ABSTRACT
Background: Adverse drug reactions are common with multidrug therapy in tuberculosis, if detected early can improve patient compliance and prevent emergence of resistance.Methods: A prospective observational study as a part of Pharmacovigilance Program under Central Drugs Standard Control Organisation was conducted in Kasturba hospital, Manipal to collect adverse drug reactions (ADR). Data of patients reported with antitubercular treatment (ATT) related ADRs from September 2012 to August 2013 was evaluated for patient demography, type of tuberculosis, ATT regimen, organ/ system affected and time of onset of ADR. ADRs were then subjected to causality assessment as per WHO scale.Results: A total of 65 ADRs were reported in 60 patients during the study period, of which 46.7% were in males and 53.3% in females. 85% of ADRs were reported in patients with pulmonary tuberculosis. 77% of ADRs were observed with daily regimen. Common ADRs were hepatitis (40%), gastritis (15%), skin reactions (15%), peripheral neuropathy (14%), gout (6%) and nephritis (3%). Median duration for the onset of ADR was 31 days each for hepatitis, gout, nephritis and 20, 11, 9 days for gastritis, peripheral neuropathy and skin reactions respectively. As per causality assessment, 80% of ADRs were assigned “possible”, 11% “probable” and 9% “certain”. As per severity scale 27.7% of ADR were severe, 36.9% were moderate.Conclusions: Early detection and management of ADRs is vital for the success of ATT and patient adherence.
ABSTRACT
Background: Cataract is a frequent surgical procedure performed worldwide. The study compared lidocaine 4% drops with 2% gel on surgeon抯 comfort, need for supplemental anaesthesia and duration of surgery in patients who underwent manual small incision cataract surgery.Methods: This was a Prospective, Comparison study conducted at a Single centre by multiple surgeons. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were surgeon抯 comfort, need for supplemental anesthesia and duration of surgery.Results: The mean duration of surgery for gel was 20�minutes as compared to 29�minutes with drops (p*- value<0.001). 26 (87%) patients in gel did not require any supplemental anesthesia as compared to 3 (10%) patients in drops. Peribulbar supplementation was required for 20 (67%) patients in drops as compared to 1 (3%) patient in gel (p*- value<0.001). 26 (87%) patients in gel were operated comfortably by the surgeon as compared to 2 (6%) patients in drops. Mild to Moderate discomfort was experienced by the surgeon in operating 27 (90%) patients in drops as compared to 3(10%) patients in gel (p*- value<0.001).Conclusions: The surgeons were more comfortable using gel with least requirement of supplemental anaesthesia and faster completion compared to drops.
ABSTRACT
Background: Cataract is globally acknowledged leading cause of blindness. This study was undertaken to compare the effects of Lidocaine 4% drops with 2% gel on intra operative and post-operative pain in patients who underwent manual small incision cataract surgery.Methods: It was a single Centre, one-surgeon, prospective, comparison study. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1 ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were ocular pain of patient during and after surgery.Results: A total of 60 patients underwent MSICS, out of which 30 each received drops and gel. Mean intraoperative pain VAS score was 2.26±0.69 for gel group and 5.13±1.13 for drops group (p*<0.001) Mean post-operative pain VAS score was 0.26±0.69 in gel group and 1.13±1.13 in drops group (p*=0.002).Conclusions: Compared to drops, Lidocaine gel has reduced intraoperative and post-operative pain.