Drug-related Factors Research Articles

A Study on Pharmacovigilance in the Hospitalized Pediatric Patients at Tertiary Care Hospital

Pharmacovigilance is a critical aspect of public health, aiming to detect, assess, understand, and prevent adverse effects and other drug-related issues. It plays a pivotal role not only in the development phase of medications but also in post-marketing surveillance, ensuring ongoing safety and efficacy. In India, the Pharmacovigilance Programme (PvPI) spearheaded by the All India Institute of Medical Sciences (AIIMS) aims to safeguard public health by collating and analyzing data to inform regulatory interventions and communicate risks to healthcare professionals and the public. The classification of adverse drug reactions (ADRs) based on types and severity provides a framework for understanding and managing these occurrences. Additionally, factors predisposing individuals to ADRs, such as drug-related, social, patient-related, and disease-related factors, are crucial considerations in pharmacovigilance efforts. Furthermore, understanding drug interactions, including pharmacokinetic and pharmacodynamic interactions, combined toxicity, additive effects, synergistic effects, and antagonistic interactions, is essential in optimizing therapy and minimizing risks to patients. Overall, pharmacovigilance is indispensable in ensuring the rational use of medicines and optimizing patient outcomes while safeguarding public health. KEYWORDS: Pharmacovigilance, Pediatric, PvPI, Adverse drug reaction.

The Role of Patient- and Drug-Related Factors in Oral Minoxidil and Pericardial Effusion: Analyses of Data From the United States Food and Drug Administration Adverse Event Reporting System.

While oral minoxidil (OM) has been associated with pericardial effusion (PE), its etiology is presently inconclusive. We characterized patient- and drug-related factors across reports from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) for PE and OM. Our observation period spanned 18.5 years. Parametric and non-parametric analyses were used; we stratified our findings according to two groups of adverse events (AEs), namely, PE and all other AEs. Across reports of OM (n = 2747), positive dechallenge (complete resolution or subsiding of AE upon discontinuation of OM) was significantly more likely to occur for PE than for all other AEs (p < 0.05). Furthermore, OM was significantly more likely to play a primary role in PE compared to all other AEs (p < 0.05). The proportion of men was significantly higher in OM reports of PE than in OM reports of all other AEs (p < 0.05). We also identified six reports of PE and topical minoxidil. Though findings from spontaneously reported data never prove causality, our findings on dechallenge and purported role may suggest one. There were no reports of PE at a dose < 2.5 mg/day, 2/35 reports at 2.5 mg/day, and 8/35 reports at 5 mg/day. Overall, the results of statistical analyses support that the relationship between OM and PE is dose independent. Caution should also be taken when applying minoxidil topically because of reports of PE associated with this route of administration.

Towards the understanding of the IVPT results variability—Development, verification and validation of the PBPK model of caffeine in vitro human skin permeation

In the context of evaluating the safety and efficacy of dermal products, pharmacokinetic (PK) studies face considerable challenges, particularly concerning topically applied formulations. This underscores the necessity for alternative methods, such as in vitro permeation tests (IVPT) and physiologically based pharmacokinetic (PBPK) modelling, to better understand the dermal pharmacokinetics of a product. The purpose of this study was to modify, verify, and validate the PBPK model of caffeine permeation through human skin previously developed by Patel et al. (2022), and compare simulation results with experimental data from IVPT studies. Moreover, the study aimed to analyse the IVPT data variability and explore the potential of using the PBPK model to understand the influence of biological and drug-related factors on the IVPT results. In total, eight manuscripts describing nine experiments were included. The overall shapes of the permeation curves were considered acceptable based on visual checks for all analysed experiments. Five out of nine experiments met the predefined standard 2-fold difference criterion for comparison of the cumulative amount of caffeine in the receptor solution.. Our investigation highlights challenges in validating PBPK models for IVPT experiments, as the quality and consistency of experimental results pose significant hurdles. Despite access to data on caffeine permeation in scientific literature, reliable model validation is currently infeasible. Inter-laboratory variation suggests that alternative validation methods may be needed. Further studies should focus on issues with other compounds, especially lipophilic ones.

