SHORT COMMUNICATION-Inappropriate use of proton pump inhibitor for stress ulcer prophylaxis in a tertiary care hospital in Karachi, Pakistan.

The use of proton pump inhibitors (PPI) has been expanded inappropriately. PPI are among the most selling drugs in the world. There is growing evidence that PPI are associated with significant adverse effects along with undue financial burden. Inappropriate prescription of PPI is common in inpatients. The objective is to determine the frequency of inappropriate use of proton pump inhibitors for stress ulcer prophylaxis. This prospective observational study was conducted in the Department of Medicine of The Aga Khan University Hospital Karachi. 151 adult patients admitted in the hospital were included. All those patients who received PPI due to a condition mentioned by American Gastroenterology Association (AGA) as an indication for PPI, were labeled as PPI appropriately indicated. While those patients who received PPI without a condition mentioned by AGA as an indication for PPI, were labeled as PPI inappropriately indicated. Mean age was 57.2±18.2 years. Route of administration was oral in 110 (72.8%) and IV in 41 (27.2%) patients. Out of 151 patients, 100 (66.2%) patients were receiving PPI without any specific indication while 51 (33.8%) patients were receiving PPI with appropriate indications. Our study showed that inappropriate use of PPI is quite common among admitted patients.

Factors Influencing Tooth Sensitivity: Insights From the Hospital Universiti Sains Malaysia Using Bootstrap-Enhanced Ordinal Regression.

Introduction Tooth sensitivity, or dentin hypersensitivity (DH), is characterized by sharp, sudden pain in response to stimuli such as cold, heat, sweet, or acidic foods and drinks. In Malaysia, there is limited understanding of the epidemiological aspects of tooth sensitivity, necessitating focused research. The condition results from the exposure of dentinal tubules transmitting stimuli to nerves within the pulp, with contributing factors including gingival recession, enamel erosion, and periodontal disease. This study aims to investigate the factors associated with tooth sensitivity among patients at the Hospital Universiti Sains Malaysia (USM) using advanced statistical methods. Methods This study employed a computational research design to develop an ordinal regression and bootstrap methodology using the RStudio software (Posit PBC, Boston, MA) to analyze secondary data from the Hospital Universiti Sains Malaysia. Six variables were analyzed: tooth wear severity, patient's age, gender, smoking status, alcohol status, and type of toothbrush. The study was conducted in three phases: 1) the development of an ordinal regression model, 2) the development of algorithms for ordinal regression and bootstrap method, and 3) validation using tooth sensitivity data. Results The analysis revealed that the replication with 1000 samples provided the most precise estimates with small standard errors (SE) and consistently significant effects across variables. Tooth sensitivity was influenced by age, toothpaste type, toothbrush type, and brushing frequency. Conclusion The study highlights the importance of considering multiple variables such as age, toothpaste type, toothbrush type, and brushing frequency in understanding tooth sensitivity. The combined ordinal regression and bootstrap technique significantly improved the model's accuracy, providing valuable insights for dental health professionals. These findings underscore the need for specific guidelines on oral hygiene practices to manage and reduce the risk of tooth sensitivity.