Extent of extravasation: Patients on parenteral plant alkaloids.

BACKGROUND: Plant alkaloids remain an essential part of many chemotherapeutic regimens. Although many adverse effects have been studied with appropriate management guidelines, extravasation (EV) is one adverse event that is yet to be studied at a regional scale to frame population-specific guidelines. METHODOLOGY: A hospital-based observational study was done for 1 year to understand the extent of extravasation among patients on parenteral plant alkaloids. Clinical pharmacists congregated information about patients satisfying the study criteria. The incidence of EV injuries associated with parenteral plant alkaloids was assessed. The severity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) v4.3. The ESMO-EONS guidelines were followed for the classification of chemotherapeutic agents as well as management of the incidents of EV. RESULTS: Among the 80 patients recruited into the study, 26.25% of patients experienced EV injuries, of which 66.67% were grade 2 and 33.33% were grade 3. Females were prevalent at 62% among the injured group. Patients in the age group 31-50 years and 51-60 years sustained 28.57% of the injuries each. In 76.19% of injured patients, ambulation status was positive during the infusion. ESMO-EONS drug classification showed that 54.84% of the drugs prescribed were vesicants. Paclitaxel was seen in 33.33% of prescriptions in the injured group, among other plant alkaloids. CONCLUSION: Our study saw a trend of vesicant-induced extravasation injury among patients prescribed parenteral chemotherapeutic regimens with a combination of plant alkaloids, indicating the significant risk they may pose.

5-Fluorouracil induced extravasation injury.

Antineoplastic drugs based on their ability to cause local damage are classified as irritants, vesicants, and non-vesicants. Previous literature has reported higher rate of vesicants induced extravasation (EV) compared to irritants. We report the first case of irritant, 5-fluorouracil causing grade III EV in 55-year-old woman. The patient was diagnosed with esophageal squamous cell carcinoma. Docetaxel, Cisplatin, and 5-Fluorouracil (DCF) chemotherapy regimen was planned and administered through peripheral venous access. Patient experienced grade 3 extravasation in her 3rd cycle following 5-fluorouracil (5-FU) administration. The suspected drug was withdrawn immediately and discontinued from the 4th cycle of the regimen. The patient completely recovered from the symptoms of pain and erythema in the next cycle and care was taken not to infuse drug in the same site again. Since there is no appropriate antidote available to manage this condition, measures need to be taken to identify the predisposing factors for EV and prevent them.

Awareness about oral cancer among nonhealth professional students - A cross-sectional study in Bengaluru city.

BACKGROUND AND AIM: Oral cancer is one of the most life-threatening conditions, early diagnosis of which greatly increases the probability of cure and survival rates. Knowledge regarding risk factors and early signs among the nonhealth professionals which help in early detection prevention and of the disease. Therefore, the aim of this study is to assess the awareness about tobacco use among nonhealth professional students in Bangalore city. METHODOLOGY: A cross-sectional descriptive questionnaire study was conducted to assess the knowledge and awareness about oral cancer among 800 nonhealth professional students in Bengaluru city. A self-administered questionnaire containing 26 questions pertaining to awareness, signs, symptoms and risk factors of tobacco use was administered to the students. RESULTS: The results revealed that the majority of the students (55.5%) were aware about oral cancer but have less knowledge in terms of its signs and symptoms of oral cancer. The main source for information pertaining to oral cancer was obtained from mass media, i.e., TV, radio and social media (21.5%). CONCLUSION: The study reveals that there is a need for education and raise awareness about oral cancer among nonhealth professional students.