Amyloid-related imaging abnormalities in antiamyloid therapy for Alzheimer's disease: a narrative review

Summary Antiamyloid therapies have sparked a new hope for a potential disease-modifying therapy for Alzheimer's disease. Antiamyloid therapy targets amyloid-beta, which is a key feature of the disease. However, adverse effects such as amyloid-related imaging abnormalities (ARIA) have raised significant concerns about the safety of these therapies. ARIA, which includes vasogenic edema (ARIA-E) and microhemorrhages or hemosiderosis (ARIA-H), is a common adverse effect to antiamyloid therapies. Patient-related risk factors for ARIA include carrying the APOE-ε4 allele and cerebral amyloid angiopathy (CAA). Drug-related risk factors for ARIA include higher drug doses, early initiation of treatment, and concomitant use of antithrombotic medications, all of which increase the likelihood of vascular disruptions. Management of ARIA involves regular MRI monitoring and possibly temporary or permanent discontinuation of therapy if adverse effects develop during therapy. A gradual dose titration is recommended to minimize the risk of ARIA. Although antiamyloid therapies have demonstrated efficacy in reducing amyloid burden, the clinical benefit remains at best modest and must be weighed against the risks of developing adverse effects such as ARIA.

Cardiometabolic risk factors in women: what's sauce for the goose is not sauce for the gander.

The aim of this review was to discuss cardiometabolic risk factors that affect women. Recent calls to action to address cardiometabolic risk factors specific to women relate to increasing evidence of sex-specific differences in patient-related, drug-related, and socio-demographic factors leading to sub-optimal care of women. Certain aspects of common modifiable cardiovascular risk factors (e.g. smoking, hypertension, dyslipidaemia and diabetes) affect female individuals more adversely. Additionally, there are risk factors or enhancers that particularly affect cardiometabolic health in women [e.g. premature menopause, polycystic ovarian syndrome (PCOS), familial partial lipodystrophy, socio-cultural factors]. Understanding these risk factors may provide insight on how to improve cardiometabolic outcomes in women.

Lichen planus following COVID-19 vaccination: a narrative review.

Lichen planus (LP) is an inflammatory disease that afflicts the skin, mucous membranes and cutaneous appendages. Moreover, LP represents a prototype of lichenoid dermatosis, being characterized by the presence of a dense dermal cell infiltrate. Although most cases of LP are idiopathic, infectious and drug-related factors must also be considered in the aetiology. In this context, the occurrence of LP and lichenoid drug eruptions following different types of vaccination is a possible event. Therefore, the aim of our review is to provide a broad perspective to clinicians by analysing the current literature of cases of LP and lichenoid eruptions following COVID-19 vaccination, and also investigating the possible pathogenetic mechanisms underlying this phenomenon. In total, 61 cases of LP and lichenoid eruption following COVID-19 vaccination have been collected. However, the number of cases of LP and lichenoid drug eruption is extremely low compared with the number of vaccines administered overall, suggesting that the risk of LP and lichenoid eruption following COVID-19 vaccination is extremely low. Certainly, further studies are desirable to identify the population most at risk and the possibility of taking preventive measures.

Unraveling the fatigue puzzle: insights into the pathogenesis and management of IBD-related fatigue including the role of the gut-brain axis.

A significant percentage of patients with an inflammatory bowel disease (IBD) encounter fatigue which can profoundly diminish patients' quality of life, particularly during periods of disease remission when gastrointestinal symptoms have receded. Various contributing risk factors have been identified including active inflammation, anemia, psychological, lifestyle and drug-related factors. While addressing these risk factors has been suggested as the initial approach to managing fatigue, a considerable number of patients still experience persisting symptoms, the primary causes of which remain incompletely understood. Recent insights suggest that dysfunction of the gut-brain axis may play a pathogenic role. This review provides an overview of established risk factors for fatigue, alongside emerging perspectives on the role of the gut-brain axis, and potential treatment strategies.

