Aims: To evaluate prescription pattern during second line Antiretroviral Therapy (ART) at tertiary care hospital. Despite a very large number of patient being covered under ART, there are limited data in Indian population regarding second line ART. Therefore, the present study was undertaken. Methods: After consultation with physician of ART plus centre, patient was interviewed and details of the patient's case record was obtained.
Considering the lack of knowledge about the magnitude of postoperative pain in our hospitals, a study to evaluate the postoperative pain in the patients undergone various surgery in different departments of P.D.U. Government Hospital Rajkot was selected. METHODS This is an observational, longitudinal study conducted at P.D.U. Govt. Hospital, Rajkot from March 2011 to May 2012 duration. The approval of institutional ethics committee was taken before start of study.
Background: Conducting drug utilization studies are crucial, particularly for pediatric patients, as it helps improve the prescribing patterns and usage of medications in the health-care system. However, there is a scarcity of research on the utilization of drugs in children, making this study an invaluable resource for understanding prescription patterns.
Aims and Objectives: Main objectives behind our study were to examine and evaluate such prescription pattern in detail including antibiotics usage and prescription analysis using core drug prescribing indicators given by the World Health Organization (WHO), to evaluate adverse drug reactions that are observed during study and to evaluate drug-drug interactions (DDIs).
Materials and Methods: This is an observational cross-sectional study of 12-month duration started after intuitional ethical committee approval. Total 450 prescriptions were studied. The study included all patients, regardless of gender, who were admitted to the pediatric intensive care unit (PICU).
Results: Our study found that the average number of drugs per prescription was 4.87. In addition, a high percentage of drugs, specifically 97.39%, were prescribed using their generic names, while 94.84% of drugs prescribed were from the WHO essential drug list for children. Moreover, we observed that in 88.88% of encounters, antibiotics were prescribed and percentage of prescriptions, in which drugs were prescribed through injectable route, was 98.22%. Very minimal amount of adverse drug reaction was seen in patients. In our study, in 75.77% of the prescriptions, DDIs were not found.
Conclusion: The study found that generic names of drugs were frequently used, and a high percentage of drugs prescribed were from the WHO essential drug list. However, the study also revealed a high percentage of encounters with antibiotics and injections prescribed. The occurrence of adverse drug reactions was minimal in the study. Moreover, most prescriptions did not exhibit DDIs, indicating appropriate therapeutic management in the PICU.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening acute adverse drug reaction (ADR), typically characterized by a long latency period (2-6 weeks to 3 months) from drug exposure. DRESS syndrome is defined by the presence of fever, cutaneous eruption, lymphadenopathy, systemic or asymptomatic internal organ involvement (e.g. Hepatitis, carditis, interstitial nephritis, interstitial pneumonitis, etc.) and haematological abnormalities, mainly leucocytosis, eosinophilia and sometimes atypical lymphocytosis. There are around 50 culprit drugs which cause DRESS syndrome e.g. carbamazepine, phenytoin, allopurinol, sulfa derivatives, antidepressants, antiepileptics, non-steroidal anti-inflammatory drugs and antimicrobials. The incidence of DRESS syndrome has been estimated to be between 1 in 1,000 and 1 in 10,000 drug exposures. There are many reported cases of DRESS syndrome due to carbamazepine, phenytoin, vancomycin, levitiracitam, ceftriaxone etc. Author presented a case of DRESS syndrome by carbamazepin. RegiSCAR and Japanese consensus group have developed specific criteria for making the diagnosis of DRESS syndrome. The patient described here met the majority of criteria according to RegiSCAR scoring guidelines for a diagnosis of DRESS syndrome induced by carbamazepine. As per RegiSCAR diagnostic criteria author had concluded that this was a “Definite” case of DRESS (Drug Reaction with Eosinophilia and Systemic Symptom) syndrome induced by carbamazepine. Carbamazepine is most common broad-spectrum antiepileptic drugs so, this case report will raises awareness among physician to suspect DRESS syndrome in patients who present unusual complaints and skin findings after starting antiepileptic drugs.
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