ABSTRACT
The case report evaluates shoulder injury related to COVID-19 vaccine administration. A 26-year-old female patient presented with shoulder pain, which increased on extension and overhead abduction in routine work. Magnetic resonance imaging (MRI) was done based on which, a diagnosis of shoulder injury related to vaccine administration (SIRVA) was reported. Significant improvement was seen after Non-steroidal anti-inflammatory drugs (NSAIDs), topical diclofenac ointment, and serratiopeptidase tablets. Physical muscle strengthening exercises were advised. Based on Naranjo and World Health Organization (WHO) casualty assessments, the adverse drug reaction (ADR) was categorized under probable. Preventability, Hartwig's scales for severity was assessed, which showed preventability and moderate grade in severity. The total cost (direct and indirect) for management was found to be rupees 7021 and 41,781 in government and private hospital respectively. Thus ADRs not only add to patient suffering but also increase the economic burden. Health care professionals (HCPs) need to be made aware of potentially fatal ADRs associated with the administration of vaccines and should be keen to report such ADRs to drug safety authorities.
ABSTRACT
Background: COVID-19 pandemic led to increased self-medication of antimicrobials, vitamins, and immune boosters among the common people and consuming without prescription can lead to adverse consequences including antimicrobial resistance. Methods: A cross-sectional study was conducted on community pharmacies in Jodhpur, India. They were inquired regarding the prescription and increased sales (<25%, 25-50%, 50--75%, or 75--100%) of various medicines (Hydroxychloroquine, Azithromycin, Ivermectin, and Vitamin C) during the COVID-19 pandemic. Logistic regression analysis was conducted to assess the relationship between requests for certain COVID-19 medications and an increase in their sale. Results: A total of 204 pharmacies took part, and 88.23% reported patients to approach them without prescriptions. Most of the pharmacies revealed that <25% of patients came without prescription. The majority came for azithromycin (68%) and vitamin C (92%). Increased sales of the four targeted medications were seen by 85.92% of pharmacies compared to last year. A majority (51.5%) reported <25% increased sales of azithromycin, but no change in the sale of hydroxychloroquine and ivermectin. However, 39.6% reported >75% increase in vitamin C sales. Conclusion: There was an increase in the demand for COVID-19 medications without prescription. This study was unable to detect a significant increase in sales of antimicrobials, which is encouraging.