ABSTRACT
Background: Adverse drug reactions (ADRs) are common cause of morbidity in the practice of medicine. Pharmacovigilance is the science of detection, assessment and understanding and prevention of adverse effects or any drug related problems. Post graduates are perhaps the first to notice ADRs in outpatient/inpatient setup as they spend most of the time bedside. Thus, this study was conducted to assess the knowledge, attitude and practices (KAP) of postgraduates about Pharmacovigilance.Methods: A prevalidated and pretested questionnaire with 20 questions related to KAP of pharmacovigilance is administered to postgraduate students after obtaining their consent. All the completed and returned questionnaires were analysed for results using appropriate statistics.Results: 180 pretested questionnaires were distributed among postgraduates out of which, 122 were returned from postgraduates of all major medical and surgical allied departments. 90.2 % defined pharmacovigilance correctly, 83.6% thought reporting ADRs is a professional obligation, while only 65.6% knew regarding the existence of national pharmacovigilance program. 58.4% have experienced ADRs, of which only 24.6% reported ADR to pharmacovigilance centre. Major reasons for under reporting are lack of time to report and difficulty to decide whether ADR has occurred or not.Conclusions: In this study, the knowledge and attitude related to Pharmacovigilance is good amongst postgraduates, but practical implementation in reporting of ADRs is poor. Sensitization programs on pharmacovigilance practice in tertiary care hospitals and regular review meetings to ensure ADR reporting to pharmacovigilance centre will strengthen the health care setup.
ABSTRACT
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Despite advances in control strategies, inadequate treatment and failure to comply with drug regimens have resulted in TB to emerge as one of the most common and deadly infectious diseases worldwide. The emergence of drug-resistant TB has evolved as a formidable obstacle for comprehensive TB control. Drug-resistant TB can be classified as multi-drug-resistant TB, extensively drug-resistant TB and totally drug resistant TB (TDR-TB). There is a paucity in the development of new drugs against drug-resistant mycobacteria. The focus has shifted to the exploration of anti-mycobacterial properties of drugs approved for other indications. Thioridazine, a drug approved for use in schizophrenia is one such potential agent, which has shown anti-mycobacterial activity. There is evidence of anti-mycobacterial action of Thioridazine in in-vitro and mouse models. There is a compelling need for new anti-mycobacterial drugs that are more effective and have less toxicity. Further clinical trials are advocated favoring the use of thioridazine as an adjuvant in the treatment of TB, especially TDR-TB.
ABSTRACT
Background: Acute organophosphorus (OP) poisoning is one of the most common poisonings in India contributing to significant morbidity and mortality. Irreversible inhibition of cholinesterase enzymes is attributed to the serious clinical outcomes in these patients, which is assessed by the estimation of serum cholinesterase (SChE) levels. The present study was undertaken to evaluate the utility of serial estimation of SChE levels in patients of OP poisoning in predicting the clinical outcome. Methods: Medical records of 31 patients from January 2013 to December 2013 admitted in our institute with acute OP poisoning were analyzed for SChE at admission, 48 hrs, 72 hrs and 120 hrs after admission. Data regarding clinical findings at admission and outcomes were recorded. Results: Monocrotophos (55%) was the most commonly used OP compound. Mean serial SChE levels (in KU/L) at admission, 48, 72, and 120 hrs in patients who survived are 0.18±0.10, 0.28±0.14, 0.41±0.21, 0.46±0.16 and in patients who expired are 0.02±0.01, 0.05±0.02, 0.03±0.02, 0.03±0.02, respectively. SChE levels at admission in survived group, compared to those in expired group were statistically significant (p<0.001). About 92% patients in moderate to severe grade of poisoning (SChE levels <0.2 KU/L) were mechanically ventilated. The relationship between serial SChE levels in survival group and was found to be statistically significant (p<0.01). Conclusion: In the present study, significant increase in serial SChE levels were correlating with better clinical outcome as evidenced by an improvement with mechanical ventilation and survival rates in acute OP poisoning.