ABSTRACT
Adverse drug reactions (ADRs) due to antibiotics is one of the major concern. Hypersensitivity reactions with clindamycin may be immediate or delayed type, but their frequency and severity are relatively rare. We here report a case of a 32-year-old male patient with road traffic accident, who later developed osteomyelitis of occipital bone. After two weeks of therapy and debridement, the patient was on maintenance therapy receiving clindamycin 300 mg q8h, ciprofloxacin 500 mg q12 h and rifampicin 450mg fasting. After six days, he developed erythematous maculopapular rashes, initially on the trunk followed by neck and arm of both upper limbs with limitation of movement, fever, chills and night sweats. The reaction subsided after withdrawal of clindamycin and administering i.v. hydrocortisone 100mg stat followed by tablet promethazine 25mg 12hourly for 3 days. The causality assessment was done as per WHO-UMC scale and it was “probable” in this case. Although the incidence of clindamycin induced drug reaction is rare, the clinicians should be aware of such reactions before prescribing it.
ABSTRACT
Introduction: Chronic Suppurative Otitis Media (CSOM) is one of the diseases resistant to current antibiotics; persisting for more than two week; and capable of causing severe discharge, tympanic membrane perforation and deafness. This may cause distress and affect their quality of life and productivity. Aims: To assess the role of topical Acetic Acid in comparison to Gentamycin for management of CSOM. Methods: It was a Randomized, open label study. Patients diagnosed as CSOM (safe type) were randomly divided into two groups, group I - topical 1.5% Acetic acid and group II - topical 0.3% Gentamicin sulphate in a dose of three otic drops thrice daily. Follow up was done every week for two weeks and was compared on the basis of otological symptoms score. Results: The mean difference of otological symptom score at day 7 and day 14 from baseline in Group I was 1.90±1.01 and 3.40±1.08; and in Group II 1.96±0.57 and 3.12±0.74; p<0.05. Among the study groups, reduction of otological symptom scores at day 7 (Group I =3.22±1, Group II=2.66±1.76; p=0.14) and at day 14 (Group I = 1.72±1.76, Group II= 1.50±1.79; p=0.56) respectively. Also, “Treatment success” seen in 46 (92%) patients in the Acetic acid group and 44 (88%) patients in Gentamicin sulphate group. Moreover, cost of the treatment for Acetic acid was 102.94 and for Gentamicin sulphate was Rs.160.25 per person. Conclusion: Topical Acetic acid was found to be equally effective to Gentamicin sulphate for the treatment of CSOM.
ABSTRACT
Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Psychosomatic disorders represent impaired adaptation or deficiencies that limit the capacity to adapt successfully to the demands of everyday life. The symptoms are thought to be a response to stress. Appropriate health consultation should be considered for further evaluation and treatment.
ABSTRACT
Background: Prescription of antidepressants has been increased from the last decade and responsible for producing sleep disorders as adverse drug reactions (ADRs). Sleep disorders can be divided into 3 large groups: (1) insomnia, (2) primary complaint of daytime sleepiness, and (3) Association of disruptive behaviours during sleep, the disorders of arousal. So active surveillance is needed to access these ADRs. Aims and Objective: To analyze the sleep disturbances as ADRs of various antidepressants prescribed to the patients attending psychiatry outpatient department (OPD). Methods: This prospective study was conducted on patients aged ≤74 years attending Department of Psychiatry OPD and were prescribed Antidepressants for the duration of 8 months (December, 2013-July, 2014). The ADRs reported were confirmed by WHO UMC Causality Assessment Scale. Results: Total number of patients enrolled on the basis of inclusion and exclusion criteria (n=50). Total number of ADRs related to drugs prescribed were found to be n=69. Total number of patients with sleep disturbances as ADRs were found to be n=28. Conclusion: The drug, most frequently implicated to cause sleep disturbances, was mirtazapine. Increased sleep was the most common ADR, found to occur. Unusual ADRs such as sleep talking was also seen.
ABSTRACT
To study the pattern of adverse drug reactions (ADR) in patients attending psychiatry OPD of a tertiary care teaching hospital. Patients attending psychiatry OPD with ADRs due to drugs prescribed for various psychiatric illnesses over a period of 1year were included in the study. Adverse event history, medication history and other relevant details were entered in the PvPI format. Causality was assessed by WHOUMC criteria. A total of 103 ADRs were reported from 85 prescriptions with a female preponderance. Majority of ADRs (45.7%) were seen with antidepressants as they were the commonly prescribed drugs followed by antipsychotics (33.3%) and others by sedative hypnotics and anticonvulsants. ADRs like somnolence topped the list (21.9%) followed by weight gain (18.4%), akathesia (6.8%) and drug induced restless legs syndrome (RLS) (5.8%). The reported ADRs were assessed for causality and maximum (80.6%) belong to the "possible" category. Maximum ADRs were seen with antidepressants followed by antipsychotics. Sedation and weight gain were the most commonly occurring ADRs.