Oral anticoagulants are widely used to prevent and treat thromboembolic disorders, but inappropriate use can increase adverse effects and reduce therapeutic efficacy. This study evaluated the utilization patterns, dosing appropriateness, and adverse effects of oral anticoagulants in a tertiary hospital in Iran. A retrospective cross-sectional study was conducted at Razi Educational Hospital, Birjand University of Medical Sciences, from April 2020 to September 2022. Data were collected from medical records and pharmacy databases for patients aged ≥18 years who received warfarin, rivaroxaban, or apixaban. Dosing appropriateness was assessed using 2021 European Heart Rhythm Association (EHRA) and UpToDate guidelines, while adverse effects were classified according to 2020 American College of Cardiology (ACC) criteria. Among 1,027 patients (mean age 64±16.4 years; 52.3% male), rivaroxaban was the most prescribed anticoagulant (43.5%), followed by warfarin (33.2%) and apixaban (23.3%).Warfarin was primarily used for valvular heart disease, whereas DOACs were mainly prescribed for non-valvular atrial fibrillation and venous thromboembolism. Adverse effects occurred in 12.1% of patients, mostly minor bleeding, with warfarin accounting for the majority. Guideline-based dosing was achieved in 61.9% of apixaban and 58.6% of rivaroxaban users; 46.9% of warfarin patients reached therapeutic INR (2-3). Correct renal dose adjustments were applied in 40.5% of apixaban and 33% of rivaroxaban users. Guideline adherence for oral anticoagulant dosing was suboptimal. Improved prescriber education, enhanced drug utilization evaluation, and routine renal monitoring may enhance patient safety and optimize anticoagulation outcomes.

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.
Body Mass Index ; Body Weight ; C-Reactive Protein ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Lung ; Lung Diseases, Obstructive ; Overweight ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vital Capacity ; Waist Circumference