Objective:The general objective of this study was to analyse the utilization patterns of cardiovascular drugs among a sample of patients in a tertiary healthcare setting during the preceding two years. Methodology: This study design was exploratory, descriptive and retrospective. Data were extracted from the case sheets pertaining to patients who had been admitted to the study site and administered CV drugs during the preceding two years, into customized data collection format. A total of 100 patient data were obtained, based on the inclusion criteria. The data collected were then analyzed by SPSS v22. Results: A total of 29 males (28.4%) and 73 females (71.6%) data were analysed. The majority of the patients were in the age range 50-55 years. Among the ethnic groups, the Malays (72.5%) were the highest, followed by Indians (14.7%) and the Chinese (11.8%). The co-morbidities observed among the sample are depicted in Table 1 with p < 0.001 (Chi-square test). It was noted that the combination of HTN +DM was the most observed (18.6%). Among the CV medications, statins (54.9%), antiplatelets (39.2%), anticoagulants (26.5%) and beta-blockers (33.3%) were more commonly used for these patients. Conclusion: The usage of all these medications was in accordance with the national guidelines in Malaysia. The mean CV drug count was 3.16, which though optimal might be indicative of potential non-compliance among patients.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
Background
Olanzapine is a commonly used atypical antipsychotic in the management of schizophrenia. Its well‐known adverse effects include sedation, weight gain and metabolic adverse effects. Enalapril is widely used as an antihypertensive with the known adverse drug effect of hyperkalaemia.
Aims
To report a very rare adverse effect of enalapril and olanzapine induced severe hyponatraemia.
Clinical details
A 56‐year‐old lady was admitted to the hospital suffering from severe lethargy, decreased oral intake, and a decreased level of consciousness. She had been taking olanzapine 10 mg once at night for the past one and a half years and enalapril 5 mg twice daily for the past three years. Laboratory investigations revealed a plasma sodium level of 110 mmol/L, blood osmolality of 244 mosm/kg and urine osmolality of 512 mosm/kg. A diagnosis of SIADH (syndrome of inappropriate diuretic hormone) was made. Enalapril and olanzapine were suspected as causative agents as there was no other apparent cause of SIADH identified.
Outcome
Patient was treated with normal saline in the ward and her plasma sodium level rose to 130 mmol/L.
Conclusion
Enalapril or olanzapine induced hyponatraemia is extremely rare. However, healthcare professionals should be aware that patients being treated with enalapril or olanzapine alone or in combination can develop hyponatraemia in addition to their known metabolic adverse effects. Sodium level monitoring is necessary if patient develop symptoms suggestive of hyponatraemia.
Background: Obesity is a complex and multifactorial disease that is strongly associated with multiple comorbidities and mortality. Weight reduction in overweight and obese patients was highly desired to minimize future complications. Meal replacement is emerging as one of the effective tools to promote weight loss. Isoflavones and soy protein present in soybean are able to promote weight loss and alleviate obesity. Aim: Our systematic review aims to investigate the weight loss effect of soy-based meal replacement among the overweight and obese population. Methods: We will conduct a systematic review of RCTs that evaluated the effect of a soy-based meal replacement on weight loss in overweight and obese patients. The primary outcome of this review is weight loss. Besides that, we will assess BMI, body fat, waist circumference and hip circumference as the secondary outcome. We will search PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. Two reviewers will independently screen titles and abstracts, review full texts, extract information and assess the risk of bias of individual studies. We will conduct meta-analyses using a random-effect model if sufficient data are available. If meta-analysis is not performed, we will present a systematic qualitative synthesis. Summary: This systematic review will identify the weight loss effect of soy-based meal replacement among the overweight and obese adult population. We expect the result may strengthen the evidence on the role of soy-based meal replacement in optimal body weight management.
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