Background: Drug-related problems (DRPs) are frequent in hospitalization in pediatrics. The main aim of present investigation is to assess drug related problems and clinical pharmacist interventions in pediatric department of tertiary care hospital.Methods: It was a prospective, observational and interventional study carried over a period of 6 months.Results: A total of 66 patients were identified with drug related problems. Among them 31 (42%) were in between 1month–2 years followed by 25 (34%) were in between 2-11 years, 10(24%) were in between 11-18 years of age. 30(45.3%) patients were prescribed with 0-3 drugs followed by 21 (31.3%) were prescribed with 3-5 drugs, 15(23.3%) were prescribed with 6-10 drugs. Most of the DRP’s observed in the study were drug interactions 52(78.78%) [major-19 (36.53%), moderate-27 (5192%) and minor-6(11.53%)] followed by adverse drug reactions 12 (18.18%), and duplication errors were 2 (3.03%). Majority of the clinical pharmacist recommendations were duration change 52 (34.66%), drug change 10(6.66%), dose reduction 2 (1.35%) followed by drug termination 2 (1.33%). Major significance of DRPs were noted high 31(57.96%), whereas 25 (39.8%) were moderate and 8 (12.12%) were minor. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high in 57 (86.66%) cases while in 9 (13.33%) cases suggestions were accepted but therapy was not changed. There were no cases with neither suggestion were accepted nor therapy changed.Conclusions: Clinical pharmacist involvement in inpatient pediatric care can significantly help to identify, resolve and prevent the drug related problems. The study concluded that the clinical pharmacist has a significant role in patients care at hospital.

Background: Anti-Retroviral Therapy regimen (ART) is the only treatment option for treating the HIV positive patients for improving the immune system by increasing the CD4 cells. But eventually these medications lead to development of some Adverse Drug Reactions (ADRs) in seropositive patients under treatment.Methods: A prospective observational study was conducted for 6 months from March to August 2018 at ART Centre, Sri Venkateswara Ramnarayan Ruya Government General Hospital (SVRRGGH), Tirupati.Results: Out of 216 ADRs identified, majority where identified in females (54.35%). Most common regimen caused ADR was tenofovir+ lamivudine+ efavirenz (TLE) (55.55%). Data were analysed using the chi-square test were P-value was found to be 0.0024. Majority of ADRs were found in patients of age group between 31-35years was found to be 45 (20.83%) followed by age group between 41-45years was found to be 40 (18.51%). Most of the ADRs were related to central nervous system (27.31%) followed by metabolic disorders (26.38%), hematologic system (23.14%), gastrointestinal system (12.96%), dermatologic system (9.25%), renal system (0.46%) and musculoskeletal system (0.46%). On evaluation of WHO-UMC causality of ADRs, majority were found to be possible (78.7%). The Hartwig and Siegel’s severity assessment scale showed that most of the ADRs were mild (64.42%). The Schumock and Thornton preventability scale showed that 50.92% patients ADRs were probably preventable.Conclusions: As most of the ADRs were observed in patients receiving TLE regimen. So, patients receiving TLE regimen need intensive monitoring. Doctors, nurses, pharmacist must focus on early detection and prevention of ADRs, based on their severity.

Background:HIBackground: HIV/ AIDS is an epidemic that is most prevalent in India affecting people of different age groups, occupations and gender. It has a severe impact on the health status of the affected individuals. With the increase in the transmission of HIV there is also an increase in the existence of TB as a co-infection. In this context, the aim of our study is to emphasize the factors affecting the occurrence, transmission and prognosis of HIV/AIDS patients along with TB co-infection.Methods: A cross sectional study was conducted from October 2015 to March 2016 at an ART center in South India. All the seropositive patients with/ without opportunistic infection above the age of 18 years were included in the study.Results: Overall 374 patients were included in the study, of which the most affected age group was 18-45 years. Women constituted 55.61% of the total population. 64.17% of the individuals were married. Majority of them belonged to rural areas (64.97%) and were illiterates (37.43%). Commonly observed WHO clinical stage was I and functional status was working. Heterosexuality (93.65%) was the predominant route of transmission. 170 had TB with PTB (60.58%) being prevalent than EPTB (33.52%). The number of smear positive and smear negative cases were 37.79% and 27.55% respectively. DOTS therapy was accessible to only 49.99%.Conclusions: There was an extensive prevalence of TB among HIV/AIDS individuals. This signifies a need for increased screening of TB among HIV seropositive individuals and vice-versa. Preventive and educational programmes should be organised to halt the transmission of HIV and to reduce the newly occurring HIV infections. V/ AIDS is an epidemic that is most prevalent in India affecting people of different age groups, occupations and gender. It has a severe impact on the health status of the affected individuals. With the increase in the transmission of HIV there is also an increase in the existence of TB as a co-infection. In this context, the aim of our study is to emphasize the factors affecting the occurrence, transmission and prognosis of HIV/AIDS patients along with TB co-infection.Methodology: A cross sectional study was conducted from October 2015 to March 2016 at an ART center in South India. All the seropositive patients with/ without opportunistic infection above the age of 18 years were included in the study.Results: Overall 374 patients were included in the study, of which the most affected age group was 18-45 years. Women constituted 55.61% of the total population. 64.17% of the individuals were married. Majority of them belonged to rural areas (64.97%) and were illiterates (37.43%). Commonly observed WHO clinical stage was I and functional status was working. Heterosexuality (93.65%) was the predominant route of transmission. 170 had TB with PTB (60.58%) being prevalent than EPTB (33.52%). The number of smear positive and smear negative cases were 37.79% and 27.55% respectively. DOTS therapy was accessible to only 49.99%.Conclusion: There was an extensive prevalence of TB among HIV/AIDS individuals. This signifies a need for increased screening of TB among HIV seropositive individuals and vice-versa. Preventive and educational programmes should be organised to halt the transmission of HIV and to reduce the newly occurring HIV infections.

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Aim: To assess the drug-related problems (DRPs) and World Health Organization (WHO) core prescribing indicators among hospitalized diabetic patients. Methodology: A prospective, observational study was made among the diabetic inpatients of the General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data pertaining to demographics, clinical variables, DRPs, and WHO prescribing indicators. Descriptive statistics like frequency, mean, and percentage were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Inferential statistics like Chi-square test was employed to test the significant association between the demographics and occurrence of DRPs. Results: A total of 199 diabetic patients were enrolled in this study. The mean age of the study participants was 55.8±11.3. The study shows the prevalence of DRPs in diabetic in-patients was 48.7%. The most commonly identified DRPs are drug interactions (53; 45.3%), adverse drug reactions (24; 20.5%), and untreated indication (21; 17.9%). Patient characteristics like, advanced age (≥60 years), presence of co-morbid condition, comprising more than 5 drugs in prescription, and stay in the hospital for more than four days are significantly associated with the development of DRPs. Findings of WHO indicators show the average number of drugs, percentage of drugs prescribed by the generic name, percentage of encounters with an antibiotic, injection, and from essential drug list have deviated from standards of WHO. Conclusion: The prevalence of DRPs in diabetic in-patients was 48.7%. Drug interactions and adverse drug reactions are the most common DRPs found in our study. Developing the drug policy guidelines focused on factors associated with DRP and WHO prescribing indicators may reduce the burden of DRPs and improves patient outcomes.