ABSTRACT
Background: Inappropriate prescribing is more prevalent in geriatric patients. A popular tool for screening appropriateness of prescribing is the screening tool of older person’s prescriptions (STOPP) and screening tool to alert doctors to right treatment (START) criteria. In this study, our aim was to estimate the incidence of potentially inappropriate prescribing (PIP) utilizing these criteria among patients attending outpatient departments. In addition, we aimed to identify potential factors that are associated with PIP. Aims and Objectives: The objectives of the study are as follows: (1) To estimate incidence of potentially inappropriate medications (PIMs) using STOPP criteria; (2) To estimate incidence of potential prescribing omissions (PPOs) using START criteria; and (3) To identify potential factors that are associated with PIP. Materials and Methods: A prospective and cross-sectional study that was observational in nature was performed in patients with age 65 years and above. Prescriptions of these patients were analyzed by collecting relevant data that were subsequently entered in specially designed case record forms. The modified version 2.0 of STOPP/START criteria was utilized to assess PIP in the form of PIMs and PPOs. Data were entered in Microsoft Excel 2013 and analyzed. Categorical variables were described as frequency and percentage whereas continuous variables were described as mean with standard deviation. Results: Prescriptions of a total 306 patients were evaluated (mean age: 69.4, 60% male, average number of medications per prescription: 5.04 ± 2.44), PIMs were detected in 88 (28.75%) and PPOs in 30 (9.8%) patients. Ninety-six patients had either a PIM or a PPO. PIMs mainly involved were duplication of drug class (26.5%), use of first generation antihistaminic for >1 week (20.4%) and use of glimepiride (18.6%). Major PPOs identified were non-use of angiotensin converting enzyme inhibitors following acute myocardial infarction (26%), non-use of statin therapy (26%), and antiplatelet therapy (21.7%) in patients with diabetes mellitus along with cardiovascular risk factor. Polypharmacy (OR 6.011, P < 0.0001) and comorbidity (OR 3.097, P = 0.015) significantly increase the risk of PIM encounter. Conclusion: PIP in the form of PIMs and PPOs was prevalent in the studied patients. Polypharmacy and comorbidity were associated with an increased likelihood of PIM.
ABSTRACT
Background: Fungal infection has a worldwide prevalence and it affects almost all age groups and both the sexes. Due to neoteric treatment modalities nowadays, people are enjoying longevity of life. However, on the other hand, immune status is compromised that has resulted in increased prevalence of fungal infection in society. Fungi reported by surgical pathologist, either incidentally or in clinically suspicious cases, greatly improve morbidity and outcome of the patients. Objective: The objective of this study is to study the prevalence of fungal infection in surgical pathology tissue and frequency and spectrum-based analysis in relation to age, gender, and systemic involvement. Materials and Methods: Ethically approved retrospective observational secondary data analysis is done based on histomorphological and cytomorphological evaluation of 17 fungal cases diagnosed at the Department of Pathology, New Civil Hospital, Surat, from January 2015 to January 2017. Results: Out of 17 cases, most common fungus seen was Candida albicans mainly affecting gastrointestinal tract. Common age group affected was 41–60 years and few rare fungi, i.e., mucormycosis and tinea corporis were also reported. Conclusion: Distribution of fungi in tissue section in relation to frequency, age, sex, various organs, and its correlation with clinical symptoms is analyzed in our study and results are found to be yielding that provided outlook in the prevalence of infectious agent.