Zahra Qaempanah , Hossein Arab-Alibeik , Marjan I Ghazi Saeed, Mohammad Ali Sadr-Ameli,
Volume 73, Issue 4 (7-2015)
Abstract
Background: Warfarin is the most common oral anticoagulant. This drug is used for the prevention and treatment of thromboembolic patients. It is difficult for physician to predict the results of warfarin prescriptions because there is narrow boundary between therapeutic range and complications of warfarin. Therefore drug dose adjustment is normally performed by an expert physician. Decision support systems that use extracted knowledge from experts in the field of drug dose adjustment would be useful in reducing medical errors, especially in the clinics with limited access to experts. The aim of this study was to propose a method for boosting the maintenance dose of warfarin for a maximum period of three days to eliminate disruptions in International Normalized Ratio (INR).
Methods: In a retrospective study, from December 2013 to February 2014 in Shahid Rajaee Heart Center, Tehran, Iran, 84 patients with International Normalized Ratio below (INR) the therapeutic range was selected who was undergone a boosting dose during three days. Patients with unstable maintenance dose were excluded from the study. In this study, data from 75 patients receiving warfarin therapy were used for developing and evaluation of the proposed model. The INR target range for 37 patients out of remaining 75 cases was between 2.5 and 3.5, while for 38 patients the intended INR range was between 2 and 3. A separate fuzzy model was designed for each of the above-mentioned therapeutic ranges.
Results: The recommended dose for 37 patients having INR therapeutic range of 2.5 to 3.5 has mean absolute error and root mean squared error of 1.89 and 2.78 respectively for three days. These error rates are 1.97 and 2.88 respectively for 38 patients who are in therapeutic range 2 to 3.
Conclusion: The results are promising and encourage one to consider this system for more study with the aim of possible use as a decision support system in the future.
Mojdeh Bahadorzadeh, Mostafa Vahedian, Mostafa Vahedian, Elaheh Khan Babaei , Pouya Derakhshan-Barjoei ,
Volume 81, Issue 6 (9-2023)
Abstract
Background: Gastrointestinal ulcers occur due to an imbalance between the defense mechanisms of the gastric mucosa and damaging forces, especially gastric acid and pepsin. Overall, complications occur in 10%-20% of these patients, and 2%-14% of wounds eventually perforate. The use of non-steroidal anti-inflammatory drugs, steroids, smoking, Helicobacter pylori and high salt diet can be mentioned as important etiologies in this regard.
Methods: In this study, the information of patients with peptic ulcer who referred to Beheshti Hospital from 2019 to 2022 was analyzed. They were divided into two groups with perforation and without perforation. Then the variables of age, sex, smoking, NSAID and opium use, Helicobacter pylori infection and proton pump inhibitor use and previous history of peptic ulcer were investigated in two groups.
Results: The findings of the present study showed that the average age in the group with perforation was 48.7 and in the group without perforation was 42.04. In the non-perforated group, 58.5% of the patients were male, and in the group with perforation, 82.2% of the patients were male. In terms of smoking, 29.6% were smokers in the group without perforation and 50.4% were smokers in the group with perforation. Opium consumption was about 15.6% in people without perforation and about 33.3% in people with perforation. In terms of NSAID use, the prevalence was 35.6% in the group without perforation and 27.4% in the group with perforation. PPI consumption was 46.7% in the group without perforation and 21.5% in the group with perforation. In terms of the prevalence of H.pylori infection, the prevalence in the non-perforated group was 45.2% and in the perforated group it was 30.4%. The previous history of PUD was 56.3% in the non-perforated group and 37.8% in the group with perforation.
Conclusion: There was a significant difference between cigarette and opium consumption in the perforated and non-perforated groups, and PPI consumption in these two groups. In general, the prevalence of PUD was higher in males in both perforated and non-perforated types. Fuzzy results also confirmed the effect of risk factors concordance with perforation. |
