ABSTRACT
Background: The OSA is commonly found in ILD with overall incidence varying from 17 to 88 %. The morbidity and mortality of OSA are high when it occurs with chronic respiratory diseases like ILD. There is lack of data on sleep breathing disorder in ILD patients from India. The present study aims is to assess the occurrence of OSA in ILD patients and its correlation with other parameters. Method: Prospective observational study of 41 ILD patients of one year duration. All patients underwent detailed clinical examination, radiological, laboratory investigations and Type 1 diagnostic polysomnography according to AASM guideline. The severity of OSA was defined as per AHI and the correlation of OSA with other parameters were assessed.
ABSTRACT
Background: Within the next few decades, India will witness a staggering increase in its elderly population owing to advancements in health care. However, an increase in life span is not mutually inclusive with high quality of living. Old age is associated with multiple ailments which decreases functionality and increases dependency, several of which go undiagnosed while catering to primary complaints. This prompts the need for a comprehensive approach to the healthcare of the elderly for which Comprehensive Geriatric Assessment (CGA is widely practiced in the west. Objectives: This study was conducted to estimate the prevalence of undiagnosed medical problems by Comprehensive Geriatric Assessment (CGA) Screening and explore its applicability in Indian tertiary healthcare setup. Methodology: Following ethical approval of the institute, a cross-sectional study was conducted among 262 geriatric patients with age over 60 years, from seven out-patients departments. A Comprehensive Geriatric Assessment (CGA) inventory was prepared by compiling screening instruments for Visual acuity, Hearing acuity, Dependency, Functionality, Depression, Cognitive impairment, Fall risk, Urinary incontinence, Nutritional Status and Insomnia. The participants were administered the screening inventory once they had already undergone a normal check-up in the OPDs. Results: Overall, 262 geriatric patients underwent CGA screening (Female: 57.3%, Male: 42.7%). There was a high prevalence of problems going undiagnosed ranging from 58.65% to 95.45% in various OPDs. Some problems had a significantly greater overall prevalence and were also prevalent in going undiagnosed in particular OPDs (urinary incontinence in Gynaecological OPD, p=0.003; insomnia in surgical OPD, p<0.005). Many patients who screened positive for certain problems were found to have a few other problems as well (dependency and cognitive impairment, p=0.003; insomnia and depression, p=0.0001). Conclusion: This study showed a high prevalence of problems going undiagnosed along with their associations with particular OPDs and other problems. Participants of this study showed a considerable acceptability for CGA. This reaffirmed the need for CGA in every geriatric patient in our tertiary care setup.
ABSTRACT
Introduction: The geriatric population assumes great significance in terms of both preventive and curative health care services utilized. The patho-physio-psychological changes associated with ageing make their problems unique. In the geriatric population, hypertension accounts for a huge proportion of cardiovascular and all cause mortality and morbidity. We conducted a study to describe the patterns of antihypertensive drug use in the geriatric population, compare it to the current recommendations and conduct an analysis using the WHO-INRUD drug use indicators. Methods: A prospective cross sectional drug utilization study of 100 prescriptions of hypertensive patients (as per JNC 7) of either sex and ≥60 years was undertaken as per the WHO – DUS and the STROBE guidelines. Results: Statistically significant relation was found between BP control, and addictions and CIRSG score. The 100 prescriptions contained 344 drugs, out of which, 171 were antihypertensive drugs. Three percent of antihypertensive drugs were prescribed by generic names. Seventy nine percent of antihypertensive drugs were prescribed from the ‘hospital drug schedule’. Amlodipine, Hydrochlorothiazide, Losartan and Telmisartan were prescribed to 79%, 24%, 11%, 11% respectively. The combination of ARB (Angiotensin Receptor Blocker) + Diuretic was prescribed to 36% and that of ARB + CCB (Calcium Channel Blocker) was prescribed to 21%. The PDD/DDD ratios of Carvedilol, Losartan, Furosemide and Telmisartan were 0.7, 0.8,1 and1.2, respectively. Conclusion: Creating awareness regarding the role of addiction in BP control and advocating lifestyle changes is paramount in HTN management. Overall, the principles of rational prescribing were followed. The prescription pattern observed was as per current recommendations.