Prescription pattern of cardiovascular drugs in intensive cardiac care unit patients in a tertiary care hospital

Background: Cardiovascular diseases (CVD) account for high morbidity and mortality all over the world. A study of prescription pattern ensures rational pharmacotherapy and assures quality medical care to the patients. The aim was to observe the prescribing pattern of cardiovascular drugs among the patients admitted to intensive cardiac care unit (ICCU).Methods: Prior permission from the Institutional Ethics Committee was obtained, and a prospective study of cardiovascular drugs was conducted on 100 consecutive patients admitted in ICCU of the Basaveshwar Teaching and General Hospital, Gulbarga. The duration of the study will be of 12 months from June 2012 to May 2013. The prescriptions of the patient who are treated during the course of the study will be audited prospectively using a specially designed form to record the required information. The data were statistically analyzed and presented as counts and percentages.Results: Majority of the patients were male (59%), and most of the patients belonged to age group of 51-60 years. Most common drug class was antianginal drugs with aspirin and clopidogrel being the mostly used combination drug. Most of the drugs were prescribed rationally.Conclusion: The present study concluded that most of the drugs were prescribed rationally according to current guidelines. In addition to prescribing drugs, patients should be educated about the risk factors of CVD and how they can be prevented

Drug utilization study of antihypertensive drugs in hypertensive diabetic patients in a tertiary care hospital

Background: Diabetes along with hypertension is a very common ailment afflicting millions of people worldwide. The socio-economic stress caused by the morbidity and mortality associated with it is mind boggling. Hence, this study was undertaken to study the utilization of antihypertensive drugs in hypertensive diabetic patients.Methods: A prospective study was conducted on 100 hypertensive diabetic patients aged between 18 and 90 years of either gender attending Basaveshwar Teaching and General Hospital, Kalaburagi. The data collected were statistically analyzed and presented as counts and percentages.Results: In our study, we found that majority (63%) were male patients and majority belonged to 51-70 years age group. The majority of the patients were prescribed angiotensin converting enzyme inhibitors (ACEIs) alone (19%), followed by a combination of ACEIs and calcium channel blockers (9%). The generic prescribing was only 23%, and patient’s knowledge of correct dosage was 64%.Conclusion: In this study, it has been observed that the antihypertensives drugs were prescribed rationally, but the generic prescribing was only 23% which is inappropriate prescribing behavior. Hence, physicians should be educated to prescribe drugs in the generic name so that the cost of drugs is reduced

Injury analysis using Anthropomorphic Test Device under vertical shock loads

Natural and manmade injuries due to terrorism, military weapon and accidents lead to cutting edge research for engineers and clinicians alike. The study of injury and its mechanism can help in predicting the severity of an injury which in turn shall guide the engineers to design safer structures and medical specialists in treating casualties. This article summarizes the various advancements and technologies available in the field of Injury Analysis. The objective of the study is to quantify the levels of an injury which occurs when an Anthropomorphic Test Device is subjected to a given vertical impact load. As a baseline a half sine shock test simulating the vertical impact was carried out on Hybrid III 50th percentile male dummy and injury analysis was done based on the standards prescribed by NATO TR-HFM-090. In the present test the injury analysis predicts that the injury during the loading is well within 10% probability of an AIS 2 or greater (AIS 2+)

Analysis of adverse drug reactions of antimicrobial agents reported to ADR monitoring centre of a rural tertiary care teaching hospital

Background: ADRs are iatrogenic diseases, escalates the burden of health care system by increasing the morbidity and mortality and also additional cost of ADRs management to patients.Methods: A prospective observational study was conducted over 1 year from January 2015 to December 2015. The yellow forms dropped in the red ADR boxes are collected and ADRs due to antimicrobials were analyzed for demographic data, causality, severity, drugs implicated, and organ system affected. The data were presented as counts and percentages.Results: Cephalosporins were the most common antimicrobial class implicated in ADRs, and the dermatological system was the most common system affected by ADRs. All the reactions either belonged to the probable or possible category. Majority of reactions were non-serious.Conclusions: Regular prescription auditing and awareness about polypharmacy will further reduce ADRs due to antimicrobials

