Résumé
Background: In current scenario, poor attendances in classes and poor performances of students are a stimulus to think beyond the conventional teaching approach. Being current digital generation, students may show their affection to e-learning. Aim of this study was to introduce the e-learning in Pharmacology with objectives to evaluate its acceptability by students and faculties and learning gain of studentsMethods: Four inter-related e- modules for a topic “drugs used in treatment of bronchial asthma” were prepared and provided to the students. Pre-test was conducted before giving E-modules. Students were instructed to complete the e-modules in seven days and post-test was conducted on last day. Feedbacks from students and faculties were collected. Learning gain of students was evaluated along with their acceptability for e-modules.Results: Total of 147 students participated in the study but, 130 students completed pre-test and post-test, both. The absolute learning gain (% post-test score - % pre-test score) was found 23.3±19.2%. The class average normalized learning gain was found 0.32 (32%) that was significant, as per Hake’s criteria for the effectiveness of educational interventions. Slow speed of internet, background noise in modules, and size of e-modules were some technical problem faced by students. The most of students perceived the modules positively and demanded the e-modules for other topics. The faculties also perceived it positively and suggested to use e-modules additionally to classroom lectures.Conclusions: E-learning modules were taken positively by students and faculties and resulted in significant learning gain.
Résumé
Background: The objective of the study was to study the clinical patterns, causality and severity of adverse drug reactions in a tertiary care hospital.Methods: Total 131 ADR forms were collected from January 2012 to December 2012 and evaluated. Patient抯 characteristics, ADR and drug characteristics, causality, severity and preventability of collected ADR were analyzed.Results: Total 131 ADR forms were evaluated. Male patient experiencing ADR were more (73, 55.7%) than female (58, 44.2%). Adult patients (12-60 years) experienced 110 (84%) ADR followed by pediatric patients (< 12 years) 11 (8.4%) and geriatric patients (>60 years) 10 (7.63%). Antimicrobial were the most common group of drugs responsible for ADR followed by NSAIDs and antipsychotic group.Conclusions: Present study shows lack of awareness among health care professionals for reporting of an ADR. Training and collaboration of health care professionals are needed for improvement in ADR reporting. Appropriate feedback from ADR reporting will help in selection of drug and promotes safer use of drugs.
Résumé
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe cutaneous drug reactions. No large scale epidemiological data are available for this disorder in India. Aims: To carry out a systematic review of the published evidence of the drug-induced SJS and TEN in Indian population. Methods: Publications from 1995 to 2011 describing SJS and TEN in Indian population were searched in PubMed, MEDLINE, EMBASE and UK PUBMED Central electronic databases. Data were collected for the causative drugs and other clinical characteristics of SJS and TEN from the selected studies.Results: From 225 references, 10 references were included as per selection criteria. The major causative drugs were antimicrobials (37.27%), anti-epileptics (35.73%) and non-steroidal anti-inflammatory drugs (15.93%). Carbamazepine (18.25%), phenytoin (13.37%), fluoroquinolones (8.48%) and paracetamol (6.17%) were most commonly implicated drugs. Regional differences were observed for fluoroquinolones, sulfa drugs and carbamazepine. Total 62.96% of patients showed systemic complications. Most common complications were ocular (40.29%) and septicemia (17.65%). Higher mortality was observed for TEN as compared to SJS (odd ratio-7.19; 95% confidence interval (CI) 1.62-31.92; p = 0.0023). Observed mortality is higher than expected as per SCORTEN score 3. Duration of hospital stay was significantly higher in TEN (20.6 days; 95% CI 14.4-26.8) as compared to SJS (9.7 days; 95% CI 5.8-13.6; p = 0.020). Cost of management was significantly higher in TEN (Rs. 7910; 95% CI 5672-10147; p < 0.0001) as compared to SJS (Rs 2460; 95% CI 1762-3158). No statistical data were described for steroid use in the studies included. Conclusion: Carbamazepine, phenytoin, fluoroquinolones and paracetamol were the major causative drugs. TEN is showing higher mortality, morbidity and economic burden than SJS.