Agenesis of all premolars – the first reported case

Abstract The agenesis of teeth is the most common developmental anomaly in humans. Although third molars, mandibular second premolars, maxillary lateral incisors and maxillary second premolars are frequently found to be missing, the absence of all premolars has never been reported in the literature. This case report highlights the first-ever case of the complete agenesis of premolars in a 10-year-old male patient. It also discusses related definitions; commonly missing teeth and their prevalence; associated dental and skeletal features; genetic, drug-related and pathogenic etiological factors; and considerations for the future management of such cases.

Drug-induced acute kidney injury in patients of the Military University Regional Hospital of Constantine

Introduction. Renal drug toxicity is the most frequent aspect of drug-induced acute kidney injury (Drug-induced AKI). This study aims to determine the incidence of drug induced AKI, and to study the clinical, biological and evolutionary characteristics of adult patients with AKI at Regional Military Hospital of Constantine (RMHC). Methods. this is prospective study, over a period of two years, from January 2017 to December 2018, interesting patients with drug-induced AKI hospitalized or seen at the outpatient clinic at RMHC. Variables were collected in a pre-established data collection form. Data entry and analysis were carried out using SPSS software version 20.0. Results. A total of 104 cases of drug-induced AKI were included in the study out of 636 AKI diagnosed from all causes, an incidence of 16.35%. Mean age was 60.48 ± 16.59 years, with a sex ratio M/F of 1.21. Drugs altering renal autoregulation were responsible for 51% of drug-induced AKI; followed by combinations of several nephrotoxic drugs in 15.4% of cases; chemotherapy products in 11.5%; contrast products in 9.6%; and antibiotics in 5.8%. At 6 months of the AKI episode, 20% of our patients recovered a GFR&gt; 60 ml / min, 55.8% presented a chronic kidney disease (CKD) stage 3, 15.8% CKD stage 4 and 8.4% CKD stage 5. Our study identified some factors of poor prognosis for progression to CKD, such as advanced age, history of diabetes and cancer, significant proteinuria, drug-related factors represented by chemotherapy products, concomitant intravenous and enteral route of administration as well as prolonged exposure to the drug, hypertensive patients under chemotherapy or Drugs altering renal autoregulation, and diabetic under chemotherapy or non steroidal anti-inflammatory drugs (NSAID). Conclusions. Subjects with drug AKI are at risk of developing CKD. Preventive measures should be taken by carefully prescribing the drugs identified in this study.

Abstract 3560: Quantified kinematics and wearable sensors to predict serious adverse events in patients undergoing cancer therapy trials

