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Biomedical subjects

Z M Khan

Publications and source records attributed to Z M Khan.

23 records · Page 2Linked to original sources
PubMed1991

Ambulatory blood pressure monitoring evaluation of a semi-automated device.

The accuracy of a semi-automated ambulatory blood pressure monitoring device (the Instrumedix 'Personal Blood Pressure Transmitter') was assessed in 36 patients undergoing diagnostic cardiac catheterisation. Blood pressure readings measured by the device and by a standard manual sphygmomanometer were compared with simultaneous intra-aortic pressure measured directly via the catheter. No measurement size trends were identified for either of the two comparisons. Compared to direct intra-aortic pressure measurement, the manual sphygmomanometer gave lower systolic (p less than 0.05), and higher diastolic readings (p less than 0.01), while the semi-automated device gave slightly higher readings for both systolic (not significant: p greater than 0.05) and diastolic (p greater than 0.05) pressure. In this assessment the semi-automated device provided at least as accurate a reflection of intra-aortic pressure as did standard manual sphygmomanometry. This device is an accurate tool for the ambulatory assessment of blood pressure where adequacy of treatment or correctness of the diagnosis is in question.

Adult↗
PubMed1991

Management of malignant ventricular arrhythmias using antitachycardia devices.

Cardioverter defibrillators were implanted in 26 patients at Charleston Area Medical Center for management of cardiac arrest (7 patients), and drug refractory sustained ventricular tachycardia (19 patients). A variety of operative approaches and concomitant surgical procedures were utilized in the implantation of these devices. No operative deaths occurred. A superficial wound infection was the only operative complication. During the follow-up period (9.3 +/- 5 months), 11 of 26 patients (46 percent) had a defibrillator discharge and one death occurred (3 percent), which was due to heart failure. Patients with malignant ventricular arrhythmias may present with sustained monomorphic ventricular tachycardia with associated syncope, pre-syncope or without any associated symptoms. Unfortunately, cardiac arrest may be the initial presentation. The use of antitachycardia devices such as implantable cardioverter defibrillators and antitachycardia pacemakers has allowed physicians to more successfully treat patients with malignant ventricular arrhythmias. In a significant number of patients with these arrhythmias, such devices are now used as first-line therapy.

Adult↗
PubMedDate not supplied

Retrospective analysis of the health-care costs of bupropion sustained release in comparison with other antidepressants.

OBJECTIVE: The objective of this study was to evaluate the health care costs associated with the treatment of a new episode of depression with bupropion sustained release (SR) rather than with other antidepressants (selective serotonin reuptake inhibitors [SSRIs], tricyclic antidepressants [TCAs], and serotonin norepinephrine reuptake inhibitors [SNRIs]). METHODS: This was a retrospective cohort study based on the private-pay, fee-for-service 1997 and 1998 MEDSTAT MarketScan databases. Individuals were included if they were 18 years of age or older, had an initial prescription for an antidepressant under study with an index prescription date between July 1997 and June 1998, and had a claim for a diagnosis of depression diagnosis within 30 days of the index date. All patients' claims from six months before and after receiving their index antidepressant prescription were examined. Total, outpatient, and pharmacy costs were compared among antidepressant groups using an intent-to-treat analysis with exponential regression models and bootstrapped 95% confidence intervals. RESULTS: A total of 1771 patients were included in the study cohort. The mean age was 41.6 years, and 69.5% of subjects were female. Most patients (75%) continued with the index antidepressant during the 6-month follow-up period. Although the drug acquisition cost was lowest for TCAs, total costs were significantly higher for patients treated with TCAs than for those treated with bupropion SR (p < .05). In comparison with bupropion SR, patients initiating therapy with sertraline had significantly higher mental health payments (p < .05). CONCLUSIONS: Initiating treatment of depression with bupropion SR was associated with lower total mental health care costs compared with TCAs and with sertraline. This study reaffirms that formulary and medical decision-makers should consider the overall impact of antidepressant treatment, including but not limited to drug acquisition costs, other health care costs, and drug efficacy and safety.

Adolescent↗