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Background: Chemotherapy induced nausea and vomiting is the most distressing side effect of cancer chemotherapy. It can seriously impact patient抯 quality of life, influence the adherence to chemotherapy and progression free survival causing a delay or refusal of potentially life-saving therapy. The objective of this study was to compare the efficacy of palonosetron with ramosetron in achieving complete response to the chemotherapy.Methods: This was a prospective randomized open-label study conducted on 130 patients admitted in Medical Oncology ward of a Tertiary Care Hospitals, Bangalore, India. Patients were randomized to receive either palonosetron 0.25 mg or ramosetron 0.3 mg I.V. along with aprepitant and dexamethasone 30 minutes prior to chemotherapy and were followed up for a period of 5 days post chemotherapy. The observations such as number and severity of vomiting and nausea, the outcome was assessed at the end of 5 days. Pearson抯 Chi-square test was used to demonstrate the difference between both the study groups with respect to various categorical data.Results: The complete response rate in delayed phase was more significant in patients who received palonosetron than patients who received ramosetron (72.3% vs 50.8%). Total control was achieved in 38.5% patients with palonosetron as compared to 15.4% patients with ramosetron.Conclusions: Palonosetron is more efficacious than ramosetron in controlling chemotherapy induced nausea and vomiting especially in delayed phase of emesis.
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Background: Pharmacology is an important part of medical education. A competent doctor should be able to prescribe rational treatment to the patients to minimise the adverse effects and contribute to the improvement of overall healthcare system. There is a dire need to reform the undergraduate pharmacology curriculum to match up to the rapidly evolving medical field. Feedback system is one of the most successful instruments in improving any system. We have undertaken a similar feedback system to study the advantages and disadvantages of various study methods for teaching theory and practical exercises to the medical undergraduates.Methods: This is a cross sectional questionnaire based study conducted in the department of pharmacology. Students of MBBS 2nd year were enrolled into the study. The purpose of the study was explained to them and clarifications were made if any. The questionnaire included questions on various aspects of teaching methodology and graded by students on internationally accepted ‘Likert’ scale.Results: In our study students favoured teaching by blackboard method (96%) and many preferred a combination of blackboard and power point presentation. Discussing on issues of clinical significance of the topic was favoured by 96% of the students and 67% students responded that stressing on the facts concerned with Post graduate entrance exams is more important. Sixty nine percent and 85% students preferred short essays and MCQs respectively as method of evaluation and 68% of them favoured evaluation by both the methods. Regarding pharmacology practical exercises most of the students preferred clinical problems, dosage calculation, ADR reporting and other problem based learning techniques. Studying pharmacology as an integrated subject with other clinical subjects was preferred by 68% of the students.Conclusions: It is well known that students learn better when they are involved actively in learning process than when they are passive recipients. In our study we realised that undergraduate pharmacology teaching pattern should be modified mostly towards pharmacotherapeutics and clinical pharmacology.
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Background: Pharmacovigilance is the science and activities relating to detection, monitoring, assessment, understanding and prevention of adverse effects or any other drug related problem from any pharmaceutical products. The core purpose of pharmacovigilance is to enhance patient care and generate the evidence based information on safety of medicines. The objective of present study was to evaluate the knowledge, attitude and practices of the healthcare professionals about pharmacovigilance and to assess the reasons for underreporting of ADRs.Methods: A cross-sectional study was conducted by administering KAP questionnaire to the healthcare professionals. There were 22 multiple choice questions. Ten related to knowledge, 5 related to attitude, and 6 related to practice. One question was asked to determine the reasons for underreporting of ADRs. The performance in each category was graded as good, average and poor if the number of participants giving correct/positive responses were >70%, 50-69%, <50% respectively. Question no 22 was assessed independently to find out reasons for underreporting of ADRs. Data was compiled and analyzed by descriptive statistics, Chi-square and ANOVA test.Results: The response rate in this study was 62.5%. The study included professors (11%), associate professors (6%), assistant professors (20%), postgraduates (26%) and interns (37%). That there was statistically very highly significant difference of mean score of knowledge, attitude and practice among health care professionals (P<0.001). The performance score with respect to attitude of health care professionals towards pharmacovigilance was good as compared to knowledge which was average followed by practice which showed poor performance (72.5% >51.6% >36.8%) (p <0.001).Conclusions: Awareness campaigns, CMEs, workshops on pharmacovigilance should be conducted regularly such that good knowledge about pharmacovigilance can be imparted which can be moulded into good practice.
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Background: Dengue is one of the most important mosquito borne viral diseases presenting with varied symptomatology. A broad-angled evaluation with integration of clinical and laboratory parameters would direct the physicians through the stages of the disease process and the line of management. The objectives were to identify the pattern of management of dengue fever in pediatric in-patients and to assess the outcome. Methods: A prospective observational study was carried out in pediatric inpatients. Data were collected by intensive case record review. Patients of age group 1-18 years of both genders diagnosed of dengue fever were included. The prescribing pattern in children presenting at various stages of dengue fever was analyzed. The outcome was assessed in terms of course in hospital and duration of hospital stay. Results: A total of 110 patients diagnosed with dengue fever with one or more warning signs were admitted during the study period. Thirty percent cases had liver enzymes more than 3 times the normal and 68% patients had platelet count <1,00,000/cumm. Two cases of dengue encephalitis were reported. Most common intravenous fluid given was ringer lactate followed by isolyte P and others. Most common antibiotic prescribed was ceftriaxone followed by ampicillin and others. The symptomatic treatment given consisted of paracetamol, anti-acidity drugs and anti-emetic drugs. Vitamin K was prescribed to 41% and zinc and folic acid supplements were prescribed to 30% children. There was no correlation found between vitamin K and outcome of the disease. Conclusion: Antibiotics and vitamin K though not a part of standard World Health Organization guidelines was seen to be an important part of management. Supportive care with judicious fluid management during the critical and recovery period with continuous monitoring is required for all patients. Further comparative studies are needed to establish the role of antibiotics and other supportive measures like zinc and folic acid on the outcome of the disease.