Abstract Background: Serious adverse events (SAEs) are a critical determinant of drug toxicity in clinical trials. However the drivers of toxicity may be related to patient factors as much or more than drug related factors. Prior studies have shown that time in non-sedentary activity predicted toxicity in cancer patients receiving highly emetogenic chemotherapy. SAEs are a critical determinant of drug toxicity in clinical trials. However, predicting SAEs using conventional PS scales measurements, such as ECOG is challenging because measurements can vary among observers. Prior studies have used activity trackers to measure physical activity and showed that time spent in non-sedentary activity predicted toxicity in cancer patients receiving highly emetogenic chemotherapy. Here, we sought to extend these findings to early phase clinical trial participants by examining data collected in two single-arm, observational, prospective studies at USC Keck and MD Anderson centers. We explored the use of out-of-clinic wearable sensors as an objective metric of frailty so as to identify patients at risk for therapy complications. Methods: Adult patients diagnosed with cancer and enrolled in early stage clinical trials across USC Keck and MD Anderson centers were included in parallel single-arm, observational, prospective studies. Patients used a consumer grade wearable activity tracker (Fitbit) and the study examined associations between the number of severe adverse events to activity levels measured by metabolic equivalents (METs) and get-up-go times across the first 30 days. Trends were assessed using t-tests. Results: 36 eligible patients were included in METs activity analysis. There was a total of 16 recorded incidences of SAEs within the first 30 study days, with 10 patients experiencing at least one SAE. The median non-sedentary time for patients with no SAEs was 27.5 hours above 1.5 METs per week, compared to 21.5 hours for those with at least one SAE occurrence (p-value=0.0146, r2=0.1629). The median get-up-go times for those without SAEs was 10.0 seconds (n=26) and with SAEs was 9.8 seconds (n=10), (p-value=0.828, r2=0.0014). Conclusions: Non-sedentary time, as an objective measure of activity, can be used to identify those patients who are at greatest risk for SAEs in clinical trials. Widely available and inexpensive consumer grade sensors can be used as a stratification tool. Findings should be confirmed in larger patient cohorts across a wider variety of trial settings. Figure 1: Weekly non-sedentary hours vs. presence of SAE in first 30 days of trial enrollment Citation Format: Eli Tran, Luciano Nocera, Anand Kolatkar, Anthony El-Khoueiry, Jacob Thomas, Peter Kuhn, Andrew Zeng, Megumi Kai, Meghan Karuturi, Jorge Nieva. Quantified kinematics and wearable sensors to predict serious adverse events in patients undergoing cancer therapy trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3560.

Drug induced Parkinson’s: A comprehensive review of the issues and measures required to tackle the same

Drug-inducedParkinsonism(DIP) closelyresemblesParkinson'sdisease(PD)inmotorsymptoms butiscausedbyspecificmedicationsdisruptingdopaminereceptorsandneurotransmitterbalance. PD involves a complex interplay of genetic, environmental, and biochemical factors resulting in the gradual degeneration of dopaminergic neurons. Environmental toxins and genetic mutations, such as LRRK2 and SNCA, contribute to the risk of developing PD. DIP primarily occurs due to the obstruction of dopamine receptors by certain drugs, notably antipsychotics and antiemetics, affecting dopamine transmission and causing Parkinsonian symptoms. Toxin-induced Parkinsonism(TIP)arisesfromexposuretosubstanceslikemanganese,herbicides,pesticides,and specific drugs, disrupting dopaminergic pathways and altering neurotransmission. This study examines various cases of DIP, emphasizing the significance of timely identification and intervention. A thorough understanding and proactive management of DIP are crucial for alleviatingsymptomsandimprovingpatientoutcomes.Healthcareprofessionalsneedtodiligently monitor patients using medications associated with DIP, adjust treatment plans, and educate patientsaboutpotentialsideeffects. Further researchisimperativetounravelthepathophysiology of DIP, considering genetic, environmental, and drug-related factors, to enhance clinical practices and optimize patient care. Addressing DIP requires a multifaceted approach, including early recognition, thoughtful management, and patient-centred care.

Risk Factors Associated With Drug-Related Side Effects in Children: A Scoping Review.

Objective. Children's vulnerability to drug-related side effects has been highlighted in several studies. However, there is no consensus on the risk factors associated with these side effects. This study aimed to investigate risk factors associated with drug-related side effects in children. Methods. This scoping review was conducted across multiple databases. The search strategy was created with a focus on drug-related side effects, as they are more predictable based on the pre-determined risk factors. Data were collected, and reported narratively. Results. The demographic, health, hospital, and drug-related risk factors may cause drug-related side effects in children. Among them, low age, sex, polypharmacy, length of hospitalization, and medications used for comorbidities may increase the risk. Conclusion. While most of the risk factors might be similar in adults and children, their impact might be different in these 2 groups. Therefore, future studies should identify more details about the impact of the risk factors in children.

