Asian Journal of Hospital Pharmacy

Prevalence of anaemia in type 2 diabetes and its associated risk

Thu, 20 Feb 2025 00:00:00 -0500

This cross-sectional study aimed to assess the prevalence of anemia in type 2 diabetes mellitus (T2DM) patients and its associated risks. Conducted at SVS Medical College and Hospital, Mahbubnagar, over six months, the study enrolled 210 patients, categorized into two groups: those with T2DM alone and those with T2DM and anemia. Data collection included demographic details, clinical parameters such as HbA1c and renal function, and Framingham risk scores. Results revealed that 66.67% of T2DM patients were anemic, with moderate anemia being the most prevalent type (89%). The study identified a significant association between anemia and increased risks of cardiovascular complications, neuropathy, nephropathy, and retinopathy. Furthermore, Framingham risk scores indicated a higher prevalence of severe cardiovascular risks in anemic patients (77%) compared to non-anemic individuals. Rural residence (51%) and female gender (53%) were associated with higher anemia prevalence. The study concluded that anemia exacerbates the complications of T2DM and highlights the need for early detection and management to improve patient outcomes. Statistical significance was tested at P < 0.05, and findings suggest targeted interventions to mitigate risks.

Review article on clinical significance and management of hyponatremia in liver cirrhosis

Tue, 11 Mar 2025 00:00:00 -0400

Hyponatremia is commonly observed in Liver cirrhosis patients, particularly in advanced stages with various complications and high mortality. The prevalence of hyponatremia in cirrhotic patients is approximately 50%., More frequently observed hyponatremia is hypervolemic hyponatremia, which occurs due to the overactivation of sodium and water retention mechanisms in response to effective arterial hypovolemia.Whereas hypovolemic hyponatremia typically results from excessive fluid loss, often due to diuretic therapy or diarrhea.In this review, we can figure out the relation between hyponatremia with clinical outcomes and management. Hyponatremia is a significant predictor of mortality and is associated with an increased risk of hepatorenal syndrome, altered mental status, infections, and poor post-transplantation outcomes. In treating hyponatremia, distinguishing between hypovolemic and hypervolemic types is essential.In hypervolemic hyponatremia,the management should be initiated only in the symptomatic patients. Prevents further declines in sodium levels by discontinuing diuretics and implementing fluid restriction. Currently, only albumin infusions can be routinely recommended, while other treatments such as vaptans, splanchnic vasoconstrictors, niravoline, or osmotic diuretics are reserved for specific scenarios, such as impending liver transplantation, or require careful indication.

A review on upper respiratory tract infection

Sat, 15 Mar 2025 00:00:00 -0400

Upper respiratory tract infection (URI) is a general term for a heterogeneous group of illnesses caused by numerous etiologic agents that affect the mucosal lining of the upper respiratory tract, including the middle-ear cavity and par nasal sinuses. URIs are primarily caused by viruses, rhinoviruses being the most common etiological agents. Respiratory viruses transmit easily via direct contact or aerosols. The incidence of URI is highest in children who suffer 6–8 infections per year. The main symptoms of URI are nasal blockage and discharge, sneezing, sore throat, and cough. Fever occurs variably, most commonly in children. Viral URIs often predispose to bacterial complications. Acute otitis media is the most common complication in children, whereas sinusitis and pneumonia are more frequent in adults and the elderly. The treatment of URI is mainly symptomatic because specific antiviral are available only for influenza viruses. Antibiotics have no efficacy for viral URI but are commonly used for treating acute otitis media and sinusitis. Most URIs are self-limited illnesses with an average duration of 7–10 days and an excellent prognosis.

Case study on carbamazepine induced drug rashes and itching over face and body

Sat, 25 Jan 2025 00:00:00 -0500

Background: A 19-year-old female with a history of epilepsy presented with a 3-day history of itching, rashes over her face, and intermittent fever. The patient had recently been started on Carbamazepine 200 mg for seizure management. The temporal relationship between the initiation of Carbamazepine and the onset of symptoms raised the possibility of a drug-induced hypersensitivity reaction.

Case Presentation: The patient reported pruritic, erythematous maculopapular rashes localized to the face, without mucosal involvement. The rashes progressively worsened over 3 days, along with intermittent fever. No previous history of similar rashes was reported. The neurological exam showed no signs of active seizures, and the patient appeared generally well, aside from the discomfort from the itching.

Differential Diagnosis: The primary differential diagnoses included a drug-induced eruption (likely due to Carbamazepine), viral exanthema, allergic reactions, seborrheic dermatitis, and systemic lupus erythematosus (SLE). The absence of mucosal involvement and systemic symptoms made SLE and viral rashes less likely.

Investigations: Relevant investigations included a complete blood count (CBC), liver function tests (LFTs), serum electrolytes, and an eosinophil count. A skin biopsy or dermatology consultation was considered if the diagnosis remained uncertain.

Management: The management plan involved discontinuing Carbamazepine and switching to an alternative anticonvulsant. Symptomatic treatment was provided with antihistamines for itching and topical corticosteroids for inflammation. Antipyretics were prescribed to manage fever, and close monitoring was recommended for potential progression to more severe reactions, such as Stevens-Johnson syndrome.

Conclusion: This case highlights the importance of recognizing drug-induced hypersensitivity reactions, particularly in patients with epilepsy starting new medications. Carbamazepine-induced rashes are common, and early recognition with prompt discontinuation of the drug can prevent severe complications. The patient's symptoms were effectively managed with symptomatic treatment, and follow-up will ensure ongoing seizure control with an alternative anticonvulsant.