ABSTRACT
Background: The systemic antifungals like Griseofulvin, Itraconazole, Terbinafine, Ketoconazole and Fluconazole are widely used for superficial fungal infection. Hepatotoxicity with oral antifungals is well established fact. The rate of transient asymptomatic changes in liver function tests accounts for about 0.5 - 10% of all patients treated with systemic antifungals. Clinical hepatic toxicity is seen less frequently. The aim of this study is to evaluate the effect of oral Itraconazole on hepatic function and it抯 efficacy in patients with extensive dermatophytosis.Methods: The total of 524 patients with extensive dermatophytosis were included in our study which was conducted in a tertiary care hospital in Navi Mumbai.Results: Itraconazole, a systemic antifungal agent is efficiently used in treatment of superficial and deep mycoses. It inhibits fungal cytochrome P450 dependent enzyme and thus impaires conversion of lanosterol to ergosterol. Adverse reactions to itraconazole includes drug reactions, gastrointestinal upset, headache, dizziness, thrombocytopenia, gynecomastia, reversible edema of extremities and metabolic side effects like hypokalemia, and hypertriglyceridemia. The level of hepatic transaminases increases in about 1%-5% of patients who have received continuous therapy with systemic itraconazole. Clinical hepatitis rarely occurs in patients and, recovery generally ensues with the cessation of medication.Conclusions: The baseline and post treatment liver function test is important to monitor if patient is on higher dose and longer duration of itraconazole therapy. The screening for high risk patients like poor liver function test, history of alcoholism, history of liver disease should be taken before stating the therapy.
ABSTRACT
Background: Mental illness is associated with high levels of health service utilization and associated costs. India is among one of the countries with the highest number of people suffering from depression. The data on antidepressant drug utilization in India is sparse. Hence, we planned to analyse the drug use pattern in patients of major depression as per the WHO recommended indicators of drug use.Methods: This prospective observational study was done to analyze the prescription pattern of hospital psychiatrist in indoor major depression patients. All the patients admitted in psychiatry indoor patient department (I. P. D.) of Dr. D. Y. Patil Hospital, Navi Mumbai were included.Results: Data of 97 patients was analysed. 55.67% of the cases were from the age group 31-50 years. Total number of antidepressants prescribed was 102(36.82%). Out of antidepressant agents, Selective Serotonin Reuptake Inhibitors (SSRIs) were the most commonly prescribed drugs 70 (68.62%). The most commonly prescribed antidepressant was Sertraline in 35 (34.3%).Conclusions: The findings of our study were similar to those of other studies conducted to evaluate the use of antidepressants.