Practices of proton pump inhibitors use in medical wards

Objective: To determine the pattern of proton pump inhibitors [PPIs] use in medical wards

Study Design: Prospective observational study

Place and Duration of Study: Department of medical post graduate medical institute, study for 24 weeks, from 01 Nov 2014

Material and Methods: One thousand eight hundred consecutive patients admitted in medical wards and emergency department were enrolled and followed during hospital stay and their discharge slips were analyzed without intervention in the management protocol of different primary consultants

Results: Results were analyzed on SPSS version 20. Out of 1800 patients, 53.3% [n=960] were males and 46.7% [n=840] females, 72.6% [n=1306] had been prescribed PPIs. Major indications for the use of PPI were stress ulcer prophylaxis [32.5%], upper G.I bleeding [20.0%], acid peptic disease [12.5%], patients of GERD [8.1%] and NSAID use [7.5%]. In 19.3% patients, indication of PPI use was not mentioned. Out of the admitted patients 57.7% patients were prescribed inject-able and 42.3% were given oral PPIs. There were 77.9% [n=1018] patients prescribed PPIs on discharge slips while duration of treatment and indication for their use were not mentioned on discharge slips for 66.3% [n=866] and 72.3% [n=944] patients, respectively

Conclusion: PPIs are over used without clear indications in hospitalized and discharged patients

Precipitating factors for diabetic ketoacidosis

To determine the frequency of various precipitating factors for Diabetic Ketoacidosis [DKA]. This descriptive, cross-sectional study based on purposive sampling method was conducted at Medical ward VI, Islamabad Hospital, Pakistan Institute of Medical Sciences, Islamabad from 15[th] July 2005 to 14[th] January 2006. Forty Two patients of type 2 diabetes mellitus who at the time of admission had diabetic ketoacidosis were analyzed to sort out the precipitating factor by history, physical examination and investigations both laboratory and radiological. Out of 42 patients 19 [45%] were male while 23 [55%] were female. 21 [50%] had infection, 11 [26.19%] were non-compliant to the treatment, 09 [21.40%] had other co-morbidity [stroke, acute pancreatitis etc] as precipitating factor while one [2.3%] had his first presentation of diabetes mellitus as diabetic ketoacidosis. A mortality of 7.15% was recorded in the study. Infection, non-compliance to treatment and comorbid conditions are the major precipitating factors for diabetic ketoacidosis