Readdressing the role of therapeutic drug monitoring for antiepileptic drugs – A tertiary care hospital experience

Background: Phenytoin is the most commonly used anti-epileptic drug (AED) in this set up due to cost effectiveness and easy availability. Significant fluctuations in serum phenytoin levels leading to toxicities or treatment failures make it an ideal candidate for therapeutic drug monitoring (TDM).Methods: Patients of age ≥18 years who were put on phenytoin were enrolled in this study. Estimation of serum phenytoin levels was done using HPLC. Data was analysed using SPSS version 20.0. Chi square test, Kruskal Wallis test were used to analyse the data.Results: A total of 105 patients enrolled in the study, twenty patients (19%) had normal or therapeutic serum phenytoin levels. Thirty-nine patients (37.2%) had sub therapeutic serum phenytoin levels, while forty-six patients (43.8%) had toxic serum phenytoin levels.Conclusions: The TDM of phenytoin should adopt a multi-disciplinary approach with active involvement of neuro-physicians, pharmacologists, pharmacists and other technical staff for improving the overall management of epilepsy. TDM data will provide the clinicians with greater insight into the factors determining the patient’s response to drug therapy.

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THE ROLE OF THE THERAPEUTIC DRUG MONITORING WHEN USING ANTIEPILEPTIC DRUGS

Epilepsia and paroxyzmal conditions ◽

10.17749/2077-8333.2016.8.3.066-073 ◽

2016 ◽

Vol 8 (3) ◽

pp. 66-73 ◽

Cited By ~ 1

Author(s):

A. V. Yakunina ◽

I. E. Poverennova

Keyword(s):

Therapeutic Drug Monitoring ◽

Antiepileptic Drugs ◽

Drug Monitoring ◽

Therapeutic Drug

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TO DETERMINE THE ROLE OF CA125 IN THE DIAGNOSIS OF ACUTE APPENDICITIS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i7.1276 ◽

2020 ◽

Vol 4 (7) ◽

Author(s):

Vinod Kumar ◽

Bhupen Songra ◽

Richa Jain ◽

Deeksha Mehta

Keyword(s):

Acute Appendicitis ◽

Clinical Diagnosis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Ca 125 ◽

Care Hospital ◽

Serum Samples ◽

Roc Curve Analysis ◽

Surgery Department

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.

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