Knowledge, attitude and practices about hemovigilance among practitioners: a cross-sectional study

Abstract: Transfusion by blood and blood products forms an important part of treatment. But this is not free from transfusion reactions which may be in the form of fever, rashes, shivering, anaphylaxis or even death. Hemovigilance is a programme of reporting such events.Materials and Methods: The present study was conducted in a tertiary care hospital of Jammu, (J& K). Permission was taken from Institutional Ethics Committee, Govt. Medical College, Jammu. A pretested questionnaire was prepared and circulated among practitioners. They were given time of 15 minutes to fill that questionnaire. After 15 minutes, the filled questionnaire were collected and were analysed. The data was presented in tabulated form.Results: Total 50 practitioners were included in the study. All the practitioners had knowledge about transfusion reactions. Only 10% of the practitioners had knowledge that transfusion reactions can be prevented, 40% of the practitioners had knowledge about hemovigilance programme and had an idea that transfusion reactions can be reported. But only 10% of the practitioners knew where to report and who can report, 6% knew how to report. Only 48% of the practitioners thought that transfusion reactions should be reported, 70% of the practitioners thought that transfusion reactions can be dangerous. 40% of practitioners told that seminars/CMEs should be planned. 80% of practitioners had encountered transfusion reactions, but only 2% had documented the same. 10% of the practitioners had attended seminars, CMEs. Many reasons were quoted for not reporting transfusion reactions.Conclusion: Overall, most of the practitioners have a positive attitude towards transfusion reaction reporting but knowledge regarding the haemovigilance concept is poor and the majority of them never reported such reaction. Hence, our study demands increased awareness and continued training to strengthen the haemovigilance system.

Adverse drug reactions due to fixed dose combinations: an observational cross sectional study

Background: In modern world, poor compliance has been the main reason of therapeutic failure. Many factors may be responsible for this. The reasons highlighted may be adverse drug reactions (ADRs), pill burden or economic reasons. Fixed drug combinations (FDC) have helped to solve this problem. The present study was conducted to see the ADR due to fixed dose combinations.Methods: After approval from institutional ethics committee, an observational study was conducted over a period of six months in December 2018 to May 2019 in adverse drug monitoring centre, GMC Jammu.Results: A total number of 112 ADRs were reported during the study period. FDCs were responsible for ADRs in 64 patients and single drug was responsible in 48 patients. As per latest WHO essential drug list, irrational FDC were responsible for ADRs in 44 patients and rational FDCs were responsible for ADRs in 20 patients.Conclusions: The results of present study underscores that drug combinations, FDC rational as well as irrational substantially contribute towards the pool of total ADRs.

Knowledge, attitude and practices about adverse drug reaction among medical students in a medical college: an observational study

Background: Adverse Drug Reactions (ADRs) are usually associated with drugs which may or may not go unnoticed. ADRs are of great concern for any health care set up as they directly or indirectly add to the cost of treatment, prolongation of treatment, hospital stay or sometimes may even cause death. Spontaneous ADR reporting forms an important part of pharmacovigilance.Methods: An observational study was carried out in a medical college to know the knowledge, attitude and practice being followed by them in a Medical College.Results: In present study all the students had knowledge about ADRs. Only 86.7% of the students knew how and where to report an ADR. 73.3% of the students knew who can report an ADR and they had visited ADRM centre but only 60% of the students knew which ADR is to be reported. 88% of the students had an attitude that it is important to report an ADR and 86.7% told that it is useful to report an ADR. 99.3% of the students had never reported an ADR. Only 1.4% of the students had really visited ADRM centre of their institution but none of the students had ever visited wards or OPDs to look for ADRs. 26.7% of the students said that they will report an ADR if they see it ever.Conclusions: There is good knowledge about ADRs and ADRM centre among students, but it needs to bring ADR reporting into practice by actively doing hands on workshops or by adding this exercise into practical curriculum.

