ABSTRACT
Sarcoidosis is a multi system disorder of unknown cause most commonly affecting the young and middle age adults and frequently presents bilateral hilar lymph-adenopathy. The diagnosis of sarcoidosis is often delayed following the onset of symptoms. The reason being first, the disease is often sub clinical; second as the disease affects any system, the diagnosis of sarcoidosis may not be considered; third, the symptoms are not disease specific hence often treated as other chronic pulmonary diseases; finally economic issues or barriers to access for further workup may affect the timeliness of the diagnosis. No laboratory diagnosis is specific for diagnosing sarcoidosis but histological confirmation from the lymph nodes accessible for biopsy either direct or by intervention may be more specific.
Subject(s)
Administration, Oral , Adult , Diagnosis, Differential , Facial Nerve Diseases/diagnosis , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Humans , Male , Middle Aged , Sarcoidosis/complications , Tomography, X-Ray ComputedABSTRACT
Immunization is a safe, effective and simple way to prevent life threatening illnesses not only in children but also in adults. Vaccines are some of the safest medicines available which can relieve suffering costs related to these preventable diseases. The reason for underutilization of vaccines in adults are 1) Low prioritization of the importance of vaccines preventable diseases among adults 2) Uncertainty or lack of knowledge about the safety and efficacy 3) Lack of universal recommendations for all adults and 4) Financial constraints, especially in developing countries. Adult immunizations are administered in primary series like previously immunized, booster doses and periodic doses. Agents include Toxoids (Diphtheria and Tetanus), Live Virus Vaccines (Measles, Mumps and Rubella), and inactivated virus vaccines (Influenza), Inactive viral particles (Hepatitis B), inactivated bacterial polysaccharide vaccine (Pneumococcal) and Conjugate / Polysaccharide vaccine (Meningococcal). And also vaccines like Hepatitis A, Polio and Varicella may be recommended in some. Since the economy and literacy rate has shown a steady rise in the South Asia and people are being aware of different health problems through the recently advanced global communication, the education and awareness for immunization not only in children but also in adults need a special consideration. Keeping in view the statistical data of suffering costs related to the non-utilization of immunization in adults, the need of hour has come for utilization of immunization to emphasize its importance.
Subject(s)
Adult , Communicable Disease Control/methods , Drug Utilization , Health Education , Health Services Accessibility , Humans , Immunization , Nepal , Practice Guidelines as Topic , Vaccines/administration & dosageSubject(s)
Bibliographies as Topic , Books , Drug Information Services/organization & administration , Education, Pharmacy, Continuing/organization & administration , Humans , Internet , Nepal , Patient Education as Topic/organization & administration , Periodicals as Topic , Pharmacy and Therapeutics Committee/organization & administration , Product Surveillance, Postmarketing , Quality Assurance, Health Care/methods , World Health Organization/organization & administrationABSTRACT
Tuberculosis is a major health burden worldwide. In Nepal, it is a significant cause of morbidity and mortality. Although better drugs are available for managing tuberculosis, treatment failure is one of the common problems encountered. Among the various causes which can cause treatment interruption, drug induced hepatotoxicity is a common cause. Isoniazid and Pyrazinamide are the common drugs causing hepatotoxicity. Upon occurrence of hepatotoxicity, the hepatotoxic drugs should be stopped and reintroduced as per the available guidelines. The healthcare professional should also counsel the patients for recognizing the early symptoms due to hepatotoxicity which could prevent morbidity.
ABSTRACT
Warfarin is a commonly used anticoagulant with documented reports of drug interactions. Tamoxifen is used in the adjuvant hormonal treatment of women with oestrogen-receptor- positive breast cancer. Warfarin and tamoxifen are known to interact with each other with a resultant increase in the bleeding tendency. These reports are mainly from the white population. We report a case of drug interaction between warfarin and tamoxifen with an acute onset. This report suggests that when these drugs are co administered, careful monitoring of the coagulation profile is needed.
Subject(s)
Anticoagulants/adverse effects , Antineoplastic Agents, Hormonal/adverse effects , Drug Interactions , Fatal Outcome , Female , Humans , Middle Aged , Tamoxifen/adverse effects , Warfarin/adverse effectsABSTRACT
Drug related complications may lead to huge economic impact and cause significant morbidity and mortality. The present study analyzed the services provided by our Drug Information Center (DIC) in relation to drug safety. Over a period of one year, the DIC received 336 drug related queries. Among these 127 queries were related to drug safety. Medical doctors asked 78% of queries and patient care was the purpose behind 64.6% of them. Half (50%) of the enquirers submitted their queries to the center personally or contacted the DIC staff. Forty one percentage of the queries were related to the causality of particular drug towards adverse drug reactions and 10 % regarding drug use in pregnancy and lactation. Centrally acting drugs accounted for 21% of the queries. Twenty two percentage of the enquirers required an immediate answer. DICs by providing unbiased and objective information can reduce the occurrences of drug related complications.