RESUMO
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
RESUMO
To evaluate the association of anthropometric indices [body mass index and waist circumference] resistance [IR] and metabolic syndrome [MS] in patients having non-alcoholic fatty liver disease [NAFLD]. From August 2005 to Mar 2006 a case series of 70 patients with clinical and/or histological diagnosis of NAFLD were selected at the gastroenterology and Hepatology clinic of Ghurki trust teaching hospital. Liver function tests, lipid profile, glucose and insulin were checked in all patients. Body mass index [BMI] and waist circumference [WC] were determined according to WHO criteria. IR was measured by means of the homeostasis model assessment [HOMA] and IR was present in those having HOMA >/= 3. Metabolic Syndrome [MS] was defined according to the Adult Treatment Panel III [ATP III]. Liver biopsy was performed in 20 cases. Body mass index >/= 30kg/m[2] [obesity] was found in 40% of the cases and BMI 25-29.9 kg/m[2] [overweight] in 52%. BMI correlated with IR [r = 0.39; P = 0.02] and WC with ALT [r =0.02; P = 0.03] IR [p=0.01] and MS [p=0.001]. The presence of steatohepatitis with fibrosis on liver biopsy was associated with overweight BMI [72%], increase of WC [50%] and IR [18%] [p<0.05]. Conclusions: Body mass index and WC are associated with MS, IR and histological findings in patients with NAFLD