ABSTRACT
Background: Epilepsy is the most common neurological condition with 65 million cases of active epilepsy found worldwide. The incidence is approximately 0.3 - 0.5% in different world populations with a prevalence rate of five to ten per thousand people. The aim of the present study was to evaluate the prescriptions according to WHO/INRUD drug use indicators and to study the adverse effects to antiepileptic drugs (AEDs).Methods: A cross sectional survey based observational study of 1year duration was conducted at tertiary healthcare hospital. Prescription data of patients (n=361) with Epilepsy from Neurology department was analysed using WHO indicators. The demographic data, type of seizures, AEDs prescribed and adverse drug reactions (ADRs) reported by the patients were recorded. Statistical analysis was done using Microsoft excel 2013.Results: A total of 593 AEDs were prescribed to 361 patients. Average number of AEDs prescribed per prescription was 1.65±0.78 (S.D) with only 02% of newer AEDs. Generalized Tonic Clonic (GTC) was the most common seizure with 55.68%. Phenytoin (32%) was commonly prescribed followed by valproate for GTCS. Carbamazepine was commonly prescribed for partial seizures. Out of 15 ADR cases that has been recorded, phenytoin (73%) was associated with most ADRs followed by valproate (20%). 53% patients were on Monotherapy, 31% on dual drug therapy.Conclusions: Older AEDs are still commonly prescribed drugs. Prescription of newer AEDs to be encouraged, as study revealed majority of adverse effects to drugs like phenytoin and valproate. Study concludes the need of creating awareness of reporting of adverse event to AEDs, in treating physician.
ABSTRACT
Background: Antimicrobial resistance(AMR) is an urgent and serious global health problem, demanding considerable attention from health care providers(HCPs) all over the world. The threat is progressing rapidly and intensifying with time. Therefore study was conducted to assess the knowledge, attitude and practices of Homeopathic HCPs about antibiotic usage and resistance(ABR).Methods: Cross-sectional, observational study. The data was collected from 75 Homeopathic HCPs practicing in Maharashtra with prior informed consent. Questionnaire based study whose responses were assessed by using five point Likert scale and analysed by using appropriate descriptive statistics.Results: 68(90.67%) respondents agreed that antibiotics are overused in India and 70(93.33%) of them facing ABR in their daily practices. Only 62(82.7%) of them were aware of the fact that bacteria are not responsible for causing colds and flu. 33(44%) believe that skipping one or two doses of antibiotic does not contribute to ABR. Only 23(30.67%) knew drug schedule H correctly. 22(29.33%) opined that antibiotics should be discontinued if patient develops mild gastrointestinal side effects. Only 28(37.33%) reads patient information leaflet(PIL) and counsel patients accordingly. 28(38.67%) feel that they don’t have enough sources of antibiotic information and 35(46.67%) find it difficult to select appropriate antibiotic.Conclusions: Most of HCPs were aware of rising issue antibiotic resistance. However, their knowledge, attitude and practices were found to be a matter of some concern. Educational intervention can be introduced to bring about behaviour changes regarding rational antibiotics prescribing. Government should take initiative against overt antibiotic promotional advertisements and to curb over the counter(OTC) sell of antibiotics.
ABSTRACT
Adverse drug reactions (ADRs) are the fourth leading cause of morbidity in the world. In order to safeguard the health of the community, Pharmacovigilance Programme of India (PvPI) is implemented as the monitoring body by Indian Pharmacopoeia Commission (IPC). It is leading national authority. National Coordinating Centre (NCC) PvPI works as the World Health Organization (WHO) collaborating centre for pharmacovigilance. Adverse drug reactions are reported to NCC PvPI which are then directed towards WHO Uppsala Monitoring Centre (UMC) Sweden which is the global monitoring centre for worldwide data. Central Drugs Standard Control Organization (CDSCO) is the regulatory authority of India under the Ministry of Health and Family Welfare (MOHFW), Government of India. This article focusses on the various strands of pharmacovigilance at the healthcare professional and consumer level. It also discusses the pitfalls in the journey of pharmacovigilance thus helping in enhancing the quality of health safety. Even a minuscule contribution by a health care professional or a consumer can voluminously help in promotion of drug safety. Therefore, there is a need of inculcating the culture of adverse drug reaction reporting for the welfare of the vulnerable masses.
ABSTRACT
Stevens Johnson Syndrome is a rare but life-threatening skin disease and Carbamazepine is considered as one of the most common cause. The reported frequency of serious Carbamazepine hypersensitivity reaction is between 1/1000 and 1/10000 new exposures to the drug. Here, we report a case of a 40 year old female patient, who developed multiple ulcerative lesions all over the body three days after starting treatment with Carbamazepine for Trigeminal Neuralgia. (Worldwide Unique Number- 2017-58502 and AMC Report Number- BJGMC-Pune/Nov-2017/BBG-1860) Stevens Johnson Syndrome was diagnosed. Carbamazepine was withdrawn, and the patient was treated with topical and intravenous antibiotics. A biopsy was done which confirmed the diagnosis of Stevens Johnson Syndrome.