Use of Endovascular Coiling to Stop Gastric Ulcer Bleeding in a Patient With Extensive Risk Factors.

Peptic ulcer disease (PUD) can lead to life-threatening bleeding. Endoscopy is a primary intervention used to locate the site of bleeding and maintain hemostasis. When considering multiple risk factors to operative intervention or failed initial endoscopic procedure in patients, the preferred treatment for acute gastrointestinal bleeding remains endovascular coiling to embolize the culprit's vessel. We report a case of a 57-year-old female who presents with melena secondary to gastric ulcer not amenable to endoscopic interventions. Various embolization techniques are available demanding clinicians' attention towards their role in managing ulcer bleeds and their impact on the controlling bleeds.

Frequency of Medication Non-compliance in Hypertensive Patients Presenting with Stroke: A Case-control Study.

Introduction Medication compliance (MC) is essential for optimum control and delaying disease progression and complications in chronic illnesses. Patients with hypertension have been repeatedly studied for their pattern of MC in the literature. However, whether or not lack of MC is an issue grave enough to cause medical complications of hypertension is still not clear. The aim of this study was to evaluate if the lack of MC is related to hypertension-related stroke. Methods In this case-control, observational study, 100 hypertensive patients admitted with hypertensive stroke were included. These cases were compared with 200 hypertensive patients without any major hypertensive complication recruited from outpatient clinics. Medication compliance was calculated using the Morisky Medication Adherence Scale (MMAS). Data was entered and analysed using SPSS v. 22.0. Results High compliance patients were more in the control group than the cases (34.5% vs. 27%), similar was with medium (41.5% vs. 30%). and low compliance patients (43% vs. 24%; p = 0.003). In both high compliant and moderate-to-low compliant group, mean systolic and diastolic blood pressure was higher among the cases (p <0.05). Among high compliant patients, cases were taking more pills per day than the controls (p = 0.032). Among moderate-to-low compliant patients, 80% perceived themselves to be highly compliant and only 20% perceived to be low complaint in the cases, as compared to 60% controls perceiving themselves compliant and 40% as low complaint (p = 0.001). Conclusion The incidence of low medication adherence is significantly higher in patients with major hypertensive complications such as stroke as compared to hypertensive patients without any major complication.