A prospective study on the prescription pattern of anti-cancer drugs and adverse drug reaction in a tertiary care hospital

Background: Cancers is a group of disease involving abnormal cell multiplication with the ability to spread to other parts of the body. Common side effects seen with chemotherapy are fatigue, hair loss, easy bruising and bleeding, infection, anemia, nausea and vomiting, appetite changes, constipation etc. The need of this study is to evaluate the prescribing pattern and the adverse drug reaction associated with chemotherapeutic drugs. The study is aimed to analyze the prescribing pattern of anticancer drugs in medical oncology department of a tertiary care hospital, Karnataka.Methods: An observational study was conducted on 30 patients of either sex admitted for chemotherapy for a period of 6 months in at HCG Cancer Institute, Gulbarga and Basaveshwar Teaching and General Hospital (BTGH), Gulbarga. The data collected is analysed statistically using descriptive statistics and presented as counts and percentages. Results are depicted in the form of tables.Results: A total of 30 prescriptions were collected with 10 (33.3%) male and 20 (66.6%) female. the maximum number of cases were noted in the age group of 46years to 55 years (10) and least in age group of 15-25 years having a single patient. In our study we found that more number of patients are breast cancer (12 patients) followed by cervical cancer and ovarian cancer (3 patients) and least are Ewing’s sarcoma and Non-Hodgkin’s lymphoma (1 patient). Most commonly prescribed anti-cancer drug is carboplatin and paclitaxel i.e. for 12 patients out of 30 patients, followed by cyclophosphamide for 10 patients and less commonly prescribed drug being dactinomycin and pemitrexate. Adverse drug reactions seen in maximum patients is hair loss among 20 pts followed by peripheral neuropathy (17) and taste change (16) and the less commonly noted side effects being chest pain and ototoxicity.Conclusions: The study concluded that the drugs which were used in the treatment of various neoplastic conditions are in adherence and in accordance with the standard treatment guidelines and most of them were prescribed with generic name which leads to reduce in cost of treatment.

Histopathologic findings in uteri and ovaries collected from clinically healthy dogs at elective ovariohysterectomy: a cross-sectional study

Opinions on ovariohysterectomy (OHE) of bitches vary depending on region and country. In this descriptive, prospective cross-sectional study, uterine tracts and ovaries exhibiting gross pathologic findings (n = 76) were collected post-surgery from a reference population of 3,600 bitches (2.11% incidence) that underwent elective OHE during September to November 2013 and evaluated by histopathology examination. Data were evaluated by using descriptive statistics and chi-squared tests. Bitches were of crossbred background with average age 5 years (range 0.6–8.0 years) and most were nulliparous (69.7%) with no anamnesis of reproductive diseases (81.6%). Frequencies of proestrus, estrus, and diestrus were 42.1%, 6.6%, and 19.7%, respectively. The presence of mammary gland masses (5.3%) significantly correlated with histopathologic findings in ovaries and age of the bitch (p < 0.05). Predominant uterine histopathologies included cystic endometrial hyperplasia, periglandular fibrosis, lymphoplasmocytary endometritis, and adenomyosis (19.7%, 14.5%, 4.0%, and 2.6%, respectively). In ovaries, hyperplasia of rete ovarii, follicular cysts, oophoritis, adenoma of the rete ovarii, cysts of superficial structures, and granulosa cell tumors (10.5%, 10.5%, 7.9%, 4.0%, 2.6%, and 2.6%, respectively) were observed. The results reveal the presence of subclinical pathologies in healthy bitches, suggesting that OHE at an early age is beneficial for prevention of reproductive pathologies.

