospital ◽  
Standard Drug ◽  
Care Policies ◽  
Health Care Policies ◽  
Pharmacy Prescriptions

Introduction: Drug-drug interaction refers to an altered or impaired responseof drug as a resultant of the other drug’s activity. However, recently advancement in field oftherapeutics has leaded the therapy toward more rational and logical trend in order to improvethe patients’ health with respect to cost effectiveness. Objective: To assess the various levels ofDDIs in Prescriptions at public sector teaching hospital of Hyderabad, Pakistan. Study Designand Settings/Methodology: A descriptive observational questionnaire based study has beenconducted by collecting initially 250 random prescriptions of various patients prescribed withmultiple drugs. Tertiary care hospital OPD and In-patient wards were visited for a period of06 months. The Prescriptions (℞) so collected were analyzed and assessed individually fordrug interactions using Standard drug interaction software i.e.. Lexi-comp’s Lexi-Interact, DrugInformation Handbook, Hansten and Horn’s drug interactions. Results: For this study, a total 250Prescriptions were collected. It was observed that 30 (12%) prescriptions contained with singlemedication, 10 (4%) prescriptions were unreadable, 210 (84%) prescriptions were containedmore than one medication. Moreover, 210 (84%) poly-pharmacy prescriptions focused keenly.Subsequently, 51 (24%) prescriptions ensured the prevalence of DDIs and 159 (76%) were Non-DDIs prescriptions. Similarly, 13 ℞ contained four or more than four drugs, 32 ℞ contained threedrugs and 06 prescriptions contained two drugs correspondingly. Conclusion: It was clearlyconcluded that the most potential reason of DDIs are Poly pharmacy. So it is of utmost needto enhance the health care policies in overall healthcare system in order to antagonize DDIsassociated morbidity and mortality among society.

scholarly journals A Study of Viral Hepatitis E Infection in a Tertiary Care Hospital in Mysore, South India

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Karkala Achutha Sudharshana Murthy ◽  
Ismailkhan Mohammed Khan ◽  
Pura Krishnamurthy Kiran ◽  
Hisham Hakeem
Keyword(s):  
Alcohol Abuse ◽  
Serum Albumin ◽  
Hospital Stay ◽  
Total Bilirubin ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Direct Bilirubin ◽  
Care Hospital ◽  
Duration Of Hospital Stay

Abstract Background.  In this study, we aimed to explore the clinical and epidemiological profile of all patients with hepatitis E virus (HEV) who were admitted to a tertiary care hospital in Mysore, India and to further assess various factors that influence the prognosis of these patients. Methods.  Two hundred ninety patients with HEV infection were included in the study and interviewed. They were subjected to clinical examination and laboratory investigations, including complete hemogram, renal, and liver function tests. Viral markers for HBV, HAV, HCV, and HEV by hepatitis B surface antigen, anti-HAV, anti-HCV, and anti-HEV antibodies, respectively, were done using the enzyme-linked immunosorbent assay method. Final outcome was recorded in the form of discharge or death. Results.  Males had higher (82.8%) incidence of HEV infection. Yellowish discoloration of urine was the most common symptom, and icterus was the most common sign at presentation. Hepatomegaly was most common finding on abdominal examination. Mean duration of hospital stay was higher among diabetics (10 days vs 7.11 ± 3.52 days). Overall, mortality observed was 3.45%. A higher mean age (P = .000) and duration of hospital stay (P = .000) were associated with higher mortality. Mortality was significantly higher among patients with alcohol abuse (25% vs 0%) (P = .004). Higher mean prothrombin time-international normalised ratio (PT-INR) (1.6 ± 0.13 vs 1.21 ± 0.32), total bilirubin (20.3 ± 5.08 vs 11.33 ± 7.26 mg/dL), and direct bilirubin (15.05 ± 3.64 vs 6.35 ± 3.71 mg/dL) were associated with higher mortality, whereas lower mean serum albumin (2.6 ± 0.11 vs 3.41 ± 0.40 gm/dL) was associated with higher mortality. Increase in renal parameters (ie, urea [97 ± 33.48 vs 32.43 ± 18.41 mg/dL] and creatinine [2.9 ± 1.38 vs 1.12 ± 0.64 mg/dL]) and electrolyte imbalances (ie, hyperkalemia [5.95 ± 1.21 vs 4.29 ± 0.51 mmol/L] and hyponatremia [123 ± 3.56 vs 136.04 ± 2.97 mmol/L]) were associated with higher mortality. There were 20-fold increases in mean serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT) values (SGPT: SGOT = 1.148) and a 1-fold increase in mean alkaline phosphatase. Conclusions.  Higher mean age, duration of hospital stay, PT-INR, total bilirubin, direct bilirubin, blood urea, serum creatinine, potassium values, alcohol abuse, presence of ascites, and fulminant hepatitis were associated with higher mortality, whereas lower mean serum albumin and sodium values were associated with higher mortality. Diabetics had a higher mean duration of hospital stay.

