Here we presented a case of Citrullinemia type 1 in a full term male neonate who presented with an acute catastrophic collapse on the 3rd day of life. The key features of increasingly poor feeding, vomiting and progressive lethargy with or without seizures should quickly direct towards a metabolic origin. This case report also shows the importance of early biochemical and metabolic screening in newborns, to reach an early and definitive diagnosis of IEM and proper management of such cases. .
Excellence (NICE) guidelines. Multivariable logistic regression was performed to examine the association between non-indication based PPI use and various patient and physician-level characteristics using 2008-2010 NAMCS data. RESULTS: The use of PPIs increased from 5.29% patient visits in 2002 to 11.82% in 2010 (p< .0001). Prescription of PPI without an appropriate indication by primary care physicians (54.26% to 48.84%), medical specialists (35.21% to 35.62%) and surgeons (10.52% to 15.53%) did not change significantly between 2005-2010 (p= 0.55). Additionally, 80.12% of patient visits involved PPI prescriptions without an appropriate indication. Results of multivariable logistic regression revealed that, patients with more than 3 chronic conditions were significantly more likely to be prescribed a PPI without an appropriate indication as compared to patient visits without a chronic condition (Odds Ratio (OR) = 2.49, 95% Confidence Interval (CI): 1.26-4.94). CONCLUSIONS: PPI use among the elderly increased significantly over the study period, with 8 out of 10 patient visits involving PPI prescriptions without an appropriate indication. Additionally, the study found no change in PPI prescribing trend across physician specialties. These findings suggest the need to improve quality of PPI prescribing in the vulnerable elderly population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.