ABSTRACT
BACKGROUND AND STUDY AIMS: There is an increasing trend to inappropriately prescribe proton pump inhibitors (PPIs) in different clinical settings despite the reported adverse outcomes. This study aimed to assess (1) the prevalence of potentially inappropriate use of PPIs and its associated risk factors among hospitalized patients, at pre-admission and discharge and (2) the prevalence of valid indications of PPIs use without prescription. PATIENTS AND METHODS: A retrospective observational study was performed at a single center, examining the records of patients aged ≥18 years who were admitted to the Family Medicine inpatient service over a one-year period. The appropriateness of PPIs use was assessed against a set of pre-approved indications. RESULTS: A total of 289 patients were included in the analysis. Of these, 34.67 % were taking PPIs upon admission, increasing to 43.67 % at discharge (p < 0.001). Inappropriate PPI use was identified in 51.92 % at pre-admission and 57.25 % at discharge. Multivariate analysis identified significant factors contributing to inappropriate PPI use: polypharmacy at both admission and discharge (OR = 4.587, p = 0.031), and the presence of two or more comorbidities at discharge (OR = 5.421, p = 0.011; OR = 13.005, p = 0.037). Age ≤65 was associated with increased inappropriate use only at discharge (p < 0.003). Conversely, appropriate prescribing was noted in patients over 65 and those on antiplatelet therapy, aligning with clinical guidelines. CONCLUSIONS: This study reveals a high prevalence of inappropriate PPI use among hospitalized patients, notably increasing from admission to discharge. Key contributors to inappropriate PPI usage included polypharmacy and high comorbidity scores at discharge, particularly in patients under 65. This emphasizes the need for targeted interventions to optimize PPI prescribing practices in clinical settings.
ABSTRACT
PURPOSE: To evaluate variability in measured intraocular pressure (IOP) values when correlated with central corneal thickness measurements obtained by both ultrasonic and optical tools. PATIENTS AND METHODS: We included 46 eyes of 46 healthy subjects (age range 35-76 years). Exclusion criteria for the current study were patients with confirmed diagnosis of glaucoma, glaucoma suspect patients and those having corneal opacities, scars or prior cornea-based laser vision correction. Central corneal thickness (CCT) was measured using two methods: ultrasonically (CCT1) by pachymeter and optically (CCT2) using anterior-segment optical coherence tomography (AS-OCT). The IOP was measured in all subjects using Goldmann applanation tonometry (GAT). RESULTS: No significant difference was detected comparing intraocular pressure values and CCT-corrected intraocular pressure (IOPcc1 and IOPcc2) (P=0.47 and P=0.06, respectively) among the study participants. A significant negative correlation was found between corneal thickness-corrected IOP values and the measured central corneal thickness by both optical and ultrasonic tools (P=0.004 and P=0.001, respectively). CONCLUSION: Intraocular pressure appears to be dependent and positively correlated with CCT changes. However, this does not appear to depend largely on methods used for measuring the CCT in the current study. Corrected intraocular pressure is negatively correlated to both ultrasonically and optically measured central corneal thickness.
ABSTRACT
BACKGROUND: The study aims at evaluating the time-course changes of pre-corneal tear film after simultaneous phacoemulsification and limbal relaxing incisions (LRIs) performed in 2 groups of patients; group-A had vertical and group-B had horizontal LRIs. METHODS: Fourty-two eyes of 28 patients with co-existing cataract and corneal astigmatism were studied before and after simultaneous cataract surgery and LRIs (at weeks 1, 4 and 12), patients were classified into 2 groups according to the orientation of LRIs; vertical (A) and horizontal (B) groups. Pre-corneal tear film stability was assessed by measuring the tear break-up time (TBUT) and the tear volume was determined using Schirmer's I test (Basic Schirmer's test; BST), both preoperatively and postoperatively. RESULTS: TBUT was significantly reduced in both the study groups (P = 0.001) without significant reduction regarding basic Schirmer's test values except for the first postoperative week in the horizontal LRI group-B (P = 0.04). CONCLUSIONS: Precorneal tear film stability is altered in the early postoperative period after simultaneous cataract and LRI incisions shown by TBUT measurement values. These changes do not appear to differ significantly depending on the orientation of LRI incisions.