Evaluation of Drug-Related Problems of Intensive Care Unit Patients by Clinical Pharmacists: A Retrospective Study.

The study aimed to identify drug-related problems (DRPs) and risk factors associated with the emergence of DRPs in intensive care unit (ICU) patients. This retrospective study included patients in the anesthesiology and reanimation ICU of a university-affiliated tertiary care hospital. DRPs identified by clinical pharmacists were classified using the Pharmaceutical Care Network Europe Classification for DRPs version 9.1. The association between various patient-related factors, and having DRPs were evaluated. In total, 222 patients were included in the study, 128 of which were male (57.7%). The number of DRPs was 388 in 135 patients (1.75 ± 2.47 DRPs per patient). The group in which at least 1 DRP was identified, the duration of hospitalization was longer than in the group in which no DRP was identified (p < 0.001). In the groups in which there was the presence of mechanical ventilation support at admission or mortality, the mean DRP count was significantly higher than that in the other group (p < 0.05). Age, duration of hospitalization, and the Acute Physiology and Chronic Health Evaluation (APACHE) II score at admission had positive relationships with the DRP count, but the Glasgow Coma Scale (GCS) showed a negative relationship (p < 0.05). According to the binary logistic regression analysis (p < 0.001), in which the age of the patient, GCS score, APACHE II score at admission, duration of hospitalization, and presence of mechanical ventilation support at admission were included, only the APACHE II score at admission and duration of hospitalization significantly affected the emergence of DRPs. The major problem was related to treatment effectiveness (47.9%), followed by treatment safety problems (29.9%). The major causes of these problems were dose selection (44.0%) and drug selection (36.8). Interventions were made at the drug (97.2%) and prescriber level (2.3%). The acceptance rate of interventions and resolution rate of the DRPs were 93.6% and 85.1%, respectively. The top three medications that caused DRPs the most were as follows: meropenem, colistin, and piperacillin/tazobactam. Clinical pharmacists can detect and treat DRPs quickly. Our analysis shows that clinical pharmacy services are needed in high-DRP wards like ICU.

Anthelmintic resistance in soil-transmitted helminths: One-Health considerations

The One-Health approach recognizes the intricate connection between human, animal, and environmental health, and that cooperative effort from various professionals provides comprehensive awareness and potential solutions for issues relating to the health of people, animals, and the environment. This approach has increasingly gained appeal as the standard strategy for tackling emerging infectious diseases, most of which are zoonoses. Treatment with anthelmintics (AHs) without a doubt minimizes the severe consequences of soil-transmitted helminths (STHs); however, evidence of anthelmintic resistance (AR) development to different helminths of practically every animal species and the distinct groups of AHs is overwhelming globally. In this regard, the correlation between the application of anthelmintic drugs in both human and animal populations and the consequent development of anthelmintic resistance in STHs within the context of a One-Health framework is explored. This review provides an overview of the major human and animal STHs, treatment of the STHs, AR development and drug-related factors contributing towards AR, One-Health and STHs, and an outline of some One-Health strategies that may be used in combating AR.

Risk factors for drug-related acute pancreatitis: an analysis of the FDA adverse event reporting system (FAERS).

Objective: While several drugs have been linked to acute pancreatitis (AP), the AP-related risk of most drugs remains unclear. This study investigated the risk factors for drug-induced AP by analyzing a large dataset from the FDA Adverse Event Reporting System (FAERS). Methods: The reporting odds ratios (ROR) were used to assess the reports of drug-induced AP from the first quarter of 2004 to the second quarter of 2022. Single-factor, LASSO, and multi-factor regression analysis were performed to explore drug-related AP-related risk factors. Bonferroni correction was applied for the multiple comparisons performed. Results: A total of 264 drugs associated with AP, including antineoplastic drugs (35/264), antidiabetic drugs (28/264), antibacterial drugs (24/264), immunomodulatory drugs (11/264), antipsychotic drugs (6/264), and other drugs (160/264) were retrieved. Multi-factor analysis showed that males, age 41-54years old, and 36 drugs, including Tigecycline, were risk factors for drug-related AP. The median time to drug-related AP onset was 31days (interquartile range [IQR] 7-102days) and about 75% of adverse events occurred within 100days. Conclusion: These findings may help clinicians to identify drug-related AP at the early stage and can be used to inform future studies of drug-related AP pathogenesis.

