ABSTRACT
Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment.
ABSTRACT
Background: Coronary artery disease (CAD) is a major cause responsible for mortality more in younger age group than in elderly. Studies have reported underuse of four evidence based medicines namely aspirin, β-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB), and statins in patients with CAD, particularly in developing countries. Therefore, this study was planned to analyse the prescriptions of patients with CAD to determine the appropriateness of the prescriptions.Methods: After obtaining the Institutional ethics committee permission, a cross sectional observational study was conducted at a tertiary care hospital. Total 150 patients were enrolled from the outpatient department, wards and intensive care unit of medicine department. Total 150 patients’ prescriptions presenting with varied category of CAD were screened and analysed.Results: The most common categories of CAD encountered was ST segment elevated myocardial infarction (N=50, 33%) followed by chronic stable angina (N=29, 20%). Among the drugs prescribed, antiplatelet drugs were prescribed to 135 (90%), hypolipidemics to 134 (89%), nitrates to 114 (76%), beta blockers to 97 (65%), ACE inhibitors to 94 (64%), anticoagulants to 60 (40%) and miscellaneous drugs to 52 (35%), patients. Of 68 (45%) patients with type 2 diabetes mellitus, 15 (22%) were prescribed only metoprolol and others were given ACE-I or ARBs.Conclusions: Among four evidence based drugs, use of 3 drugs, antiplatelets, beta blockers and hypolipidemics was apparent in 90% of prescriptions. Use of ACE inhibitors and ARBs was observed in type 2 diabetic patients with CAD, reflecting rational prescribing behavior of clinicians.
ABSTRACT
Background: Needle stick injury are the most common reason behind occupational blood exposure and most important source of exposure to another person’s blood.Methods: A cross-sectional observational questionnaire-based study of 450 undergraduate medical students which includes 100 from each years, Second year: Part I (II/I: Third Semester), Second year: Part II (II/III: Fifth Semester), Third Year (III: Seventh Semester), Fourth year (IV: Ninth Semester) MBBS and 50 Interns. The participation was voluntary and written consent was taken prior to enrollment. The objectives of study were explained, and validated questionnaire was administered to the students and collected in a single visit after 30-40 minutes.Results: The average age was 21.91±2.03 years. About 406 students were aware of disease transmitted by NSI. 189 students felt that occurrence of NSI, first person to be contacted is Medicine Physician. 208 don’t know of existence of PEP. 164 felt PEP is to be given for 4 weeks. According to 138 students PEP guidelines were proposed by NACO while 101 students felt WHO. 261 students felt that most probable chance of getting NSI was in emergency ward. 363students felt that need for NSI PEP training before clinical exposure is very important. 345 felt the need for insurance of HCWs for diseases transmitted by NSI.Conclusions: Medical students are highly vulnerable to NSI and there is need to provide adequate preventive measures, frequent training for needle stick injury and postexposure prophylaxis to all healthcare workers.