Polypharmacy and pattern of medication use among patients with gastroesophageal reflux disease: results from Pars Cohort study

BACKGROUND

Gastroesophageal Reflux Disease (GERD) is a common chronic condition. Its chronic nature may affect the pattern of medication use. This study aimed to investigate the prevalence, associated factors, and patterns of polypharmacy and medication use among GERD patients in southwestern Iran.

METHODS

We used data from the Pars Cohort Study. We classified drugs using the Anatomical Therapeutic Chemical classification system. The Lexicomp® database was used to assess potential drug-drug interactions. Multivariable Poisson regression was applied. Adjusted prevalence ratio (PR) and its 95% confidence interval (CI) were estimated.

RESULTS

A total of 9262 participants were included. Among 2,325 patients with GERD, age-standardized prevalence of polypharmacy was 9.5% (95% CI: 7.5%, 11.6%) in males, and 19.3% (95% CI: 17.2%, 21.4%) in females. The PR of experiencing Polypharmacy by GERD patients compared to non-GERD patients was 1.82 (95% CI: 1.61, 2.05%). Multimorbidity (PR: 3.33; CI: 2.66, 4.15), gender (PR: 1.68; CI: 1.30, 2.18), and metabolic syndrome (PR: 1.77; CI: 1.45, 2.15) were associated with polypharmacy among GERD patients. Drugs for acid-related disorders were the most common used drugs among men, women and elders. We found that 13.9%, 4.2%, and 1.1% of GERD patients had type C, D and X drug interactions, respectively.

CONCLUSION

GERD is correlated with a higher prevalence of polypharmacy. Among GERD patients, females, those with multi-morbidities, and those with metabolic syndrome may be affected more by polypharmacy. Considering the fairly high rate of interactions identified, a review of the medication list is essential when approaching GERD patients, and physicians must check for medications that may worsen GERD.

Seborrheic keratosis in an adolescent: A rare presentation

Seborrheic keratosis is a common benign epidermal lesion that typically occurs in the elderly population. Its occurrence in childhood and adolescence is rare and can pose a diagnostic challenge for clinicians and dermatopathologists. We report a case of a 16-year-old boy with multiple brown, black oval-shaped stuck-on lesions on his face, which were diagnosed as seborrheic keratosis based on histological findings. The patient had no significant medical history or family history of seborrheic keratosis. In this report, we discuss the differential diagnoses of seborrheic keratosis-like lesions in childhood and adolescence and explain why they were not compatible with our case. We also review the available treatment options. Our case emphasizes the need for dermatologists to consider seborrheic keratosis in the differential diagnosis of cutaneous lesions in young patients.

First record of the gobiid fish Aulopareia ocellata (Teleostei: Gobiidae) from Qeshm Island, The Gulf, with discussion of its generic placement

The poorly known gobiid fish species Aulopareia ocellata is recorded for the first time from the intertidal zone of north-east Qeshm Island, The Gulf, Iran. The species has been referred to previously as Parachaeturichthys ocellatus, but here is placed in Aulopareia, pending a revision of the genus. The morphological features of A. ocellata are described and compared with congeners and brief comparisons of the genera Aulopareia and Parachaeturichthys are provided. A full description of the species is given, with illustration of the sensory papillae and head-pore pattern. This species has previously been recorded from India (Mumbai) and Pakistan (Karachi).