scholarly journals Physical disabilities in pregnant women: impact on care and pregnancy outcome

2017 ◽  
Vol 6 (4) ◽  
pp. 1306
Author(s):  
Swati Chitnis ◽  
Padmaja Samant
Keyword(s):  
Pregnant Women ◽  
Health Care Providers ◽  
Health Workers ◽  
Tertiary Care Hospital ◽  
Physical Disabilities ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Tract Infections ◽  
The Impact

Background: Health care providers are often insensitive to and unfamiliar with the needs of pregnant women with disability. Medical services are many times not tailored to the needs of the disabled. This study analyzes the impact of disabilities on pregnancy in women delivering in a tertiary care hospital in India.Methods: Prospective study of total of 50 pregnant women with various disabilities was conducted in a tertiary care hospital in Mumbai, India. Each patient’s antepartum, intrapartum and postpartum course were noted. Patients were also interviewed with help of a structured questionnaire for difficulties accessing services, and impact on their daily life, pain.Results: Rate of cesarean deliveries due to pelvic problems, and complications like urinary tract infections which arise due to mobility issues were significantly higher in patients with physical disabilities. 30% participants found examination tables unsuitable and 20% found it difficult access toilets.  Over all patients were satisfied with skills of health workers.Conclusions: Healthcare facilities have to be equipped for receiving patients with disabilities and should train health workers in management of these clients. They require pre-conceptional counseling and planning.

scholarly journals Questionnaire based Prediction of Hypertension using Machine Learning

2020 ◽  
Author(s):  
Abhijat Chaturvedi ◽  
Siddharth Srivastava ◽  
Astha Rai ◽  
A S Cheema ◽  
Desham Chelimela ◽  
...  
Keyword(s):  
Machine Learning ◽  
Health Care Providers ◽  
Real World ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Machine Learning Algorithms ◽  
Care Hospital ◽  
Care Providers ◽  
Effective Performance ◽  
The Impact

AbstractMachine Learning has proven its ability in healthcare as an assisting technology for health care providers either by saving precious time or timely alerts or vitals monitoring. However, their application in real world is limited by availability of data. In this paper, we show that simple machine learning algorithms especially neural networks, if designed carefully, are extremely effective even with limited amount of data. Specifically with exhaustive experiments on standard Modified National Institute of Standards and Technology database (MNIST) dataset we analyse the impact of various parameters for effective performance. Further, on a custom dataset collected at a tertiary care hospital for hypertension analysis, we apply these design considerations to achieve better performance as compared to competitive baselines. On a real world dataset of only a few hundred patients, we show the effectiveness of these design choices and report an accuracy of 75% in determining whether a patient suffers from hypertension.

scholarly journals Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yan-Jun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiao-Ying Liu ◽  
Ling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Severe Neutropenia ◽  
Care Hospital ◽  
The Impact

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not. Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

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