Risk factors for abnormal glucose metabolism during antipsychotic treatment: A prospective cohort study

Antipsychotic medications increase the risk of abnormal glucose metabolism. However, in clinical practice, it is difficult to predict this risk because it is affected by medication-related and background factors. This study aimed to identify the risk factors for abnormal glucose metabolism during antipsychotic treatment. We conducted a multicenter, prospective, cohort study in patients with schizophrenia, schizoaffective disorder, or bipolar disorder. Of these patients, those with prediabetes or possible diabetes were excluded. Finally, 706 patients were included in the analysis. The hazard ratio (HR) for each factor was calculated for events of progression to hyperglycemia using time-dependent Cox regression analysis stratified according to facility type and adjusted for available background and drug-related factors. Treatments with olanzapine (HR = 2.06, 95% confidence interval [CI] = 1.05–4.05), clozapine (HR = 4.25, 95% CI = 1.56–11.60), and chlorpromazine (HR = 4.48, 95% CI = 1.21–16.57), overweight and obesity (HR = 1.57, 95% CI = 1.02–2.41), and hypertriglyceridemia (HR = 1.72, 95% CI = 1.02–2.88) were associated with a significantly higher occurrence of hyperglycemic progression. The number and daily dose of antipsychotics were not associated with their occurrence. Our study demonstrated that more careful monitoring is necessary during olanzapine, clozapine, and chlorpromazine treatment because of the higher occurrence of abnormalities in glucose metabolism. Furthermore, patients with obesity or hypertriglyceridemia warrant monitoring for the occurrence of abnormal glucose metabolism, regardless of the type of antipsychotic medication.

Risk factors for medication-related short-term readmissions in adults – a scoping review

BackgroundHospital readmissions due to medication-related problems occur frequently, burdening patients and caregivers emotionally and straining health care systems economically. In times of limited health care resources, interventions to mitigate the risk of medication-related readmissions should be prioritized to patients most likely to benefit. Focusing on general internal medicine patients, this scoping review aims to identify risk factors associated with drug-related 30-day hospital readmissions.MethodsWe began by searching the Medline, Embase, and CINAHL databases from their inception dates to May 17, 2022 for studies reporting risk factors for 30-day drug-related readmissions. We included all peer-reviewed studies, while excluding literature reviews, conference abstracts, proceeding papers, editorials, and expert opinions. We also conducted backward citation searches of the included articles. Within the final sample, we analyzed the types and frequencies of risk factors mentioned.ResultsAfter deduplication of the initial search results, 1159 titles and abstracts were screened for full-text adjudication. We read 101 full articles, of which we included 37. Thirteen more were collected via backward citation searches, resulting in a final sample of 50 articles. We identified five risk factor categories: (1) patient characteristics, (2) medication groups, (3) medication therapy problems, (4) adverse drug reactions, and (5) readmission diagnoses. The most commonly mentioned risk factors were polypharmacy, prescribing problems—especially underprescribing and suboptimal drug selection—and adherence issues. Medication groups associated with the highest risk of 30-day readmissions (mostly following adverse drug reactions) were antithrombotic agents, insulin, opioid analgesics, and diuretics. Preventable medication-related readmissions most often reflected prescribing problems and/or adherence issues.ConclusionsThis study’s findings will help care teams prioritize patients for interventions to reduce medication-related hospital readmissions, which should increase patient safety. Further research is needed to analyze surrogate social parameters for the most common drug-related factors and their predictive value regarding medication-related readmissions.

