Sodium valproate is a commonly used antiepileptic drug (AED) for control of a broad range of seizures. Adverse drug reactions (ADR) due to sodium valproate range from sedation to nausea, vomiting, weight gain, idiosyncratic adverse effects like hepatotoxicity and life threatening conditions like pancreatitis. We present a case of sodium valproate induced enuresis in child. This ADR of valproate is an underreported ADR and requires special attention of pediatricians as it can interfere with the further treatment of the disease.
Objective: To assess the prescription pattern & Adverse Drug Reaction (ADR)) profile of Antiepileptic drug (AEDs) therapy in children of rural population. Materials and Methods: This prospective open label, observational study was carried out over one and half year duration on 142 newly diagnosed epileptic children below 12 yrs age receiving AEDs in pediatric department in a tertiary care rural hospital. Follow up was done every month for 6 months duration. Prescription pattern and incidence, causality and severity of ADRs due to AEDs were assessed at each visit. Results: Out of 142 patients on AEDs, 97.2% patients were on mono-therapy and 2.8% patients were on poly-therapy. Valproic acid was the most commonly prescribed drug (58) and Lorazepam was the least prescribed drug (1). Central nervous system related ADRs (50%) were most common followed by gastrointestinal system (14.7%). Sedation and gastrointestinal distress were among the most frequently reported ADRs and29.4% of probable category while 70.5% ADR's were possible category. 72% ADRs were mild, 22% were moderate and 5.8% of ADRs were severe. Conclusions: Children receiving AEDs should be closely monitored for the development of any ADRs, especially related to their behavior and cognition. as it can influence their learning and memory, Active surveillance can help in knowing the exact incidence of ADRs. This study emphasizes on the role of patient / parent education and importance of health care professionals in pharmacovigilance studies.
SummaryBackground: Many disorders can occur during pregnancy, labour, postpartum. Some women become normal, some seriously ill and some die. It is essential to know disorders' burden.Objectives: of present study were to know burden of disorders, which cause severe illnesses, during pregnancy, birth, post birth, profile of such cases.Material Methods: Analysis of profile of cases admitted over 5 years at rural referral institute was done. Criteria was admission to intensive care area with system for ventilatory support in obstetric department.Results: Majority of women were of 20-29 years, mean age 24 years, 2.6% adolescents. 39.7% were rural, 36.2% urban, 24.1% from urban settlements with low resources, 69.7% were antenatal, 18.5% intranatal, 11.8% postnatal. Sixty two percent were nullipara. Severe morbidity had 'U' curve in relation to age. Hypertensive disorders (53% of severely ill cases) were commonest basic disorder, next were medical disorders (26%)(severe anaemia, heart disease, malaria, infective hepatitis, pneumonia).Others were, late haemorrhage 12%, (antepartum and postpartum haemorrhage), early pregnancy complications(abortions, ectopic pregnancy, hydatiform mole) 5%, puerperal sepsis 2%, acute fatty liver of pregnancy 1.2%, rupture uterus 0.8%. Conclusion:Severe maternal morbidity with reference to age followed a 'U' curve. More cases were primigravida. Highest ratio was of cases from low resource urban settlements. Majority of severely ill cases were antenatal, some postnatal too. Commonest primary cause of severe illness was hypertensive disorders, followed by medical disorders, haemorrhage, complications of early pregnancy, puerperal sepsis, acute fatty liver of pregnancy, rupture uterus in descending order. Quality maternal care, at primary level, timely referral, quality maternal care at referral is essential. Also a lot of research is needed for prevention of some disorders, their severity.
Background This study examines the concept that elevated homocysteine levels are associated with sudden infant death syndrome. The study aimed to determine whether elevated serum homocysteine levels were related with an increased risk of iatrogenic stillbirths. Method In this retrospective case-control study, 100 women who had stillbirths for unknown reasons and 100 who had normal pregnancies served as cases and controls, respectively. The serum homocysteine levels were evaluated using enzyme assays, and other pertinent clinical and demographic information was also gathered. Result Significantly differing homocysteine levels were found between the case group (mean ± standard deviation: 12.5 ±2.1 units) and the control group (mean± standard deviation: 8.3± 1.5 units; p0.001). After adjusting for potential confounding factors Conclusion The results suggest that elevated serum homocysteine levels may be a biomarker for the unknown risk of stillbirth in women. Further research is required into potential treatments and prevention strategies for hyperhomocysteinemia-related pregnancy complications. This study supports the theory that elevated homocysteine levels induce sudden infant death syndrome. Significant therapeutic implications result from these findings, as systematic homocysteine monitoring throughout pregnancy may help identify high-risk patients and implement appropriate therapies to reduce stillbirths. Recommendation There is a need for additional research to validate these findings and investigate methods to reduce maternal homocysteine levels.uch as maternal age, smoking status, and gestational age, logistic regression analysis revealed a important association between elevated serum homocysteine levels and unexplained stillbirths (odds ratio: 2.90, 95% confidence interval: 1.70-4
Objective: To determine the frequency, severity and morphological pattern of ACDRs and their correlation with various risk factors. Methodology: A prospective, observational study was conducted in Muzaffarnagar Medical College & hospital, Muzaffarnagar Uttar Pradesh from Feb 2013 to Jan 2014 for one year. All patients of either sex and all age groups with suspected ACDRs attending/referred to Dermatology department were included. Results: Total of 90 cases were reported over a period of one year. ACDRs were observed with 0.5% incidence of patients attending OPD. ACDRs were commonly seen in adult age group (mean age 36.93 yrs) and have 3 or more drugs prescribed with equal gender distribution. As per Naranjo Algorithm, maximum number of ACDRs were of Possible type (74%), while 23 cases were of "Probable" category with female and male preponderance respectively. 71 of ACDRs were Moderate in severity (79%) followed by 11% of mild and 10% of severe category. Most common clinical pattern was Urticaria with 32 cases followed by 24 cases of Maculopapular Eruptions, 9 cases of Acneiform eruptions and 8 of fixed drug reactions and SJ Syndrome. Commonest Drug groups causing ACDRs were Antibiotics (38%) and Antiepileptics (30%).This was followed by NSAIDs induced ACDRs (9%). Phenytoin was the most common drug causing 12 ACDRs followed by 6 with Cabamazipine and Ceftrixone each and 5 cases with ATT. Conclusion: Incidence was low as compare to global incidence; better steps must be needed to strengthen the activity of pharmacovigilance in this state of the country.
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