Objective: The aim of the study was to study the prescription pattern of prophylactic antiemetics in breast cancer patients. Methods: A retrospective observational study was carried out. Over a period of 3 months, all chemotherapy order sheets of breast cancer patients were collected and evaluated for prophylaxis of chemotherapy-induced nausea and vomiting (CINV). We compared each antiemetic drug used for CINV prophylaxis with international antiemetic guidelines, the National Comprehensive Cancer Network (NCCN). Results: A total of 103 breast cancer patients were included in the study, for which 141 chemotherapy physician prescriptions included antiemetic drugs. Approximately 51.06% of anticancer agents had high emetic risk, 2.13% had moderate emetic risk, and 43.26% and 3.55% of anticancer agents had low and minimal emetic risk, respectively. Most frequently prescribed anticancer drug was paclitaxel 49 (34.75%). About 43.97% of the antiemetic regimen were found following NCCN guidelines. Conclusion: The development of institutional policy for assessment and guidance of the chemotherapy-induced nausea and vomiting prophylaxis may improve the consistency between antiemetic prescribing and guidelines.
Objectives: Adverse drug reaction (ADR) is an important factor contributing to mortality and morbidity worldwide. Since undergraduate (UG) and postgraduate (PG) students are the future caregivers to the patients, they should have sound knowledge, a positive attitude, and good practice of Pharmacovigilance (PV). Hence this study was conducted to assess their knowledge, attitude, and practice (KAP) of PV and ADR reporting. Furthermore, secondarily this study tried to look into the impact of competency-based medical education (CBME) on the KAP of the students. Methods: Questionnaire-based, observational, and cross-sectional study. The questionnaire was pre-validated and consisted of 30 questions to assess the KAP of UG and PG medical students of a tertiary care teaching hospital in Assam. Results: A total of 419 students participated in the study. Data were analyzed using Microsoft Excel Sheet and the Student’s t-test. Both UGs and PGs have good knowledge about PV, ADR, and the types of ADRs to be reported. They also have a positive attitude but in practice, only a few have filled up the ADR form. Mean score analysis showed p-value was significant for attitude and practice among the UGs and PGs and highly significant for KAP when the CBME and Old Curriculum were compared. Conclusion: Although students have good knowledge and attitude, they need to improve in their practice. Regular training and awareness programs might help in educating them about PV and ADR reporting. However, the introduction of the CBME curriculum has been shown to improve the knowledge and attitude of the students about PV and ADR reporting.
Background: Acute leukemia in pregnancy is estimated to occur in less than one in one lakh pregnancies. Management of these patients differs by the trimester in which they present, because of the differential sensitivity of the fetus to chemotherapy during the three trimesters. Because of the rarity of this situation, there is scarcity of data on the management of these patients. Materials and method: We included patients with acute leukemia diagnosed and treated during pregnancy at our institute and reviewed 3 successive patients for this case series. Results and conclusion: Acute leukemia in pregnancy presents a unique challenge for treatment and requires multidisciplinary co-ordination for treatment. When judiciously managed, good outcomes of disease of mother and fetus can be achieved. Our three patients included one in each trimester; the first trimester patient underwent medical termination of pregnancy and has successfully completed treatment. The second trimester patient underwent induction chemotherapy and delivered a healthy baby. The patient diagnosed in the third trimester delivered a pre-term healthy baby during treatment and continues to be on chemotherapy.
Background: Coronavirus disease 2019 (COVID-19) is a pandemic caused by a novel beta coronavirus severe acute respiratory syndrome coronavirus (SARS-CoV-2). The symptoms range from mild to severe in nature. The severity of respiratory symptoms is due to the cytokine storm. The tocilizumab, interleukin-6 inhibitor, can prevent the cytokine release and decrease the mortality. Patients and methods: This is a retrospective observational study of 20 COVID-19 positive cases who received tocilizumab. Results and conclusion: There were 75% males with a mean age of 47.20±9.68 years in our study. 50% had diabetes mellitus, 35% had hypertension, 5% had Chronic kidney disease, 5% had obesity and 5% had hypothyroidism. Mortality was reduced to 65% with tocilizumab administration. There was statistically significant reduction of C- reactive protein (p<0.00052) and IL-6 (interleukin) (p<0.023) after administration of tocilizumab. Keywords: tocilizumab; interleukin-6; COVID-19; C-reactive protein
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