Prevalence, predictors and outcomes of potential drug-drug interactions in left ventricular failure: considerable factors for quality use of medicines

Hospitalized patients with left ventricular failure (LVF) are at high risk for potential drug-drug interactions (pDDIs) and its related adverse effects owing to multiple risk factors such as old age, comorbidities and polypharmacy. This cross-sectional study conducted in two tertiary care hospitals aim to identify frequency, levels and predictors of pDDIs in LVF patients. Data about patients' demographic, hospital stay, medication therapy, sign/symptoms and laboratory test results were collected for 385 patients with LVF. Micromedex Drug-Reax® was used to screen patients' medication profiles for pDDIs. Overall prevalence and severity-wise prevalence of pDDIs were identified. Chi-square test was performed for comparative analysis of various variables. Logistic regression was applied to determine the odds-ratios (OR) for predictors of pDDIs. The prevalence of pDDIs was 96.4% (n=371). Overall 335 drug-interacting pairs were detected, which were presented in a total of 2870 pDDIs. Majority of pDDIs were of major- (48.9%) and moderate-severity (47.5%). Logistic regression analysis shows significant association of >6 all types of pDDIs with >12 drugs as compared with <8 drugs (OR=16.5; p=<0.001). Likewise, there was a significant association of >4 major-pDDIs with men as compared with female (OR=1.9; p=0.007) and >12 drugs as compared with <8 drugs (OR=10.9; p=<0.001). Hypotension (n=57), impaired renal function (23) and increased blood pressure (22) were the most frequent adverse outcomes associated with pDDIs. This study shows high prevalence of pDDIs in LVF patients. Majority of pDDIs were of major- and moderate-severity. Male patients and those prescribed greater number of medicines were more exposed to major-pDDIs

Ovarian Cancer among Women of Lahore Metropolitan; a Survey.

The symptoms, causes and different risk factors related to ovarian cancer (OC) in Lahore Metropolitan are studied. Information was collected from 52 patients (having mean age 45±10 years) referred to the Institute of Nuclear Medicine and Oncology Lahore (INMOL), Pakistan. The risk was found relevant in the patients having positive family history of any cancer other than OC and that’s why 21.1% patients faced this dilemma. Marital status was not found a cause of OC as unmarried and married patients both were affected. Birth control pills were not a cause of OC as 96.6% patients in Lahore did not used them. High parity and Brest feeding were the cause of OC as 59.6% patients have high parity and 78.8% have breast fed their children for more than one year. Fallopian tube tide (94.2%), hysterectomy (86.5%) and smoking (98.1%) were not the cause of OC. Irregularity in menstrual cycle (30.8%), eating disorders (38.5%), abdominal pain or bloating (90.4%) and natural menopause (50%) were the symptoms of OC. Hormone replacement therapy (HRT) is not found a cause of OC in Lahore as all the selected patients under study never used HRT.