Apolipoprotein E Dyslipidemia and Nephrotic Syndrome: A Rare Connection

Severe hyperlipidemia warrants an extensive evaluation. We report a case of a 25-year-old man of Chinese descent seen in the cardiology-lipid clinic. He was found to have a serum low-density lipoprotein cholesterol of 12.12 mmol/L (468 mg/dL) and serum triglycerides of 2.29 mmol/L (203 mg/dL) during routine screening. Work-up revealed nephrotic-range proteinuria, and renal biopsy showed dilated glomerular capillary loops with lipid deposits, pathognomonic of lipoprotein glomerulopathy. Genetic studies showed apolipoprotein E3/E4 phenotype. He was treated with a high-intensity statin and fibrate therapy, which resulted in a marked improvement in dyslipidemia and proteinuria

Persistent FDG Uptake at Apical Aneurysm in a Patient With Cardiac Sarcoidosis

We present a case of cardiac sarcoidosis with persistent, focal fluorodeoxyglucose uptake at the left ventricular apical aneurysm concerning for ongoing active inflammatory injury, prompting aggressive immunosuppressive therapy. This case highlights the importance of understanding the various clinical entities that may resemble disease activity on fluorodeoxyglucose positron emission tomography/computed tomography imaging. (Level of Difficulty: Intermediate.

Outcomes Among Heart Failure Patients Hospitalized for Acute Pulmonary Embolism and COVID-19 Infection: Insight From the National Inpatient Sample

There is paucity of data regarding the outcomes of hospitalized acute pulmonary embolism (PE) patients with heart failure (HF) and Coronavirus Disease 2019 (COVID-19) infection. We utilized the 2020 National Inpatient Sample (NIS) Database in conducting a retrospective cohort study to investigate the outcomes of hospitalized acute PE patients with HF and COVID-19, looking at its impact on in-hospital mortality, thrombolysis, and thrombectomy utilization as well as hospital length of stay (LOS). A total of 23,413 hospitalized acute PE patients with HF were identified in our study, of which 1.26% (n = 295/23,413) had COVID-19 infection. Utilizing a stepwise survey multivariable logistic regression model that adjusted for confounders, COVID-19 infection among acute PE patients with HF was found to be an independent predictor of overall in-hospital mortality (adjusted odds ratio [aOR]: 2.77; 95% confidence interval [CI], 1.15–6.67; p = 0.023) and thrombolysis utilization (aOR: 5.52; 95% CI, 2.57–11.84; p ≤ 0.001) compared to those without COVID-19. However, there were comparable rates of thrombectomy utilization and LOS among acute PE patients with HF regardless of the COVID-19 infection status. On subgroup analysis, patients with HF with reduced ejection fraction was found to be associated with increased risk for in-hospital mortality (aOR: 3.89; 95% CI, 1.33–11.39; p = 0.013) and thrombectomy utilization (aOR: 4.58; 95% CI, 1.08–19.41; p = 0.042), whereas both HF subtypes were associated with increased thrombolysis utilization. COVID-19 infection among acute PE patients with HF was associated with higher over-all in-hospital mortality and increased thrombolysis utilization but had comparable hospital LOS as well as thrombectomy utilization

Cost-Effective 1T-MoS2 Grown on Graphite Cathode Materials for High-Temperature Rechargeable Aluminum Ion Batteries and Hydrogen Evolution in Water Splitting

The high dependence on and high cost of lithium has led to a search for alternative materials. Aluminum ion batteries (AIBs) have gained interest due to their abundance, low cost, and high capacity. However, the use of the expensive 1-ethyl-3-methylimidazolium chloride (EMIC) electrolyte in AIBs curtails its wide application. Recently, high-temperature batteries have also gained much attention owing to their high demand by industries. Herein, we introduce cost-effective 1T molybdenum sulfide grown on SP-1 graphite powder (1T-MoS2/SP-1) as a cathode material for high-temperature AIBs using the AlCl3-urea eutectic electrolyte (1T-MoS2/SP-1–urea system). The AIB using the 1T-MoS2/SP-1–urea system exhibited a capacity as high as 200 mAh/g with high efficiency of 99% over 100 cycles at 60 °C when cycled at the rate of 100 mA/g. However, the AIB displayed a capacity of 105 mAh/g when cycled at room temperature. The enhanced performance of the 1T-MoS2/SP-1–urea system is attributed to reduced viscosity of the AlCl3-urea eutectic electrolyte at higher temperatures with high compatibility of 1T-MoS2 with SP-1. Moreover, the electrocatalytic lithiation of 1T-MoS2 and its effect on the hydrogen evolution reaction were also investigated. We believe that our work can act as a beacon for finding alternative, cost-effective, and high-temperature batteries