Causes of New Onset Fever among Hospitalized Patients and Predictors for In-Hospital Mortality in a Teaching Hospital in Japan / General Medicine

<b>Background: </b>New onset fever is a common symptom among hospitalized patients and it may be a manifestation of fatal illnesses such as infection. However, its epidemiology and predictors for mortality have not been fully determined in a Japanese teaching hospital.<br><b>Methods: </b>We investigated adult patients with new onset elevated temperature of 37.5 degrees Celsius or greater the 3^rd day after admission during a 4-month study period. Only the first, single episode per patient was analyzed. We determined the causes of fever among these patients with new onset fever. We also analyzed predictors for in-hospital mortality among these patients. These predictors were based on multivariable adjusted logistic regression using demographics, vital signs at the time of fever onset, baseline diseases, and basic laboratory data.<br><b>Results: </b>From a total of 2,271 admitted patients, 126 patients (5.6%) developed fever. Among these febrile patients, 98 (78%) had infectious diseases with a prevalence of 4.3% in all admitted patients. The most common cause of infection among those patients was respiratory tract infection, followed by urinary tract infection. Causes for non-infectious fever included neoplastic diseases, inflammatory diseases, and drug fever. In-hospital mortality was associated with lower mean blood pressure <60 mmHg with odds ratio (OR) of 12.7 (95% CI, 1.3–121), tachycardia >90/min with OR 4.1 (95% CI, 1.2–13.5), tachypnea >20/min with OR 10.0 (95% CI, 2.8–35.2), and neoplastic disease with OR 4.1 (95% CI, 1.3–13.1). Infection as a cause of fever was not associated with mortality.<br><b>Conclusion: </b>The majority of inpatients with new onset fever had infectious diseases, however fever was also caused by neoplastic diseases, inflammatory diseases and drug fever. Abnormality of vital signs and neoplastic disease were related to in-hospital mortality.

Proctosigmoidoscopy - a statistical study of 1000 consecutive examinations

1) 1000 consecutive proctosigmoidoscopies were statistically studied2) Hemorrhoidal disease is very common - much more common than all other anorectal diseases put together, in this series. Discounting hemorrhoids, there are but few pyogenic infections and diseases involving the anorectum among Filipinos3) The incidence of neoplastic disease, whether benign or malign is low compared to foreign statistics.

Infections in Children with Neoplastic Disease

PURPOSE: Infection is a major complication in patients with malignant disease. This study was performed to identify the causes and the etiologic agents of febrile infections and to characterize the clinical courses including the response to antimicrobial agents inpediatric cancer patients. METHODS: This study reviewed 274 febrile episodes occurring in 163 children with neoplastic disease which were indentified prospectively at Seoul National University Children's Hospital from January, 1991 to June, 1993. Neutropenia was defined as [granulocyte+band from] < or = 500mm(3). Each febrile episode was classified as a microbiologically documented infection(MDI), a clinically documented infection(CDI), and a probale infection(PI). The responses to initial antimicrobial atents were categorized into improvement, temporary improvement, failure, and not evaluable according to period to defervescence. RESULTS: Seventy seven percent of the febrile epidodes developed in neutropenic state. MDI were 98(36%), CDI 92(34%), and PI 84(30%) episodes. Bacteria were isolated in 75%, viruses in 13% and fungi in 11% of MDI. Fifty two episodes(19% of all) were associated with a bacteremia, and focal infections were indentified in 63% of bacteremia. The most frequent organisms causing MDI were E. coli(22%), K. pneumoniae(15%), S.epidermidis(7%). The great majority of infections other than bacteremia ocurred in the lung(32%), oral cavity(17%), skin and soft tissue(13%), and urinary tract(11%). The frequency of antimicrobial resistance of causative organisms was high. The responses to initial antimicrobial agents were improvement in 49%, temporary improvement in 13%, and failure in 38%. Patients with bacteremia responded less well than those with other categories. Mortality was 7% of total episodes. All of the fatal cases occurred in neutropenia and all but one had hematologic malignancies. CONCLUSIONS: This study documents the etiology and the type of infections and the responses to antimicrobial therapy in children with neoplastic diseases. The changes of causative agents and antimicrobial resistance should be considered in therapeutic strategies of cancer infection.

Septicemia in children with neoplastic disease

No abstract available.