Aims Self-medication is an essential component of self-care; however, its use has significantly increased. Its practice has many risks such as wrong diagnosis, adverse drug reactions, antimicrobial resistance, etc. Being future doctors, self-medication has a special impact on MBBS students. Henceforth, the present study was undertaken to sensitize MBBS students in a medical college in Bihar and to analyze its role in different aspects of self-medication. Methods and material This was a cross-sectional, questionnaire-based study. The questionnaire was circulated to MBBS students of all the phases. After collecting the responses, scoring and grading was done and then a sensitization and awareness program was conducted through different modes and medium. After three months the same questionnaire was distributed, and their response was again collected. Statistical analysis used With an expected 40% prevalence, the minimum sample size needed to attain a power of 95% and an alpha value of 0.05 was calculated to be 201. Statistical Package for Social Sciences version 16 was used for data analysis. The chi-square test was used to see the association in responses obtained, before and after sensitization. A P-value with ≤0.05 was considered statistically significant. Results The questionnaires were circulated among 439 students. On comparing the grades, we found that phase III students comparatively had better knowledge regarding different aspects of self-medication. On analyzing different aspects of self-medication, we found that there was a significant improvement in many aspects post-sensitization. Conclusions MBBS students are future doctors, hence they should be more educated about the pros and cons of self-medication. This study showed that the perception of participants improved after our educational activities. We hope that after becoming aware, these young budding doctors will spread awareness, which, in turn, will benefit society. Additionally, we hope that this study will have an impact on students from different medical colleges and even healthcare providers, promoting responsible self-medication practices when necessary.
Survival of post renal transplant patients has been improved by the suppression of the recipient's immune system by immunosuppressive agents. However, various adverse drug reactions are also associated with immunosuppressive agents. Keeping this in mind, present study was planned to study the prescriptions pattern of immunosuppressant drugs and to study adverse drug reactions associated with immunosuppressant drugs. Materials and Methods: It was an observational and cross-sectional study. We have collected reported ADRs, prescriptions, IPD files and laboratory reports of 40 patients who had already undergone renal transplant prior to start of this study and 10 patients who undergone renal transplant after start of this study. Result: Most patients were prescribed prednisolone + tacrolimus + MMF as immunosuppressive regimen (70%) followed by prednisolone + cyclosporine + MMF (22%). Prednisolone was prescribed to all patients. Tacrolimus was prescribed to 72% of patients. Total 78 ADRs were reported from 50 patients in our study (incidence rate 68%). Drug MMF was mostly associated with ADRs (35.90%) followed by tacrolimus (29.49%), prednisolone (19.23%) and cyclosporine (15.38%). Most of the ADRs was mild (65.38%) while only one ADR was severe. Conclusion: Corticosteroid continues to be mainstay of therapy in post renal transplant patients. Calcineurin inhibitors were exclusively associated with nephrotoxicity. MMF was associated with most ADRs followed by tacrolimus. Most of the ADRs were mild and treated symptomatically.
Chemotherapy is one of the integral components in the management of carcinomas. Significant variation in the response rate of individual anticancer drugs, availability of different regimens, and intolerability of combination regimens necessitate observation and evaluation of cancer chemotherapy. It has been found that the ADR profile of cancer chemotherapeutics is very less reported and the situation is even worse in India. Present study was conducted to delineate the various drugs used in carcinomas to find discrepancies, if any, between the actual and the ideal prescribing pattern of psychotropic drugs, to assess prevalence of various carcinomas and to assess adverse events. This was an observational and prospective study in which chemotherapy prescriptions and data regarding adverse event (patients complain, clinician report, laboratory data) were collected from out-patient department of Medical Oncology. Their prescriptions were collected and they were screened for adverse events of grade 1-4 of CTC version 5. Descriptive analysis was done to analyse and compare the results. Most of the patients were of age group 46-60 (39.08). Gall bladder cancer was mostly found in age group 61-70. Hodgkin’s lymphoma and germ cell tumour were mostly found in younger patient. Cisplatin (15.13%), Gemcitabine (13.38%) and Carboplatin (11.40%) were mostly prescribed drugs. 20.56% of all adverse event were haematological. Most of the grade 3 adverse events were haematological. More recent developments in the availability of anticancer drugs which include molecular-targeted therapy such as targeting the proteins with abnormal expression inside the cancer cells should be utilized judiciously. Nevertheless, an early detection of these ADRs may help in minimizing the damage by either modifying the dose or changing the offending agent.
