Assessment of adverse drug events of atypical antipsychotics in cases with schizophrenia

Background: Atypical antipsychotics are the drug of choice to manage schizophrenia in general clinical practice. Antipsychotics cause various side effects, including metabolic syndrome, extrapyramidal symptoms, hyperlipidemia, weight gain, and hypotension in patients treated for schizophrenia. Aims and Objectives: The aim of the study was to assess the side effects due to antipsychotic drugs and their effect on the outcome in schizophrenia cases. Materials and Methods: A total of 200 cases with the diagnosis of schizophrenia were recruited. Cases were divided into five groups based on administered drugs (Asenapine, Iloperidone, Olanzapine, Aripiprazole, and Ziprasidone). Treatment procedure and side effect profile were documented. Drug side effects were assessed by a standard antipsychotic side-effects evaluation questionnaire. Cases were followed up for the status of side effects at the end of 1st month, 3rd month, 6th month, 9th month, and 12th month. Results: The rates of weight gain were 20%, 30%, 50%, 25%, and 15% and menstrual complications were seen at 2.5%, 7.5%, 7.5%, 7.5%, and 1% in all five groups, respectively. Lactation disturbance was observed in 5%, 5%, 12.5%, and 5% iloperidone, olanzapine, aripiprazole, and ziprasidone, respectively. The extrapyramidal symptoms were higher in the iloperidone group compared to the asenapine, olanzapine, aripiprazole, and ziprasidone drug groups. Conclusion: Atypical antipsychotic drug consumption leads to considerable weight gain and few metabolic abnormalities. Clinicians should estimate the adverse events associated with atypical antipsychotics and compare the benefits of antipsychotics versus the quality of life of cases.

High incidences of hepatocellular carcinoma – A report from Population-Based Cancer Registry Center in Western Arunachal Pradesh

Background: Primary hepatocellular carcinoma (HCC) is a major health hazard and frequent cause of liver cancers accounting 90% of cancers of liver worldwide. It has high mortality, prevalence, and incidence rate in Sub-Saharan, South Africa, and South-east Asia. Its etiology is associated with infection, dietary habits, and lifestyle factors. Aims and Objectives: The present study was designed to discuss the various possible etiologies for high incidence of HCC in Western Arunachal Pradesh, India. Materials and Methods: Data were collected as one among 33 population-based cancer registries in India under national cancer registry program of national center for disease informatics and research, Indian Council of Medical Research between 2012 and 2014 in Tomo Riba Institute of Health and Medical Sciences, Naharlagun. Data were represented in frequency and percentage using descriptive statistics. Results: With 194 cases, HCC represented 13.5% of overall malignancies in the region. It is 3 times more common in males than in females. Age-adjusted incidence rate for men was 21.44 and for women was 7.05. Conclusion: Western Arunachal Pradesh reported high incidence of hepatocellular carcinoma in the world. This finding may be associated with high prevalence of hepatitis and alcoholism in the region and perhaps also associated with local food habits.

Measure of liability in Medical Negligence A hospital based study

Background: Negligence is the breach of a legal duty of care. Liability is the responsibility of a person for his acts of commission and omissions. Aim: This study aimed to determine the role of liability in medical negligence in teaching hospital. Materials and methods: A total 36 medical negligence cases reported during the period of 3 years i.e. from July 2011 to June 2014 were gathered from Hospital Case Records, Inquest Reports, Post Mortem Examination Reports, and Forensic Science Laboratory Reports. Results: Among these 36 cases of medical negligence doctors were liable for their negligence in 15 cases i.e. 41.7% and vicariously liable in 3 cases i.e. 8.3%. There was no liability for doctors in 18 cases i.e. 50%. Conclusion: It this study, male and female was equally suffered for medical negligence. Among the females pregnant cases were more common. Most of the medical negligence cases had come to the hospital with major health problem. Health care professionals are increasingly facing complaints Naveen Kumar E, Ramesh K, Alugonda Y, Kothapalli J, Goud AK. Measure of liability in Medical Negligence – A hospital based study. IAIM, 2016; 3(3): 123-127. Page 124 regarding the facilities, standards of professional competence and the appropriateness of their therapeutic and diagnostic methods.