Assessment of knowledge, attitude and practice about dengue in factory workers of Jammu region, India

Background: Dengue, a mosquito borne, arboviral disease has become a major cause of health concern in the recent times throughout the world. In India, we have been witnessing annual outbreaks for the past few years and lack of knowledge about prevention and treatment of dengue among majority of the population leads to increased mortality. In spite of this fact, very few studies have been done to know about the knowledge of people regarding dengue fever and whether proper preventive measures are being practiced by the community to limit its spread. The objective of the study is to assess the knowledge, attitude and practices (KAP) regarding dengue in factory workers in Jammu.Methods: An observational study was conducted in a factory of Jammu to assess knowledge, attitude and practices of factory workers about dengue.Results: Majority of workers had knowledge about dengue (92.56%), source (81.81%), nature of disease, symptoms, but complications were not known. Majority of the workers had no idea that laboratory test for dengue is not available in every laboratory.63.63% of the workers knew that papaya is useful in dengue. 74.38% of the workers knew that low platelet count is found in dengue. There were 82.64% of the workers told that they think dengue is curable and preventable. There were 54.54% of the workers told that dengue can be prevented by avoiding stagnation of water. 57.85% of the workers told that they are aware about the sprays used by govt. to kill mosquito.Conclusions: There is a need to bring awareness about dengue, prevention and treatment as it is a prevalent disease now.

Prescription pattern of medicines in a tertiary care hospital: a cross-sectional study

Background: Prescribing drugs for any disease is not complete until it is rationally done. Irrational prescriptions often lead to treatment failure, toxicity or drug interactions which may prove detrimental to the patient. Antibiotics are very much prescribed in day to day practice but their rational use prevents treatment failure, resistance.Methods: A cross sectional study was conducted in a tertiary care hospital to see the antibiotic prescribing pattern. Prescriptions were screened one time from different OPDs with prior permission from the doctor attending the respective OPD.Results: A total of 200 prescriptions were assessed out of which 121 had monotherapies prescribed, 79 had FDCs. Antibiotics were the most commonly prescribed drugs. Prescriptions having drug combinations were assessed and pantoprazole domperidone was the most commonly prescribed (32.91%).Conclusions: Drugs should be prescribed rationally for proper therapeutic benefit. It encourages the patient to properly use the medicine and properly comply to it.

To compare the efficacy and safety of silodosin and dutasteride combination with alfuzosin and dutasteride combination in patients of benign prostatic hyperplasia: a randomized, open label study

Background: BPH is a major cause of bothersome lower urinary tract symptoms (LUTS) and affects quality of life (QoL) which deteriorates if not taken care with the passage of time. The aim and objective of the study was to compare the efficacy and safety of combination of silodosin and dutasteride with the combination of alfuzosin and dutasteride in patients of BPH.Methods: A randomized, open label, intention to treat study was carried out on newly diagnosed patients of BPH. Patients were randomly divided into two groups and followed up to 12 weeks. Group 1 of patients received a combination of silodosin 8 mg and dutasteride 0.5 mg (SD) (n=20) while the patients of group 2 received combination of alfuzosin 10 mg and dutasteride 0.5 mg (AD) (n=20). Primary endpoint was measured by changes in the mean baseline International prostate symptom score (I-PSS) and uroflowmetry and secondary outcome with changes observed on ultrasonography.Results: IPSS and IPSS-QOL significantly improved in both the treatment groups (p <0.001) along with mean maximum flow rate (Qmax) and mean average flow rate (Qavg). Prostate volume and residual urine volume showed a significant improvement in both the treatment groups at 12 weeks. However, the intergroup differences in IPSS, uroflowmetry and USG parameters were not significant. Both treatments were well tolerated.Conclusions: The current study established that both the drug combinations i.e. silodosin and dutasteride (SD) and alfuzosin and dutasteride (AD) largely have a comparable effect on both the dynamic and static components of BPH. Further, both drug combinations appear to have a comparable safety profile.

Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India.

Background & objectives: Drug-induced diseases (DIDs) are well known but least studied. data on DIDs from India are not available. Hence, this retrospective cross-sectional study was undertaken using suspected adverse drug reaction (ADR) data collected form Pharmacovigilance Programme of India (PvPI) to evaluate profile of DIDs over two years, in a tertiary care teaching hospital from north India. Methods: the suspected ADRs in the form of DID were evaluated for drug and disease related variables and were classified in terms of causality. Results: DID rate was 38.80 per cent. Mean duration of developing DIDs was 26.05 ± 9.6 days; 25.16 per cent had more than one co-morbid condition. Geriatric population (53.99%) accounted for maximum DIDs followed by adult (37.79%) and paediatric (8.21%). Maximum events were probable (93.98%) followed by possible (6.04%). All DIDs required intervention. Gastritis (7.43%), diarrhoea (5.92%), anaemia (4.79%), hypotension (2.77%), hepatic dysfunction (2.69%), hypertension (1.51%), myalgia (1.05%), and renal dysfunction (1.01%) were some of the DIDs. Anti tubercular treatment (ATT ), anti retroviral treatment (ART), ceftriaxone injection, steroids, non-steroidal anti-inflammatory drugs, antimicrobials and anticancer drugs were found as commonly offending drugs. Interpretation & conclusions: Our findings show that DIDs are a significant health problem in our country, which need more attention.

