Adverse drug reaction (ADR) is an unwanted, undesirable effect of medication resulting in mild to severe effect on the patient. This review explains definitions of ADR and it differentiation with adverse drug event, medication error. ADRs may cause increased length of stay or initial reason for admission and are major cause of morbidity and mortality worldwide. Risk factors for ADR occurrence include age, gender, patients with multiple diseases and multiple drug therapy (polypharmacy). ADRs are classified into different types based on the mechanism and onset of reaction. The causal relation between suspected drug and reaction can be assessed by using causality assessment scales. The severity and preventability of ADR can be assessed by severity assessment scale and preventability scale respectively. Clinical Pharmacists play an important role in monitoring and management of ADRs.
Vascular dementia and cognitive impairment are major problems in stroke which must be diagnosed properly and very less effort is put into management of cognitive decline after stroke.This study is a prospective; questionnaire based observational study conducted for 6 months among stroke patients admitted into in patient setting of a tertiary care teaching hospital done to estimate the prevalence of stroke based on age, sex and educational status and to estimate the prevalence of dementia and cognitive impairment among stroke patients using neuropsychological testing. Data was collected from a total of 181 stroke patients of the age distribution 20 to 85 y with a mean age of 57.68±12.34 y and 75.6% patients were diagnosed with ischemic stroke and 24.3% with hemorrhagic stroke. Majority (76.79%) of patients were from rural population. Diagnostic and Statistical Manual of Mental Disorders-IV, Revised text criteria were used to assess dementia. Mini-mental state examination and short portable mental state questionnaire were used to know the extent of cognitive impairment. Various comorbid conditions like hypertension, diabetes mellitus, coronary artery disease and epilepsy were observed in 69.06% patients. The percentage (45.83%) of people with mild cognitive impairment is high with short portable mental state questionnaire and the percentage (77.69%) of people with moderate dementia is high using mini-mental state examination. 92.81% patients out of 181 were prescribed with neuroprotective drugs. The tools used for screening dementia are not perfect in case of uneducated patients and patients with low education. Current hypotheses and methodologies for the management of post-stroke dementia must be re-evaluated, and new strategies need to be explored.
Introduction: Diabetes is a serious health concern all over the world. Among people with diabetes, a key factor influencing quality of life (QOL) is degree and nature of diabetes related complications experienced by the patients over a lifetime. QOL is important health related factor and one of the most widely used measure to self-assess the effect of the management of chronic disease on health and monitors the physical, psychological, and social aspects of personal health.Methodology: This study is a prospective questionnaire based observational study which was conducted over a period of 6 months in a tertiary care hospital among diabetic patients. The subjects are interviewed with WHOQOL-BREF questionnaire and relevant information was collected. The domain wise scores are calculated.Results: A total of 140 diabetic patients were included in the study of which 100 were with complications and 40 were without complications. On conducting single sample unpaired test analysis, we found significant difference in the patients. The inference obtained this study was that nephropathy is the most common microvascular complication and affects the psychological and environmental status of subjects.Conclusion: The study was done to know the influence of complications on QOL and to reduce the burden of disease by improving QOL by effective counselling points and self-care management. We conclude that taking proper diabetic diet and self-care can prevent the worsening of QOL in patients with microvascular complications.
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