Objective: Due to limited availability of newer antibiotics to treat emerging multidrug-resistant species of pathogen, there is an urgent need for highlighting the misuse of antibiotics and taking appropriate measures to promote rational antibiotic prescription. This study was designed to know the antibiotic prescription patterns in MICU, the prevalence of antibiotic resistance, the effectiveness of empirical antibiotic therapy and safety and tolerability of the antibiotics prescribed. Materials and Methods: This study was an observational and prospective study. 100 consecutive prescriptions were collected from MICU, IGIMS, Patna from January 2019 to June 2019. All antibiotics listed on first prescription slip was noted and their dosage schedule, route of administration, date of discontinuation, generic name and related laboratory investigations were also recorded. Result: 723 drugs were prescribed out of which 244 were antibiotics. 3rd generation cephalosporins (118 prescription/48.36 %) were most frequently prescribed followed by Amoxicillin + Clavulanate (40 prescriptions/16.39%). Prevalence of resistance was most in cephalosporins (6%) followed by Amoxicillin + Clavulanate (5%). Approx. 27.5% failure of treatment was found in patients receiving empirical antibiotic therapy. Percentage of suspected ADRs was mostly found in linezolid (33.33%) followed by Ceftriaxone (16.66%). Conclusion:Antibiotics are overprescribed in our ICUs and this is increasing the burden of unnecessary adverse effect, resistance and treatment costs. At the time of admission, patients with poor prognosis and older age are prescribed more antibiotics. Antibiotics stewardship programs should be promoted and regulation of antibiotic utilization, proper use of guidelines and proper surveillance should be ensured by responsible authorities.
Diabetic patients generally require life-long treatment and continuous follow up. In spite of their benefit of achieving glycemic control, there are many safety concerns with antidiabetic drugs such as gastrointestinal side effects, metabolic complications, central nervous system (CNS) symptoms, musculo-skeletal problems, genito-urinary disorders like UTI, development of peripheral oedema, weight gain etc. To highlight pattern of Adverse Drug Reactions with use of oral anti-diabetic drugs.All suspected Adverse Drug Reaction Reporting Form having any anti-diabetic drug as suspected cause of ADR were collected. The reported ADRs on the notification forms, after being confirmed by the physician-in-charge, were assessed for causality using WHO-UMC Causality Categories14, preventability using Modified-Schumock and Thornton scale15 and severity using Modified Hartwig and Siegel scale.: The data from the forms was presented in tabular form and data will be interpreted by using Microsoft Excel 365 software. Adverse drug reaction related to gastrointestinal system were most reported ADRs (41.31%). Among GI adverse events, nausea was mostly reported ADR and it was mostly associated with DPP-4 inhibitors. Hypoglycemia was most frequently observed in patients taking sulfonylureas. Causality assessment according to WHO-UMC criteria showed 61.68% ADRs had probable causality while 37.43% had possible causality and only 0.90% had certain causality. Most of the ADRs in our study were non-preventable (57.78%) & were of mild to moderate grade. Hypoglycemia continues to be major concern in patients taking anti-diabetic medications and sulfonylureas were commonest drugs responsible for it. As anti-diabetic medication is generally taken for lifetime, the risk of development of adverse effects related to concurrent related co-morbidities of patients shouldn’t be ignored while prescribing. The physician should report these adverse effects to ADR monitoring centre, so that proper signal could be generated for the welfare of the society.
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