Factors Influencing Adherence to Antiretroviral Therapy among HIVpositive Youth Patients Attending ART Clinic in Kiryandongo General Hospital Kiryandongo District

This research aimed to assess the factors influencing adherence to antiretroviral therapy (ART) among HIV-positive youth patients attending the ART Clinic in Kiryandongo General Hospital, Kiryandongo District. The study utilized a descriptive cross-sectional research design, with a sample of 355 respondents between the ages of 10 and 25 who were receiving antiretroviral treatment. The study found a low level of adherence to antiretroviral treatment (33%), significantly lower than the national target of 90%. Adherence was influenced by various individual, drug-related, and healthcare factors. Individual factors included gender, age, marital status, education, place of residence, family size, and religion. Drug-related factors included having all the required drugs, challenges with the drugs, the frequency of taking ARV pills, challenges during medication intake, and accessibility to ARV drugs. Health-related factors encompassed routine education and counseling, sources of information, proximity to healthcare facilities, distance from home to the facility, availability of ARVs on appointment days, availability of healthcare workers, frequency of ARV refill visits, and waiting time during appointments. The low adherence was attributed to missing doses due to stigma, forgetfulness, drug stockouts, lack of routine education about ART, long distances to healthcare facilities, inadequate information, and extended waiting times. Keywords: HIV, Antiretroviral therapy, Adherence, Youths, Stigma

Influence of underlying disease and immunosuppression on the immunocompetence in inflammatory rheumatic diseases

Patients with inflammatory rheumatic diseases have ahigher risk of infections in comparison to the general population. For this patient group, in addition to cardiovascular diseases, infections play an important role with respect to morbidity and mortality. Even if it is difficult to make concrete statements with respect to individual diseases, it can be assumed that there is alower risk of infections in inflammatory joint diseases in comparison to connective tissue diseases and vasculitides. The increased risk of infections is determined by multiple factors, whereby the underlying factors are classified into three main categories: patient-related factors (age, comorbidities, lifestyle), disease-related factors (immunological dysfunction as part of the disease pathophysiology) and drug-related factors (type and dosage of the immunosuppression and/or immunomodulation). An improved understanding of the complexity of these associations enables the optimization of treatment and disease control taking the individual risk factors into account, with the aim of asignificant reduction in the risk of infections.

Clinical Profile of Patients Presenting With Recurrent Stroke at a Tertiary Care Center

Background: Recurrent stroke provides a higher risk of fatal or debilitating complications than a first-time stroke. Over the past 40 years, the death rate from initial strokes has reduced, but the number of people at risk for subsequent strokes has grown. In order to help doctors, prescribe the most effective treatment options to lower the risk of recurrent stroke while also informing patients about the risk factors involved and strategies to reduce stroke recurrence, this study was aimed at determining the proportion and the underlying risk factors involved in recurrent stroke.&#x0D; Methodology: Total 84patients with recurrent stroke were studied at a single centre. A detailed history was taken and neurological examination relevant to stroke was performed. Baseline investigations like CH LFT, KFT, RBS, Lipid Profile and Chest X-Ray were done. Diagnosis of the stroke was confirmed by CT/MRI of the brain.&#x0D; Results: The prevalence of recurrent stroke was 25.8%. Among risk factors, alcohol consumption was reported in 34.5% of recurrent cases, smoking reported in 32.1% cases, tobacco use found in 9.5% cases, diabetes mellitus occurred in 53.57% cases and hypertension encountered in 82.1% patients. The cause of recurrence involved patient related factors in 75% cases, drug related factors in 2.4% cases and disease related factors in 45.2% cases.&#x0D; Conclusion: Present study concluded that recurrent stroke is common in our area. The most common factor responsible for recurrence is the patient related factors.&#x0D; Keywords: Recurrent stroke, Tertiary care center, Clinical profile, Neurological examination