ABSTRACT
"PURPOSE: Drug wastage is a major concern in oncology where costs of antineoplastic drugs are exorbitant, and the disposal of toxic drugs increases the chances of occupational hazards to healthcare and sanitary workers and environmental pollution at the site of disposal. The principal objective of this study was to ascertain the extent of drug wastage and calculate its financial costs. MATERIALS AND METHODS: This was a prospective pilot study conducted to ascertain the quantity of drug wastage in a tertiary care hospital.This pilot study was conducted in day care and inpatient facilities in February 2016. The prescription of cytotoxic drugs, recommended dose, the quantity used, and remainder (waste) left were recorded from the nurses and pharmacy files of the hospital. Cost evaluation of the actual use and the waste was undertaken and an audit was conducted to understand in which anticancer drug the maximum wastage was generated. RESULTS: The results of this study indicated that 6.1% of the total amount of reconstituted drugs was wasted. The highest drug wastage was observed in trastuzumab (29.55%), followed by etoposide (20.4%), dacarbazine (17.14%), daunorubicin (16.67%), and carboplatin (11.29%). Cost analysis showed that the total cost of the drug issued during the study period was Rs. 1,294,975 and the cost of drug wastage amounted to Rs. 143,820 (11.1%). CONCLUSION: To the best of authors’ knowledge, this is the first study from India and the results indicate that the financial impact of anticancer drug wastage was substantial. Attempts should be directed at minimizing the wastage and cost savings without risking patients’ treatment regimen and administering effective dose schedule."
ABSTRACT
To estimate the incidence of chest infections in renal allograft recipients, the mortality of lung infections, the incidence of Tuberculosis, its common presenting features, and determine significant risk factors for such infections. Over an eighteen month period [January 2001 to July 2002], 100 kidney graft recipients were checked for any past or present history of chest infection. All the recipients acquired their graft from living related or unrelated donors. The study was conducted in Al-Shaheed Adnan Hospital Centre for kidney disease and transplantations in Medical city, Baghdad Teaching Hospital and Al-Karama Teaching Hospital. Statistical analyses were carried out using Chi square test and Yate's correction wherever needed. A P value of less than 0. 05 was taken as significant. Bacterial pneumonia was the commonest pulmonary infection [n=13, 32.5%] followed by the probable acute viral bronchitis [n=10, 25%], pulmonary tuberculosis [n, 22.5%] and fungal infection in five [n=5, 12.5%], nocardiosis in two and candidacies in three recipients. The mortality from chest infections including pulmonary tuberculosis in renal allograft recipients was seven [17.5%] recipients. Pulmonary tuberculosis should be included in the differential diagnosis of infections causing fever of unknown origin in the renal transplant patients, especially in endemic areas. Leucopenia and diabetes mellitus were significant risk factors for serious pulmonary infections Unrelated donor is also a risk factor for serious post renal transplant recipient pulmonary infections including tuberculosis which presents with high grade intermittent fever