Profile of Adverse Drug Reactions with Fixed Drug Combinations: How Big is the Problem.

The current study was undertaken to analyze the profile of adverse drug reaction (ADR) contributed by fixed drug combinations (FDC). A cross-sectional, retrospective study was conducted over a period of 2 years to evaluate the profile of ADR contributed by FDC using suspected ADR data collection form used under Pharmacovigiliance Programme of India (PvPI). A total number of 2242 ADRs were reported during the study period of two years out of which drug combinations responsible for ADRs were 589 (26.27%). Fixed drug combinations (FDC) contributing to ADRs were 88(3.9%). As per latest WHO essential drug list, irrational FDC were responsible for 83 (3.70%) accounting 94.3% of the total FDC. Whereas, only 5(0.2%) of rational FDC contributed to the total pool of ADRs. Most frequent drug combination contributing to ADR was of anticancer drugs leading to vomiting and alopecia, where as most common irrational FDC was aceclofenac plus thiocolchicoside and ofloxacin plus ornidazole leading insomnia & rash respectively. Levodopa plus carbidopa and trimethoprim plus sulphamethoxazole were two common rational FDC contributing to ADRs. The above results underscores that drug combinations and FDC as well as irrational FDC substantially contribute towards the pool of total ADRs.

Comparative Profile of Adverse Drug Reactions with Antimicrobials:Women Vs Men.

The current retrospective cross sectional study was undertaken using suspected ADR data collection form used under Pharmacovigiliance Programme of India (PvPI). A total of 2586 ADR events were recorded in 3years out of which 392(15.15%) were because of antimicrobials. males constituted 253 patients (64.54%) and females constituted 139 patients (35.45%) with male: female ratio as 1.8:1. Adults were more commonly affected followed by geriatric and pediatric population in both the groups. I.V route followed by oral route of drug administration accounted maximum ADR in similar way in both the genders. Monotherapy was responsible for 81.81% for males and 82.01% for females. Among combinations 78.26% in males and 64% in females were irrational as per latest WHO13th essential drug list. Majority of ADR, 88.14% and 92.80% were of moderate severity among males and females respectively. Maximum ADR were latent, type-A, probable in nature as per Naranjo and WHO-UMC scale. Inj.ceftriaxone followed by tab. azithromycin, tab.ofloxacin-ornidazole were the commonest antimicrobials responsible for ADRs in both the genders. The most common system involved was dermatological followed by GI in both males and females. On statistical comparison, no significant differences were observed among both the genders in any of the parameters except causality assessment scale (P<0.5). The current study suggests the ADRs due to antimicrobials are a significant health problem. No major gender related differences were observed in ADR profile of our study cohort.

Prevalence of Vitamin D Deficiency in Critically Ill Patients of Acute Coronary Syndrome.

To evaluate the prevalence of vitamin D deficiency among patients of ACS and establish any correlation between two states.This prospective observational cross sectional analysis was carried out. Group-1: included 50 patients of ACS of both sex with any co morbid condition and Group 2: included age matched 50 apparently healthy subjects of both sex. Vitamin D levels were measured by radioimmunoassay & compared statically to find out any possible correlation. In the current study vitamin D deficiency was recorded in 38% and insufficiency in 52% of total patients of ACS taking total count to 90% and only 10 % of the population had adequate Vitamin D levels. Significant (p<0.01) correlation between the vitamin D deficiency and ACS in comparison to healthy controls was recorded. Study recorded a very high vitamin D deficiency in patients of ACS and suggests significant correlation between the two.

Isoniazid Induced Psychosis (Self Harm Behaviour) with Neuropathy & Vitamin B6 Deficiency.

Isoniazid induced psychosis (IIP) is well reported with varied clinical presentations. Many hypotheses are available to explain the mechanism of (IIP) but lack conclusive evidence in its favour. The current case establishes neuropathy with vitamin B6 deficiency as a possible cause for IIP warranting early clinician's attention as the condition may be potentially serious & life threatening.