Title: Incidence of medical comorbidities and allergies among patients visiting the Oral diagnosis department at CMH LMC and IOD Lahore
Biography:
Pakistan
Abstract
ABSTRACT
Objective: To determine the incidence and type of different drug allergies and medical comorbid conditions in individuals presenting to Oral medicine department.
Study Design: Systematic reviews/meta-analysis
Place and Duration: Outpatient Department (OPD) of oral medicine and diagnostics department of CMH medical college Lahore, from June 2023 to September 2023.
Methods: A total of 6462 patients with significant medical history were included for conducting this study. Patients’ histories were obtained through a computerized system which included separate sections for medical alerts and drug allergies. The variables used were gender, medical comorbid conditions and drug allergies.
Results: Among the 6462 individuals in this study, 46% were males, and 53% were females. The most prevalent comorbid condition was hypertension, followed by diabetes. Penicillin drug allergy had the highest incidence, followed by NSAIDs and sulfonamides.
Conclusion: Individuals seeking oral medicine frequently presented with medical comorbid conditions and drug allergies. The most prevalent medical alerts were hypertension, diabetes, hep B, and asthma, with penicillin allergy being the most common. It’s crucial to document these alerts and allergies for improved patient care, management, and to prevent potential medical emergencies resulting from insufficient patient assessment by dental practitioners.
Key words: comorbid, hypertension, penicillin, NSAIDs, sulfonamides.
INTRODUCTION
Clinical or a dental audit is a technique That fouses on improving quality of type of care provided to patient by systematically evaluating care, based on clear criteria.
The potential for clinical audit in Expansive and rapidly growing field of dentistry is endless. (1)
In this realm of dentistry, it’s crucial to highlight all medical allergies since every drug class commonly employed in dental practice maybe involved. When documented in a patients record it’s essential to explore the nature of the reaction since many patients may misconstrue allergic reactions with intolerances. E.g sometimes patient confuses side effects of a medicine with allergy. This is important to document to avoid giving patients medications they are allergic to. (02) The existence of comorbidities is a significant concern associated with poorer health outcomes and increased medicinal cost.
Comorbidity refers to the presence of one or more added medical illness along with the presenting ailments. It is that challenge which is quite hard to handle and many individuals are still oblivious to it. (05)
Many patients that present to dental OPD with their oral health issues are mostly ignorant of the importance of giving a detailed medical history which includes their existing medical conditions. This is due to various reasons ; sometimes they are not comfortable sharing, or sometimes they think it’s not related to their dental issue or sometimes simply they’ are unaware of presence of any existent medical condition. Many times they do not share their previous illnesses or surgeries because they feel it has been treated. (1)
The dental practitioner must grasp the potential complications arising from dental treatment in medically compromised patients and discern when pre or post treatment medications or emergency care is warranted. Therefore, it’s crucial for a dentist to thoroughly gather a patient’s medical history before any therapeutic procedure. Overlooking certain medical conditions could result in adverse consequences and repercussions.(22)
We planned this study to evaluate the incidence of different medical conditions and drug allergies based on the history provided, among the patients reporting with oral diseases at Oral Medicine Department of Institute of Dentistry, CMH medical college Lahore.
With this gathered information, we can help our House Officers and dental practitioners with providing the best dental treatment to medically compromised patients whilst keeping their safety in mind and avoiding any medical emergency on a dental unit.
METHODOLOGY
ETHICAL COMMITTEE APPROVAL
After approval from ethical committee, all patients which reported to the oral medicine department of CMH Lahore for general OPD before referrals to other departments were included collectively from June 2023 to September 2023.
SAMPLE COLLECTION
Patient details were obtained from history forms, which featured dedicated sections for medical alerts and known allergies. This information was entered into computers for record-keeping purposes. Furthermore, specific inquiries about drug allergies were made and meticulously documented to ensure the accuracy of information provided by the patients.
The variables used for this study included gender , allergies and medical comorbidities such as diabetes, ischemic heart disease, hypertension, HEP B and C, psychiatric and bleeding disorders.
RESULTS
Out of a total of 6462 individuals included in this study 3011 (46%) were males and 3451 (53%) were females as shown in table 1.
Common comorbid conditions that were observed were hypertension, Diabetes Mellitus, Asthma, Hep B, Acid reflux disease, epilepsy, depression, bleeding disorders and others. Out of these 258 patients had Hypertension, making it the most common comorbid condition followed by diabetes (190) and then Hep B and Asthma ( 44 and 43 respectively) as shown in figure 2.
When allergies to drug classes were recorded, 18 patients were found to allergic to Penicillin which was the highest. 12 patients were found allergic to NSAIDs and 9 patients were found allergic to Sulfonamides as shown in figure 3.
Number of patients from June 2023 to September 2023