Evaluation of Potential Drug-Drug Interactions with Medications Prescribed to Geriatric Patients in a Tertiary Care Hospital.

BACKGROUND AND OBJECTIVES: The drugs most commonly implicated in major potential interactions are those used in the day-to-day clinical management of elderly patients with chronic diseases. This study is planned to evaluate the profile of drug-drug interactions in the medications prescribed to elderly population and also to identify the possible predictors for potential drug-drug interactions in the elderly. METHODS: This cross-sectional study included patients aged above 60 years with a minimum of two drugs in the prescriptions. Data were collected from medical prescriptions and patients' medical records. The data collected included demographic characteristics such as age, gender, height, weight, educational status, socioeconomic status, medical history, and medications prescribed. The prescriptions were analyzed for the potential drug interactions using Lexi-Interact™ Online, an online software to check drug-drug interactions. RESULTS: A total of 209 patients were included in the study, among them 104 (49.8%) were males and 105 (50.2%) were females. The mean number of medications received was 6.53 ± 2.15 per prescription. Around 138 (66%) patients received more than six medications. The mean number of potential drug interactions seen in the prescription of these patients was 3.17 ± 2.78. Around 18.2% patients had more than five drug interactions. Major drug interactions were observed in 21.42% of cases. Around 3.02% of drug interactions belonged to risk category X, i.e., to be avoided. Logistic regression analysis showed that age above 70 years was associated with the presence of drug interactions. Increased number of medication was independently associated with the occurrence of drug interactions. The presence of drug interactions was not associated with increased number of comorbidities. CONCLUSION: A significant number of potential drug-drug interactions were seen in the prescriptions of elderly patients. Increasing age and polypharmacy were identified as the predictors of potential drug interactions.

A "Handy" tool for hypertension prediction: Dermatoglyphics.

BACKGROUND: Fingerprints studied by dermatoglyphics are unique for a given individual. It depends on the genetic makeup of an individual. Hypertension, a harbinger of many complications, is determined by genetic and environmental factors. In this observational study, we tried to find an association of palmar dermatoglyphic parameters and hypertension. METHOD: Two hundred fifty known hypertensives as cases and 250 normotensives as controls were enrolled after considering inclusion and exclusion criteria. Dermatoglyphic patterns on tips of fingers obtained by digital imaging were noted in both the groups, and "atd" angle was calculated using "screen protractor" software. Collected data were statistically analyzed to find any association between dermatoglyphic qualitative and dermatoglyphic quantitative patterns and hypertension. RESULT: Mean "atd" angle was higher in cases than in controls. Comparison of dermatoglyphic patterns in both the groups in various ways-both hands together, the right hand and left hand separately, similar fingers on right and left hand together, and similar fingers separately-was performed which revealed that at every level, whorls were more frequent in cases than in controls and that distribution of dermatoglyphic patterns were statistically significant in cases than in controls. CONCLUSION: Fingerprint patterns can be reliably used to identify individuals likely at risk for hypertension, and accordingly, preventive measures can be targeted. This subject area demands a need for further research and analysis with large sample size to allow dermatoglyphics to evolve into a cost-effective and handy tool for identifying individuals at risk of hypertension.

Neurological melioidosis presenting as intracranial abscess.

Melioidosis is an emerging disease in our country caused by the bacteria Burkholderia pseudomallei. Melioidosis can virtually affect any organ. It has varying clinical presentations ranging from pneumonia to fatal sepsis. Central nervous system (CNS) involvement in melioidosis is rare. We present a case of CNS melioidosis from South India. As the incidence of diabetes is increasing in our country varying manifestations of melioidosis will be seen in routine clinical practice. Melioidosis should be considered in the differential diagnosis of intracranial abscess and meningoencephalitis, especially in diabetics.