Introduction: Thalassaemia Major patients require frequent blood transfusion leading to iron overload. Excessive iron gets deposited in vital organs and leads to dysfunction of the heart, liver, anterior pituitary, pancreas, and joints. Our body has limited mechanism to excrete iron, so patients with iron overload and its complications need safe and effective iron chelation therapy. Aim:To assess the efficacy of Deferasirox (DFX) as an iron chelator, with specific reference to reduction in serum ferritin level. Materials and Methods:This is a prospective; observational study done in 45 multitransfused Thalassaemia Major Children receiving DFX therapy at registered Thalassaemia society Raipur Chhattisgarh. DFX was given in an initial dose of 20 mg/kg/day and according to response increased to a maximum of 40 mg/kg/ day. Serum ferritin level was estimated at time of registration and at every three monthly intervals (four times during study period). The primary end point of the study was change in serum ferritin level after 12 months of DFX therapy. Results:The mean serum ferritin before DFX therapy of all cases was 3727.02 ng/mL. After 12 months of mean dose of 38 mg/kg/ day of DFX, the mean decline in serum ferritin was 1207.11 ng/ mL (drop by 32.38%, p-value <0.001).Conclusion: DFX monotherapy has a good safety profile and effectively chelates total body iron in Thalassaemia major patients.Shikha Jaiswal et al., Efficacy of Deferasirox as an Oral Iron Chelator in Paediatric Thalassaemia Patients www.jcdr.net

BACKGROUND:India is a developing country and adverse drug reactions (ADRs) influence most of the diseases in our population, and monitoring is required due to the paucity of ADRs. The present study was done to analyze the ADRs at the ADR monitoring center (AMC) of tertiary care hospital in Raipur during 1 year.MATERIALS AND METHODS:Study of ADR monitoring of outpatient and inpatient was a prospective and observational study carried out between September 2015 and August 2016. The ADRs in the form of Individual Case Safety Report (ICSR) was sent to the Indian database (Vigiflow®).RESULTS:Total ICSRs reported to Vigiflow® were 232 during 1 year. Among them, 63.79% were found to be nonserious and 36.21% were serious. Nearly 45% of ADRs were implicated only due to antimicrobials, which is highest among all other groups of drugs. A maximum number of ADRs were observed in 31–60 years of age group (52.15%). In causality assessment, the probable cases had a higher incidence (67.24%), followed by possible (27.58%) and certain (4.74%). The frequency of ADR reporting at our AMC was low (0.043%) compared to national average. Our AMC shared 0.35% of total ICSRs, which is insignificant (P < 0.001) compared to the JSS, Mysore and PGIMER, Chandigarh, AMCs, which have shared most of the ICSRs in Vigiflow®.CONCLUSIONS:The frequencies of ADRs reporting in our study are less compared to those reported with other similar studies. Underreporting is a very serious concern in Raipur, and Pharmacovigilance Programme of India must intercede to pick up ADRs across the country.

Background: Diseases of the ear, nose and throat (ENT) are common among general population affecting all age groups and accounts for most of the drugs prescribed and used. The aim of the study is to assess the prescription pattern of drugs in ENT outpatient department in a tertiary care teaching hospital.Methods: A prospective observational study was conducted from December 2017 to May 2018 in the ENT OPD (Outpatient department) at Pt. J.N.M. Medical College and associated Dr. B.R. Ambedkar Memorial Hospital, Raipur. Data were collected in a proforma and evaluated.Results: A total of 313 prescriptions were analysed. Most of the patients (40.89%) belonged to 13 - 35 years age group.185 patients (59.10%) were male and 128 patients were females (40.90%). A total of 1003 drugs were prescribed. The average number of drugs per prescription was 3.2. Most common class of drugs prescribed was antimicrobials (24.42%), followed by H1 antihistaminics (18.84%), antiulcer drugs (15.55%) and nonsteroidal anti-inflammatory (NSAIDs) drugs (14.35%). The average number of antimicrobials per prescription was 0.78. One or two antimicrobials were prescribed in 202 prescriptions (64.53%). The most common prescribed antimicrobial was of Penicillin group (64.89%) followed by Fluoroquinolone (25.71%). The most common prescribed route of drug administration was oral route (81.35%). The most common prescribed dosage form was tablets (74.87%). FDC constituted 24.62% of prescribed drugs.Conclusions: The study revealed that the most common class of drug prescribed was antimicrobials followed by H1 antihistaminics, antiulcer drugs and NSAIDS.

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Background: Pharmacovigilance has evolved as an important tool for dealing with Adverse Drug Reactions (ADRs) both in pre-marketing and post-marketing scenario. Underreporting of ADRs at our Adverse drug reaction Monitoring Centre (AMC) led us to conduct this study to assess Knowledge, Attitude and Practice (KAP) of the practicing clinicians at our tertiary care Pt. J.N.M. Medical College associated Dr. B.R.A.M. Hospital, Raipur, Chhattisgarh, India, towards ADRs reporting.Methods: This was a cross-sectional study using pretested questionnaires consisting of 29 questions related to KAP of the practicing clinicians at Pt. J.N.M. Medical College associated Dr. B.R.A.M.  Hospital, Raipur towards ADRs reporting. The percentage of responders for each question was calculated. All statistical analysis was performed in Microsoft Office Excel 2007.Results: Out of 135 questionnaires distributed only 100 were considered for analysis, so the overall response rate was 74.07%. We calculated the result from the 100 responders. Overall 77% responders were aware of existence of ADR monitoring system in India, while only 40% were aware of its existence at their hospital. Only 8% responders had reported ADRs to the National Pharmacovigilance Centre and 10% to the Adverse drug reaction Monitoring Centre (AMC) at their hospital. Lack of knowledge about where, how and whom to report ADRs, lack of time, inability to decide what to report (known or unknown ADRs) and unavailability of ADR reporting form were the important factors discouraging them reporting ADRs.Conclusions: Creating awareness regarding ADR reporting through CMEs among practicing clinicians and early sensitization at medical undergraduate level for medical students may improve the current ADR reporting rate.

Background: Empirically chosen antibiotics based on the local resistance pattern of uropathogens remain the principle treatment of urinary tract infections (UTI).Methods: Antibiogram of most frequent uropathogen was determined. Based on the antibiogram result, authors compared effectiveness of drugs recommended for UTI by National centre for disease control (NCDC), India, and assessed age and gender based variability in the effectiveness of these drugs.Results: 1278 urine samples were accounted, of which 405 samples showed significant growth. E. coli was the most common uropathogen (n=146, 36%) followed by enterococcus species (31%) and Klebsiella pneumoniae (10%). Using McNemar’s test authors found that nitrofurantoin (90% sensitivity) was statistically the most effective drug among drugs recommended by NCDC for uncomplicated cystitis. Furthermore, authors used Fisher’s exact test on adults and paediatrics and found that significant difference in effectiveness was observed for nitrofurantoin (p-value <0.001) and cotrimoxazole (p-value 0.034). Using logistic regression, authors found that with age, effectiveness of ciprofloxacin and cotrimoxazole deteriorate significantly (p-value 0.021 and 0.002 respectively). Additionally, authors observed that cotrimoxazole has significantly better efficacy in males compared to females (p-value 0.022).Conclusions: In accordance with present study, nitrofurantoin can be used as first line treatment for uncomplicated cystitis. Age and gender should be considered while prescribing empirical treatment for UTI. Periodic surveillance should be carried out to identify the on-going pattern of antibiogram to update the guideline for empirical therapy.